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What Is Dual Diagnosis?

What is dual diagnosis? How does it impact individuals’ health and wellness? Read on to find out about co-occurring disorders and treatment options.

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What Is Dual Diagnosis?

Mental health and addiction can be complex issues on their own. But when they co-occur, the challenges can be even more significant. So, what is dual diagnosis?

Dual diagnosis is when an individual has a mental health and substance use disorder simultaneously. Other common terms include co-occurring disorders, comorbidities, or dual disorders.

What Is Dual Diagnosis in Relation to Mental Health Disorders?

What is dual diagnosis in relation to mental health conditions? Common mental health conditions associated with dual diagnosis include:

  • Depression
  • Anxiety
  • Bipolar disorder
  • Post-traumatic stress disorder (PTSD)
  • Borderline personality disorder

What Is Dual Diagnosis in Relation to Substance Use?

What is dual diagnosis in relation to substance use? Common substances associated with dual diagnosis include:

  • Alcohol
  • Opioids
  • Cocaine
  • Methamphetamine
  • Prescription medication

What Is Dual Diagnosis Prevalence?

The prevalence of dual diagnosis is high. According to nationwide surveys from 2008 to 2014, 37.9% of individuals with substance use disorders also had mental illnesses, and 18.2% with mental illnesses also had substance use disorders.1
The significant prevalence highlights the importance of understanding the dual diagnosis and providing effective treatment that addresses both issues.

What is Dual Diagnosis? A Closer Look

What Are the Risk Factors for Dual Diagnosis?

The development of co-occurring mental health and substance use disorders can be influenced by several common risk factors. Some of these factors include:2

Genetics and Family History

Certain genes may increase an individual’s risk of developing both mental health and substance use disorders. For instance, some genes have been linked to a greater likelihood of developing conditions like depression, anxiety, and addiction.3
Individuals with a family history of mental health and substance use disorders have a higher risk of developing these disorders themselves. This can be due to specific genes that increase susceptibility or growing up in a household where mental health and substance use disorders are prevalent.

Environmental Factors

Environmental factors can contribute to the development of co-occurring disorders. Some examples include:4

  • Stress
  • Trauma
  • Abuse, physical or verbal
  • Neglect
  • Poverty

Exposure to these life stressors can increase the likelihood of developing mental health conditions and substance use disorders.

Developmental Factors

The earlier an individual experiences a mental health or substance use disorder, the greater the likelihood they will experience the other. For example, individuals who begin using drugs or alcohol at a young age are more likely to develop mental health conditions later in life.

Social Factors

Social factors can contribute to the development of both mental health and substance use disorders. Some examples include:
  • A lack of social support
  • Isolation
  • Peer pressure
It is important to note that not everyone who experiences these risk factors will develop these conditions. Other individual factors may also contribute to developing these conditions, such as personality traits, coping skills, and access to treatment.

Risk Factors for Substance Use Disorder (SUD)

what is dual diagnosis

What Are Common Co-Occurring Disorders?

Below are some of the most common co-occurring disorders:

Depression and Alcohol Use Disorder (AUD)

Depression causes persistent sadness, hopelessness, and feelings of worthlessness. Alcohol is often used as a form of self-medication to ease these symptoms, but it can worsen depression in the long run.5

The Relationship Between Alcoholism and Depression

Anxiety and Substance Use Disorder

Anxiety disorders are characterized by excessive worry, fear, and apprehension. Individuals with anxiety may use substances to alleviate these symptoms, hoping to improve their daily lives.
This can lead to dependence and addiction. Additionally, some substances can exacerbate anxiety symptoms.

Bipolar Disorder and Substance Use Disorder

Bipolar disorder causes periods of manic and depressive episodes. Individuals with this disorder may use substances to self-medicate their symptoms. Research shows that between 40% and 70% of individuals with bipolar disorder have a history of substance use disorder.

Substance abuse can worsen bipolar symptoms and increase the risk of mania and depression. This leads to a cycle of substance use and worsened mental health symptoms.

Post-Traumatic Stress Disorder (PTSD) and Substance Use Disorder

PTSD is a mental health disorder that can develop after exposure to a traumatic event. Individuals with PTSD may use substances to alleviate symptoms, such as:

  • Anxiety
  • Flashbacks
  • Nightmares

Borderline Personality Disorder (BPD) and Substance Use Disorder

BPD causes distorted self-image, mood swings, and delusions. Individuals with BPD may use substances to cope with their symptoms.

