What Is a Dual Diagnosis?

Individuals with a mental health disorder are particularly vulnerable to developing substance use disorders (SUDs) and vice versa. The presence of both a mental health disorder and SUD is referred to as a dual diagnosis or co-occurring disorder. 

Prevalence rates for dual diagnoses remain high, affecting nearly half of those with mental illness or SUD. It is important to understand that these conditions are comorbid. When they are left untreated, the interactions of the conditions can worsen the course of both. Becoming familiar with what dual diagnoses are and why they occur can be vital for preventing them, as well as achieving and maintaining lasting recovery from them.

Understanding a Dual Diagnosis

The National Institute on Drug Abuse (NIDA) explains that nearly 7.7 million individuals are affected by co-occurring disorders. As mental health disorders and SUDs share many similar symptoms, it can be challenging to identify a dual diagnosis and even more difficult to determine what disorder developed first. 

Examples of Dual Diagnoses

There is no one example of a dual diagnosis. However, there are many common co-occurring combinations that can help individuals better understand a dual diagnosis. Consider the following mental health disorders:

  • Anxiety disorders: such as generalized anxiety disorder (GAD) or social anxiety disorder 
  • Mood disorders: including depression and bipolar disorder
  • Personality disorders: such as borderline personality disorder (BPD) 
  • Eating disorders: such as anorexia nervosa and bulimia nervosa
  • Trauma-related disorders: such as post-traumatic stress disorder (PSTD)

These conditions may occur simultaneously with the following SUDs:

  • Opioid use disorder (OUD)
  • Marijuana use disorder
  • Stimulant use disorder
  • Nicotine use disorder
  • Alcohol use disorder (AUD)

Why Do Mental Health Disorders and Substance Use Disorders Co-Occur?

It is important to understand that the presence of a dual diagnosis does not mean that one condition triggers the development of the other. Rather, the National Institue of Mental Health (NIMH) highlights three possibilities that explain why SUD and mental health disorders commonly co-occur:

#1. Shared Risk Factors

One possibility comes from the fact that both mental health disorders and SUDs share similar underlying risk factors. First, genetic risk factors are known to increase an individual’s risk of developing these conditions. A family history of substance abuse or mental illness, or undiagnosed and untreated mental illness, can all impact an individual’s vulnerability. 

Environmental factors can also contribute to increased risks of developing mental health disorders and SUDs. Common environmental risk factors to consider include the following:

  • Lack of parental monitoring and involvement
  • Untreated trauma, such as assault and abuse
  • Access to alcohol and other drugs within the home environment
  • Associating with deviant peer groups
  • Limited access to social support resources
  • Favorable family attitudes toward substance use

#2. Mental Health Disorders Can Trigger Self-Medicating Practices

The second possibility highlights the problem with self-medicating practices. Individuals who struggle with mental health disorders – including depression, anxiety, post-traumatic stress disorder (PTSD), and more – may be more susceptible to turning to alcohol and other drugs to cope. While doing so may provide temporary relief, substance abuse can worsen symptoms of mental illness over time. 

Additionally, relying on self-medicating practices to cope can quickly transform into SUD and addiction. This is because the use of alcohol and other drugs can trigger lasting changes in the brain that make it easier for individuals to use substances repeatedly.

#3. Substance Use Can Trigger the Development of Mental Health Disorders

The third possibility explains that substance abuse and SUD can also trigger the development of mental health disorders. As mentioned above, substance use triggers lasting changes in the brain. This not only makes it more likely for an individual to develop an addiction but also mental health disorders. Many of the brain areas that are affected by mental illness are also affected by substance abuse.

Treatment and Recovery for a Dual Diagnosis

There is no one-size-fits-all approach for addiction recovery, especially when it comes to dual diagnosis treatment. However, research has found that the most effective type of treatment is both integrated and individualized. 

Integrated Treatment

Integrated treatment involves treating both conditions simultaneously. If an individual has a co-occurring diagnosis of depression and AUD, then their treatment plan must address ways to overcome both conditions at the same time. 

Consider the following: if this individual was only being treated for AUD, it is likely that the symptoms of their depression will worsen. Following treatment, they would experience a higher chance of relapse because their depression was never addressed in treatment. This can be especially concerning if this individual developed AUD in an attempt to self-medicate their depressive symptoms. 

Individualized Treatment

Individualized treatment is tailored to fit a client’s unique needs and recovery goals. Likewise, it is a client-centered approach. No addiction or mental health disorder presents itself in the exact same way for different people. For example, an eating disorder may manifest from a lack of social connectedness for one person, whereas it may manifest from an unhealthy relationship with food for another. 

Likewise, when two co-occurring disorders intersect, treatment and recovery become even more challenging. Rather than following one specific treatment approach to help a client overcome a dual diagnosis, individualized treatment programs utilize several therapeutic approaches. This ensures that a client’s well-being is being addressed from all angles.

It is vital to understand that individualized needs for dual diagnosis recovery change over time. Recovery is often a lifelong journey. Having support from a dedicated and compassionate treatment center can help individuals achieve lasting sobriety and recovery from their dual diagnosis. 

A dual diagnosis is the presence of a mental health disorder and substance use disorder (SUD) that occurs simultaneously. These disorders can be challenging to treat and require a combination of integral and individualized treatment for the most effective and successful recovery outcome. We at 12 South Recovery understand the additional challenges that may present as a result of a dual diagnosis. We are dedicated to helping you recover from mental health disorders, substance abuse, and dual diagnoses through our wide range of treatment programs and therapeutic options. From partial hospitalization (PHP) to our intensive outpatient (IOP) and general outpatient programs (OP), we can meet you where you are in your healing journey. Learn more by calling 866-839-6876 today.

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