What is dual diagnosis?

Dual diagnosis describes an occurrence when someone is diagnosed with both a mental health disorder (such as bipolar disorder, anxiety, depression, etc.) and a substance use disorder.

A combination of these two conditions can complicate the recovery of an individual – meaning that there might be a less favorable treatment outlook and a greater risk for further negative health consequences without proper treatment.

People who have a dual diagnosis should seek dual diagnosis addiction treatment, as it is only through dual diagnosis addiction treatment that those with both diagnoses are able to attain recovery.

Dual diagnoses are common

People challenged with both a psychological disorder and substance abuse is not an occurrence that is uncommon.

More than 25% of people who are experiencing mental illness also suffer from substance use problems. Those who are diagnosed with mood or anxiety disorders are almost twice as likely to additionally suffer from substance use problems.

The lifetime prevalence of dual diagnosis is 47% for those suffering from schizophrenia, 56% for people struggling with bipolar disorder, and 78% for those who are getting treatment for substance abuse issues.

Of the people who were hospitalized in mental health treatment centers in 2021, a total of 6% were found to have a dual diagnosis with substance use disorder not involving alcohol, 4% with alcohol use disorder, and 4% for both alcohol and drugs.

Mental illness can be associated with certain substances

The effects of certain substances tend to work with particular mental health issues in somewhat predictable ways. The effects of certain substances act to counter the symptoms of a particular psychological condition.

For example, drugs that are relaxing are used more often by people with anxiety-related disorders; drugs that stimulate and make people “feel good” are more often used by people with mood disorders, like depression.

Schizophrenia and antisocial personality disorder have the highest rates of comorbidity with substance abuse disorders. 60-80% of people who are diagnosed with antisocial personality disorder were found to also suffer from alcoholism, and 20-40% of people who were diagnosed with alcoholism were also diagnosed with an antisocial personality disorder.

Substance abuse disorder often looks like a mental disorder

Substance abuse can manifest symptoms that might be confused with mental disorders. The symptoms of substance abuse are a little different from those of an independent mental disorder as they are a direct result of abuse of a substance, and so can usually be treated more quickly by stopping the use of the substance.

Symptoms may be related to a pattern of abuse, the effects of intoxication, or any withdrawal syndrome which is related to discontinuation of the substance.

Examples of this include:

• Psychosis induced from methamphetamine
• Anxiety caused by discontinuation of benzodiazepines
• Depression from stopping stimulants
• Korsakoff’s syndrome (memory and cognitive problems) as a result of chronic alcohol abuse

Mental illness can lead to substance abuse and vice-versa

Someone with a mental disorder might use substances in an attempt to treat their symptoms by self-medicating. A person with depression might take drugs that help alleviate depression, such as heroin.

A person with a mental disorder might be inclined to experiment with substances more than other people. Particularly people with disorders that involve problems with impulse control.

A substance abuse issue might also lead to a mental disorder. Continued use of substances can affect the chemical balance of the brain, which can create, aggravate or uncover certain mental disorders.

Cocaine use might precipitate panic attacks or anxiety.

Environmental effects from drug use can also play a part in creating or exacerbating mental health problems, as substance abuse can expose a user to more stress and fewer sources of emotional support to cope with these increased levels of stress.

This might lead to the development of a mental disorder.

Dual diagnosis can have adverse physical effects

The consequences of a dual diagnosis often depend on the substance being abused and the mental disorder or disorders present. Each disorder can compound the negative effects of the other and can lead to exaggerated symptoms of both.

Because someone with a dual diagnosis can experience more extreme symptoms, they are also more likely to start neglecting personal care.

Both types of disorders have health consequences which overlap, and a diagnosis of both conditions indicates that someone is at an increased risk for developing various diseases.

It is unfortunate that people with either or both of these disorders often have less access to health care services, which might contribute to negative health consequences persisting in these populations.

Dual diagnosis addiction treatment is the treatment that should be sought by anyone with both mental health problems and addiction issues, as it is only by treating both of these that recovery can begin.