Dual Diagnosis

A dual diagnosis refers to the simultaneous presence of a substance use disorder (SUD) and a mental health disorder. Research indicates that approximately 25% of people with severe mental illness also struggle with SUD.[1]

Because SUD and mental illness are so often intertwined, it’s challenging to know which condition appeared first. Many people use drugs or alcohol to cope with mild or moderate mental health symptoms before they receive a diagnosis of a psychiatric disorder. Over time, substance use often worsens existing mental health issues. Similarly, people with a genetic predisposition for certain psychiatric disorders may find that their substance abuse accelerates the onset of a mental health disorder. 

Both SUD and mental health disorders share common risk factors, such as genetics, brain development, and environmental influences like chronic stress and childhood trauma. Because these conditions exacerbate one another, individuals with a dual diagnosis typically experience more severe symptoms than those with a single disorder. Uncovering and addressing the relationship between disorders is crucial for effective treatment and recovery.

1. Bethesda. (2020). Common Comorbidities with Substance Use Disorders Research Report. In PubMed. National Institutes on Drug Abuse (US).

Substance use disorder (SUD) often co-occurs with various mental health conditions. Some of the most common disorders associated with SUD include:

• Depression
• Anxiety disorders
• Bipolar disorder
• Post-traumatic stress disorder (PTSD)
• Borderline personality disorder (BPD)
• Attention-deficit/hyperactivity disorder (ADHD)
• Schizophrenia

Understanding the interplay between these disorders is essential for effective treatment and recovery. Addressing both SUD and co-occurring mental health issues can lead to more comprehensive care and improved outcomes.

The symptoms of a dual diagnosis can vary based on the specific mental health condition and substance use disorder involved. For example, an individual with bipolar disorder may experience significant mood swings and fluctuating energy levels; someone with depression might lose interest in activities they once enjoyed or struggle with sleep. 

Common signs and symptoms of a dual diagnosis may include: 

• Treatment resistance – Lack of success with traditional addiction or mental health treatment.
• Social isolation – Withdrawing from friends and family.
• Daily functioning challenges – Difficulty keeping up with daily activities, routines, and responsibilities.
• Risky behavior – Engaging in dangerous or illegal activities.
• Mood instability – Experiencing mood swings, irritability, or aggression.
• Increased tolerance – Needing higher quantities of drugs or alcohol to achieve a desired high.
• Escalating substance use – Gradually increasing the frequency and amount of drugs or alcohol consumed.
• Sleep issues – Trouble falling or staying asleep.
• Relationship struggles – Difficulty maintaining personal relationships.