What Is Dual Diagnosis?

About half of people living with a substance use disorder simultaneously struggle with another mental illness such as anxiety or depression. This is known as a dual diagnosis. Co-occurring mental health disorders can be driving factors behind addictive behavior, causing people to turn back to drugs or alcohol even after long periods of abstinence.

Because of this, effective addiction treatment programs must treat co-occurring disorders alongside addiction, addressing the root causes of substance abuse to promote long-lasting recovery.

What Are the Most Common Co-Occurring Disorders?

According to the Substance Abuse and Mental Health Services Administration, over 9.2 million people in the United States live with a co-occurring mental health disorder.

A research report by the National Institute on Drug Abuse (NIDA) found high rates of co-occurring substance use disorders (SUDs) and anxiety disorders, including:

• generalized anxiety disorder
• panic disorder
• post-traumatic stress disorder

Other common co-occurring mental health conditions include:

• depression
• bipolar disorder
• attention-deficit hyperactivity disorder (ADHD)
• borderline personality disorder
• psychotic illness
• antisocial personality disorder
• eating disorders

Data shows that people with severe mental illness – such as major depression, schizophrenia, and bipolar disorder, are particularly likely to also have a SUD.

The Substance Abuse and Mental Health Services Administration reports that individuals receiving treatment for a mental health condition often abuse the following legal and illicit drugs.

• Prescription medications
• Hallucinogenic drugs
• Marijuana
• Opioids
• Stimulants
• Tobacco
• Alcohol

What Is the Relationship Between Co-Occurring Disorders and Substance Abuse?

For an individual struggling with drug or alcohol abuse and another mental health condition, the relationship between the two disorders can be complex. On the one hand, mental disorders can lead to substance abuse; at the same time, substance abuse can exacerbate the symptoms of mental illness.

Without effective treatment, individuals can find themselves in a destructive cycle of worsening mental health symptoms and increased substance abuse, as one factor reinforces the other. The good news is that dual diagnosis programs can interrupt this cycle, turning it into a positive one of recovering from addiction and improving mental well-being.

How Do Mental Health Disorders Lead to Substance Abuse?

Some people with a mental illness may turn to drugs or alcohol as a form of self-medication, to cope with feelings of emotional distress. Substance use can offer a temporary escape from reality or have momentary calming effects.

However, while they may offer temporary relief, substances can exacerbate the symptoms of mental illness in the long term. Moreover, people with mental disorders may have unbalanced brain chemicals that enhance the addictive potential of drugs or alcohol, making it more likely that they will use them again.

Many mental health services now use drug and alcohol screening techniques to identify substance abuse among people with a psychiatric disorder. Identifying and treating substance abuse problems early can prevent them from developing into more severe substance use disorders. In some cases, mental health professionals may be able to intervene before drug or alcohol misuse turns into dependence or addiction.

Recognition of dual diagnosis has been a great step forward in the treatment of both mental illness and addictions.

How Does Drug Abuse Affect Mental Health Conditions?

Drugs and alcohol work by affecting chemical balances in the brain which regulate important functions such as memory, emotion, motivation, and sleep. This causes the temporary effects that substance users seek, such as relaxation or euphoria.

Over time, repeated substance use can cause long-term imbalances in chemicals, affecting mood and behavioral functions. These changes can worsen the symptoms of existing conditions such as depression and anxiety and may make the development of a new co-occurring disorder more likely.

What Role Does Genetics Play in Mental Illness?

Genetics may offer part of the explanation for the high prevalence of co-occurring disorders among people with substance use disorders. Since both mental illness and SUDs tend to run in families, genetics likely plays a role in the development of both conditions. In some cases, the same genetic patterns may make an individual vulnerable to both a mental health disorder and substance abuse.

Environmental factors such as early life adversity (exposure to childhood trauma, neglect, abuse, and other difficult conditions) also increase the chances of developing both conditions.

How Do Dual Diagnosis Programs Work?

Dual diagnosis programs work by treating co-occurring disorders alongside addiction. The types of treatment that the programs include vary depending on the co-occurring condition(s) that affects each client. Professionals at mental health clinics are trained to respond to many different kinds of psychiatric disorders and SUD.

For example, people living with the dual diagnosis of SUD and depressive symptoms may attend cognitive-behavioral therapy (CBT) to identify negative thinking patterns and turn them into more positive ones. They may develop healthy coping mechanisms for difficult emotions and practice breaking down overwhelming tasks into smaller steps.

Someone living with an anxiety disorder may use CBT and exposure therapy to help them re-engage with tasks and activities that they have avoided because of anxiety. They may also use medication to manage panic attacks and practice relaxation techniques such as yoga and mindfulness.

Developing these skills and coping mechanisms helps to prevent individuals with a dual diagnosis from re-engaging with substance abuse in times of emotional distress. As individuals recover from co-occurring disorders and their mental well-being improves, their triggers for drug use also reduce, making it easier to maintain abstinence in the long term.

Similarly, it is difficult for people with a dual diagnosis to effectively engage in mental health treatment if they are still struggling with substance abuse. Substance use disorders often take over a person’s life, preventing them from focusing, fulfilling responsibilities, and taking care of themselves. Dual diagnosis treatment supports individuals to stay sober so that they can fully engage in and benefit from mental health support.

Achieving Holistic and Long-Lasting Recovery

Addiction treatment providers usually offer dual diagnosis treatment as part of a broader recovery program that addresses the multiple needs of each individual. Some of the other treatment options that may be included in a treatment plan are:

• Cognitive-behavioral therapy
• Group programming
• Support groups
• Experiential therapies
• Complementary therapies
• Medical-assisted treatment
• Life skills development

Recovery from substance use disorders is a life-long process involving continued dedication and support. Likewise, many mental illnesses also require long-term or maintenance treatment to help maintain good mental health and prevent relapses.

Effective addiction treatment and dual diagnosis programs usually include comprehensive aftercare to guide clients through the months and years ahead. This may involve connecting them with local facilities and support groups or offering ongoing coaching. Alumni programs can help people stay connected to their recovery community and provide a place to call or visit if things get tough with their mental health disorder or SUD.

Alina Lodge – At the Forefront of Addiction Treatment

Alina Lodge is one of the nation’s most renowned residential addiction recovery centers. For over 60 years, we’ve provided top-tier support to our clients, combining scientific innovation with compassionate care.

Our clinical program offers a diverse range of treatments to meet the multiple needs of each client. From grief therapy to mindfulness-based relapse prevention, our treatment approaches address the root causes of addiction, promoting long-lasting change. We offer dual-diagnosis treatment for anxiety, depression, and other co-occurring disorders, supporting clients to focus on both issues simultaneously for a stronger recovery.

At Alina Lodge, we understand the importance of family in addiction recovery, including loved ones in the process through family therapy and in other ways. Our closely-knit team of mental health professionals acts as a trusted support system throughout the treatment experience, cultivating a caring and communal environment.

If you are living with a dual diagnosis or a substance use disorder, reach out to us today to get the help you deserve.