What is Dual Diagnosis? Signs, Symptoms, & Treatment
Medically Reviewed by
Dr. David Hu, MD on 09/13/2022
Dr. Hu is a nationally licensed psychiatrist with 21 years of experience treating mental and behavioral health.
By: Zinnia Healing Editorial Staff | Edited By: Rebecca Hill | Medically Reviewed by: Dr. David Hu, MD
The term dual diagnosis means the diagnosis of two mental health disorders or substance abuse problems. People who suffer from dual diagnoses often experience symptoms of both conditions simultaneously.
People suffering from dual diagnosis disorders face unique challenges. Along with addiction, they are likely to struggle with depression, anxiety, and other mental health concerns. This makes them more vulnerable to relapse and poor treatment outcomes. Therefore, it’s important to find the best treatment providers possible. These providers should be knowledgeable about dual diagnosis disorders to ensure the best possible results.
What is a Dual Diagnosis Disorder?
A dual diagnosis disorder occurs when someone has both a mental health condition and a substance abuse problem. Substance use disorders include alcohol addiction, drug addiction, and opioid addictions.
Mental health conditions include:
- Bipolar Disorder
- Eating Disorders
- Personality Disorders
If you suffer from one of these conditions, you may also be at risk of developing a co-occurring substance use disorder.
Why Do Substance Use Disorders and Mental Disorders Occur Together?
Although these problems often occur together, they don’t always happen simultaneously. Sometimes, one appears first, while the other follows later. But researchers aren’t sure exactly how this happens. They believe there are three possible reasons:
Common risk factors are:
These common risks can lead to both mental disorders and drug abuse. Some genes make you more likely to develop mental health issues, and others make you more prone to abusing substances. Stress and trauma can also play a role. People who experience stressful events tend to turn to drugs or alcohol to cope with those feelings. And sometimes, trauma leads to mental illness.
Mental disorders can contribute to drug use and substance use disorders. People with psychiatric disorders might use drugs or alcohol for temporary relief. People with mental disorders might use drugs or alcohol because they’re trying to treat themselves. This is called self-medication.
The Dangers of Self-Medication
Self-medicating is a way many will cope with mental health conditions like depression, anxiety, and bipolar disorder. Some people use alcohol, marijuana, prescription medications, over-the-counter medications, or illicit drugs to treat their mood or sleep issues. Others turn to food to soothe difficult emotions.
Self-medication can be extremely dangerous. Some believe that using illegal drugs will relieve their emotional pain. However, research shows that this isn’t true. Drug use can worsen mental health conditions. Without medical care, you will not receive the diagnosis and guidance you need to move forward.
Common Mental Health Issues and Addiction
There are several common mental health issues that often coexist with addiction. People suffering from depression, anxiety, bipolar disorder, PTSD, ADHD, and schizophrenia are more likely to develop addictions, such as alcohol abuse, later in life. These conditions can make recovery from an addiction more difficult because the brain changes associated with each disorder can affect how we think, feel, and behave.
Warning Signs of A Co-Occurring Disorder
Many people don’t realize that they’re suffering from a co-occurring disorder until they receive treatment for their primary disorder. It is important to know what to look out for because early intervention is key in helping someone recover. Here are some warning signs you might see in yourself or someone else. If you have difficulty with:
- Controlling your emotions
- Managing stress
- Frequent mood swings
- Making decisions
- Low energy levels
- Getting along with others
- Maintaining friendships
- Completing tasks
- Keeping up with work responsibilities
- Remembering things
- Thinking clearly
- Focusing on details
- Following through on plans
- Staying organized
- Eating healthy foods
- Periods of hyperactivity
What are the Treatments for Dual Diagnosis?
Many individuals with co-occurring conditions are often misdiagnosed and incorrectly treated. This leads to a cycle of relapse and failure, which usually begins when someone tries to manage one problem without addressing the other.
While many individuals develop an addiction to substances like alcohol or drugs before being diagnosed with a psychiatric issue, others become addicted afterward. Some experience symptoms of a mental illness long before developing drug use problems, while others begin abusing drugs or alcohol before experiencing certain symptoms of a mental illness.
The best way to treat co-occurring disorders is to address each condition individually in a customized treatment plan, but most people don’t know how to do that. Instead, they tend to approach either addiction or mental illness separately, treating one condition without considering whether it might exacerbate another.
In the case of a dual disorder, the structured and safe atmosphere of an inpatient rehabilitation facility can be very helpful. Patients typically spend several weeks receiving intensive therapy and medication management, which leads to longer periods of recovery.
People with co-occurring issues tend to arrive at rehab in different stages of emotional distress. They’re often physically unwell and suffering from insomnia, anxiety, depression, panic attacks, psychosis, suicidal thoughts, hallucinations, delusions, flashbacks, nightmares, and severe mood swings.
A dual diagnosis can require the help of both mental and physical health specialists. Addiction counselors can provide support during detoxification and teach coping strategies that reduce cravings and ease symptoms. Mental health experts can provide insight into the root causes of the patient’s behavior and offer advice on improving overall well-being.
If you or a loved one suffers from a dual diagnosis, call Zinnia Healing at (855) 430-9439 or fill out our contact form to learn more about our dual diagnosis treatment options. Professional, quality help is available to help you on your path to recovery from substance abuse and mental health issues.
There are many ways to help people with dual diagnoses, including medication, therapy, and support groups.
