Dual diagnosis treatment is most effective when a mental health condition and substance use disorder are treated simultaneously.

A dual diagnosis is when a person has both a mental health disorder and a substance use disorder. The conditions are usually treated separately, but they are related when diagnosed in the same person and can have noticeable impacts on one another.

For the most effective outcome, a person with a dual diagnosis should receive treatment for both disorders simultaneously. Dual diagnosis treatment programs address each issue individually. They also consider how the other condition may influence the treatment plan. For example, dual diagnosis rehab treats substance use disorder by allowing the person to go through withdrawal and treat their addiction. During addiction treatment, the person will also receive therapy for their mental health disorder.

What Is Dual Diagnosis?

A dual diagnosis is when a person has one or more mental health disorders (such as anxiety, depression or a personality disorder) and one or more substance use disorders (such as alcohol or opioid abuse). A dual diagnosis can also be termed co-occurring disorders or comorbidity.

Several different types of dual diagnosis treatment exist. These will differ depending on the specific combination of disorders a person has but will usually focus on alleviating psychiatric symptoms and reducing substance use. For example, several cognitive behavioral therapies have been developed to treat post-traumatic stress disorder and substance use disorders concurrently. Some treatments used for dual diagnosis patients include:

  • Motivational Enhancement
  • Cognitive Behavioral Therapy 
  • 12-Step Meetings
  • Contingency Management
  • Dialectical Behavioral Therapy
  • Integrated Group Therapy
  • Peer-Led Supportive Services
  • Pharmacotherapy (medications used to treat mental health disorders like depression)

Most important in patients with dual diagnosis is that patients receive integrated treatment that addresses both the mental health disorder and substance use disorder.

Symptoms of Mental Health Disorders and Co-occurring Addiction

Only a mental health professional can diagnose a mental health or substance use disorder. However, knowing the common symptoms of dual diagnosis may help individuals recognize when they need assistance.

Dual diagnosis symptoms are similar to mental health and substance use disorders but occur in the same person. Those symptoms include:

  • Sudden behavior changes
  • Difficulty managing daily tasks
  • Retreating from relationships with family and friends
  • Poor attendance or performance at work or school
  • Changes in personality or mood
  • Neglecting health and hygiene
  • Engaging in risky behaviors
  • Developing high tolerance to a substance
  • Feeling the need to use the substance to function normally
  • Losing control over substance use
  • Using substances under unsafe conditions
  • Experiencing withdrawal symptoms

How Common Are Co-Occurring Disorders?

According to the National Survey on Drug Use and Health, co-occurring disorders are quite common. An estimated 19.4 million American adults in 2021 were diagnosed with co-occurring disorders (any mental illness and at least one substance use disorder). The prevalence of co-occurring disorders was highest in young adults aged 18–25. The most common mental health disorders that co-occur with substance use disorders include:

The most common mental health disorders that co-occur with substance use disorders include:

Benefits of Dual Diagnosis Treatment

When only one disorder is treated, the treatment is less likely to be as effective as it would be in a person without a dual diagnosis. Comprehensive treatment that addresses both issues is essential to facilitate the best outcomes for patients with co-occurring disorders. 

A dual diagnosis is likely to be a complex case, requiring a more intensive treatment program than a mental health disorder on its own. The benefits of dual diagnosis treatment are that the person can:

  • Receive the necessary treatment to stop using drugs or alcohol
  • Receive therapy to help them cope with their mental health disorder
  • Work with a therapist to understand how their co-occurring disorders are connected
  • Address the roots of addiction and the causes of their mental health disorder
  • Learn coping mechanisms for mental health conditions
  • Identify and avoid triggers associated with relapse
  • Build a solid relapse prevention plan
  • Increase their motivation for engaging in treatment

Related Webinar: Dual Diagnosis: Dealing with Double Trouble 

Dangers of Self-Medication

A person with a mental health issue may use substances to cope with physical and psychological symptoms. This action is called self-medication and is dangerous. It can lead to substance addiction and make mental health problems worse. For example, a person may use alcohol to ease the symptoms of their depression, but as soon as the alcohol wears off, they feel even more depressed. This process can be a vicious cycle that leads to addiction.

Additional risks of self-medication include:

  • Delaying the diagnosis of an underlying mental health disorder
  • Feeling amplified symptoms when not using the substance
  • Developing tolerance to the substance, building a desire to use more

Is Dual Diagnosis Treatment Right for Me?

Dual diagnosis treatment is important for anyone simultaneously diagnosed with a mental health disorder and a substance use disorder. Getting help for both issues is essential rather than just addressing one condition alone.

