Dual Diagonosis

What is a dual diagnosis?

A dual diagnosis is when someone has both a mental health disorder and a substance use disorder at the same time. This means they’re dealing with two conditions that must be treated together. Common examples include depression paired with alcohol addiction, anxiety alongside opioid dependency or bipolar disorder combined with cocaine addiction.


Treating both issues at the same time is crucial for successful recovery. If one condition is left untreated, it can make the other worse. So, addressing both simultaneously is key to helping someone get better.

What’s the difference between a dual diagnosis and co-occurring disorders?

The terms’ dual diagnosis’ and ‘co-occurring disorder’ sometimes overlap, but there are slight differences. Dual diagnosis specifically refers to one mental health disorder and one substance use disorder, while co-occurring disorders can involve multiple mental health and substance use issues. Dual diagnosis is often used in clinical settings for clear-cut cases of two conditions. In contrast, co-occurring disorders is a more inclusive term used in broader contexts like research and public health discussions.

What are common signs of a dual diagnosis?

When it comes to identifying addiction or a mental health issue, it can be difficult, especially if symptoms aren’t easy to spot or the person is trying their best to hide an addiction. When dual diagnosis happens, it can make the situation even more difficult. 


Below, we take a look at some common signs of a dual diagnosis so you can be more prepared to spot it in others or perhaps even yourself:


Fluctuating mood and behaviour


  • Sudden changes in mood, such as extreme highs and lows.
  • Unpredictable behaviour, including aggression or irritability.


Increased substance use


  • Escalating use of alcohol or drugs.
  • Using substances to cope with stress, anxiety or depression.


Mental health symptoms


  • Persistent feelings of sadness or hopelessness.
  • Anxiety, panic attacks or excessive worry.
  • Delusions or hallucinations in severe cases.


Social withdrawal


  • Isolating from friends and family.
  • Loss of interest in activities once enjoyed.


Difficulties in daily functioning


  • Trouble maintaining employment or academic responsibilities.
  • Neglecting personal hygiene and self-care.


Physical health issues


  • Unexplained health problems, such as headaches or digestive issues.
  • Significant changes in weight or appetite.


Cognitive impairments


  • Difficulty concentrating or making decisions.
  • Memory problems or confusion.


Risky behaviour


  • Engaging in dangerous activities while under the influence.
  • Legal issues related to substance use or mental health crises.

Why do addiction and mental health issues occur so often?

There are several reasons why these two issues often occur together, and understanding the links between mental health and addiction can help shed light on this.


Firstly, many people with mental health disorders turn to substances as a form of self-medication. For instance, someone with anxiety might use alcohol to calm their nerves, or someone with depression might turn to drugs to feel a temporary sense of relief. While this might provide short-term comfort, it often exacerbates the underlying mental health issue and leads to dependency on the substance.


Secondly, addiction can also lead to mental health problems. Substance abuse can alter brain chemistry and function, sometimes triggering mental health issues in individuals who previously didn’t have them. For example, prolonged use of stimulants can lead to anxiety disorders, while chronic alcohol abuse can result in depression.


Another important factor is that certain risk factors contribute to both addiction and mental health disorders. These include genetic predisposition, trauma and environmental stressors. A person with a family history of mental illness or addiction is more likely to develop one or both of these conditions. Similarly, traumatic experiences, such as childhood abuse or significant life stressors, can lead to both mental health issues and substance use as a coping mechanism.

What are some of the most common dual diagnosis? 

While every person is different and unique, meaning some may be predisposed to either addiction or certain mental health issues, some common combinations occur. Below, we take a look at a range of common dual diagnosis:

ADHD and Addiction
ADHD can make it challenging to focus and manage impulses. This often leads individuals to self-medicate with drugs or alcohol, worsening symptoms and increasing addiction risks. Understanding this…

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Anger Management and Addiction
Struggling with anger management can lead to substance abuse as a way to cope. However, addiction only amplifies anger issues, creating a vicious cycle that makes recovery difficult without address…

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Anxiety and Addiction
Anxiety disorders often push individuals towards substances for temporary relief. Unfortunately, this can lead to addiction, worsening anxiety symptoms and making it harder to achieve lasting peace…

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Autism and Addiction
Those with autism may turn to substances to cope with social challenges or sensory overload. This self-medication can quickly lead to addiction, necessitating specialised treatment to address both …

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Bipolar and Addiction
Bipolar disorder’s extreme mood swings can drive people to use drugs or alcohol to stabilise emotions. However, this often leads to addiction, complicating the management of both bipolar disorder a…

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Borderline Personality Disorder and Addiction
Borderline Personality Disorder involves intense emotional instability, which can lead to substance abuse as a coping mechanism. Addressing both addiction and BPD is vital for effective recovery.

