A dual diagnosis, also known as a concurrent disorder, is when a person is diagnosed with both a mental disorder and a substance use disorder.
An example of a dual diagnosis is having an alcohol or drug use disorder and a mental illness, such as a mood disorder or anxiety disorder, he saidMadan, Ph.D., Assistant Professor of Psychiatry at Yale School of Medicine.
If you or a relative has a dual diagnosis,You are not alone. In 2020, 17 million adults in the United States live with mental illness and substance use disorders.
Often have a dual diagnosisno coincidence"Mental illness is about twice as common among people diagnosed with a drug addiction," says Dr. Cavallo. The National Institute on Drug Abuse (NIDA) states that about half of people with a substance use disorder also suffer from a mental illness at some point in their lives, and vice versa.
This article explores the causes of dual diagnosis, the diagnostic process and treatment options, and some coping strategies that may be helpful.
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Causes of Dual Diagnosis
According to the National Institute of Mental Health (NIMH), here are some reasons why substance use disorders and mental illness coexist.
common risk factors
Both substance use disorders and mental illness share common risk factors, such asemphasizeandtrauma. Genetic factors may also play a role, since mental illness and substance use disorders often run in families.
Mental Illness Can Lead to Substance Abuse
Mental illness can change a person's brain, making them more susceptible to the beneficial effects of alcohol. This can make them more likely to continue using the substance and develop a diseaseseekalso.
Dr Dana Cavallo
People with mental health problems may use alcohol or other substances to do thisself-medicationtheir symptoms.
— Dr. Dana Cavallo
For example, people with anxiety, depression, or post-traumatic stress disorder (PTSD) may turn to substances like alcohol or drugs to help them feel better. Although substances can provide a temporary remedy, over time they can worsen the symptoms of these conditions.
Substance use can lead to mental illness
Substance use can also change the situationbrainIn a way that makes a person more vulnerable to mental illness. Therefore, people who use alcohol or substances may be more likely to develop mental health problems, and the longer they use substances, the greater the risk of mental illness, Dr. Cavallo.
Although substance use disorders and mental illness can co-occur, it can be difficult to determine which came first or caused the other."The etiology of concurrent disease is sometimes difficult to determine," said Dr. Cavallo.
Diagnosis of Simultaneous Faults
The National Alliance on Mental Illness (NAMI) states that symptoms of co-occurring disorders can vary widely depending on an individual's medical condition.
A dual diagnosis is recognized when a professional, usually a psychiatrist or psychologist, conducts a thorough assessment of the patient, asking about the symptoms of various disorders and understanding the onset of symptoms and how they evolve over time, says Dr. Cavallo.
Interpreting these symptoms is often difficult because mental health symptoms can be related to patterns of substance use, intoxicating effects, and even other factorswithdrawalAssociated with specific substances, Dr. explained. Cavallo. "For example, a person may stop using cocaine, and the acute effect may be depressed mood."
So it's also important to ask about any symptoms that may or may not have been present prior to substance use, and whether substance use worsened psychiatric symptoms, says Dr. Cavallo. "Recognize psychosocial triggers, such as great stress ortrauma historyJust as importantly, both disorders can be the underlying cause. "
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Treatment of Concurrent Diseases
Treatment of concurrent disease requires an integrated approach.
"Dual diagnosis treatment must address both mental illness and substance abuse because both can have a significant impact on a person's life. Therefore, the approach to treatment is to integrate the two disorders together, rather than focusing on each disorder individually, " Cavallo.
These are some of the treatments a healthcare provider may recommend when facing a dual diagnosis:
- Detoxification:The first step, and this can be a major hurdle, is to stop using these substances and flush them out of the system. thisdetoxificationThe procedure is often performed in an inpatient setting, so healthcare providers can monitor the patient and provide medication and care if the patient experiences withdrawal symptoms.
- Psychotherapy:Therapy is often an important part of the treatment plan.Cognitive Behavioral Therapy (CBT)Often helps to change unhealthy thought patterns that lead to substance use. Some people may need intensive treatment at first, but once their symptoms are under control and they learn useful coping skills, they can reduce the frequency of treatment, says Dr. Cavallo.
- drug:Medication not only helps with withdrawal symptoms, but also helps reduce cravings for drugs and alcohol, and relieves symptoms of mental illness.
- Inpatient rehabilitation:People with co-morbidities may benefit from inpatient rehabilitation, where they receive ongoing monitoring and psychological care.
- Self-Help Groups:Dealing with a dual diagnosis can be challenging.mutual aid groupProvide opportunities for people to share advice, celebrate successes, vent frustrations, find resources, and offer help and inspiration.
Dr Dana Cavallo
A dual diagnosis treatment plan must recognize that co-occurring conditions can be more persistent and severe than one condition, and that you cannot treat the other without assessing risk factors for the other.
— Dr. Dana Cavallo
For example, you don’t want to use it to treat anxietyPotentially Abused Drugs;Likewise, people don't want to treat a substance use disorder without understanding the person's use of the substance and how it affects them, Dr. Cavallo.
A 2018 study noted that a comprehensive approach is critical because lack of improvement in either condition can lead to relapse in both.
