Trusted Content

Dual Diagnosis Treatment And Recovery

Joseph Sitarik, DO

Medically reviewed by

Joseph Sitarik, DO

March 26, 2019

Drug or alcohol addictions have a wide range of influences, chief among them mental health problems. Unfortunately, the co-occurrence of these two problems can lead to a situation known as dual diagnosis. This troubling situation can create a loop of abuse that can feel impossible to escape. However, it’s always possible to pull out of the negativity of addiction. It requires a lot of personal strength and dedication, but treatment and help are available. Here’s what you need to know.

What Is Dual Diagnosis?

The term “dual diagnosis” can be used in two different ways. First, it identifies a health problem and second, it defines the treatment method used to treat the problem. For the sake of simplicity, we will discuss the term “dual diagnosis” as it refers to the problem. According to the National Alliance On Mental Illness, dual diagnosis is an issue that impacts about one-half of all people with a substance abuse problem.

The same group defines dual diagnosis as a term “for when someone experiences a mental illness and a substance abuse problem simultaneously.” NAMI goes on to state that “dual diagnosis is a very broad category. It can range from someone developing mild depression because of binge drinking, to someone’s symptoms of bipolar disorder becoming more severe when that person abuses heroin during periods of mania.”

Statistics show that men are more likely to develop this problem, as are people who are struggling with money, and military veterans. The latter group is especially impacted by this problem: according to the Department for Veteran Affairs, 60 percent of all returning veterans have post-traumatic stress disorder and 10 percent suffer from several alcohol and drug addictions.

People who are at high risk for developing a mental health disorder (whether through genetics or personal circumstance) are, therefore, more likely to develop a dual diagnosis. The interplay between these two problems is complex and must be delved into completely before understanding which came first, the addiction or the mental health problem.

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How Complex Is The Interaction Between These Two Problems?

In many cases, people with mental health disorders use illicit substances to self-medicate. While this behavior is understandable, it, unfortunately, leads to addiction in so many cases. Typically, this is what people think of when they think of dual diagnosis, but mental health problems don’t always come first.

For example, imagine a well-balanced and successful person who develops an addiction to heroin after trying it at a party. Their addiction to heroin causes guilt and may decrease their self-esteem. Over time, that guilt can build, cause inferiority complexes, paranoia, and other unbalanced behaviors. Typically, it’s possible to treat these symptoms by eliminating substance abuse.

But what about drugs that actually cause psychosis? Early Psychosis Intervention—a group dedicated to helping people avoid this dangerous problem—has reported that cocaine and amphetamines, two stimulants, can create severe psychosis. Though rarely permanent, these moments of psychosis can create a severe impact on a person’s mental health, leading to the development of more problems.

Those aren’t the only drugs that can create mental health problems. reports that marijuana, a substance that many people consider harmless, can cause temporary psychosis. Hallucinogenic drugs also create a psychosis that can linger for days, weeks, and even years.

What Are The Symptoms Of A Dual Diagnosis?

Cigna, just one of the many insurance companies that cover addiction treatment, created a pamphlet for their agents that defined dual diagnosis and helped them spot symptoms of these problems in their clients. These symptoms have been studied multiple times by a variety of medical experts and have been confirmed as the best way to gauge whether a loved one is suffering from a dual diagnosis. These symptoms include:

  • Pulling away from the support of friends and family members
  • Behaving erratically or dangerously
  • Showing signs of paranoia or mistrust
  • Hiding drug or alcohol use
  • Mood swings that are unprompted
  • Signs of withdrawal symptoms, including nausea, confusion, and agitation
  • Talking to themselves or acting out in their “own little world”
  • Difficulty paying attention or concentrating
  • Troubles at work or with the law
  • Discussions of suicide or suicide attempts
  • Glazed eyes and shaking hands
  • Periods of intense energy and joy contrasted with agitation and depression

These behaviors indicate the unpredictability that is caused by dual diagnosis. The negative behaviors caused by both co-occur and increase in severity. Treating them individually is not an option, as their interaction is so difficult to unwind. Instead, they must be treated at the same time.

What Treatments Are Available?

As mentioned above, dual diagnosis treatments require treating all mental health problems and addiction at the same time. This is called an “integrated dual diagnosis treatment,” and it involves understanding a person’s psychiatric history and the history of their addiction. Typically, it starts by assessing the person’s mental health problems and digging into the root of where they began.

Often, these problems begin at home. One study in the American Journal of Drug And Alcohol Abuse reported people with difficult living arrangements, problematic family relationships, social anxiety, and difficulty getting along with parents were more likely to develop a serious mental health problem and, subsequently, an addiction.

When getting treatment for a dual diagnosis, you’re not likely going to receive outpatient care. This care is very effective in many circumstances, but the demands and severity of dual diagnosis make it untenable. As a result, inpatient programs are most commonly used. In this way, you can receive withdrawal treatment, appropriate psychological treatment, and behavioral adjustment techniques.

Once the withdrawal has passed, medication may be prescribed to help balance mental health. Problems like bipolar disorder, depression, anxiety, and schizophrenia all need to be medicated in order to reverse their symptoms. Behavioral adjustments help teach a person new coping methods for their problems, methods that don’t integrate the use of illicit drugs. Behavior adjustments also help teach a person how to avoid relapse triggers and to fight off cravings.

This varied approach attacks addiction and mental health at all possible angles. It is a rigorous and demanding experience that challenges the willpower and strength of everyone who attends. However, those who finish find themselves handed a brand new slate in life, one on which they can draw a whole new successful and drug-free future.

How Effective Is Dual Diagnosis Treatment?

Studies have shown that dual diagnosis is one of the most effective ways to treat addiction. The study “Implementing Dual Diagnosis Services for Clients With Severe Mental Illness,” which was researched and written by 10 medical doctors, is one of the most trusted and influential papers about dual diagnosis. It discussed the process in great detail, including information regarding its growth.

In it, they discussed the early beginnings of dual diagnosis treatments in the 80s. Addiction experts then were troubled by the lack of success their one-sided approach was having. The connection between mental health and addiction wasn’t well understood at the time, and a majority of the people who passed through rehab relapsed down the road.

To counteract this failure, eight studies into the effectiveness of dual diagnosis were performed in the 90s. These studies tried out a new approach, one that focused on treating both substance abuse and mental health problems. Each study used different methods to treat these problems, but the results were overwhelmingly positive.

As the paper put it: “The eight studies demonstrated a variety of positive outcomes in domains such as substance abuse, psychiatric symptoms, housing, hospitalization, arrests, functional status, and quality of life… Although each had methodological limitations, together they indicate that current integrated treatment programs are more effective than non-integrated programs.”

This first step in the direction of dual diagnosis treatment opened the floodgates for new and successful treatment methods. Ever since that groundbreaking study, dual diagnosis treatments have been tweaked, studied, and every time, their effectiveness has been confirmed. That’s why so many people are turning to or talking about this beneficial mode of treatment for the ongoing success of themselves or their loved ones who need not suffer any longer.

Learn More About Dual Diagnosis Today

If you or someone you love is suffering from a dual diagnosis, there is hope for your recovery. Please contact us at to learn more. We can help you find a center near you that fits your needs and your budget and get you on track for a life free of addiction.

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