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Codependency and Addiction
Codependency involves an excessive emotional reliance on others, often leading to substance abuse. Treating both codependency and addiction is essential for fostering healthy relationships and last…

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Depression and Addiction
Depression can drive individuals to self-medicate with drugs or alcohol, but this only deepens the depressive state. Effective treatment requires addressing both the depression and the addiction.

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Grief and Addiction
Coping with loss can lead to substance abuse as a way to numb emotional pain. However, this often leads to addiction, complicating the grieving process and recovery without proper support.

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Insomnia and Addiction
Insomnia can lead individuals to use substances to aid sleep. Over time, this can result in addiction, making it harder to achieve natural, restful sleep without professional help.

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OCD and Addiction
Obsessive-Compulsive Disorder can lead to substance abuse as individuals attempt to manage their symptoms. This often results in addiction, requiring treatment for both OCD and substance use.

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PTSD and Addiction
Post-Traumatic Stress Disorder often drives individuals to self-medicate with drugs or alcohol to escape trauma-related symptoms. Addressing both PTSD and addiction is crucial for comprehensive hea…

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Personality Disorder and Addiction
Personality disorders can lead to substance abuse as individuals try to manage their symptoms. Effective treatment must address both the personality disorder and the addiction for successful recovery.

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Schizophrenia and Addiction
Schizophrenia can lead to substance abuse as individuals attempt to self-medicate. This combination complicates treatment, necessitating a comprehensive approach to address both conditions.

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Self-Harm and Addiction
Self-harm and substance abuse often co-occur as individuals use drugs or alcohol to cope with emotional pain. Treating both issues is essential for effective recovery and emotional healing.

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Stress and Addiction
High stress levels can lead to substance abuse as a coping mechanism. However, this often results in addiction, making it crucial to address both stress and substance use in treatment.

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Suicide and Addiction
Addiction significantly increases the risk of suicidal thoughts and behaviours. Understanding and treating both addiction and suicidal tendencies is vital for saving lives and fostering recovery.

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How are dual diagnoses treated?

Most mental health issues, on their own, can be treated in an outpatient setting, typically involving medications, therapy and regular check-ups. However, the severity of the issue increases significantly when addictions are involved. Usually, an addiction on its own is best treated in an inpatient setting, so when a mental health issue is added into the mix, inpatient treatment becomes even more necessary. 


Attempting to manage co-occurring disorders on your own is discouraged, as self-help strategies are generally ineffective for long-term recovery. Dual diagnosis issues are complex, requiring a deep understanding of both addiction and mental health disorders. It’s essential to seek professional help rather than trying to navigate this challenging journey alone.

How can I expect my dual diagnosis to be treated in rehab?

When you’re entering rehab with a dual diagnosis, you can expect a comprehensive approach to treat both your mental health and addiction. Here’s an outline of what you might experience:

Initial assessment

Your journey will start with a thorough initial assessment. During this phase, medical professionals will take the time to understand the severity and nuances of both your mental health issues and your addiction. They’ll ask about your medical history, current symptoms and any previous treatments you’ve undergone. This helps them create a personalised treatment plan tailored specifically to your needs.


The next step is detox, focusing on the addiction side of your dual diagnosis. This process involves safely managing and minimising withdrawal symptoms as your body clears the substances. Medical staff will closely monitor you to ensure your comfort and safety. This phase is crucial for setting a stable foundation for the rest of your treatment.


Therapy is a vital component of dual diagnosis treatment, addressing both the roots of your addiction and your mental health issues. Various types of therapy can be beneficial, including:


  • Cognitive Behavioural Therapy (CBT): This helps you understand and change harmful thought patterns and behaviours, offering tools to manage both addiction and mental health symptoms.
  • Dialectical Behaviour Therapy (DBT): Useful for managing intense emotions and improving relationships, DBT teaches skills like mindfulness, distress tolerance and emotional regulation.
  • Group therapy: These sessions focus on treating both addiction and mental health issues simultaneously. This creates a supportive community where you can share experiences and learn from others.
  • Holistic therapies: Practices like yoga, meditation and art therapy can help you manage stress and promote overall well-being.


After completing the main phases of treatment, aftercare serves as a safety net, offering continuing support and care. This ongoing phase is essential for re-evaluating and strengthening your coping skills as your life circumstances change. Aftercare can include regular therapy sessions, support groups and check-ins with your treatment team. It ensures a robust support system to help you maintain progress and navigate challenges.

What’s next?

Struggling with a dual diagnosis can feel overwhelming, but you’re not alone. Seeking help at a rehab centre is crucial to reclaiming your life. These specialised centres offer comprehensive care tailored to address both mental health and substance use disorders. With professional support, you’ll gain the tools and strategies needed for a healthier, balanced future.

Contact UK-Rehab for a tailored search and advice on the best rehab programme for you.

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