Understanding the Dynamics of Dual Diagnosis in Addiction Recovery

Co-occurring disorders or more commonly known as dual diagnosis is a term used to describe someone who has a substance abuse disorder and a mental health diagnosis.

It is common for someone with a mental health problem to self-medicate with drugs and alcohol even though drugs and alcohol are known to worsen the mental illness symptoms.

Professionally, the fields of recovery from substance abuse and mental health have entirely different cultures. This tends to make finding integrated care challenging.

If you have a co-occurring disorder then, you will want to seek out a program that integrates its care at every level.


Finding care for dual diagnosis is becoming easier because it is becoming a more recognized problem.

According to a 2014 National Survey focused on Drug Use and Health, 7.9 million Americas experience both a substance use disorder and mental health disorder simultaneously.

Recognizing the Symptoms

Because many dual diagnosis combinations can occur, the symptoms will widely vary. As a result, mental health facilities are using the screening tools for alcohol and drugs to identify people at risk for substance abuse disorder.

The symptoms of substance abuse disorder may include:

  1. Sudden behavioral changes

  2. Withdrawing from family, friends, and interests

  3. Using substances with dangerous conditions

  4. Needing a substance to feel normal

  5. Engaging in risky behavior

  6. Becoming physically dependent on alcohol or drugs

  7. Experiencing withdrawal symptoms

  8. Loss of control over substance use

Meanwhile, the symptoms of mental health conditions vary. Some warning signs may include:

  1. Extreme changes in mood

  2. Difficulty concentrating

  3. Avoiding friends

  4. Avoiding social activities

  5. Thoughts of suicidal

  6. Self-injury or harm


Causes of Dual Diagnosis

Biological and environmental factors often influence the way mental health and substance abuse disorders occur.

Addiction and mental illness are each dynamic disorders with varying rate of progression, severity, and manifestation of symptoms. Both disorders are influenced by genetics, environment, and pharmacological influences.

Some individuals have a high genetic risk for these disorders while others have an environmental risk that helps ignite or sustain these disorders.

Those who struggle with a mental health diagnosis are more likely to experience substance abuse disorder or alcohol use disorder.

Mental illness is known to lead people to self medicate with drugs and alcohol to help make themselves feel better for a short period.

There are also cases where a substance abuse disorder can trigger severe mental and emotional distress.

Dual Diagnosis Inpatient Treatment Benefits

It takes an educated expert to properly identify and then treat a patient with a dual diagnosis. There are many benefits to getting inpatient treatment. Those benefits include but are not limited to:

·       Having psychiatric professionals and addiction therapists diagnose, evaluate, and help you come up with a treatment plan.

·       Integrative treatment for both mental health and substance abuse disorder all under one roof at a single rehab facility.

·       Close collaboration among professionals who are in treatment.

·       Individual counseling and peer to peer support groups with aftercare resources for both disorders.

·       Provides access to medical treatment for depression, anxiety, and other mental health problems.

·       Holistic recovery for dual diagnosis patients such as equine-assisted therapy, hypnotherapy, and acupuncture.


Treating Someone with A Dual Diagnosis

Integrated intervention is the best treatment for someone with a dual diagnosis.

When an individual receives treatment for their substance abuse disorder and mental illness, they have a higher chance of recovery.

The idea is that both issues need to be addressed to achieve a sustainable recovery from substance abuse and mental illness.

It is important for you and your treatment provider to understand the conditions interact and what treatment will be most effective.

Treatment planning is not the same for everyone, but here are some common methods that are typically used as part of the treatment plan:

The Detox.

Many with a dual diagnosis have to overcome the hurdle of being physically dependent on their drug of choice.

Going through inpatient detoxification is usually more effective than outpatient for the initial safety and sobriety of a person.

During an inpatient detoxification stay, trained medical professionals monitor you 24/7 for up to seven days.

Depending on your plan you may be weaned off of your substance or its medical alternative to lessen the effects of withdrawal.