Attention-Deficit/Hyperactivity Disorder (ADHD) and Substance Use Disorder

ADHD is a neurodevelopmental disorder. It is characterized by inattention, hyperactivity, and impulsivity. People with ADHD may use substances to alleviate symptoms, such as:
  • Restlessness
  • Impulsivity
  • Trouble focusing
  • Sleep issues
what is dual diagnosis

What Are the Signs of Dual Diagnosis?

What is dual diagnosis like? The signs and symptoms of dual diagnosis can vary depending on the disorders. However, some common signs of dual diagnosis include:

Changes in Mood or Behavior

Individuals with dual diagnosis may experience changes in mood or behavior. They may become:
  • Withdrawn
  • Irritable
  • Anxious
  • Sad or depressed

Difficulty in Managing Daily Responsibilities

Another sign is difficulty managing daily responsibilities, such as work, school, or household tasks. Individuals may also have difficulty maintaining relationships with family and friends.

Physical Symptoms

Substance abuse can cause physical symptoms, such as:
  • Weight loss
  • Fatigue
  • Changes in appetite
  • Headaches
  • Changes in appetite
  • Muscle tension

Changes in Sleep Patterns

Individuals with dual diagnosis may experience changes in sleep patterns. They may have problems falling asleep, staying asleep, or waking up early.

Legal Problems

Substance abuse can lead to legal problems, such as:
  • Driving under the influence
  • Possessing illegal substances
  • Arrests
  • Theft

Financial Problems

Substance abuse can lead to financial problems. This can be due to various reasons, such as: 
  • Spending too much money on substances
  • Impulsive buying
  • Job loss

Risky Behavior

Individuals with dual diagnosis may engage in risky behavior, such as:
  • Driving under the influence
  • Unprotected sex
  • Drug use

What Are the Effects of Dual Diagnosis?

What is dual diagnosis like regarding its effects? Individuals with dual diagnosis are at an increased risk of
  • Suicide
  • Self-harm
  • Accidental death
What is dual diagnosis like regarding its effects on others? The effects of dual diagnosis can be devastating for individuals and their families. They can experience challenges such as:
  • Social isolation
  • Difficulty maintaining employment
  • Financial instability
  • Homelessness

Who Is Most Likely to Be Diagnosed With Mental Illness and Addiction?

Mental illness can affect people of all ages, genders, races, and socioeconomic backgrounds. However, research suggests that young adults between eighteen and twenty-five may be more vulnerable to mental illness than other age groups.
What is dual diagnosis susceptibility like in young adults? Here are some of the factors that make young adults more susceptible to mental illness and substance abuse:

Biological Changes

Young adulthood is a time of significant biological changes, such as hormonal fluctuations and brain development. These changes can affect mood, behavior, and mental health, potentially triggering mental health issues and substance abuse.

Stressful Life Events

Young adulthood is also a time of significant life changes. Adolescents often leave home, start college, and enter the workforce. These changes can be stressful and may trigger mental health and substance use problems.

Substance Use

Young adults are more likely to engage in substance use than any other age group. This can be due to:
  • Peer pressure
  • A lack of impulse control
  • Increased risk-taking behaviors
Substance use can increase the risk of developing mental illness, leading to co-occurring disorders.


Traumatic experiences can occur at any age. Still, young adulthood is a particularly vulnerable time for trauma. Trauma can increase the risk of developing mental illness if not treated or resolved. 

Family History

Young adults with a family history of mental illness are more likely to develop mental illness themselves.

Lack of Access to Mental Health Care

Many young adults lack access to mental health care due to financial or logistical barriers. This can make it difficult to receive timely diagnosis and treatment for mental illness.

what is dual diagnosis

What Is Dual Diagnosis Treatment?

What is dual diagnosis treatment? Effective treatment for dual diagnosis typically involves a comprehensive and integrated approach that addresses both conditions simultaneously. Here are some key components of co-occurring disorder treatment:

Integrated Assessment

The first step in treating co-occurring disorders is to undergo a thorough assessment to identify the presence and severity of both conditions. This involves assessing the following:
  • Physical health
  • Emotional and psychological health
  • Social functioning
  • History of substance use and mental health issues
  • Family history

Medication-Assisted Treatment (MAT)

Medication-assisted treatment is a common approach to treating co-occurring disorders. It involves combining medication, behavioral therapies, and counseling.

The Food and Drug Administration (FDA) approved various medications to treat AUD and opioid use disorder (OUD). They include:

  • Alcohol Use Disorder Medications: Acamprosate, disulfiram, and naltrexone
  • Opioid Use Disorder Medications: Buprenorphine, methadone, and naltrexone
These medications help manage withdrawal symptoms, reduce cravings, and block the euphoric effects of the substance.