Medication Therapy for Dual Diagnosis
The medications available to treat a dual diagnosis depend on a patient’s conditions. People with coexisting mental illnesses may need more than one medication to control their symptoms. Medication choices depend on the specific condition being treated. Some common medications may include:
- Antidepressants: Antidepressant medications work by increasing levels of serotonin and norepinephrine in the brain. Serotonin helps regulate moods, while norepinephrine controls arousal. When these chemicals are low, people feel depressed. In some cases, antidepressants may also help alleviate symptoms of schizophrenia, bipolar disorder, and obsessive-compulsive disorder. Examples include selective serotonin reuptake inhibitors (SSRIs), which increase levels of serotonin in the brain. SSRIs are effective for treating OCD, PTSD, and generalized anxiety disorder.
- Antipsychotics: People who suffer from schizophrenia, bipolar disorder, or schizoaffective disorder may benefit from taking antipsychotic medications. These medications can stabilize moods and control psychotic episodes. However, they can cause side effects such as weight gain, drowsiness, and dry mouth.
- Anxiolytics: Anxiolytic medications are used to treat anxiety disorders. Examples include benzodiazepines, which have sedative properties and are not recommended for patients in recovery from substance abuse. Buspirone is a widely used non-narcotic alternative.
Dual Diagnosis Behavioral Therapy
Psychotherapy can be effective for people with dual diagnoses. It helps them understand their mental illness and learn how to manage symptoms. Therapists also help clients develop coping skills so they don’t fall back into old habits.
There are many different types of behavioral therapies that psychotherapists utilize for patients with a dual diagnosis. The most common therapies include:
- Cognitive Behavioral Therapy (CBT): CBT focuses on teaching patients new behaviors and thought processes to cope with their problems. This type of therapy works best when combined with other treatments.
- Dialectical Behavioral Therapy (DBT): DBT teaches patients to identify negative emotions and unhealthy behaviors before acting on them. By identifying triggers, patients can avoid falling back into negative patterns.
- Interpersonal Psychotherapy (IPT): IPT helps patients improve relationships with family members and friends. It teaches them to recognize and change destructive interactions.
- Mindfulness Based Cognitive Therapy (MBCT): MBCT teaches patients to focus on the present moment and accept things as they are. They learn to notice thoughts without judging themselves or others.
- Motivational Interviewing (MI): MI is an intervention technique that encourages people to make positive changes in their lives. It’s based on the idea that people will only change if they want to do so.
- Problem Solving Skills Training (PSST): PSST teaches patients problem-solving techniques to deal with life stressors. It helps them develop strategies for dealing with difficult situations.
- Self-Management Skills Training (SMST): SMST teaches patients to monitor their own behavior and adjust it accordingly. For example, if someone has difficulty controlling impulsive behaviors, he or she learns to plan and set limits.
- Social Skills Training (SST): SST teaches patients to interact appropriately with others. It teaches them to communicate effectively and express feelings.
Support Groups for Dual Diagnosis
A support group can be a great way to connect with other people who are going through similar experiences. It also provides a safe space where you can share your thoughts and feelings about your diagnosis without judgment or criticism.
There are different types of counseling that might be involved in your dual diagnosis treatment. These include:
- Individual Counseling: If you’re having difficulty managing your symptoms, individual counseling might be helpful. Individual counselors usually specialize in one area of psychology, such as addiction treatment, eating disorders, or depression.
- Group Counseling: Group counseling involves two or more patient struggling with similar disorders. These groups are often led by trained professionals who have experience helping people with a dual diagnosis.
- Family Counseling: Sometimes families struggle with a dual diagnosis. In these cases, family counseling can provide support and guidance. Young adults can specifically benefit from substance abuse and mental health family counseling.
Helping a Loved One with a Dual Diagnosis
The road to recovery is often a bumpy ride. For those struggling with addiction and another mental illness, it can feel like being stuck in a rut. But there are ways to navigate the obstacles and make progress toward lasting sobriety.
In many cases, people with dual diagnoses struggle with resistance to treatment — refusing to seek help for either addiction or mental illness. They may think changing their lives is impossible, not be ready to recover, believe that they’re too ill to recover, or think that seeking help will hurt others around them.
First, try to understand why your loved one isn’t ready to change. Accept that he or she may not agree to seek treatment. If your loved one continues to resist treatment, consider talking to a doctor or therapist about options for managing his or her symptoms. A psychiatrist might prescribe medications to treat depression or anxiety, or a psychologist could recommend cognitive behavioral therapy.
Continue to speak with them and advocate for their care. Sometimes taking a step back and allowing their consequences to catch up to them can assist in creating a “rock bottom.” Once your loved one is ready to seek help, you can have options ready for them. There are different levels of treatment available, including inpatient, outpatient, and partial hospitalization for their mental health problems and drug or alcohol use.
Get Help for A Dual Diagnosis
If you’re struggling with addiction, finding the right treatment program can seem like a daunting task. But it doesn’t have to be difficult. Find one that offers evidence-based treatments. This includes cognitive behavioral therapy (CBT), motivational interviewing, family counseling, and contingency management. These types of therapies have been proven to help people overcome mental health diagnoses and addictions.
Look into the facility’s history. The most reputable facilities have had success helping others successfully address their issues. If possible, find out how long the facility has been around, what kinds of clients they treat, and whether they work with other organizations.
If you’re struggling with a dual diagnosis, there are several resources available to help you get better. Zinnia Healing can help you get the treatment you need. Call our helpline at (855) 430-9439 or fill out our online contact form to learn more about dual diagnosis treatment options. We utilize an evidence-based approach to treating a wide range of mental health disorders and substance use disorders.