Inpatient Rehab.

If someone has a dangerous pattern of substance abuse and is experiencing an untreated mental illness, then they may benefit from inpatient care.

An inpatient rehabilitation center is a place where they can get mental health and medical care 24/7.

These facilities or treatment centers are known to provide support, therapy, health services, and medication to treat the substance abuse problem and any underlying mental health causes.

Outpatient Rehab.

Outpatient treatment allows those suffering from substance abuse to go to group therapy for several hours a week to recover.

Outpatient treatment can include mental health support, group counseling, individual counseling, and informational classes for those struggling with a mental health and substance abuse problem.

Some treatment centers have intensive outpatient treatment programs that provide many hours of care several days a week.

Supportive Type of Housing.

Supportive housing can be a group home or sober home, these are residential treatment centers that are designed to help people who are newly sober avoid a relapse.

These treatment centers provide their residents with independence and support.

Continued Psychotherapy.

Psychotherapy is usually an important part of an effective dual diagnosis treatment plan.

Cognitive-behavioral therapy, or CBT for short, is known to help people change ineffective patterns of thinking.

It is also designed to learn how to cope with negative feelings and has been successful in treating people with a dual diagnosis to avoid relapsing.


Different types of medications are known to help people treat their mental illnesses.

In addition to this, there are certain medications known to help ease withdrawal symptoms for patients undergoing the detoxification process in substance abuse disorders.

Self-Help Support Groups.

Having a dual diagnosis is challenging and can be isolating.

Support groups are a great way to safely share your anger, celebrate success, get referrals for appropriate specialists, swap recovery tips, and find resources that are unique to your community.

They are also a good way to form healthy friendships with people who are encouraged to stay clean. Some good self-help support groups are:

  1. Double Trouble in Recovery is a 12-step based fellowship for those dealing with both a mental health problem and substance abuse issue.

  2. Narcotics Anonymous is a 12-step based fellowship focused on those dealing with drug and alcohol abuse.

  3. Alcoholics Anonymous is a 12-step based fellowship focused on those dealing with alcohol abuse and addiction.

  4. Smart Recovery is a sobriety support group for all addictions that is not based on the 12 steps or faith.

Those with a dual diagnosis often need a lot of different services besides substance abuse and mental health treatment.

Important needs commonly include housing and case management to gain access to social and community health services.

These resources can be essential for those struggling with a dual diagnosis.

SAMHSA, Substance Abuse and Mental Health Services Administration, of the United States Department of Health and Human Services recommends that there is an integrated approach to co-occurring disorders.

Having an integrated treatment plan means treating both mental health and substance abuse intervention together instead of treating each one separately without any consideration for the other disorder.

Integrated treatment allows the person to receive well-rounded care.

It is known to help people gain knowledge, get support, develop new skills and have a new hope that they can manage their problems and pursue meaningful goals in life.

Integrated treatments may include:

  1. Helping patients think about how drugs and alcohol play a role in their lives. People are freer to talk about these problems when the discussion is nonjudgmental, private and doesn’t have any legal consequences.

  2. Offering patients an opportunity to learn more about drugs and alcohol. Knowing things like how substance abuse interacts with mental illness, other medications, and alcohol is one way to gain insight into your particular problem.

  3. Providing patients with other services and employment helps the process of recovery.

  4. Helping patients identify and get recovery goals. If a person believes their drugs and alcohol use is a problem a trained counselor can guide that person in developing personalized recovery goals.

  5. Providing counseling that is designed for people with a dual diagnosis.


Dual Diagnosis and Youth

Sometimes young people will turn to drugs and alcohol to cope with life’s difficulties.

They do it to fit in, rebel, satisfy curiosity, and to feel more adult-like.

Teens who also have other mental health problems and depression are exceptionally vulnerable to drugs and alcohol abuse.

Teenagers are known to fail to recognize the symptoms of depression or what is causing them to feel depressed. They notice that when they do drugs or drink it alleviates emotional pain and stress.