If you have been diagnosed with a co-occurring mental health and substance use disorder, then dual diagnosis treatment is right for you. Additionally, to be sure, you can:

How to Find Dual Diagnosis Treatment Near Me

Dual diagnosis treatment centers can help individuals struggling with co-occurring mental health and substance use disorders. To find a dual diagnosis treatment facility, you can:

  • Call the Substance Abuse and Mental Health Services Administration’s helpline at 1-800-662-HELP (4357)
  • Use a behavioral health treatment locator tool
  • Ask your doctor for a rehab center recommendation
  • Ask your therapist for a recommendation for a dual diagnosis center
  • Search recovery resources by zip code
  • Find the nearest location of The Recovery Village (most locations offer dual diagnosis care)

Dual Diagnosis Programs at The Recovery Village

At The Recovery Village, we understand that many people who struggle with drug and alcohol addictions also live with mental health conditions. We believe that lasting healing begins with addressing both conditions simultaneously and allowing people to recover physically and psychologically. We offer dual diagnosis treatment in our residential and outpatient programs at most of our locations nationwide.

If you or a loved one are struggling with a mental health disorder and a substance use disorder, The Recovery Village can help. The Recovery Village has dual diagnosis treatment programs that address both diagnoses and get individuals the right recovery plan to improve treatment outcomes. To learn more about our comprehensive treatment plans, call The Recovery Village to speak with a Recovery Advocate to learn more about our comprehensive treatment plans.

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Editor – Theresa Valenzky
Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more
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Medically Reviewed By – Jenni Jacobsen, LSW
Dr. Jenni Jacobsen is a licensed social worker through the Ohio Counselor, Social Worker and Marriage and Family Therapist Board. She has over seven years working in the social work field, working with clients with addiction-related and mental health diagnoses. Read more

FAQs


What makes dual diagnosis treatment different?

Dual diagnosis treatment differs because it integrates approaches that simultaneously address substance use and mental health disorders rather than providing individual treatments for each condition. Dual diagnosis treatment combines multiple modalities, such as psychotherapy and pharmacological interventions, into one treatment plan, rather than creating separate treatment plans for mental health and substance abuse.

What are the risk factors of dual diagnosis?

Research suggests shared risk factors are associated with mental health disorders and substance use disorders. These risk factors include genetics, family problems, poverty and lack of parental monitoring.

Why is it so important to treat both conditions simultaneously?

When a person has co-occurring disorders, it’s important to treat them simultaneously because not treating one will lead to worse treatment outcomes. For example, an untreated mental health disorder can cause addiction symptoms to return and vice versa.

Why do substance use disorders and mental health disorders occur together?

Several potential causes of co-occurring mental health disorders and substance use disorders exist. In some cases, substance use may lead people to develop mental health disorder symptoms. In other instances, people with mental health conditions may develop substance use disorders if they use drugs or alcohol to self-medicate mental health problems. Finally, mental health disorders and substance use disorders can share certain risk factors, including genetics, exposure to trauma and brain function abnormalities.

How long is a dual diagnosis treatment program?

How long a person spends in dual diagnosis treatment can differ based on individual needs and circumstances and the facility offerings where a person seeks treatment. Depending on the severity of their co-occurring disorders, some people may need longer treatment stays. In addition, some people may spend a certain time, such as 30 days, in an inpatient treatment program and then transition into an outpatient program.

Sources

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Khantzian, E.J. “The self-medication hypothesis of substa[…]applications.” Harvard Review of Psychiatry, January 1997. Accessed February 17, 2023. 

McGovern, M.P.; Lambert-Harris, C.; Acquilano, S.; Xie, H.; Alterman, A.I.; Weiss, R.D. “A cognitive behavioral therapy for co-oc[…]ss disorders.” Addictive Behaviors, October 2009. Accessed February 17, 2023. 

Yule, Amy M.; Kelly, John F. “Integrating Treatment for Co-Occurring M[…]onditions.” Alcohol Research Current Reviews, 2019. Accessed February 17, 2023. 

Substance Abuse and Mental Health Services Administration. “Co-Occurring Disorders”>.” September 27, 2022. Accessed February 17, 2023. 

Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indi[…]se and Health.” December 2022. Accessed February 17, 2023. 

Wüsthoff, Linda E.; Waal, Helge; Gråwe, Rolf W. “The effectiveness of integrated”><[…]pa[…]of integrated

treatment in patients with substance use[…]domized trial.” BMC Psychiatry, 2014. Accessed February 17, 2023. 

MentalHealth.gov. “Mental Health and Substance Use Co-Occur[…]ng Disorders.” March 10, 2022. Accessed February 17, 2023. 

Kendler, Kenneth S.; Prescott, Carol A.; Myers, John; et al. “The Structure of Genetic and Environment[…]en and Women.” JAMA Psychiatry, September 2003. Accessed February 17, 2023. 

Kelly, Thomas M.; Daley, Dennis C. “Integrated Treatment of Substance Use an[…]ic Disorders.” Social Work in Public Health, 2013. Accessed February 17, 2023.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.