Dual Diagnosis: Substance Abuse & Mental Health


dual diagnosis

Dual diagnosis is any mental health diagnosis in combination with drug or alcohol addiction - also called a co-occurring disorder. These conditions occur together often, and according to the National Library of Medicine, roughly 50% of individuals with a substance use disorder are also dual diagnosed with a mental illness.


Which Came First - Substance Abuse or Mental Illness?


Because one disorder can mask or heighten symptoms of the other, it is often difficult to determine which came first. It’s common to see anxiety and/or depression with alcohol use disorder. In these situations, most individuals are using substances to alleviate the symptoms of anxiety or depression.


Substance use and addiction have also been found to contribute to the development of a mental disorder. Substance use can change the brain in ways that make individuals more likely to develop a mental disorder.


Whether or not the substance abuse or the mental illness came first, it’s important to treat both. If an individual knows one is stronger than the other, start there. However, it can be difficult to tell, and in that case treating the substance abuse first is often the best course of action.


When substance abuse is treated first, the goal is to get an individual to a baseline without substance use and reevaluate. Is there a mental health issue that has been masked by substances for years? Or has the substance use been creating the symptoms of mental illness that are now under control?


At Care Addiction Center, individuals complete a biopsychosocial assessment with one of our trained and compassionate counselors before treatment. It touches on many different factors that include medical or genetic issues, mental health and a social aspect. If mental health issues are evident, we can put you in contact with a doctor to help treat or medicate for those while you are in outpatient rehab.


Common Mental Health Issues That Occur With Addiction


Many combinations of mental health and substance use disorders can occur. However, the mental health problems that most commonly co-occur with substance abuse are depression, anxiety and bipolar disorder.


Symptoms of Substance Abuse

  • Not able to stick to limits

  • Drinking or using more than you planned or intended

  • Increase in tolerance - meaning you need more of the substance to achieve the desired effect that you’ve had in the past

  • Using in situations that are hazardous - for example, drinking and driving

  • Continued substance use regardless of negative impacts - for example, problems in relationships, spending too much on alcohol or drugs, or health problems


Symptoms of Depression

  • Feelings of helplessness and hopelessness

  • Loss of interest in daily activities

  • Inability to experience pleasure

  • Appetite or weight changes

  • Sleep changes

  • Loss of energy

  • Strong feelings of worthlessness or guilt

  • Concentration problems


Symptoms of Anxiety

  • Excessive tension and worry

  • Feeling restless or jumpy

  • Irritability or feeling “on edge”

  • Racing heart or shortness of breath

  • Nausea, trembling, or dizziness

  • Muscle tension, headaches

  • Trouble concentrating

  • Insomnia


Symptoms of Bipolar Disorder

  • Feelings of euphoria or extreme irritability

  • Unrealistic, grandiose beliefs

  • Decreased need for sleep

  • Increased energy

  • Rapid speech and racing thoughts

  • Impaired judgment and impulsivity

  • Hyperactivity

  • Anger or rage



How To Help A Loved One With Dual Diagnosis


It can be hard to approach a loved one struggling with addiction and mental illness. A good approach is to start by acknowledging mental health is not a moral flaw, it’s a disease just like addiction to substances is a disease. In addition, be a good listener, practice empathy and encourage their recovery.


Want to hear about Dual Diagnosis from those that have been there? Listen to Sober.Coffee podcast with Mike and Glenn.



If you or a loved one need help with substance abuse, Care Addiction Center can help you along every step of the way. Call our Illinois rehab today at 630-402-0144.