What Is Dual Diagnosis and How Is It Treated?

Maybe you have heard the term “dual diagnosis” and have wondered what that is. Dual diagnosis is when a person has both a mental health condition (such as depression, anxiety, or obsessive-compulsive disorder) and an addiction (such as alcoholism, addiction to pain pills, or addiction to gambling). The two issues often go hand-in-hand and it can be difficult to determine which came first, the mental health condition or the addiction. Read on to find out more about dual diagnosis, how it is treated, and how you can get help for someone you love who you suspect has a mental health condition, a substance addiction, or both.

When Mental Health Conditions Lead to Addiction

Sometimes, a mental health condition will lead to an addiction. The mental illness can be just about anything, from depression to anxiety to bipolar disorder to obsessive-compulsive disorder. The individual with the condition might feel bad physically and/or emotionally. They might decide not to pursue treatment for a variety of reasons. Reasons for not pursuing treatment can include:

  • Not knowing they have a disorder
  • Not being able to pay for the treatment
  • Wanting to avoid being subjected to the stigma of having a mental health condition

Instead, people might choose to self-medicate with whatever their vice is. For many, it is alcohol or drugs. These substances alter the way that they feel by reducing their inhibitions. They also block some of the symptoms of the mental health condition. For example, a person with depression who drinks might feel less sad and hopeless. An individual with severe anxiety might feel much more relaxed after taking pain pills.

Another way that mental health conditions can lead to addiction is when someone is prescribed medication for their condition. One common example is when an individual is prescribed an appropriate amount of Xanax, which is a benzodiazepine (or benzo), for their anxiety. As their tolerance to the medication grows, they might take it more and more often. This can lead to an addiction that due to misusing prescription medication.

Behavioral Addictions

Not everyone with a dual diagnosis is addicted to a substance. In some cases, they are addicted to shopping, video games, gambling, or sex. These addictions can be just as serious as substance addiction. Addictions to shopping and gambling can cause major financial problems. An addiction to video games can cause health issues from sitting so long and also financial issues if the person is unable to hold down a job. A sex addiction can lead to sexually transmissible infections as well as the danger of being abused or harmed by an unknown partner.

When Addiction Leads to Mental Health Conditions

Sometimes, the correlation between addiction and mental health conditions goes in the other direction. An individual can develop an addiction to a substance or a behavior and that, in turn, can cause a mental health condition. It could be depression, social anxiety, or generalized anxiety disorder. As the person feels worse about their addiction, they spiral into a cycle of using more of the vice to make themselves feel better. This creates a cycle of worsening mental health and a stronger and more impactful addiction.

One example of how this can happen would be an individual who has a problem with compulsive shopping. The person might know that their family members disapprove of them wasting money on shopping. They might begin to have piles of clutter in their homes from all of their excess purchases. The family disapproval and the messy home are stressors that can combine with the stress of not having enough money to pay bills and telephone calls from bill collectors. All of this can lead to depression and anxiety, which can make the person crave shopping even more.

Facts About Treatment for Dual Diagnosis

Treating dual diagnosis is tricky. It is important to find out exactly which mental health conditions correlate with the person’s addiction. It can be impossible for a practitioner to know whether a person’s symptoms are stemming from the addiction or from the mental health condition. Where should treatment start and what it should entail?

Dual diagnosis treatment often takes longer and is more intensive than the treatment for either an addiction or a mental health condition. It is also important to remember that the individual might have more than one mental health condition. As treatment progresses, it will often become apparent that there is an additional mental health condition present.

Treatment will often take place in a residential facility for the most immersive experience. It will include medical detoxification if the person is addicted to a substance. It will also include intensive counseling, group therapy, and possibly family therapy.  Expressive arts therapies, such as art therapy or equine therapy, might also be incorporated into the treatment. Some peoples’ treatment might include medication; every person’s case is unique. A professional addictions specialist will work with the individual and, in many cases, their family to create an individualized treatment plan.

Where to Start If You or a Loved One Needs Help

If you believe that you or a loved one are struggling with a dual diagnosis, the first step is to take a screening test. There are online screenings you can take to see if you might have an addiction or another mental health condition. Keep in mind that the results of these screenings do not rule out or confirm a diagnosis; it is important to take the results to your primary care doctor to look over and continue the evaluation process. You can also ask for screenings from your physician or ask for a referral to a mental health professional. From there, you will be referred to the appropriate specialists who can help address the addiction as well as the mental health condition or conditions you or your loved one is dealing with.

While a dual diagnosis can be difficult to overcome, there is hope and help available. With proper treatment, there is every reason that you or your loved one can go on to live a fulfilling life without being plagued by an addiction or by the symptoms of a mental health condition.


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