Dual diagnosis: definition and treatment (2023)


What is dual diagnosis?

Dual diagnosis means you both have amental disorderit is asubstance use disordersimultaneously. Other names for dual diagnoses are co-occurring and co-occurring disorders. Dual diagnosis is not one diagnosis, but a combination of diagnoses.

Mental disorders include depression, anxiety and other mental illnesses. A substance use disorder can includeAlcohol,drugsor other addictive substances. When these conditions occur together, the effects of both can be worse. If left untreated, mental health issues can make substance use problems worse and intensify. And as your substance use increases, your mental health issues may also increase. This creates a vicious circle.

How common are dual diagnoses?

dual diagnosisDiseases often occur together. Researchers have found that 50% of people who experience a substance use disorder in their lifetime also experience a mental disorder, and vice versa. In 2020, 17 million adults in the US had a co-occurring mental health disorder and substance use disorder.

symptoms and causes

What are the symptoms of a dual diagnosis?

Your drug addiction and mental health issue each have their own set of symptoms. The symptoms of a dual diagnosis therefore depend on the substances and mental disorders involved. Symptoms can vary greatly as there are many different combinations of dual diagnoses.

Symptoms of a substance use disorder can include:

  • Withdrawal from family and friends.
  • Difficulty maintaining focus.
  • Sudden changes in your behavior.
  • Engage in risky behavior.
  • Development of high tolerance to the substance and/or withdrawal symptoms.
  • The feeling that you need the substance to function.

Symptoms of a mental disorder can include:

  • Extreme mood swings.
  • Confusion.
  • concentration problems.
  • Unable to function at work or school.
  • Avoiding social activities.
  • thoughts andSuicide.

Which disorder comes first in a dual diagnosis?

As with the chicken or the egg, it can be difficult to figure out which came first. Even if dual diagnoses occur together, it doesn't mean that one caused the other.

Substance use disorders may not directly cause mental disorders (or vice versa), but there is a clear connection between the two. Drugs and alcohol can make symptoms of mental illness worse. And the continued use of these substances can increase the risk of developing a mental disorder.

What causes a dual diagnosis?

Researchers have a few theories about why substance use and mental disorders coexist.

Certain risk factors can contribute to mental illness and substance use disorders. These risk factors can include:

  • Genetic:Mental health disorders and substance use disorders can run in families. Research shows manyGenecan contribute to the risk of developing any condition.
  • Environmental Factors:environmental factors liketo emphasizeand trauma can be passed down from generation to generation. These can contribute to the development of a substance use disorder or a mental disorder.

Mental health disorders may contribute to substance use disorders

If you have a mental disorder, you can self-medicate. This means using alcohol or drugs to try or deal with feeling better. While these substances may relieve symptoms temporarily, they can make them worse over time. Mental health disorders can also change the way your "reward centers" workBrainto work. This can make you more likely to become addicted.

Substance use disorders may contribute to mental disorders

Alcohol, drugs, and other substances can cause changes in your brain's structure and function. This can make you more likely to develop a mental disorder.

diagnosis and test

How is dual diagnosis diagnosed?

Dual diagnosis is not one diagnosis, but a combination of diagnoses. It can be difficult for your doctor to make an accurate diagnosis because the symptoms of both conditions can overlap.

However, your doctor will use comprehensive screening tools to screen you for both conditions. It's important to be honest when talking with your doctor. Your answers will help them determine which disorders you may have and identify the appropriate treatment.

management and treatment

What is dual diagnosis treatment?

Dual diagnosis treatment involves treating your mental health condition and your substance use disorder at the same time. You'll work with your doctor to understand how each of your conditions affects the other. In this way, you can determine which treatment is most effective.

To get dual diagnostics recovery you must stop usingaddictive substances. For many people, this can start with a detox. During your inpatient detox, you will be monitored 24/7 by healthcare professionals for up to one week. They help you come off the substance and offer ways to lessen the effects of withdrawal.

Based on a number of factors, your treatment for a dual diagnosis may include behavioral therapy, medication, support groups, or inpatient treatment.

behavioral therapy

Behavioral therapies that have been shown to treat co-occurring disorders include:

  • Cognitive Behavioral Therapy (CBT):Cognitive behavioral therapy can teach you how to manage and change ineffective thinking patterns.
  • Dialectical Behavior Therapy (DBT):Dialectical behavior therapy can reduce self-injurious behavior. This can include drug use, cutting, and suicidal thoughts or actions.


Your doctor may prescribe medication for one or both of these conditions. Some medications can help alleviate the symptoms of both dual-diagnosis conditions. For example, the FDA has approved bupropion to treat depression (Wellbutrin®) and for nicotine dependence (Zyban®).

support groups

Support groups can be very helpful in giving you the emotional and social support you need to stay sober. The people in these groups have been in your shoes before. Your colleagues can share their experiences and answer your questions. They can also share tips on how to deal with everyday challenges.


If you have an addictive pattern of substance use along with a mental illness, you may benefit from a dual diagnosis treatment center. There you will receive medical and psychological care, including medication, therapy and support.


How can I reduce my risk of dual diagnosis?

Mental health disorders and substance use disorders are bothbrain diseases. While you can't avoid them, you can reduce your risk by:

  • Know your family's biological history.
  • Limiting the amount of alcohol you consume.
  • Talk to your doctor.

Outlook / Forecast

What can I expect from a dual diagnosis?

With proper treatment, your chances of recovering from dual diagnosis are very good. You can improve your quality of life and expect a good result. You must continue to work with your healthcare professionals and/or support groups for recovery to continue. Don't be afraid to ask for help.

live with

What can I do to help my loved one with a dual diagnosis?

Helping someone with a co-occurring disorder can be very difficult. Your loved one may deny they have a problem and resist treatment. Once you start treatment, the road to recovery can be a long one.

Accept what you can and cannot do. You cannot force your loved one to sober up, take medication or seek counseling. But you can make positive decisions for yourself, encourage your loved one to seek help, and offer your unconditional support.

A note from the Cleveland Clinic

Going through a double diagnosis can feel like a double whammy. You may feel that you caused it yourself. But it's important to remember that mental disorders and substance use disorders are medical illnesses. Just because you can't "see" them doesn't mean they aren't real illnesses. Don't be afraid to contact your doctor. Be honest and upfront with them so they can help you find the treatment you need. Asking for help is the first step.

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