Clinically Reviewed by Linda Whiteside, LPCC

Medically Reviewed by: Dr. Ryan Peterson, MD

What is Dual Diagnosis? Signs, Symptoms and Treatment

Table of Contents

Are you or a loved one feeling trapped in a cycle where mental health issues and substance abuse feed off each other, creating a downward spiral that seems impossible to escape? Dual Diagnosis might just be the lifeline you’re looking for. This comprehensive approach to treatment recognizes that mental health disorders and substance use disorders often coexist, feeding into one another.

Dual Diagnosis, sometimes known as a co-occurring disorder, is when a person has both a substance use disorder and a mental health disorder. This means that a person is dealing with drug or alcohol addiction and mental illness at the same time.

Many people who struggle with substance use disorder also deal with mental health conditions. These co-occurring disorders can happen in any combination and to any degree of severity. It’s a tricky situation because, often, one disorder can make the other worse. For example, someone with a mental health condition might try to self-medicate with drugs or alcohol. This can lead to a substance use problem, worsening their mental health.

Dual Diagnosis offers a more effective pathway to recovery and a brighter, healthier future by addressing both issues simultaneously.

Understanding the Prevalence of Dual Diagnosis

According to the Substance Abuse and Mental Health Services Administration, in any given year, about 9.2 million American adults have a dual diagnosis. It’s common and a significant health issue, but it often goes unrecognized and untreated.

Factors Contributing to the High Occurrence of Dual Diagnosis

A dual diagnosis situation arises when a person experiences a mental health disorder and a substance use disorder at the same time. This co-occurring scenario is surprisingly common. A national survey reported by the Substance Abuse and Mental Health Services Administration showed that almost half of those with a substance use disorder also experienced a co-occurring mental health issue. Several factors contribute to the high occurrence of dual diagnosis:

Genetics: Genetics plays a vital role in the onset of mental illnesses and substance use disorders. According to the National Institute on Drug Abuse, people’s genes account for about half of their addiction vulnerability.

Brain Chemistry: Those with certain mental health disorders may have an imbalance in the natural chemistry of the brain. Substance use can initially alleviate these symptoms, leading to self-medication, but over time, this drug use can exacerbate mental health issues and spur a substance use disorder.

Environmental Influences: These include factors like stress, trauma, and exposure to drug abuse. A person experiencing trauma, like post-traumatic stress disorder, may turn to drugs or alcohol as a way of self-medicating their pain. This could lead to drug abuse or alcohol abuse, and thus a dual diagnosis.

Developmental Disorders and Issues: Early exposure to stress and traumatic experiences can contribute to mental health problems and the development of a substance use disorder. For instance, a child exposed to a traumatic event may develop a mental disorder, like depression, and later resort to substance use as a coping mechanism.

Mental Health Disorders: Certain mental health disorders, including mood disorders like depression or bipolar disorder, anxiety disorders, and other psychiatric disorders like schizophrenia, often co-occur with substance use disorders. According to the American Psychiatric Association, the presence of a mental health disorder is a risk factor for a substance use disorder and vice versa.

Lack of Adequate Treatment Programs: Sometimes, individuals with mental health issues may not receive the right treatment program for their condition. This could lead to the development of a substance use disorder as they may try to self-medicate their symptoms.

A dual-diagnosis treatment center can provide comprehensive treatment for individuals with co-occurring disorders. Such facilities offer a combination of mental health services and addiction treatment services, enabling patients to address their substance abuse and mental health issues simultaneously.

Common Mental Health Disorders Associated with Dual Diagnosis

Common Mental Health Disorders Associated with Dual Diagnosis

Depression and Substance Abuse

Depression is a mood disorder that causes persistent feelings of sadness and loss of interest in activities. Someone with depression might turn to substances to try to feel better, which can lead to a cycle of abuse and worsening mental health symptoms.

Signs of depression in individuals with dual diagnosis include feelings of hopelessness, changes in appetite or weight, sleep disturbances, and difficulty concentrating. Treatment for depression and substance abuse often includes a combination of medication and therapy, with support from mental health clinics and self-help groups.

Anxiety Disorders and Substance Abuse

Anxiety disorders involve excessive, long-lasting worry and fear about everyday situations. Just like with depression, someone with an anxiety disorder might use drugs or alcohol to cope with their symptoms.

Signs of an anxiety disorder in individuals with a dual diagnosis can include feeling nervous, restless, or tense, having a sense of impending danger, and having trouble sleeping. Treatment for anxiety disorders and substance abuse might include medication, cognitive-behavioral therapy, and participation in support groups.