Dealing with Dual Diagnosis
Dr. Cavallo suggests some strategies that may help manage dual diagnoses:
- For help:The first step in helping someone deal with a dual diagnosis is convincing themask for help.Finding a compassionate provider who is willing to listen and understand how the diagnosis affects their physical health, emotional health, and social life is a must for a successful intervention.
- Actively participate in treatment:Talking to a professional is just the beginning of the recovery process. Active participation in treatment is critical. It is very beneficial to fully participate in treatment and provide appropriate support both inside and outside of the treatment plan.
- Focus on feeling better:Any mental disorder or substance use disorder presents various challenges for patients, their friends and family. A dual diagnosis can complicate treatment plans, but education, support, therapy, and medication can help those affected recover and live productive lives.
Dr Dana Cavallo
Remember, with the right treatment, people can and do recover. It's important to keep an open mind, find a support group, and not give up on the recovery process.
— Dr. Dana Cavallo
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A word from Verywell
Dealing with a substance use disorder can be challenging, and a dual diagnosis can make it even more difficult because both conditions are exacerbated by co-occurring disorders.It is important to seek help, get an accurate diagnosis, and in these cases treat to feel better.
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Verywell Mind uses only high-quality sources, including peer-reviewed research, to support the facts in our articles. read ourediting processLearn more about how we fact check and ensure our content is accurate, reliable and trustworthy.
Substance Abuse and Mental Health Administration.Key Indicators of Substance Use and Mental Health in the United States: Results of the 2020 National Survey on Substance Use and Health.
National Institute on Drug Abuse.The Link Between Substance Use Disorders and Mental Illness.
National Institute of Mental Health.Substance Use and Co-occurring Mental Disorders.
National Library of Medicine.double diagnosis.Medical Plus.
National Alliance on Mental Illness.substance use disorder.
McGovern MP、Lambert-Harris C、Gotham HJ、Claus RE、Xie H.Dual diagnosis capacity in mental health and addiction treatment services: an evaluation of a multistate system program.Management Policy Mental Health. 2014;41(2):205-214。 doi:10.1007/s10488-012-0449-1
National Alliance on Mental Illness.substance use disorder.
Subodh BN、Sharma N、Shah R.Psychosocial intervention for patients with dual diagnosis.Indian J-Psychiatry. 2018;60(Suppl 4):S494-S500. doi:10.4103/psychiatry.IndianJPsychiatry_18_18
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What is dual diagnosis? A person with dual diagnosis has both a mental disorder and an alcohol or drug problem. These conditions occur together frequently. About half of people who have a mental disorder will also have a substance use disorder at some point in their lives and vice versa.What is the most common dual diagnosis? ›
- Generalized anxiety disorder. ...
- Eating disorders. ...
- Bipolar disorder. ...
- Post-traumatic stress disorder. ...
- Personality disorders and mood disorders. ...
- Schizophrenia. ...
- Attention deficit hyperactivity disorder. ...
- One-on-one counseling.
Findings support the development of integrated treatment programs that address both types of disorder. Drs. Drake and Wallach describe four perspectives on dual diagnosis—medical, moralistic, psychosocial risk, and phenomenological.What are the problems with dual diagnosis? ›
Increased Risk of Relapse or Developing Maladaptive Behaviors. Individuals with a dual diagnosis are at a higher risk of relapse or developing maladaptive behaviors in the long run, even after treatment.What is the best example of dual diagnosis? ›
Dual diagnosis is having a combination of drug addiction and mental illness. For example, you can struggle with depression and alcoholism concurrently.What comes first in dual diagnosis? ›
Sometimes, the mental illness comes first and the substance use begins as a way to self-medicate or cope. At other times, substance use and mental health issues start at the same time and stem from a common cause such as trauma, stress or genetics.What are 3 possible associated factors for someone with a dual diagnosis? ›
In addition, similar environmental triggers may underlie both disorders. High levels of stress, a history of trauma, and early exposure to drugs are all related to the development of dual diagnosis conditions. Each of these factors must be considered when evaluating an individual for a potential dual diagnosis.Is ADHD a dual diagnosis? ›
Another term for this would be “dual diagnosis.” Many people with attention deficit disorder (ADHD or ADD) have one or more comorbidity — additional diagnosis — such as depression, a substance abuse disorder, a learning disability, oppositional defiant disorder (ODD), or some other condition.What are the 3 most commonly diagnosed disorders? ›
According to the Centers for Disease Control and Prevention (CDC), roughly 1 in every 5 Americans is currently living with a mental illness. Of those, the three most common diagnoses are anxiety disorders, depression and post-traumatic stress disorder (PTSD).How do I know if I have dual diagnosis? ›
- Withdrawal from your family and friends.
- Difficulty maintaining focus.
- Sudden changes in your behavior.
- Engaging in risky behaviors.
- Developing a high tolerance for the substance and/or having withdrawal symptoms.
- Feeling like you need the substance to function.
Dual diagnosis is a term used to describe a person who is diagnosed with a mental illness and a substance use or abuse disorder at the same time. More than half of persons who have a serious mental illness also have a substance use or abuse disorder.Is PTSD a dual diagnosis? ›
This is also known as post traumatic stress disorder or PTSD. Sometimes people use drugs or alcohol to manage their symptoms related to PTSD, which can lead to substance use disorders and addiction. In behavioral health, this condition is considered a dual diagnosis.