Dual diagnosis, also known as co-occurring disorders, refers to the presence of both a mental health disorder and a substance use disorder (SUD) in an individual. In the United States, approximately 9.2 million adults experience this intersection of conditions (Substance Abuse and Mental Health Services Administration [SAMHSA], 2020). Identifying and treating dual diagnosis is complex because the symptoms of mental illness and substance use often overlap, mask, or exacerbate one another.
Identifying Dual Diagnosis
Identification is the first hurdle in the recovery journey. Because symptoms are intertwined, it is rarely clear which condition emerged first. For instance, an individual might use alcohol to “self-medicate” social anxiety, or chronic stimulant use might induce symptoms of a manic episode.
Common indicators of a potential dual diagnosis include:
- Sudden mood swings or extreme emotional shifts.
- Difficulty maintaining daily responsibilities (work, family, or hygiene).
- Social withdrawal from friends and activities once enjoyed.
- Ineffective treatment history, such as failing to achieve sobriety despite attending rehab, or mental health symptoms that do not improve with standard therapy alone.
Effective identification requires a comprehensive screening process. Clinicians must look beyond the immediate “crisis” and examine the longitudinal history of the patient’s symptoms. A diagnosis is typically confirmed when an individual meets the criteria for both a mental health disorder—such as depression, bipolar disorder, or PTSD—and a substance use disorder according to the DSM-5 (American Psychiatric Association, 2013).
Evidence-Based Treatment Approaches
The historical approach to dual diagnosis was “sequential treatment,” where one disorder was treated before the other. However, modern research indicates that Integrated Treatment is the gold standard (National Institute on Drug Abuse [NIDA], 2020). Integrated treatment addresses both conditions simultaneously within the same clinical team and setting.
Integrated Psychotherapy
Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are highly effective. CBT helps adults identify “triggers” for both substance use and mental health flare-ups, teaching them to restructure harmful thought patterns. For those with high emotional dysregulation, DBT provides tools for distress tolerance and mindfulness (SAMHSA, 2020).
Pharmacotherapy
Medication management is often necessary but must be handled with care. For example, treating depression with SSRIs can reduce the urge to use alcohol as a sedative. However, clinicians must be cautious when prescribing potentially addictive medications (like benzodiazepines for anxiety) to someone with a history of substance abuse (NIDA, 2020).
Intensive Outpatient Treatment
Specialized substance abuse treatment programs when combined with mental health treatment, such as Intensive Outpatient Dual Diagnosis Treatment, provide 12 step groups and mental health support both for sobriety and treatment of mental health without stigma. Unlike traditional groups that may focus solely on abstinence, these groups acknowledge the necessity of psychiatric medications, mental health coping skills, effective communication skills, and emotional regulation.
The Importance of Aftercare
Recovery from a dual diagnosis is rarely a linear process. Relapse in one area often triggers a setback in the other. Therefore, treatment plans must include a robust aftercare strategy, involving ongoing therapy, family education, and lifestyle changes that prioritize stability and stress reduction.
When mental health and substance use are treated as a singular, complex challenge rather than two isolated problems, the chances of long-term stability increase significantly. By fostering a holistic environment that addresses the “whole person,” adults with dual diagnosis can move beyond survival and toward a meaningful, productive life.
New Dimensions Can Help!
New Dimensions Intensive Outpatient Programs for Dual Diagnosis offer a structured, compassionate, and effective pathway toward sobriety and peace of mind—without requiring you to leave your life behind. By addressing both the psychological and physical aspects of addiction and mental health issues, intensive outpatient treatment helps individuals build the foundation for mental health and a substance-free future. To schedule your complimentary assessment, visit us atwww.nddtreatment.com or call 1-800-685-9796.
References
- American Psychiatric Association. (2013).Diagnostic and statistical manual of mental disorders (5th ed.).https://doi.org/10.1176/appi.books.9780890425596
- National Institute on Drug Abuse. (2020).Common comorbidities with substance use disorders research report. U.S. Department of Health and Human Services.https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders
- Substance Abuse and Mental Health Services Administration. (2020).Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. U.S. Department of Health and Human Services.https://www.samhsa.gov/data/