This ultimately leads to an addiction that will, in turn, make stress, and emotional pain worse Alcohol is a drug with harmful consequences and serious risks. It is not to be taken lightly

Signs of Teen Substance Abuse

  1. Using substances like alcohol or drugs regularly

  2. Lying about their drug and alcohol use

  3. Giving up interests and activities for drugs and alcohol

  4. Avoiding others so they can get drunk or high

  5. Drinking and driving

  6. Needing more to achieve the same high as before

  7. Planning their drinking in advance

  8. Using drugs and alcohol alone

  9. Experiencing frequent hangovers

  10. Pressuring others to use drugs

  11. Taking part in risky sexual activities

  12. Taking part in risky or dangerous situations

  13. Feeling hopeless, depressed, suicidal, and run-down

  14. Acting out of selfishness

  15. Talking about drugs excessively

  16. Getting into legal trouble

  17. Being suspended from school due to substance abuse

Potential Consequences of Teen Substance Abuse

Some behavioral, physical, and life consequences associated with substance abuse can include:

  1. Having difficulty concentrating

  2. Experiencing personality changes

  3. Experiencing a general lack of energy and motivation

  4. Experiencing sleep changes or disturbances

  5. Having appetite changes

  6. Being oversensitive

  7. Becoming mood and nervous

  8. Engaging in unplanned sex that is unprotected

  9. Failing in school or declining grades

  10. Depression

  11. Excessive need for privacy

  12. Engaging in suspicious or secretive behavior

  13. Loss of interest in friends and family

  14. Suffering from injuries due to driving under the influence

  15. Having legal problems

Dual Diagnosis and Depression

Having depression is a serious medical condition that is treatable.

The risk of depression is higher for those who have a serious medical condition such as stroke, cancer, heart disease, or diabetes.

The warning signs are usually missed because those who are suffering from depression ignore the warning signs. This results in a delay in treatment for the underlying depression.

Depression is not a normal response to another illness. That makes it important to treat all of a patient’s problems.

Those With Dual Diagnosis Have Hope

The most successful treatment for those with a dual diagnosis aside from addiction intervention is cognitive behavioral therapy, contingency management, motivational interviewing, and relapse prevention.

  1. Cognitive Behavioral Therapy is a treatment that helps you deal with negative and destructive thought patterns.

  2. Contingency management, also known as motivation incentives, is a behavioral therapy rooted in providing regards for desired behaviors such as clean drug screens.

  3. Motivation Interviewing is a psychotherapy approach that helps the client address and resolves their ambivalence.

  4. Relapse Prevention is a therapy that is rooted in helping an individual abstain from alcohol and drug use.

Recovery from a dual diagnosis takes a ton of work.

By nature, mental illnesses and substance abuse make you feel unmotivated. However, if you work past your ambivalence, then recovery is possible.

To get off of drugs and alcohol you have to be ready to quit for good. No one else can make you stop using. That must come from within.

When you do decide to get clean and treat your co-occurring mental health, remember, there are many resources available to you.

Remember… Recovery is achievable.

If you need help with your recovery, you can get in touch with the Hotline at our Recovery Center where trained and experienced professionals are available to assist you in every way.

The staff at Chateau Recovery is always available to help you with all of your questions regarding addiction recovery and treatment.  Call anytime.

Chateau Recovery Center 375 Rainbow Lane
Midway, UT 84049, USA http://chateaurecovery.com

If you or someone you love has questions concerning the rehabilitation process, call our free helpline Phone: +1 888-971-2986 for more information. Calls are always confidential, private, and secure.

Co-Occurring Disorders in Recovery from Addiction by Dr. Bob Weathers

Establishes the clear necessity of substance abuse counselors working hand-in-hand with mental health professionals as they collaborate in the treatment of individuals with twin diagnoses of substance abuse or dependence, on the one hand, and psychiatric disorder (e.g., depression, anxiety, or PTSD), on the other.