What Is a Dual Diagnosis? Your Guide to Co-Occurring Conditions

A dual diagnosis, also commonly known as co-occurring conditions, refers to having a mental illness and substance use disorder (SUD) simultaneously. It is common for these conditions to occur together, or to have one as a result of the other not being treated properly.

Dual diagnoses can complicate the recovery process for a variety of reasons, but long-term wellness and recovery are both still possible, even with multiple co-occurring conditions. Let's take a look at possible causes for dual-diagnoses and the best routes for coping and treatment for those that struggle with multiple conditions at once. 

Possible Causes for Dual-Diagnoses

There are several possible causes for why dual diagnoses occur. First, consider the presence of one untreated mental illness, such as depression or bipolar disorder. The person who suffers from one such condition may either have incorrectly self-diagnosed themselves or believe treatment for the condition is manageable on their own. In these cases, many people turn to substances, such as drugs or alcohol, as a form of self-medication. 

Self-medication is extremely problematic and carries a high probability of developing into SUD or addiction. This only makes the underlying mental illness — along with its\ associated symptoms — worsen over time. 

Another possible cause happens when the addiction or SUD came first. A person that uses substances regularly might develop mental illness as a result of impaired or altered brain function due to their drug use. Typically, one condition begins before another, although these issues can be identified at the same time.

There is also the potential that neither condition caused the other. Risk factors involved in developing either condition are similar. Addiction impacts the same brain areas that mental illness does, including the regions responsible for regulating emotions or guiding behavior. At least half of the people who struggle with a mental illness will also have an addiction or SUD at some point, and vice versa. 

Commonly Occurring Conditions With Dual-Diagnoses

The most common combination of mental illness with addiction is SUD along with a mood or anxiety disorder.

Other common conditions that are known to occur with SUDs and addiction include:

• Generalized anxiety disorder

• Social anxiety disorder (SAD)

• Major depressive disorder

• Post-traumatic stress disorder (PTSD)

• Bipolar disorder

• Attention-deficit hyperactivity disorder (ADHD)

• Schizophrenia

• Borderline personality disorder (BPD)

Signs and Symptoms of Dual-Diagnosis

Many factors play a role in the symptoms experienced from a dual diagnosis. Some of those factors include an individual's brain chemistry, the severity of mental distress, their substance of choice, and how long symptoms have been present. 

Even when two people have the same combination of conditions, like SUD and depression, their symptoms may vary greatly from one another. In general, it is wise to be mindful of the following signs and symptoms that could suggest that you or your loved one is struggling with a dual diagnosis.

Signs of a SUD or addiction may include:

• A persistent desire to drink or use drugs as a form of self-medication or coping

• Compulsive drug-seeking behavior despite negative consequences of using substances

• Increased tolerance to the substance in question

• Physical or psychological withdrawal symptoms when decreasing or stopping drinking or drug use

• Physical or psychological cravings for the substance

• Extreme risk-taking behavior

• Social isolation from family, friends, or activities once found exciting

Signs of untreated mental illness — although they vary by the condition — include but are not limited to:

• Unmanageable feelings of anxiety and/or stress

• Inconsistent sleep patterns or insomnia

• Problems with eating or appetite

• Extreme fluctuations in mood or behavior

• Persistent low mood

• Problems with cognitive abilities, such as concentration and decision-making

• Persistent feelings of worthlessness or hopelessness

• Self-destructive behavior, such as substance misuse or abuse

• Suicidal ideation 

Treatment Options for Dual-Diagnoses

The most effective way to treat dual diagnoses is to treat both conditions simultaneously through an intensive, comprehensive treatment program. Because treatment for dual diagnoses is challenging, it is essential that treatment is collaborative, meaning several health professionals who specialize in different areas of mental health must work together to do what is best for the client. 

The person looking to heal from their multiple conditions must usually first go through a detox program to rid their body of toxins from drugs or alcohol. Once they go through detox, they may be admitted into a rehab facility that specializes in treating co-occurring conditions. Inpatient, or residential, rehab services are much more intensive than outpatient and can make a significant difference in an individual's healing process. 

While in treatment, several different therapeutic interventions may be used to help combat the withdrawals, cravings, and triggers of SUD while navigating through mental and emotional pain caused by the co-occurring condition. This usually includes teaching and creating strategies to cope with symptoms of both conditions after treatment.

Examples of therapies might include:

• Psychotherapy

• Cognitive-behavioral therapy (CBT)

• Dialectal behavioral therapy (DBT)

• Group therapy

• Medication-assisted treatment (MAT)

• Contingency management (CM)

Dual Diagnoses Are Difficult to Identify and Even More Challenging to Treat

Both conditions must be treated simultaneously to ensure long-term healing. Since the signs and symptoms may vary between types and severity of conditions, it is important to understand the general signs of substance use disorders and the general signs of mental illness.

The Edge Treatment Center is an addiction rehab facility that specializes in treating clients with co-occurring disorders. We are here to honor your treatment goals while providing you with the most effective treatment interventions to help you overcome both conditions simultaneously.

For more information, call The Edge today at (800) 778-1772.