Dual Diagnosis

Dealing with addiction alone is a challenge, but many individuals in treatment for substance abuse also have co-occurring mental health issues. Whether you’re dealing with depression, anxiety, or some other mental health condition, it’s important to treat both conditions separately to give you the best chance for success in both areas.

Understanding Dual Diagnosis

The National Survey on Drug Use and Health (NSDUH) reports that almost half of the individuals dealing with a mental illness will also struggle with a substance abuse problem. The relationship between mental illness and substance use disorder is complex.

Comorbidity for individuals in treatment for a substance abuse problem can present some additional challenges to their addiction recovery. However, you or your loved one can still successfully live a healthy life free from substance misuse with the right treatment plan.

What Is a Dual Diagnosis?

A dual diagnosis, or comorbidity, is the presence of both a substance use disorder and one or more mental health disorders.

According to the American Psychiatric Association, a mental illness is a health condition that involves “changes in emotion, thinking, or behavior.”

Diagnosing a mental health disorder alongside substance abuse can be challenging. Some symptoms of mental health issues can also present as side effects of drug or alcohol use, such as depression, agitation, or even psychosis.

Mental Health Issues Common with Addiction

In some cases, an individual with an existing mental health condition may develop substance use disorder due to self-medicating to cope with the symptoms of their illness. For instance, someone struggling with PTSD or an anxiety disorder may use opioids or cannabis to lessen their feelings of anxiety or help them sleep.

While substance abuse doesn’t necessarily cause mental illness, drugs and alcohol can also trigger or exacerbate existing mental health issues. For example, ongoing research has identified a correlation between certain drug use and first-time episodes of schizophrenia.

The National Institute on Drug Abuse (NIDA) reports the following mental health conditions commonly co-occur alongside substance use disorder:

  • Depression
  • Bipolar Disorder
  • Anxiety Disorders
  • Attention-Deficit Hyperactivity Disorder (ADHD)
  • Obsessive-Compulsive Disorder (OCD)
  • Panic Disorder
  • Schizophrenia
  • Post-Traumatic Stress Disorder (PTSD)
  • Borderline Personality Disorder (BPD)
  • Eating Disorders

Treatment for Co-Occurring Disorders

Dual diagnosis treatment is a bit different than alcohol or drug addiction treatment. While you will still have the option to choose between inpatient and outpatient treatment centers, your recovery will also include special attention to your behavioral health.

The critical difference lies in treating both conditions separately, being sure to address the issues of your mental health disorder apart from treating your substance use disorder.

Types of Treatment for Dual Diagnosis

Psychiatry, such as Cognitive Behavioral Therapy (CBT), is commonly used to treat alcohol abuse/drug abuse but is also very effective for the treatment of mental health issues that occur alongside substance abuse.

Support groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) can also help you address your addiction while providing a supportive environment.

Having a solid support system such as AA meetings to attend can help improve your mood, decrease isolation, and allow you to meet similar individuals who may also have a dual diagnosis. Hearing the stories of peers in recovery can encourage you and help you feel less alone.

Similarly, sober homes or halfway houses can also provide an ideal living situation for someone with a dual diagnosis. Together with other residents, you can learn from one another, celebrate your successes, and enjoy community resources to help you with your addiction recovery and mental health.

Challenges Around Dual Diagnosis

Many combinations can occur with a dual diagnosis, with different symptoms presenting and overlapping. Diagnosing each variation can be a challenge for medical professionals and require meticulous evaluation.

In addition to the difficulty of getting an accurate diagnosis, the challenge of dealing with substance use disorder on top of a mental health condition can seem overwhelming. However, many treatment programs now recognize the need for treating both disorders individually and can accommodate you or your loved one’s individual needs.

How to Support Someone with a Dual Diagnosis

Not sure how to help a family member or friend with a dual diagnosis? The first thing you can provide is nonjudgemental support and encouragement. Having a solid support system during addiction recovery is crucial to long-term recovery.

You can also provide your loved one with an outlet for healthy activities unrelated to drug or alcohol use. Even something as simple as encouraging them to join you for a walk or spending time together can help them feel less isolated as they work on their sobriety and recovery.

Getting Help for a Dual Diagnosis

You can use the Substance Abuse and Mental Health Services Administration (SAMHSA) locator to find treatment centers near you to provide the support you need to manage your substance use disorder and mental health conditions.

Frequently Asked Questions about Dual Diagnosis

What does dual diagnosis mean?

A dual diagnosis is the occurrence of substance use disorder alongside one or more mental health conditions.

How is dual diagnosis treated?

Typically a patient with a co-occurring disorder will receive treatment for their addiction and mental illness separately. While the two can be linked, treatment should focus on each issue individually.

How do I get tested for dual diagnosis?

If you suspect you might have a co-occurring disorder, you can speak to your clinician or a mental health professional to request an evaluation.

Reviewed by:Chris Carberg

Addiction Guide Founder & Mental Health Advocate

  • Fact-Checked
  • Editor

Chris Carberg is a visionary digital entrepreneur, the Founder of Addiction Guide, and a long-time recovering addict from prescription opioids, sedatives, and alcohol.  Over the past 15 years, Chris has worked as a tireless advocate for addicts and their loved ones, while becoming a sought-after digital entrepreneur. Chris is a storyteller and aims to share his story with others in the hopes of helping them achieve their own recovery.

Written by:

Content Manager

Jessica Miller is a USF graduate with a Bachelor’s Degree in English. She has written professionally for over a decade, from HR scripts and employee training to business marketing and company branding. In addition to writing, Jessica spent time in the healthcare sector (HR) and as a high school teacher. She has personally experienced the pitfalls of addiction and is delighted to bring her knowledge and writing skills together to support our mission. Jessica lives in St. Petersburg, FL with her husband and two dogs.

7 references
  1. Häfner, H. M. (n.d.). Substance abuse and the onset of schizophrenia. Biological psychiatry. Retrieved April 24, 2022, from https://pubmed.ncbi.nlm.nih.gov/8931919/

  2. Report to Congress – Nov 2002. SAMHSA Report to Congress – Nov 2002 – Chapter 1 – Understanding Co-Occurring Disorders. (n.d.). Retrieved April 24, 2022, from https://web.archive.org/web/20120501034913/http://www.samhsa.gov/reports/congress2002/chap1ucod.htm

  3. U.S. National Library of Medicine. (2021, August 10). Dual diagnosis. MedlinePlus. Retrieved April 24, 2022, from https://medlineplus.gov/dualdiagnosis.html 

  4. Berenz, E. C., & Coffey, S. F. (2012, October). Treatment of co-occurring posttraumatic stress disorder and substance use disorders. Current psychiatry reports. Retrieved April 24, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466083/

  5. Mental health and substance use co-occurring disorders. Mental Health and Substance Use Co-Occurring Disorders | MentalHealth.gov. (n.d.). Retrieved April 24, 2022, from https://www.mentalhealth.gov/what-to-look-for/mental-health-substance-use-disorders

  6. Mental health and substance use disorders. SAMHSA. (n.d.). Retrieved April 24, 2022, from https://www.samhsa.gov/find-help/disorders

  7. U.S. Department of Health and Human Services. (2021, April 13). Part 1: The connection between Substance Use Disorders and mental illness. National Institutes of Health. Retrieved April 24, 2022, from https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness

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