In the addiction recovery field, dual diagnosis describes a comorbidity between substance abuse and mental health disorders. Comorbidity is two disorders occurring in one person, either at the same time or in close succession. Comorbidity can also imply that the two illnesses affect one another.

For instance, a person who suffers from depression may self-medicate with alcohol. In that case, the depression symptoms worsen when the addictive substance has a hold over them. Addiction itself is a form of mental illness.


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According to the National Institute on Drug Abuse (NIDA), addiction can fundamentally change the brain, affecting the reward center and the way it processes a normal hierarchy of needs. Compulsive behavior that comes from addiction is similar to the effects of other mental illnesses and can exacerbate or lead to mental problems.

Unfortunately, due to the stigma that still very much surrounds both substance use disorders and mental health disorders, many people will avoid seeking treatment for either issue, instead choosing to self-medicate and plunge themselves deeper into a dangerous form of isolation that could prove to be deadly.

Ending the negative associations attributed to both addiction and mental health disorders is the first step in ensuring that people with comorbid substance use and mental health disorders can get the proper addiction treatment they need, in this case, dual diagnosis.



Mental Health Disorders Associated with Substance Abuse

Dual-diagnosis can occur with a number of mental health issues and psychological disorders. However, a few conditions frequently occur with drug and alcohol abuse. Here are some mental issues that are commonly found in dual diagnosis cases:

  • Bipolar disorder
  • Borderline personality disorder
  • Generalized anxiety disorder
  • Depression
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Eating disorders (bulimia, binge eating, anorexia)
  • Personality disorders
  • Schizophrenia
  • Post-traumatic stress disorder (PTSD)

Both disorders can occur simultaneously, or one can bleed into the other. The depressant nature of substances like opioids or alcohol can cause or worsen depression symptoms. However, co-occurrence does not always mean one disorder causes the other. Mental disorders and addiction have a number of possible causes, many of which overlap like heredity, family life, and environment.

What Causes Dual Diagnosis

Depending on a variety of factors like family life, heredity, stressful occupations, chronic medical conditions, and isolation, some people are at greater risk of developing a mental illness. Because drug and alcohol abuse is a risk factor for mental illness, according to the Mayo Clinic, it can be what tips the scales towards developing a disorder.

Mental illness can also lead to substance abuse by means of self-medication. People suffering from anxiety or depression often use alcohol or other drugs for a brief period of relief. However, these substances ultimately exasperated mental disorders and can develop into substance abuse disorders.

It’s important to note that comorbidity does not always mean that one disorder was responsible for the other. In fact, according to NIDA, it is frequently difficult for even doctors to accurately determine which disorder came first. This is due to the shared risk factors for both disorders, and there is also the fact that many people are unaware that that substance use disorders are actually considered a form of mental illness.

How Common is Dual Diagnosis?

Dual diagnosis of substance abuse and mental health disorders is fairly common. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), millions of people suffer from both a mental health issue and addiction. People who suffer from mood and anxiety disorders are twice as likely to suffer from addiction and vice versa when compared to the overall population. Adolescents with significant behavioral problems are seven times more likely to have used or abused substances like drugs or alcohol in the past month.

According to the SAMHSA 2015 National Survey on Drug Use and Health, 8.1 million people (or 41.2 percent) among 12.6 million adults with past-year Substance Use Disorder also possessed at least some form of mental health disorder.

In other words, nearly half of those that struggled with a dependence on alcohol or drugs are also concurrently dealing with a co-occurring mental health disorder, which also known as a dual diagnosis.

Though there are greater numbers of people who suffer from substance abuse disorders without any diagnosed second disorder, substance abuse dramatically raises risk factors for developing other mental health disorders.

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Dual Diagnosis Treatment

Treating addiction through the lens of mental illness hasn’t always been an option for rehab. As we learn more about mental health, clinicians can better understand the source of addictive behaviors and self-medication.

This has led addiction professionals to create specific treatment plans for those with a dual diagnosis.

In the middle of the opioid crisis, states are also working to improve treatment options for people with dual diagnosis. Before a treatment plan is developed, a professional will evaluate you and your experience with both addiction and mental health issues. 


For dual diagnosis treatment to have a real, tangible level of effectiveness, the treatment facility must use an integrated approach to being able to treat both mental health disorders and addiction.

There are a few important factors that must be taken into consideration when it comes to the treatment of a dual diagnosis patient, such as:

  • What kinds of drugs or alcohol were they abusing?
  • What is the co-occurring mental health disorder?
  • How long were they self-medicating with drugs or alcohol?

Different mental health disorders require different therapeutic techniques. The therapy for someone with bipolar disorder is not going to be the same as someone with schizophrenia. Dual diagnosis treatment must be done on an individual basis to properly meet a given patient’s unique set of needs.

What Types of Therapy are Used in Dual Diagnosis Treatment?

As we just mentioned, dual diagnosis treatment plans will vary from person to person depending on their co-occurring disorder and what therapy type will prove most effective for them. It’s never a one-size-fits-all situation, but there are some common therapy types that people are likely to experience as part of their dual diagnosis treatment, including:


Commonly known as CBT, this is widely considered to be the gold standard in therapy treatment for both substance use disorders as well as mental health issues, making it the go-to for many dual diagnosis treatment plans.


Mindfulness can be an extremely helpful technique for those with anxiety or similar disorders, and meditation is a common starting point for instilling habits of mindful, centering behavior.


Similarly, yoga has also long since been a staple of not only holistic therapy but also in many mainstream addiction treatment therapy programs. Yoga can help instill focus, relaxation, and patience. It’s another way to provide a centering of the self, which is useful in both addiction therapy and mental health treatment.


Addiction is often referred to as a “family disorder,” both due to how it often runs in families as well as how when someone has a substance use disorder it affects their entire family. Mental health disorders can function this way as well, and so it is often a very practical form of therapy for both disorders to work with the patient and their family side-by-side to build a better understanding of their disorders and open healthy methods of communication.

What Are the Benefits of Dual Diagnosis Treatment?

Treating either a substance use or mental health disorder on its own when suffering from both is not really treatment at all, because the two disorders feed off of each other, and unless they are addressed together, then it is only a matter of time before you slide back into a cycle of one disorder flaring up and making the other worse.

Untreated mental health issues can drive someone back to using drugs or alcohol as a means of coping, while an untreated substance use disorder can intensify the worst symptoms of mental illness. Dual diagnosis treatment is the only way to do more than put a bandage on the problem.

Dual diagnosis treatment can be a revelation for some. Many people may not even be aware that they’re suffering from a co-occurring disorder until they check into treatment for a substance use disorder and are diagnosed with a mental health disorder as well. Finally being able to understand part of what is feeding into their addictive behaviors will help to better learn healthy, positive coping methods as well as get the proper treatment for something they might not have even known was there.

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The Palm Beach Institute is also committed to staying up-to-date with the latest and best treatment methods for both medical and psychological care. While some facilities may merely treat symptoms of withdrawal to get addicts through detox, we believe in treatment that results in long-lasting addiction recovery.

Through medical monitoring, cognitive behavioral therapy, group sessions, and a variety of other treatment options, people suffering from a dual diagnosis can learn ways to overcome addiction and cope with triggers for both addiction and mental health issues.

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If you or a loved one is suffering from addiction, or if you believe addiction is affecting your mental health, call the Palm Beach Institute at (855) 960-5456 today to learn more or contact us online.