What is Dual Diagnosis? Understanding Mental Health and Addiction
When discussing mental health and substance abuse, a crucial but often misunderstood term is dual diagnosis. This condition, also called co-occurring disorders, occurs when an individual has both a mental illness and a substance use disorder at the same time. These disorders can interact in complex ways, making treatment more challenging.
According to the National Institute on Drug Abuse, people with substance abuse disorders are twice as likely to experience mental health disorders and vice versa. This highlights the need for integrated treatment, where both conditions are treated simultaneously by the same treatment provider.
In this article, we'll explore what dual diagnosis is, its causes, symptoms, and the best approaches for treatment.
What is Dual Diagnosis?
The term dual diagnosis (or co-occurring mental disorders) refers to the presence of both a psychiatric disorder and a substance use disorder.
These disorders can include:
Mood disorders (e.g., bipolar disorder, depression)
Anxiety disorders (e.g., generalized anxiety disorder, PTSD)
Personality disorders (e.g., borderline personality disorder)
Psychotic disorders (e.g., schizophrenia, co-occurring psychotic disorders)
Autism spectrum disorder (which can co-exist with substance misuse)
At the same time, individuals may struggle with substance abuse problems such as:
Alcohol use disorder (alcohol addiction)
Prescription medication misuse (such as benzodiazepines or stimulants)
Polysubstance abuse (using multiple substances simultaneously)
Common Risk Factors for Dual Diagnosis
There is no single cause of co-occurring disorders, but there are common risk factors that can contribute to the development of both mental health disorders and substance abuse problems:
Genetics – A family history of mental health conditions or addictive disorders increases vulnerability.
Brain chemistry – Imbalances in neurotransmitters can lead to psychiatric symptoms and drug abuse.
Environmental influences – Exposure to trauma, stress, or early drug use can trigger mental health symptoms and substance use.
Unaddressed mental health issues – Some people use drugs or alcohol to self-medicate severe mental illness, unknowingly making their condition worse.
Prescription medication misuse – Misuse of psychiatric drugs can lead to substance abuse compared to individuals who take medications as prescribed.
The Link Between Mental Disorders and Substance Abuse
Many people with mental health issues use substances as a way to cope with their symptoms. However, substance abuse and mental illness reinforce one another, creating a vicious cycle.
For example:
Depression and alcohol abuse – Alcohol temporarily numbs emotional pain but worsens negative consequences like suicidal thoughts.
Anxiety disorders and prescription medication – Some individuals misuse anti-anxiety medications, leading to addiction.
Bipolar disorder and drug use – People with bipolar disorder may use stimulants during manic episodes or depressants during lows.
PTSD and substance use disorders – Individuals with PTSD may turn to substance misuse to suppress flashbacks and anxiety.
This highlights the need for mental health services that address both conditions together, rather than treating addiction and mental health symptoms separately.
Symptoms of Dual Diagnosis
Identifying co-occurring disorders can be difficult because mental health symptoms and withdrawal symptoms from substance misuse often overlap.
Some common warning signs include:
Extreme mood swings (indicating mood disorders like bipolar disorder)
Paranoia or hallucinations (co-occurring psychotic symptoms)
Social withdrawal and difficulty maintaining relationships
Changes in everyday life, such as losing a job due to drug use
Difficulty managing psychiatric medication due to substance abuse
Increased substance use despite negative consequences
A mental health treatment team will assess an individual using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to determine the appropriate diagnosis and dual diagnosis treatment plan.
Treatment for Dual Diagnosis
Successful substance abuse treatment for individuals with co-occurring disorders involves an integrated treatment approach that addresses both mental illness and substance use disorders.
This may include:
1. Behavioral Therapy (Talk Therapy)
Cognitive Behavioral Therapy (CBT) – Helps individuals recognize and change harmful thought patterns.
Dialectical Behavior Therapy (DBT) – Beneficial for individuals with personality disorders or self-destructive behaviors.
2. Medication Management
Psychiatric medication such as antidepressants or mood stabilizers can help stabilize mental health symptoms while reducing relapse risk.
Only a treatment provider experienced in dual diagnosis treatment should prescribe medication to avoid potential substance misuse.
3. Support Groups and Emotional and Social Support
Support groups like Dual Recovery Anonymous (DRA) provide emotional and social support for individuals struggling with mental health problems and substance abuse disorders.
Peer support is critical because recovery is an ongoing process, not a one-time event.
4. Holistic and Alternative Therapies
Mindfulness practices and lifestyle changes can improve everyday life and long-term well-being.
Exercise, nutrition, and meditation can help individuals cope with mental health issues without resorting to substance misuse.
Why Integrated Treatment Matters
The Substance Abuse and Mental Health Services Administration (SAMHSA) emphasizes that treating co-occurring disorders separately is less effective than an integrated approach. Individuals need a treatment provider who understands both mental health disorders and substance use disorders.
Finding the Right Help
If you or a loved one are struggling with co-occurring substance abuse and mental illness, know that help is available. Dual diagnosis treatment programs offer the comprehensive care necessary for long-term recovery.
At Insight Northwest Recovery, we provide evidence-based substance abuse treatment and mental health services tailored to individuals with co-occurring disorders. Our experienced treatment team is dedicated to helping you regain control of your everyday life.