What Is Dual Diagnosis Treatment?

Dual diagnosis treatment is a specialized approach to addiction care that addresses mental health conditions and substance use disorders at the same time. Because these two issues so frequently occur together and directly affect each other, treating one without the other often leads to incomplete or short-lived results.

Most dual diagnosis programs are offered through addiction treatment facilities that have licensed psychologists or psychiatrists on staff to manage both the clinical and psychiatric sides of care simultaneously.

The Connection Between Addiction And Mental Health Disorders

The overlap between addiction and mental health disorders is well-documented and more common than many people realize. According to SAMHSA’s 2024 National Survey on Drug Use and Health, approximately 21.2 million adults in the United States had a co-occurring mental illness and substance use disorder. Despite how widespread the issue is, only 14.5% of those adults received treatment for both conditions, while 41.2% received no treatment at all.

Studies suggest that about 50% of people who experience a substance use disorder during their lives will also have a mental health disorder, and vice versa. Whether the mental health condition or the addiction came first is often difficult to determine, but research consistently shows that each increases the risk of developing the other, which is why treating both at the same time produces better results.

Dual Diagnosis Treatment Approaches

Dual diagnosis treatment is an umbrella term that merely refers to the simultaneous treatment of an addiction and at least one other mental illness.

The exact approach used during your dual diagnosis treatment program can vary based on your individual diagnoses. Psychotherapy and prescription medications are two common tools. 

Psychotherapy

Psychotherapy is a broad category of evidence-based mental health treatment that includes treatments like cognitive behavioral therapy and dialectical behavior therapy.

In the case of addiction treatment, both of these approaches address harmful thoughts and behaviors to change the way you view yourself and the way you react to potential triggers. 

Prescription Medication

Prescription medication is often an important part of dual diagnosis treatment plans, because it can be used to correct chemical imbalances in the brain. 

As with any other illness, mental illness sometimes requires a medicated approach to support long-term healing. 

How Do Co-Occurring Disorders Start?

It is difficult to say whether the addiction or the mental health disorder comes first in situations where a dual diagnosis has been made. 

However, there are two common paths of development that are more likely to occur in specific situations.

Self-Medication For Pre-Existing Disorders

In cases where the diagnosed mental illness is likely the result of genetic predisposition or a triggering event, co-occurring drug and alcohol addiction often result from self-medication.

The term self-medication refers to an individual’s attempts to address the symptoms of their mental health disorder by using alcohol or illicit drugs. These are common examples.

Bipolar Disorders

Bipolar disorders are characterized by intense highs and lows. People with untreated bipolar disorder may attempt to self-medicate by using stimulants during depressive episodes.

Schizophrenia

Schizophrenia is characterized by delusions, hallucinations, confusion, and paranoia.

The condition most frequently manifests in young adults. They are usually in their late teens and may not understand what is happening to them if adults in their lives miss the warning signs.

In these cases, people with untreated schizophrenia may use stimulants or alcohol as a form of escape from their symptoms.

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder can cause anxiety, depression, and sleep disorders. It isn’t uncommon for people with PTSD to use alcohol or illicit drugs to counter their symptoms.

Borderline Personality Disorder (BPD)

Borderline personality disorder (BPD) is most often associated with impulsivity, intense emotions, and dramatic mood swings.

People with BPD may self-medicate through drug or alcohol abuse depending on their symptoms at the time.

Attention Deficit Hyperactivity Disorder (ADHD)

For people with undiagnosed ADHD, illegal stimulants may provide some relief from their symptoms, prompting continued substance abuse as a form of self-medication.

Mental Health Disorders Connected To Chemical Dependency

In cases where your mental health disorder is tied to changes in brain chemistry, it may be more likely that your substance abuse acted as a trigger. 

While it is certainly possible for anxiety or depression to lead to a substance use disorder, they are the diagnoses most commonly associated with chemical dependency. 

Anxiety

Certain stimulants, like cocaine or amphetamines, directly affect the parts of your brain that manage stress. They can produce an exaggerated stress response, including anxiety and paranoia.

Over time, drug use can change the normal behavior of your brain, making your anxiety disorder a more permanent part of your experience. 

Depression

Any drug that increases the concentration of serotonin and dopamine in the brain puts you at an increased risk of developing depression. 

When you use an addictive substance like alcohol, opiates, or any other illicit drug, your brain gradually adapts its production of those vital “feel good” hormones to establish balance.

That means that your brain is no longer producing normal amounts of dopamine or serotonin when you aren’t actively using, increasing feelings of depression.

Eating Disorders

In a slightly different vein, disordered eating may result from substance abuse due to the ability of some drugs to suppress or enhance appetite.

FAQs For Dual Diagnosis Treatment

Dual diagnosis treatment is an important tool for approximately 40% of people who seek professional addiction treatment at a rehab center.

To help you better understand what dual diagnosis treatment entails, our team has put together a short list of answers to your most common questions.

Is Prescription Drug Management A Part Of Dual Diagnosis Treatment?

Prescription drug management may be part of your dual diagnosis treatment if you are in an inpatient or residential treatment program. 

If you are receiving dual diagnosis treatment through an outpatient program, the management of your prescriptions will be up to you and your prescribing healthcare provider.

Can Dual Diagnosis Treatment Cure My Mental Health Disorder?

Dual diagnosis treatment is a highly effective therapy for mental health disorders, but it doesn’t always offer a cure. The majority of mental health disorders are chronic, and you will likely require some level of treatment to manage your disorder for the rest of your life. 

With that said, mental health disorders resulting from the chemical imbalances caused by substance abuse may be cured by long-term sobriety once your brain adjusts. 

What Aftercare Services Are Available For Dual Diagnosis Treatment?

Having a dual diagnosis can increase your risk of relapse if you do not receive proper support from family members and continued behavioral health treatment. Once you have completed your core addiction treatment program, it is important that you take advantage of your treatment provider’s aftercare services as frequently as you need. 

Common and useful aftercare treatment services for dual diagnoses include individual counseling, support groups, and access to optional sober living programs.

Written by the Affordable Rehabs Editorial Staff