Mental health disorders and substance use disorders (SUD) often go hand in hand. For many who have struggled with mental illness, they may feel as if there is no way out. They may turn to substance abuse as a way to self-medicate or to cope with the pain. Any potential relief that this yields is only temporary and will often end up causing more mental health problems in the future.
When someone is struggling with addiction and mental health issues at the same time, it is what is known as a co-occurring disorder or dual diagnosis. Treating a dual diagnosis is a delicate process because clinicians must ensure that neither condition gets worse as a result of treating the other. They must also be sure to get to the root cause of the individual’s mental illness, or they may be likely to return to substance misuse.
At The Raleigh House, our team of clinicians is highly skilled and experienced in the delicate process of treating those with dual diagnoses. We also understand that each person’s experience with addiction and mental health conditions is different. Because of this, we strive to develop a unique treatment plan that is carefully tailored to each person’s individual needs. If you are ready to take back your life from addiction, we encourage you to reach out for more information regarding our treatment program today.

What Is a Dual Diagnosis?
If you have a dual diagnosis, it means that you are struggling with a mental health disorder and substance use disorder simultaneously. An example of this could be struggling with depression and alcohol use disorder at the same time. When you have a dual diagnosis, each condition can affect the other.
In other words, your mental health disorder can make your addiction worse and vice versa. You may turn to substance use as a way to try to cope with your mental health disorder, only to find that doing so makes it even worse. This can become a vicious cycle that is difficult to escape from without the guidance of mental health professionals. However, with counseling and addiction treatment, it is possible to recover from both disorders and live a happy and productive life.
Common Co-Occurring Disorders
A dual diagnosis can occur in many different forms. For example, someone may struggle with alcohol abuse and post-traumatic stress disorder (PTSD) simultaneously. Another example could be struggling with opioid addiction and schizophrenia at the same time.
Some people who struggle with anxiety disorders may misuse medications that are actually intended to treat anxiety. For example, they may abuse benzodiazepines such as Xanax to try to find greater relief from their anxiety. However, taking a medication like this without a prescription or different from what is prescribed can lead to worsened anxiety over time.
Another common and dangerous pairing may be bipolar disorder and marijuana. Someone might use marijuana, thinking of it as a seemingly harmless substance. However, this practice can lead to severe manic episodes and can make the symptoms of bipolar disorder even worse.
The Relationship Between Substance Use Disorder and Mental Health
Substance Use and Addiction Can Contribute to the Development of a Mental Health Disorder
The relationship between mental health and addiction is very complex. Substance use can increase your likelihood of developing a variety of mental health disorders, including anxiety and depression. If you already struggle with a severe mental illness, it can make the symptoms of that mental illness significantly worse.
This is because substance misuse disrupts your brain chemistry. It can lead to chemical imbalances, particularly related to neurotransmitters like dopamine and serotonin. These neurotransmitters play an important role in helping to regulate your emotions. Thus, when they become imbalanced, it can increase your likelihood of developing mental health problems like depression and anxiety.
Substance use can also take a toll on your mental health, even impacting your body’s ability to properly absorb important vitamins and nutrients. It can also affect the quality of your sleep and your appetite. Because your physical health and mental health are closely connected, if you are struggling with your physical health, your mental health can suffer as a result.
Mental Health Disorders Can Contribute to Drug Use and SUD
Just as substance use can lead to mental health problems, mental health problems can also contribute to someone’s likelihood of turning to substance use. This is because many people use substance use as a form of self-medication. In other words, they may turn to alcohol or drug abuse to try to alleviate the symptoms of their mental health disorder.
The symptoms they may be trying to find relief from depend on the type of mental health disorder they are struggling with. For example, in the case of depression, they may be trying to find relief from feelings of hopelessness or low mood. In the case of anxiety, they may be trying to find relief from constant worry or fear. For those who struggle with PTSD, it could be flashbacks or sleep problems that they’re trying to get rid of.
Self-medication is a dangerous practice that most often only makes mental health issues worse. This is why seeking professional mental health care is so important.
How Common Is a Dual Diagnosis?
