Dual diagnosis is very common when treating addiction and mental health, and it seems that the two go hand in hand. The term refers to someone who experiences a mental illness and substance use disorder at the same time. People who have a mental health condition may self-medicate to improve their symptoms, but research has shown that drugs and alcohol actually make the symptoms much worse.

Addiction can dramatically affect how the brain functions. Drug and alcohol consumption changes how the reward center is affected, and this will, in turn, create a new hierarchy of need in the user’s life. Compulsive behavior stemming from addiction can be similar to other mental illnesses and, in some cases, be exacerbated.

In the two professional fields of mental health and substance use recovery, the two very different cultures make it difficult to find integrated care. An estimated 7.9 million people in the United States experience both a mental disorder and substance use disorder together.

Despite the progress made to take away the stigma of treatment and substance use disorders, it still is prominent in our society. In some cases because of this, those using will submerge themselves deeper into the cycle of addiction than seek help because of the negative connotation about treatment. Until the stigma surrounding addiction finally dissipates, this will be a problem for those on the verge of reaching out for the proper addiction treatment.

Mental Health Disorders Associated With Substance Abuse

A number of mental health issues can occur with psychological disorders, but there are only a few conditions that frequently occur with drug and alcohol abuse. The most common mental health disorders likely to be found in a dual diagnosis case are:

  • Borderline personality disorder
  • Bipolar disorder
  • Depression
  • Generalized anxiety disorder
  • Obsessive-compulsive disorder (OCD)
  • Eating disorder
  • Panic disorder
  • Schizophrenia
  • Personality disorders
  • Post-traumatic stress disorder (PTSD)

While two disorders can happen at the same time, one can exaggerate the symptoms of the other and make both disorders worse. For example, depressants like opioids or alcohol can cause worsening depression symptoms. Co-occurrence does not always mean one disorder causes another. Mental disorders and addiction have several areas where causes can stem from such as family life, heredity, and environment.

What Causes Dual Diagnosis?

Dual diagnosis can arise from many factors including heredity, family life, stressful occupations, chronic medical conditions, and isolation. Those with these risk factors have a higher chance of managing a mental health disorder. Drug and alcohol abuse is a significant factor in mental illness and can be what pushes someone completely over the edge.

Mental illness is notorious for driving affected people to self-medicate. Anxiety and depression push people into alcohol or drug use for a brief period of relief. Even consuming alcohol in a social setting can lead to a full-blown addiction. It is necessary to be aware of the symptoms that are involved with mental illness.

It is difficult for doctors to determine which disorder came first, or if one disorder was caused by the other. This is because of the shared risk factors of both disorders. Many individuals remain oblivious that substance use disorders are a form of mental illness. Educating the public about this topic can lead to more people seeking the proper treatment.

How Common Is Dual Diagnosis?

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that millions of people have a mental health disorder and substance use disorder. People who have anxiety and mood disorders are twice as likely to struggle with an addiction compared to the overall population. Another study estimates that adolescents with significant behavioral problems are seven times more likely to be used or abused substances in the past month.

Nearly half of those with a dependence on alcohol or drugs are also dealing with a co-occurring mental illness. This is the definition of a dual diagnosis, and it is of great concern to addiction specialists.

The adverse effects in the community from mental health disorders and addiction have pushed professionals in the field of addiction treatment for solutions. A comprehensive plan needed to be created to help those suffering from symptoms of addiction and mental illness.

States are in the process of improving treatment options for those with a dual diagnosis, and they want to evaluate the person and their experience with both addiction and mental health issues. For this diagnosis to be effective, the treatment facility must use an integrated approach to treat both mental health disorders and addiction. The treatment will not be as useful to the individual if this is not implemented.

Factors to take into consideration when it comes to a dual diagnosis include:

  • What kind of drugs were used?
  • Was alcohol abused?
  • Were drugs and alcohol both abused?
  • What is the co-occurring mental health disorder?
  • How long was the person self-medicating with drugs or alcohol?

Due to how specific conditions affect people, different diagnoses will require a different approach to techniques used. Someone with bipolar disorder will receive different treatment from someone who has schizophrenia.

These interviews must be done on a person-to-person basis as the needs of them will vary greatly.

What Types of Therapy Are Used in Dual Diagnosis Treatment?

These treatments must vary by the person to ensure effectiveness. If the root of the problem is not adequately treated, it will be a waste a time. Deciding which therapies will have the most positive effect will be done at the addiction specialist’s discretion. The most common therapy types that someone will experience during dual diagnosis treatment are:

Cognitive Behavioral Therapy

Known as CBT, it is believed to be the gold standard in therapy treatment. It is highly effective for treating both substance use disorders as well as mental health issues. This form of therapy has proven to yield the best results in treatment.


Through various studies, it has been shown that mindfulness is a useful technique for people with anxiety disorders. Meditation can be the beginning of creating habits of mindful and centering behavior.


Yoga is another staple of holistic therapy that helps teach rediscovery of oneself. It helps to create focus, encourages relaxation, and can teach patience. These are all useful traits in addiction therapy and mental health treatment.

Family Therapy

Addiction affects families as a whole, and to truly heal someone who has been using, the entire family will require therapy. Helping everyone directly involved is a practical solution, and will heal all sides of the equation. This allows the family to understand what created these urges in the user and for the user to see the family’s perspective as well.

What Are the Benefits of Dual Diagnosis Treatment?

When you treat only the addiction but not your mental health, or your mental health and not the addiction, this is not a solution that will work long-term. These disorders feed off one another, and only servicing one end of the spectrum will not eliminate the other. This will often push the user to relapse immediately after their treatment. If they are still suffering from the fuel that pushed them to use before, it is likely to present itself after treatment.

A dual diagnosis can be a life-changing event for those informed by a medical professional. Most who suffer are completely unaware that this exists until they check into treatment for substance abuse. Being able to understand what is feeding their addiction allows them to learn healthy coping mechanisms that would have never come to fruition without the diagnosis.

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