Bipolar Disorder and Substance Abuse

Bipolar disorder is a mental health disorder that causes extreme mood changes, including emotional highs (mania or hypomania) and lows (depression). Many people with bipolar disorder also struggle with substance use disorders, which can complicate treatment.

Signs of bipolar disorder in individuals with dual diagnosis may include periods of unusually intense emotion, changes in sleep patterns, and uncharacteristically risky behavior. Treatment for bipolar disorder and substance abuse typically includes medication, therapy, and support services.

Schizophrenia and Substance Abuse

Schizophrenia is a severe mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia often face substance abuse problems, leading to a dual diagnosis.

Signs of schizophrenia in individuals with dual diagnosis may include hallucinations, delusions, and disorganized thinking. Treatment for schizophrenia and substance abuse usually involves medication, psychotherapy, and comprehensive social support services.

Identifying the Signs and Symptoms of Dual Diagnosis

Recognizing the signs and symptoms of dual diagnosis is the first step toward getting the necessary help. Individuals experiencing this co-occurring disorder often show physical, psychological, and social symptoms.

Physical Signs and Symptoms

The physical signs of a dual diagnosis can range from subtle to very noticeable and may include the following:

  • Changes in Appetite and Weight: Unusual weight loss or gain can be an indication of mental illnesses or substance use. Eating disorders may co-occur with substance addiction and could contribute to these changes.

  • Sleep Disturbances: Sleep issues are common in both mental health conditions and substance abuse. Insomnia or oversleeping may indicate a dual diagnosis.

  • Decline in Personal Hygiene: A noticeable lack of self-care, such as neglecting personal grooming or cleanliness, often indicates a mental health problem or drug use.

  • Physical Health Issues Associated with Substance Abuse: The presence of withdrawal symptoms, or health problems like liver damage from alcohol abuse or lung problems from drug use, are indicative of substance abuse.

Psychological Signs and Symptoms

Dual diagnosis can also manifest through various psychological symptoms, which might include:

  • Mood Swings and Emotional Instability: Sudden and intense mood swings, signs of depression, anxiety, or other mood disorders may indicate a co-occurring disorder.

  • Impaired Cognitive Function: Difficulty concentrating, remembering, or making decisions can be a sign of both mental health disorders and drug or alcohol use.

  • Poor Impulse Control: This could manifest as an inability to control drug use or resist harmful behaviors, often indicative of an addictive disorder or certain mental health conditions like borderline personality disorder.

  • Impact on Relationships: Co-occurring disorders can strain relationships, leading to frequent arguments, distancing, and breakdowns in communication.

Social Signs and Symptoms

The social signs of a dual diagnosis may become evident in different areas of a person’s life:

  • Isolation and Withdrawal: Individuals with a dual diagnosis may withdraw from family, friends, and social activities, a common indicator of mental health conditions and substance abuse.

  • Financial Difficulties and Legal Problems: These may result from the costs associated with substance use, loss of employment, or legal issues related to drug use or behaviors driven by a psychiatric disorder.

  • Strained Relationships: Co-occurring disorders can cause significant relationship problems, leading to isolation from family and friends.

  • Impacts on Employment and Productivity: Frequent absences, decreased productivity, or job loss may be an indication of a dual diagnosis.

Early identification of these signs is essential for prompt intervention. Dual-diagnosis treatment centers offer comprehensive programs to address mental health disorders and substance abuse simultaneously. This approach, coupled with emotional support from support groups, often leads to better outcomes for individuals with dual diagnoses.

Diagnostic Process and Dual Diagnosis Assessment

An accurate dual diagnosis is critical because the treatment for mental health disorders and substance use disorders is quite different. A missed diagnosis can lead to ineffective treatment and worsening symptoms.

Healthcare professionals use various assessment tools to diagnose dual diagnosis. These tools can include interviews, questionnaires, and scales that measure the severity of symptoms.

Healthcare professionals, including psychologists, psychiatrists, and substance abuse counselors, play a critical role in diagnosing dual diagnosis. They work collaboratively to assess the individual’s mental health and substance use and to create a treatment plan.

Treatment Approaches for Dual Diagnosis

Treatment Approaches for Dual Diagnosis

Integrated Treatment Model

The integrated treatment model treats both the mental health disorder and the substance use disorder at the same time by the same treatment provider. This approach is effective because it addresses all of an individual’s health needs at once.

Medication-Assisted Treatment (MAT)

Medication-Assisted Treatment (MAT) uses medications, in combination with counseling and behavioral therapies, to treat substance use disorders and prevent opioid overdose. It can also help to alleviate the symptoms of co-occurring mental disorders.