Dual diagnosis is more common than you may think and affects many people across the country. Diagnosing co-occurring disorders as soon as possible is very important.
Prevalence of Dual Diagnosis
According to Psychiatry Research, adults with dual diagnoses are estimated to make up approximately 25.8% of all those who have a psychiatric disorder of any kind. There are many factors that can play into why this number is so high. For example, some key factors include a lack of access to mental health care, stigma surrounding mental illness, and the tendency of many with mental health problems to try to self-medicate.
Diagnosing Co-Occurring Disorders
Diagnosing co-occurring disorders can be a complex process because there are times when the symptoms of both conditions can overlap. For example, because alcohol is a depressant, it can be challenging to determine whether a person has a depressive disorder or if what they are experiencing is the result of their alcohol use. Similarly, stimulant misuse and bipolar disorder can both lead to symptoms of mania.
However, on the flip side of things, it is also possible for serious mental illnesses to go undiagnosed because they are mistaken for symptoms of a person’s substance misuse. This is why it is critical that clinicians perform a comprehensive assessment. When making their diagnosis, they must also take into consideration factors like the individual’s history and whether or not they have family members who struggle with mental illness.
Barriers to Accurate Diagnosis
Some of the key barriers that can stand in the way of an accurate dual diagnosis may include overlapping symptoms, stigma, and timing. In regard to timing, it is important that a clinician monitors a person’s mental health symptoms when they are still in active substance use and when they’ve been in recovery. In some cases, they may notice that their mental health symptoms improve. However, in other cases, they might not, and further mental health treatment might be necessary.
Stigma is a significant barrier to accurately diagnosing a co-occurring disorder because it may make some people afraid to seek help for either substance misuse or a mental health problem. Negative stigma surrounding both of these conditions prevents many people from getting the professional help that they truly need.
What Are the Symptoms of a Dual Diagnosis?
The symptoms of a dual diagnosis can vary from person to person and depend on the particular mental health disorder that a person is struggling with. However, the many symptoms include cognitive symptoms, social symptoms, and an impact on daily functioning.
Cognitive Symptoms
Some of the primary cognitive symptoms associated with dual diagnosis include:
- Trouble concentrating
- Illogical thinking
- Memory issues
- Confusion
- Intrusive thoughts
- Risky behavior
- Poor judgement
- Brain fog
- Anxiety
- Indecisiveness
- Trouble making decisions
Social Symptoms
Some of the primary social symptoms associated with dual diagnosis include:
- Strained relationships
- Financial problems
- Loss of trust within relationships
- Frequent conflict
- Social withdrawal
- Legal issues
- Codependent or enabling relationships
Impact on Daily Functioning
Struggling with an untreated dual diagnosis can impact your life in many different ways. Some key examples include:
- Struggling to keep up with personal or professional responsibilities
- Trouble taking proper care of children
- A decreased performance at work or school
- Trouble staying motivated to get things done
- Difficulty managing time
- Trouble keeping up with hygiene or health
- Difficulty keeping a job
- Having to rely on other people for basic needs
Which Disorder Occurs First in a Dual Diagnosis?
Either a mental health disorder or substance use disorder can occur first in a dual diagnosis. In addition, it is possible for them to develop around the same time but be connected to one another.
When a mental health disorder occurs first, it is likely that the person may have tried to self-medicate using drugs or alcohol. When substance use disorder occurs first, a person’s mental health disorder may develop because of their drug or alcohol use.
Common Risk Factors Can Contribute to Both Mental Health Disorders and SUD
There are several common key risk factors that can contribute to both mental health disorders and addiction. One of them is genetics. In other words, someone who has a direct family member who struggles with mental illness may increase their likelihood of also developing that kind of mental health disorder. Also, if someone has a close family member who has struggled with addiction, that can increase one’s likelihood of also struggling with drug or alcohol use.
There are also environmental factors that may contribute to someone’s likelihood of experiencing dual diagnosis. For example, this may include factors like whether the individual grew up around substance use or if they experienced peer pressure.