Counseling and MAT

Behavioral therapies and counseling help individuals:
  • Cope with symptoms and triggers
  • Manage emotions
  • Improve well-being
  • Become more self-sufficient

Behavioral Therapy

Behavioral therapies help individuals learn coping skills to manage both their mental health symptoms and substance use. Examples include:

Support Groups

Support groups provide a supportive environment for individuals to connect with others who are going through similar experiences. It can help reduce feelings of isolation and promote ongoing recovery. Popular examples include Alcoholics Anonymous (AA) and Narcotics Anonymous (NA).

Holistic Approaches

Holistic approaches focus on the mind, body, and spirit. They can help reduce stress, anxiety, and depression, which can trigger substance use. Some examples include:

  • Yoga
  • Meditation
  • Mindfulness techniques
  • Art therapy
  • Music therapy
  • Exercise

What Is Dual Diagnosis Treatment Like?

What is dual diagnosis treatment like? The goals of treatment include the following:
  • Manage the symptoms of both disorders
  • Prepare the individual to live independently
  • Develop coping skills
  • Improve social support networks
  • Promote healthy habits such as exercise and nutrition

Why Is Addressing Co-Occurring Disorders Important?

Here are some of the main reasons why it is crucial to address co-occurring disorders:

Improved Treatment Outcomes

Both mental health and substance use disorders are addressed simultaneously. This reduces the chance of one disorder triggering another. So, the individual is more likely to experience improved treatment outcomes.

Reduced Risk of Relapse

Treating only one disorder will leave the individual still suffering from symptoms of the other. Experiencing these symptoms of the untreated disorder can lead to a relapse to cope. Thus, addressing co-occurring disorders can reduce the risk of relapse.

Improved Quality of Life

Addressing both disorders can improve the quality of life by teaching the individual how to:
  • Manage symptoms
  • Maintain healthy relationships
  • Engage in meaningful activities
  • Cope with triggers
  • Practice self-care

Reduced Risk of Suicide

Co-occurring disorders increase the risk of suicide. Addressing both disorders can reduce this risk by providing comprehensive treatment and ongoing support.

Improved Social Functioning

Co-occurring disorders can also impact an individual’s ability to function socially. Addressing both disorders can improve the individual’s ability to communicate effectively. They can form healthy relationships and engage in social activities.

Reduced Burden on the Healthcare System

Co-occurring disorders can be costly to the healthcare system, especially when not addressed effectively. Addressing both disorders can reduce the burden on the healthcare system by reducing the following:
  • Hospitalizations
  • Emergency department visits
  • Relapses

How Does Boardwalk Recovery Center Handle Dual Diagnosis

Boardwalk Recovery Center is a treatment facility specializing in treating dual diagnoses. What is dual diagnosis treatment like at Boardwalk Recovery?

Comprehensive Assessment

We will begin by conducting a comprehensive assessment to determine the extent of the problem. This assessment includes the following:
  • Physical exam
  • Psychological evaluation
  • Review of the individual’s medical and psychiatric history

Individualized Treatment Plan

Based on the assessment, we will create an individualized treatment plan. The plan addresses both mental health and substance use disorders through a multimodal approach. While each treatment plan varies from person to person, they typically include the following:
  • Individual therapy
  • Group therapy
  • Medication
  • Holistic treatments

Evidence-Based Therapies

What is dual diagnosis treatment like at Boardwalk Recovery? Boardwalk Recovery Center offers many evidence-based therapies, such as:

  • Cognitive behavioral therapy (CBT)
  • Dialectical behavior therapy (DBT)
  • Acceptance and Commitment Therapy (ACT)
  • Motivational Interviewing (MI)
  • Psychoeducational Group Sessions
  • Family Therapy

Holistic Treatments

We also offer a variety of holistic treatments, including:
  • Outdoor Group Therapy
  • Mindfulness and Grounding Practices
  • Guided Meditation
  • Breath Work

Aftercare Services

After successfully completing a rehabilitation program, we will assist you in preparing for aftercare. Aftercare helps keep you motivated to stay sober beyond our facility.
We will develop a list of objectives to accomplish to keep you engaged in positive activities. We will also refer you to nearby support groups that offer ongoing guidance and assistance. Our goal is to ensure that you don’t feel unprepared.

Contact Us Today

For more information on what is dual diagnosis, please reach out to Boardwalk Recovery today.
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