Psychotherapy and Counseling

Psychotherapy, including cognitive-behavioral therapy and dialectical behavior therapy, plays a crucial role in treating dual diagnosis. It helps individuals understand and manage their thoughts, behaviors, and emotions.

Supportive Services and Self-Help Groups

Supportive services, like case management, housing services, and employment services, can help individuals with dual diagnoses navigate everyday life. Self-help groups provide peer support, which can positively impact treatment outcomes.

Overcoming Challenges in Dual Diagnosis TreatmentOvercoming Challenges in Dual Diagnosis Treatment


Stigma and Dual Diagnosis

The stigma associated with mental health disorders and substance abuse can hinder individuals from seeking treatment. Education and awareness can help to combat this stigma and encourage individuals to seek help.

Relapse Prevention and Dual Diagnosis

Relapse is common in individuals with dual diagnosis. A comprehensive treatment plan that includes relapse prevention strategies and skills can help individuals maintain their recovery.

Dual Diagnosis in Special Populations

Certain populations, such as adolescents, older adults, and diverse populations, may face unique challenges when dealing with dual diagnosis. These populations may require specialized treatment approaches.


Understanding dual diagnosis is critical in addressing the co-occurrence of mental health disorders and substance use disorders. Early intervention and comprehensive treatment, including medication, therapy, and supportive services, can significantly improve the quality of life for individuals with dual diagnosis. If you or someone you know is dealing with these issues, don’t hesitate to seek help. Recovery is possible, and it starts with reaching out.

Seek the Right Treatment for Dual Diagnosis at NuView Treatment Center

Seek the Right Treatment for Dual Diagnosis at NuView Treatment Center

If you or a loved one are experiencing the signs and symptoms of a dual diagnosis, you may feel overwhelmed, anxious, or uncertain about the future. However, remember that you are not alone, and help is readily available. NuView Treatment Center is equipped with experienced professionals who understand the complexity of co-occurring disorders and are ready to provide comprehensive, personalized care.

At NuView Treatment Center, we focus on:

  • Dual-diagnosis treatment strategies are tailored to each individual’s unique circumstances.

  • Providing a supportive and therapeutic environment that encourages recovery.

  • Offering comprehensive treatment programs that simultaneously address both substance abuse and mental health disorders.

  • Ensuring emotional and social support through various group therapies and peer connections.

Remember, it’s never too late to seek help. Reach out to NuView Treatment Center today at (323) 307-7997 or send us a message from our contact page, where a healthier, brighter future awaits. You don’t have to face dual diagnosis alone – let us be your support and guide towards a path of recovery and well-being.

Frequently Asked Questions about Dual Diagnosis

Dual diagnosis treatment is a specialized approach to treating individuals who are dealing with both a mental health disorder and a substance abuse problem. This method focuses on treating both disorders simultaneously to provide a comprehensive recovery plan.

Various types of mental illnesses can co-occur with substance abuse, including post-traumatic stress disorder, eating disorders, and other mental health conditions. The National Institute on Drug Abuse reports that individuals with mental health disorders are significantly more likely to experience drug and alcohol abuse.

When disorders are treated simultaneously, it means that both the mental health problem and substance abuse problem are addressed at the same time during treatment. This approach is seen as crucial for effective recovery because the two issues often feed into each other.

Yes, a dual-diagnosis treatment program can include medication management. Medical professionals might prescribe medication to help manage symptoms of a mental health disorder, withdrawal symptoms, or both. However, medication is typically just one aspect of a comprehensive treatment program.

Certain risk factors may increase an individual's likelihood of developing a dual diagnosis. These can include a family history of mental illness or substance abuse, a history of trauma, and other mental health conditions. It's important to note, however, that these factors do not guarantee the development of a dual diagnosis; they merely increase the risk.

Yes, dual diagnosis treatment can address addictive disorders to key substances like alcohol, illicit drugs, and prescription medications. The key is that the treatment addresses all aspects of an individual's mental and physical health.

Often, individuals with untreated mental health disorders may use drugs or alcohol in an attempt to self-medicate or alleviate their symptoms. This can lead to substance abuse problems and, ultimately, a dual diagnosis. Effective treatment programs work to address this cycle and provide healthier coping mechanisms.

“Co-occurring Disorders: Medications, Counseling & Related Conditions.” Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 2023,

NIDA. 2019, August 5. Genetics and Epigenetics of Addiction DrugFacts. Retrieved from on 2023, July 10

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Written By: Linda Whiteside

Licensed Clinical Professional Counselor who has been providing mental health services for over 10 years.

Medically reviewed by: Dr. Ryan Peterson

Went to medical school at The George Washington University School of Medicine in Washington, D.C.

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