female patient sitting with doctor during dual diagnosis assessment

Substance use disorder is a growing problem in the US. It affects millions of lives each day. It weighs heavily on the lives of both those living with the disorder, as well as those who are close to them. One of the factors that contribute to the challenge of treating cases of a substance use disorder, or SUD, is the presence of co-occurring mental health issues or conditions. 

In many cases, these co-occurring conditions can make addiction treatment incredibly challenging if they are not addressed in what’s known as dual diagnosis treatment. The National Survey on Drug Use and Health indicates that as of 2020, there were more than 17 million adults in the US that had co-occurring substance abuse and mental health issues, making it incredibly widespread among those that require addiction treatment.

What is Considered a Dual Diagnosis?

Dual diagnosis is also known as co-occurring disorders. It indicates that an individual has developed both a substance use disorder and a mental health disorder that is present at the same time, even though one or the other may appear first. One of the largest challenges with dual diagnosis treatment is obtaining the diagnosis in the first place, since the substance use disorder or the mental health disorder can cover up, alter, or enhance symptoms that assist in diagnosis. 

One of the most common combinations of co-occurring disorders is being diagnosed with anxiety or panic disorder as well as substance use disorder. There are indications that a significant portion of those living with substance use disorder or alcohol use disorder are also dealing with one or more mental health disorders. 

What is a Substance Use Disorder?

Substance use disorder is the clinical term for what is commonly called alcohol or drug addiction or chemical dependence. It is a complex condition that is indicated by the uncontrollable use of dangerous substances even in the face of harm or undesirable consequences. These substances can be illegal drugs, legal drugs being misused, or even legal substances like alcohol or tobacco. The DSM-5 lists the criteria for SUD diagnosis, and some of the signs and symptoms include:

  • Wanting to stop using the substance but being unable to.
  • Experiencing some form of withdrawal symptoms when the use is halted.
  • Inability to cope with daily challenges of life without the substance.
  • Having trouble at work, school, or with daily home life due to substance use.
  • Increasing tendency to isolate from friends and family and limiting most interaction with others that use the substance.
  • Developing a tolerance for the substance and requiring larger amounts or more frequent use to feel the same effect.
  • Increased participation in dangerous or risky behavior while using the substance.
  • Spending larger amounts of time obtaining, using, or recovering from the use of the substance.

What is a Mental Health Disorder?

Mental health disorders are also known as mental illnesses, and the term encompasses an incredibly wide range of mental conditions. Some of the most commonly diagnosed disorders include:

  • Anxiety
  • Depression
  • Disordered eating
  • Mania and bipolar disorders
  • Borderline personality disorder
  • Addiction
  • Dissociative disorders

Conditions that May Co-Occur

While there are countless potential mental illnesses that can be co-occurring with substance use disorder, there are some that are found to be far more common in dual diagnosis treatment. The most common co-occurring conditions include:

  • Anxiety and panic disorders
  • Depression
  • Bipolar I and bipolar II
  • Post-traumatic stress disorder
  • Disorders of compulsion
  • Personality disorders
  • Dissociative disorders
  • Schizophrenia and other schizoaffective disorders

Additionally, since alcohol use is so prevalent in our society as well as widely available, it’s incredibly common for those living with substance use disorder to also develop an alcohol use disorder or AUD. They will commonly use alcohol to reduce or temporarily escape from other uncomfortable symptoms of their SUD or mental illness.

Signs and Symptoms of a Dual Diagnosis

Due to the countless combinations of disorders, the signs and symptoms of dual diagnosis can vary tremendously. This is one of the many reasons that obtaining a dual diagnosis can be so difficult. The symptoms of mental illness and substance use disorder can overlap or even contradict each other. This makes not only a diagnosis difficult but dual diagnosis treatment as well. 

Some of the most common potential signs that someone may have co-occurring disorders and require dual diagnosis treatment can include:

  • Significant mood swings and emotional instability
  • Unexpected or sudden changes to personality, behavior, or cognitive function
  • Withdrawing from family, friends, social obligations or activities, and even educational or professional commitments
  • Partaking in risky behavior, such as unprotected sex with multiple partners or dangerous activities while under the influence
  • Intermittent or persistent confusion
  • Difficulty maintaining concentration or focus.
  • Indications of self-harm, suicidal ideation, or attempts
  • Feelings of fear
  • Neglecting hobbies or other activities once loved
  • Sudden changes in libido and sex drive, either by increase or decrease
  • Disregard for personal appearance and hygiene
  • Changes in perception or loss of touch with reality
  • Sudden physical complaints or illnesses

Treatment Options for Dual Diagnosis

A commonly effective treatment option is to obtain professional treatment in an integrated treatment facility. This allows someone to receive both addiction treatment and mental health treatment with dual diagnosis treatment programs where both aspects of the diagnosis are treated simultaneously. In some cases, the treatment may also be effective when taking one disorder at a time, treating them sequentially.

The best course of action is to use inpatient treatment to address the primary concern of substance use disorder and allow the individual to detox. During this time, additional treatment can occur in the same facility. Psychotherapy is one of the most important aspects of dual diagnosis treatment.

How to Get Started

If you or someone you care about may be living with a dual diagnosis, getting help as soon as possible is a significant factor for a healthy recovery. Working with local addiction treatment experts can be the first step to a lasting recovery effort, so reach out today and speak to an admissions coordinator that can help create an individualized treatment plan.