Dual Diagnosis Definition And Management

Medically reviewed by Julie Dodson, MA, LCSW and Melissa Guarnaccia, LCSW
Updated October 23, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention substance use-related topics that could be triggering to the reader. If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Support is available 24/7. Please see our Get Help Now page for more immediate resources.

Managing life with a mental health condition can feel challenging. If you are experiencing a mental health condition and substance use disorder simultaneously, this is known as a "dual diagnosis." This term does not relate to having two or more mental health conditions, such as anxiety and depression, without a substance use disorder. 

Dual diagnosis and co-occurring mental health disorders

Substance use and dependency may occur when someone is living with a mental health condition. Individuals might use substances like alcohol or illicit medications to attempt to cope with overwhelming symptoms. A co-occurring disorder is a term that describes the combination of these two conditions. In comparison, dual diagnosis is a term to describe how both mental illness and addiction may be diagnosed together. 

Safe medication for a dual-diagnosis of substance use disorders and mental illness

These terms can be significant for healthcare teams responsible for treating someone with a co-occurring condition. They may focus the treatment plan on mental health and dependency. Additionally, medications prescribed by a psychiatrist or doctor may be dangerous or unwise to prescribe to someone with a substance use disorder, depending on the medicine. Talk to your doctor before starting, stopping, or changing a medication for any symptom or condition. 

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Were you diagnosed with multiple mental health disorders?

What causes co-occurring disorders?

Co-occurring conditions may arise when an individual uses or becomes dependent on substances to reduce symptoms of a mental health condition or in conjunction with a mental health diagnosis. Substance use may exacerbate mental health symptoms, leading to further use in some cases. 

Diagnostic evaluations of underlying conditions

Treating one condition may require the treatment of both. Substance use disorders might be more visible than mental health conditions, and their diagnosis could lead to the diagnosis of any underlying concern. Many people treated for co-occurring disorders may not have a diagnosis or understand what is occurring. 

Treatment for substance use disorders and mental illness, as co-occurring disorders

How co-occurring disorders are treated could depend on the substance and the underlying condition. Some mental health disorders are treated with medication. Depending on an individual's dependency, it may be necessary to treat substance use disorder through rehabilitation or medication. Treatment for mental health conditions may involve talk therapy, like cognitive-behavioral therapy (CBT). 

Depending on the substance, prescriptions may be necessary to treat substance use disorder. Some mental and emotional health disorders are never treated with medication. Talk to your doctor if you think a medication may benefit you. Treatment plans are often individualized and can depend on the situation. Note that it may be possible to manage a co-occurring disorder without using medication. 

Supporting yourself or a loved one with a diagnostic evaluation

Receiving a dual diagnosis can feel overwhelming. Considering the positive sides of diagnosis could allow a smoother transition into treatment. Often, diagnoses are required for treatment through insurance. However, certain types of therapy may not require this, such as talk therapy online. Anyone may talk to a therapist or counselor.
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If someone about whom you care has received a dual diagnosis, you may feel unsure how to offer support. Try to communicate openly with the individual and learn what would feel most beneficial to them. Setting boundaries can be valuable if you believe the individual is taking advantage of you or disregarding your space in some way. 

Note that individuals dealing with substance use may experience relapse. Although it is not your responsibility to care for someone experiencing a dependency, support can be rewarding in challenging times. 

Are there connections between specific conditions?

Some substances might cause mental health conditions to occur. For instance, those who use alcohol or illicit substances and become dependent are often at an increased risk of developing co-occurring conditions.

Link between mental health conditions and substance abuse

Some mental health conditions are more likely to lead to substance abuse. For example: 

  • People living with schizophrenia or borderline personality disorder may be more likely to become dependent on substances. 

  • People with an anxiety disorder might be more likely to use depressants, including alcohol. 

  • People experiencing depression might use stimulants, such as prescription medications. 

The conditions listed may be treatable through talk therapy, medication, or a combination of the two. In some cases, mental health conditions may not be related to substance use and could arise from other cognitive disabilities. For example, autistic adults may be more likely to experience depression or anxiety due to social masking. While depression may be treated with medication, autism is not curable and may be considered neurodiversity.

Managing treatment options

Depending on how you received your dual diagnosis, you might not have control over treatment options. For example, some who receive a dual diagnosis may receive court orders for specific treatment. In other cases, family or court orders may send individuals to a rehabilitation facility. 

However, some individuals receive their dual diagnosis through a primary or mental healthcare provider and often have some control over treatment options. There are a few methods you can utilize to find support. 

Community resources for patients with substance abuse disorders and mental illness

Many cities have free community support groups. You might be able to find a support group for substance use conditions, such as AA for those with alcohol dependency or NA for those struggling with dependency on narcotics, medications, or illicit substances. 

You can also check your newspaper or preferred search engine for support groups near you for various topics, including depression, post-traumatic stress disorder, grief, anxiety, and more.  

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

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Were you diagnosed with multiple mental health disorders?

Counseling 

Another option that you can explore is counseling. You might find a counselor near you by utilizing a search engine or talking to your primary care physician about options in your area.  Having a formal diagnosis may make it easier to gain financial assistance through health insurance. However, if you are uninsured or don't wish to seek help in your community, you might try a cost-effective solution like online therapy. 

Additionally, research shows that 71% of participants in a recent study found internet-based counseling preferable to traditional in-person therapy. The participants also perceived that it was more effective in reducing symptoms of mental health conditions.  

If you would be interested in meeting with a counselor online, consider a platform like BetterHelp for individuals or Regain for couples. 

Takeaway

Receiving a dual diagnosis may seem confusing. However, it can help you find treatment options that target your specific symptoms. If you're interested in getting started, reach out to a counselor for further guidance and support.

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