Some additional risk factors may include:
- Whether a person has experienced past trauma
- Adverse childhood experiences
- Lack of access to mental health care
- Social environment
- Lack of positive role models
- Neurological problems
Dual Diagnosis Treatment
Dual diagnosis treatment often involves an integrated approach. This may encompass things like behavioral therapy, medication, and peer support groups.
Integrated Treatment Approach
So what does an integrated treatment approach look like? It typically involves using a variety of treatment options to address both a person’s addiction and their mental health problem at the same time. Coordinated treatment of both disorders is critical in getting to the root of each issue and preventing a possible relapse. This type of treatment may involve the collaboration of multiple different doctors, psychologists, and treatment professionals.
Behavioral Therapy
Behavioral therapy may include a variety of different evidence-based treatments, such as cognitive-behavioral therapy (CBT) or dialectical behavioral therapy (DBT).
Medication
In some cases, medication may be used to treat either disorder. For example, this could include antidepressants or other medications that can impact mood.
Support Groups
Support groups are very helpful, particularly for those in recovery from substance use. This may include groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).
Prevention Techniques
You can prevent developing a dual diagnosis by learning about your family history, keeping an eye on your substance use, and staying connected to your healthcare provider.
Reducing the Risk of Dual Diagnosis
You can do your part by reducing the risk of dual diagnosis by limiting your substance use and being aware of whether or not addiction or mental health issues run in your family.
Learning About Your Biological Family History
Talk to your loved ones about your family history. Being aware of these things can give you an idea of what you may need to look out for in the future.
Limiting the Amount of Alcohol You Consume
If you drink alcohol, you should limit the amount. You should also be aware of the signs of alcohol dependence and addiction.
Talking to Your Healthcare Provider
If you believe you have a problem with either substance use or a mental illness, don’t hesitate to reach out to your doctor.
Helping a Loved One With a Dual Diagnosis
If you have a loved one who is struggling with a dual diagnosis, it is important to approach them with compassion, empathy, and respect.
Understanding Their Experience
Try to understand what they may be struggling with and why. Make it clear that you’re not coming from a place of judgment.
Encouraging Professional Help
Encourage your loved one to seek professional help and consider providing them with local treatment options to make this process as easy as possible.
Creating a Supportive Environment
Do your best to provide as much support to your loved one as possible, even after they have already sought treatment.
Finding Help For Dual Diagnosis at The Raleigh House
If you are struggling with dual diagnosis, our team at The Raleigh House can help.
Treatment That Specializes in Dual Diagnosis
At our treatment center, we utilize an integrated treatment approach that focuses on treating each condition simultaneously. In addition, we prioritize coming up with a specialized treatment plan that is based on your unique needs. We offer a variety of treatment options, including both inpatient and outpatient care. Some of the therapies we may use include a combination of CBT and DBT, psychotherapy, and medication when necessary.
FAQ
Is ADHD a dual diagnosis?
ADHD is not a dual diagnosis on its own. However, some people may struggle with ADHD and substance misuse simultaneously, which would be considered a dual diagnosis.
Is dual diagnosis a disability?
Yes, according to the Americans with Disabilities Act (ADA), both mental health disorders and substance use disorders are considered disabilities if they significantly impact your ability to work, function socially, or care for yourself. However, the severity of these disorders can influence whether or not it is considered a disability.
Does a dual diagnosis always have to involve SUD and mental health disorders?
In most cases, dual diagnosis does involve both SUD and mental health disorders. However, it is possible that someone may struggle with multiple types of SUD or multiple types of mental health disorders at the same time. This could also be referred to as a co-occurring disorder.
Many people struggle with mental health problems or substance misuse in silence because they are afraid of seeking help. This is often a result of negative stigma surrounding both of these conditions. Some people may be worried that if they ask for help, they will be judged or ridiculed. They may worry about being treated differently or not being understood. It can be a very isolating experience to struggle with either of these conditions. If that is your situation, our team at The Raleigh House is here to help. We have helped many people take their lives back from mental health problems and addiction. We want to help you, too. Call (720) 891-4657 today to learn more