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What is Dual Diagnosis?

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Medically Reviewed By: Diana Vo, LMFT

March 14, 2024

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If you are looking into substance abuse treatment options, you may have come across the term “dual diagnosis” and asked yourself “what is dual diagnosis”. Let’s get into it.

Essentially, if you have a substance use disorder and also suffer from a co-occurring mental health condition, this is known as a dual diagnosis. Addiction sometimes results from an underlying mental health condition. In other patients, addiction triggers a mental illness. The conditions can also occur simultaneously.

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According to NSDUH data, 45% of those with substance use disorder have a co-occurring mental health disorder. Data from NAMI (the National Alliance on Mental Illness) shows that 9.2 million adults in the United States have a dual diagnosis.

Dual diagnosis calls for integrated treatment addressing both of these interconnected issues simultaneously, something you can achieve at Renaissance Recovery.

What is dual diagnosis in mental health, exactly?

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What Does Dual Diagnosis Mean?

What is dual diagnosis co-occurrence?

These two terms actually mean the same thing. A dual diagnosis is commonly called a co-occurring disorder. These terms are more specific than co-morbidity, a descriptor for more than one illness presenting simultaneously.

Dual diagnosis refers to a simultaneous substance use disorder and serious mental health condition.

Substance use disorders can include any of the following:

  • Alcohol
  • Marijuana
  • Meth
  • Cocaine
  • Crack
  • Heroin
  • Benzodiazepines
  • Opioids

Similarly, many mental health conditions co-occur with substance use disorders, including:

  • GAD (generalized anxiety disorder)
  • Major depressive disorder
  • PTSD (post-traumatic stress disorder)
  • Bipolar disorder
  • ADHD (attention-deficit hyperactivity disorder)
  • Schizophrenia

Dual diagnosis has myriad possible permutations, with no two cases precisely the same.

At least one substance use disorder and mental health disorder must be established for a diagnosis of a co-occurring disorder. These must be diagnosed independently of each other rather than diagnosis reflecting a cluster of symptoms stemming from one of the disorders.

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Understanding What is a Co-Occurring Disorder

According to the National Survey on Drug Use and Health, people with a mental health condition are twice as likely as those without to suffer from a substance use disorder. Conversely, those with a substance use disorder or alcohol use disorder are more prone to co-occurring mental health disorders than those in the general population.

It is now widely agreed that substance abuse can induce mental health disorders, just like mental health disorders can trigger substance use disorders, research in this area is ongoing, with the aim of establishing what causes these conditions to co-occur.

Researchers understand that multiple overlapping factors can inflame both substance use disorders and mental health disorders, including:

  • Genetics: Current research shows that genetics accounts for up to 60% of your risk of developing addiction.
  • Responses in the brain: If you abuse certain drugs, this can induce symptoms mimicking those of mental illness. In some cases, the excessive use of marijuana can trigger psychosis.
  • Environmental triggers: Persistent anxiety, trauma, or chronic stress can be contributory factors to the development of both addictions and mental health disorders.
  • Early exposure to substances: Adolescents and young adults are more susceptible to brain damage than adults when abusing substances. Those who experiment with substances at a young age are more likely to develop issues with dual diagnosis in later life.

One of the most frequent flashpoints with dual diagnosis is self-medication. This occurs when you attempt to soothe the symptoms of a mental illness by using alcohol or drugs (illicit drugs or prescription medications).

Self-medicating often offers short-term relief. Unfortunately, relief is only fleeting, and you will be doing nothing to address the underlying cause.

Beyond this, using substances can lead to dependence and addiction, ultimately inflaming the mental health condition at the same time.

Luckily, there’s no need to struggle alone if you find yourself grappling with a mental health condition, or if you’re struggling with substance abuse.

Do You Have a Dual Diagnosis?

There are a couple of questions to ask yourself that should clear this up for you…

1.   Do you often reach for drink or drugs if you feel unhappy?

2.   Have you suffered with emotional problems for a long time without seeking any form of therapy?

Now, if you answer yes to both of these questions, you could have an undiagnosed mental health issue that’s causing you to use substances to counter low moods.

You should take a moment to assess things realistically, though. Everyone goes through ups and downs. That’s just the way life ebbs and flows. If you’re finding yourself abnormally low, low to the extent you reach for drink or drugs, though, it’s perhaps time to look for help. Many people don’t do this, and a problem like dual diagnosis will not resolve itself.

If, for example, you find your depression suddenly gets much worse and you start drinking a bottle of wine with dinner or smoking a couple of joints to cope, speak with your doctor openly about this. You could be suffering from an underlying health condition like bipolar disorder or PTSD.

By establishing the root cause of your negative thought patterns, there’s a far stronger chance you can control the triggers and stay on track with your recovery.

If you haven’t yet addressed the issue of your substance abuse and accompanying mental health condition, you need to find a specialist dual diagnosis treatment facility to maximize your chances of staying sober.

How can you go about getting that treatment, then?

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Where to Find Dual Diagnosis Treatment

Maybe you developed a mental health condition like depression or anxiety and then started abusing drugs or alcohol. Perhaps your long-term alcohol abuse led to major depressive episodes. However your co-occurring disorder came about, the best dual diagnosis treatment programs will help you address both conditions at the same time.

SAMHSA (the Substance Abuse and Mental Health Services Administration) recommends the integrated care treatment model for a co-occurring disorder. You are more likely to remain engaged with comprehensive and integrated treatment than if you attempt to unpack each condition independently.

Often, residential rehab works best for dual diagnosis. If you prefer to engage with outpatient therapy, you may find programs with a greater time commitment are beneficial. With an IOP (intensive outpatient program) or a PHP (partial hospitalization program), you can reap many of the benefits of inpatient rehab without the expense or restrictions.

Dual diagnosis treatment often involves MAT (medication-assisted treatment). FDA-approved medications can help reduce the intensity of both withdrawal symptoms and cravings. Medications can also be beneficial for the treatment of all mental health disorders.

MAT is most effective when delivered in combination with psychotherapies like CBT (cognitive behavioral therapy) and DBT (dialectical behavior therapy). Psychotherapy, also known as talking therapy, will help you explore the relationship between your feelings, thoughts, and behaviors. You will also learn what triggers you to abuse substances, and you’ll discover how to use healthier coping strategies instead.

These evidence-based treatments for dual diagnosis are complemented by holistic therapies to ensure you benefit from a whole-body approach to healing and recovery.

Here at Renaissance Recovery’s California and Florida rehab programs, all of our dual diagnosis treatment plans are highly personalized to help you address what’s holding you back in life. Reach out to admissions today at 866.330.9449.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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