Dual Diagnosis During Drug & Alcohol Addiction Treatment

What is Dual Diagnosis?

The term “dual diagnosis” is used to describe a person who struggles with both a mental health issue and substance abuse. When an addiction co-occurs with a psychological disorder, the patient may not realize ​the existence of the mental issues due to the overwhelming dominance of the substance abuse and its specific behaviors. The reality is that alcohol and drug misuse is often complicated and exaggerated by existing mental health struggles such as depression, PTSD, or bipolar disorder. Many who struggle with mental health will look to self-medicate or reduce those symptoms by taking street drugs or consuming alcohol – which will accelerate the progression into addiction.

What are symptoms of a dual diagnosis?

The symptoms of an underlying mental health condition often mirror the side effects of drug abuse. In the simplest terms, the symptoms of drug abuse include intense urges to use the drug regularly and needing more of the drug over time. When paired with a mental health issue, the symptoms that suggest a dual diagnosis will include:

  • Mood changes that swing to extremes.
  • Confusion in thinking and problems concentrating.
  • Isolation and thoughts of suicide.
  • Failure to maintain interpersonal relationships.
  • Inability to gain or maintain employment.

The challenge of dual diagnosis in drug treatment programs arises when the same mental health symptoms associated with dual diagnosis occur as a side effect of extreme drug use or heavy drinking. Symptoms like agitation, anxiety, sleep problems and mood swings should subside the longer the person remains abstinent. A dual diagnosis may cause these symptoms to persist or intensify.

What is dual diagnosis treatment?

In order to successfully treat addiction for people who have an underlying mental health issue,  drug treatment programs must properly assess the patient and customize treatment protocols  to overcome the challenges of dual diagnosis. This includes:

  • Assessing persons whose substance abuse mimics a mental disorder such as Methamphetamine-induced psychosis
  • Determining if a person is self-medicating a mental illness with drug use such as using heroin to relieve depression
  • When prolonged substance abuse is creating a mental condition such as heavy drinking precipitating depression and psychosis
  • When the environmental and behavioral effects of using causes extreme emotional and physical stress and leads to suicidal thoughts
  • When a person’s mental genetics and/or brain chemistry contributes to both substance abuse and mental health issues

When mental illness and substance abuse occur together, the effects of the abused drug can disguise or counteract the underlying psychological condition. For instance, a person who has an anxiety-related disorder may gravitate towards relaxing drugs such as marijuana, benzodiazepine and opioids. Individuals that present symptoms of mood disorders such as depression or bipolar disorder tend to seek out drugs that make them feel good, such as cocaine, valium, or alcohol

The mental disorder most strongly related to substance abuse is bipolar disorder (BPD). Some estimates put the lifetime prevalence of drug abuse for people who have BPD at 50-60%. This means that the probability of substance use and bipolar disorder occurring together is 50 to 60%.


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William Smith

LCDC, SAP, ADC, Admissions Director

William, better known as Billy around here is head of our admissions team. If you inquire about any of our treatment services, you will most likely speak with Billy in some capacity. Billy is one of the most passionate people when it comes down to recovery. You don’t have to have a long conversation to understand how much he cares about helping others. A recovered addict himself, he knows how miserable it is for those and their families who suffer from alcohol and drug addiction. He has been a part of Bay Area Recovery Center since 2008.

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