Stephanie had a problem. Several problems, actually. She was addicted to perfectionism, alcohol, and drugs. An obsession with her body image eventually led to an eating disorder. Not too long ago, Stephanie’s combined issues were referred to as co-morbidity or dual diagnosis. What exactly does that mean? A dual diagnosis indicates that a person has two or more addictions or a chemical dependence mixed with a mental health issue (anxiety disorder, depression, etc.). Naturally, the combined symptoms could make treatment difficult.

Stephanie gained weight when she started to use marijuana and drink alcohol. Because she couldn’t allow her body to be anything less than perfect, she forced herself to diet. This was followed by an aggressive intake of diet pills, then bulimiarexic behavior (sometimes she starved herself, sometimes she binged and purged). She felt so bad about these habits, she drank, which made her gain weight, which only made things worse.

Though a fictional person, Stephanie’s dilemma is all too real. There are many other combinations that can come into play:

  • Rageaholism and alcoholism. This combination often leads to child or spouse abuse
  • Chemical dependence and relationship addiction
  • Sexaholism in addition to religion addiction
  • Workaholism with alcoholism
  • Sexaholism and workaholism

It’s not unheard of for clients to suffer from at least three big obsessions. You may run into somebody who struggles with workaholism, sexaholism, and religion addiction. Compulsive caretaking and relationship addiction with a bit of misery addiction? That happens, too. When everything comes together, you get intense internal battles.

Alcoholism and workaholism are prime examples of how combined dependencies can be dangerous. Some workaholics push themselves so hard, they need to drink on the weekends to “loosen up.” This leads to a risk for alcoholism. If they misbehave while drinking (hit on a stranger, etc.), they may feel they should make up for causing problems by working harder.

Dr. Patrick Carnes, an expert on the subject of sexual addiction, says these sicknesses are connected to each other. Think of them as a series of gears moving together. When one comes alive, the others come alive, too. To prevent a relapse, each and every behavior should be addressed by health experts. Treating them at the same time (or closely together) covers all the bases and gives the client a better outcome.

Dr. Carnes provides advice for multi-issue addicts in his book Don’t Call It Love.

  • Take on the most severe issue first, then move on to the next
  • Find a solid group of supporters
  • Learn what sets off your addictions and how they come together
  • Realize that your issues come from pain. It’s important to confront this pain
  • Hold yourself accountable for your actions
  • Understand that, once you’ve conquered one addiction, you still have to conquer the others

There is no such thing as an instant cure. However, with determination and persistence, there is hope.