Last Updated on September 9, 2021 by Morris Green

Many people can have a dual diagnosis of a substance use disorder and mental disorder, but don’t know it.

It’s important to inform ourselves on the aspects of dual diagnosis by watching for symptoms of addiction and early warning signs of mental illness.

What is a dual diagnosis?

A dual diagnosis is when a person has both a substance use disorder and a mental disorder. You might also hear it called co-occurring disorders or comorbid disorders, which mean the same thing as a dual diagnosis. This can look different for everyone because there are many different combinations with dual diagnoses.

It’s very common for conditions such as depression, anxiety, PTSD, and other mental disorders to co-occur with addiction. These disorders often feed off each other and share similar triggers and traumatic experiences that bring on the condition. Unfortunately, if one disorder goes undiagnosed and untreated, both can continue to worsen over time.

Mental health and addiction

According to the National Institute on Drug Abuse, about half of people who experience mental illness will also experience a substance use disorder and vice versa. And 1 in 4 people with a serious mental illness also has a substance use disorder.

A big part of this is because mental illness and addictions share many common denominators. For example:

• Genetic predisposition: A person can be genetically predisposed to both mental illness and addiction.
• Environmental issues: Things like a person’s home life, childhood upbringing, financial situation, and trauma can bring on co-occurring disorders.
• Stress: This is one of the largest motivators for substance abuse and mental illness.

Either mental illness or addiction can come first when it comes to a dual diagnosis. Something like an anxiety disorder can bring on an alcohol addiction because a person self-medicates their anxiety with alcohol. Or, drug addiction can bring on depression because of the depressant effects of some drugs and the mental effects of long-term drug use.

Recognizing the signs of dual diagnosis

To know whether you have a dual diagnosis, there are a few things to keep in mind. Look out for major changes that are largely different from how you felt before. Here are some of the symptoms and signs of a dual diagnosis:

• Changes in your thought patterns
• Mood swings
• Being dependent on a substance to relieve feelings of stress, sadness, anxiety, or other unwanted emotions
• Feeling unsatisfied and empty without using drugs or alcohol
• Suicidal thoughts or actions
• Financial problems from spending money on substances
• Self-isolation and withdrawing from friends and family
• Major changes in behavior
• Engaging in risky or dangerous behavior
• A history of mental illness and/or drug abuse in the family
• An inability to stop using drugs or alcohol

If you notice any of the above symptoms in yourself or someone you care about, they may have a dual diagnosis. These are just some of the symptoms that can happen, but a dual diagnosis is personal and depends on the person.

Most common dual diagnoses

Some of the most commonly diagnosed co-occurring disorders are substance abuse and:

• Depression
• Bipolar disorder
• Anxiety disorder
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Attention-deficit/hyperactivity disorder (ADHD)
• Psychotic illness
• Borderline personality disorder (BPD)
• Antisocial personality disorder (APD)

Getting treatment

The best way to know if you have a dual diagnosis is to get professional help. A trained counselor who’s experienced in treating mental illness and substance abuse will be able to help you to determine whether you have co-occurring disorders. In therapy or a substance abuse program, a therapist will look at the overall picture and symptoms to find out whether there should be a dual diagnosis.

If you get a dual diagnosis, this is not the end. There are many treatment options available to break the vicious cycle of mental disorders and addiction so that a person can feel free from both substances and mental illness.

A few of the most effective treatment options for dual diagnosis are:

• Medication-Assisted Treatment (MAT): This can help those struggling with substances like opioids, prescription drugs, alcohol, and more. It combines the use of addiction medication with behavioral therapies to address dual diagnoses.
• Outpatient Rehab: There are a lot of different options in outpatient treatment that can focus on mental illness and addiction.
• Short- or Long-Term Residential Rehab: Someone in a residency program can live in a treatment center and get 24-hour care for mental illness and substance abuse.

Receiving a dual diagnosis is the first step to starting a healthier path. If you or someone you love is dually diagnosed with a substance use disorder and a mental illness, know that you’re not alone and recovery is possible.