If you struggle with a substance abuse disorder and mental illness at the same time, you have what’s known as a dual diagnosis. While it remains unclear what causes both conditions, it’s understood that the two often go hand-in-hand. Throughout this article, we’re going to take a deeper look at dual diagnosis.

Dual Diagnosis Defined

Drug and alcohol addiction isn’t easy to overcome. The addictive nature of substances warps the brain and body to become dependent on the chemical influx. This is why withdrawal symptoms are so intense – the brain and body struggle to return to a state of homeostasis. ¹

However, these challenges are only furthered if you also struggle with a mental health condition. This is what’s known as a dual diagnosis. ²

There are no specific requirements for a dual diagnosis. Simply put, it comes down to being diagnosed with a substance use disorder and mental illness simultaneously.

To overcome both these conditions, medical professionals will attempt to understand which condition came first. However, this is a difficult process. Mental illness often leads to addiction and, vice versa, addiction can turn into mental illness.

Dual Diagnosis Statistics

The term “dual diagnosis” was first coined back in the 1980s when clinicians discovered a growing number of people struggling with both mental illness and addiction. It came to their attention that standard treatments for both conditions weren’t effective. As a result, they joined the two under a dual diagnosis and developed a specialized treatment. ³

Since its discovery, several statistics have appeared concerning the condition: ⁴

• 9.2 million American adults (ages 18 and older) live with a dual diagnosis – that’s nearly 3.7% of the total population.
• About 3.2 million adults struggle with a serious mental illness alongside a substance abuse disorder.
• This number rose in 2017 according to 2015 and 2016 surveys.
• In adults aged 50 and over, about 16 million struggled with a mental health condition – 4.5 million of those adults also struggled with a substance use disorder (about 1.5% of the total population).

While these statistics are alarming, it’s a reminder that you aren’t alone in your battle.

What Causes a Dual Diagnosis?

Medical professionals have only theorized what causes a dual diagnosis. It’s believed this condition isn’t caused by a single matter. Instead, there are several cards at play, including:

• Environment – The place where a person grows up or lives is integral to their mental health. For example, if someone lives in a stressful environment, they may be prone to anxiety and turn to drugs and alcohol as a form of relief. ⁵

• Genetics – If you have a family member who has struggled with a mental health condition, there’s an increased chance you’ll also struggle with one. However, genetics isn’t always a deciding factor for a mental illness diagnosis. ⁶

For medical professionals, the tricky part is determining which came first: the addiction or the mental disorder. People often turn to drugs or alcohol to cope with their mental health. Vice versa, substance abuse can trigger mental illness. For example, people who use too much alcohol tend to be more prone to depression.

The best way to properly treat a dual diagnosis is to determine which condition came first.

How to Treat a Dual Diagnosis

With a dual diagnosis, you’ll receive several options for treatment. The most common include:

• Detox – When you struggle with a drug or alcohol addiction, it’s vital to clean your body of the substance. To do so, you must undergo a detox. Admittedly, this may be one of the most difficult parts of becoming sober. Detox requires you to go through extremely uncomfortable withdrawal symptoms to return your body back to a state of balance.

• Evidence-Based Therapy – When it comes to specific medical conditions, evidence-based therapies are the most effective. These are based on science and already show evidence to potentially treat mental health and addiction. ⁷ The two most common forms of therapy are Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR).

• Experiential Therapy – If evidence-based therapies aren’t effective, some decide to dive deeper and discover subconscious issues. One of the best ways to do this is through experiential therapy. These therapies involve an individual going through an experience, such as guided imagery or role-playing. The activities involved in experiential therapies are meant to allow you to explore what you may have hidden from yourself.

• Holistic Therapy – Beyond what we know about the brain and body, many also turn to spirituality to overcome a mental health condition. Holistic therapies have had success alongside traditional treatments. ⁸ You can incorporate a variety of practices, from acupuncture to massage to meditation.

Final Word

Managing a dual diagnosis isn’t easy. In fact, overcoming addiction alongside a mental health condition may just prove to be one of the most difficult aspects of your life. However, we guarantee you can overcome it with the right kind of effort.

References

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² Sheehan MF. Dual diagnosis. Psychiatr Q. 1993 Summer;64(2):107-34. doi: 10.1007/BF01065865. PMID: 8316597.

³ Hryb K, Kirkhart R, Talbert R. A call for standardized definition of dual diagnosis. Psychiatry (Edgmont). 2007 Sep;4(9):15-6. PMID: 20532112; PMCID: PMC2880934.

⁴ Wendie TF, Ahmed A, Mohammed SA. Drug use pattern using WHO core drug use indicators in public health centers of Dessie, North-East Ethiopia. BMC Med Inform Decis Mak. 2021 Jun 25;21(1):197. doi: 10.1186/s12911-021-01530-w. PMID: 34172067; PMCID: PMC8228957.

⁵ Common Comorbidities with Substance Use Disorders Research Report. Bethesda (MD): National Institutes on Drug Abuse (US); 2020 Apr. Available from: https://www.ncbi.nlm.nih.gov/books/NBK571451/

⁶ Andreassen OA, Hindley GFL, Frei O, Smeland OB. New insights from the last decade of research in psychiatric genetics: discoveries, challenges and clinical implications. World Psychiatry. 2023 Feb;22(1):4-24. doi: 10.1002/wps.21034. PMID: 36640404; PMCID: PMC9840515.

⁷ Locher C, Meier S, Gaab J. Psychotherapy: A World of Meanings. Front Psychol. 2019 Mar 22;10:460. doi: 10.3389/fpsyg.2019.00460. PMID: 30984050; PMCID: PMC6448000.

⁸ Ng JY, Dhawan T, Fajardo RG, Masood HA, Sunderji S, Wieland LS, Moher D. The Brief History of Complementary, Alternative, and Integrative Medicine Terminology and the Development and Creation of an Operational Definition. Integr Med Res. 2023 Dec;12(4):100978. doi: 10.1016/j.imr.2023.100978. Epub 2023 Jul 28. PMID: 37927333; PMCID: PMC10623279.