Having a diagnosis — no matter how dire — is often a greater comfort than wondering if you should have one. Once it has a name, a definition and a treatment protocol, your condition is a little less scary. It seems more surmountable. By that logic a dual diagnosis should be twice as welcome, but knowing that your symptoms actually add up to two different illnesses can be a bit overwhelming.

Not uncommon, a dual diagnosis is important to the treatment of addiction. Addiction recovery is complicated, as is anything related to brain chemistry, so any definition or distinction that can be brought to a situation is helpful. A dual diagnosis also illustrates the complexity of brain chemistry and offers a good reason to avoid interfering with it whenever possible.

You should understand that a dual diagnosis can be treated. People live in recovery from this situation and go on to live happy lives. With the right treatment, you can, too.

What is Dual Diagnosis?

What is Dual Diagnosis?Addiction is a confusing concept that doctors are still trying to understand fully. Currently, it is classified as a mental illness because it changes your brain by disrupting the way you respond to needs and desires such as the way you experience pleasure. The diagnosis of addiction is dependent on the elements of compulsive use, tolerance, and withdrawal.

A person with a dual diagnosis is suffering from addiction and another mental illness at the same time. There is no cause-and-effect relationship required for this diagnosis. A dual diagnosis is still a dual diagnosis whether the addiction caused another mental illness, or the mental illness was the underlying condition that led to addiction.

Mental illnesses cover a wide range of conditions that affect mood, thinking and behavior. Addiction clearly fits this definition with its compulsive behaviors to obtain more drugs, in addition to its mood- and behavior-altering effects. Drugs ultimately work on your brain, changing the way it thinks. When you continually abuse drugs, altering your brain, it is possible to create another mental illness. Some of these changes to your brain can be permanent.

Dual Diagnosis Statistics


Dual diagnosis is also referred to as a co-occurring condition. Co-morbidity, a term referring to a person with two chronic diseases at the same time, can also refer to this condition. Addiction is considered a chronic disease, and other mental illnesses fit the description of chronic, like bipolar disorder, anxiety or schizophrenia.

Mental illness, experienced by approximately 18.6 percent of the population, is probably more prevalent than most people realize. Of those 43.7 million people suffering from mental illness, 13.6 million find that their disease limits major life activities. That means that 4.1 percent of adults in this country are impacted in a substantial way by mental illness.

13.6 million daily lives affected by diseaseThere are approximately 23.5 million people in the US addicted to drugs and alcohol. When you add the significant limitations caused by addiction to the issue of mental illness, the greater problem becomes clear. Roughly 40.7 percent of those addicts also suffer from another mental illness — that’s approximately 8.4 million people dealing with a dual diagnosis.

Mental illnesses — aside from addiction — tend to develop early in life. An average of 75 percent of all people afflicted with a chronic mental disease developed that disorder by the time they were 24 years old. Half of them were diagnosed by their 14th birthday. Coincidentally, a larger portion of people under the age of 24 suffer from addiction as well.

24 Million people affected

How to Identify Dual Diagnosis: Substance Abuse and Mental Illness

When looking for signs of a dual diagnosis, you must understand the role of denial. Addicts are capable of denying the facts of their substance abuse because they are ashamed or don’t want to face the reality of their situation. But denial can make it harder to assess which symptoms are related to addiction and which may be part of an underlying mental illness.

The most obvious evidence of denial is the fact that an addict will continue to use drugs despite knowing how dangerous they are for their health. Even when an addict can draw a direct connection between their substance abuse and the loss of their job, family or friends, they will continue to use. Denial can be a huge obstacle to recovery.

Denial often starts long before drug abuse. Many alcoholics, for instance, are shocked to realize they grew up with addicted parents. In their families no one talked about alcoholism, so they grew up believing their parents’ behavior was normal. People turn the guilt and shame they feel about addiction into lies that end up perpetuating their behavior through generations.

Addicts will still use despite connectionsAddiction recovery does not happen when the problems are ignored. In most cases, the addiction just gets worse, potentially effecting more people. The first step in identifying a dual diagnosis is honest observation.

  • Family history — Addiction and other mental disorders tend to follow genetic lines. If someone in your family was diagnosed or treated for mental illness, even two or more generations back, there is a possibility you inherited the illness. Sometimes figuring out your family medical history can be difficult — especially in regard to mental health, because people do not like to talk about these issues. No one might have labeled the problem, but you can probably tell from behaviors depicted in family stories if addiction or other mental illness was present.
  • Personal sensitivity — Some people are more susceptible to the effects of drugs than others. Notice how alcohol or even aspirin affects you. Do you get the intended results from the recommended dosage? Does just one drink change your behavior significantly or make you feel hyper or drowsy? Do you notice any emotional reactions to substances like cold medicines? Understanding your personal tolerance levels to any drugs that you take will give you clues to your mental health.
  • Baseline feelings — Depression and anxiety are closely related to addiction. Notice if you feel depressed when you are not using drugs. Is the anxiety brought on by the drug abuse, or is it there even when the drugs are not? Long periods of sobriety may help you better assess your mental health and separate addiction symptoms from other mental illnesses.
  • Mental health treatment — Consider whether or not you have ever been treated for addiction or a separate mental health issue. If you relapsed after treatment, it might be because of an underlying issue that was never addressed. Once addiction and other mental illnesses co-exist, it is impossible to treat one without treating the other. Whichever one is left untreated will always cause your recovery to fail.

Mental illnesses are essentially invisibleMental illnesses are essentially invisible, which adds a layer of difficulty to recognizing and treating them. In general, addiction is probably easier to spot than other mental illnesses, but you have to be observant and free from denial.

If you can answer yes to any of these questions, you likely have an addiction problem:

  • Does alcohol or drug use cause problems in your relationships?
  • Are you ashamed of your drinking or drug use?
  • Did you try to drink or use drugs less and fail?
  • Do you ever regret things that you say or do while under the influence?
  • Did drinking or drug use ever make you black out?
  • Have you ever gotten into trouble at work because of your drug use?
  • Do you lie about how much you drink or use drugs?

These are all signs of addiction. The more signs you display, the more serious your problem is. No matter what your substance of choice, addiction can happen quickly. Just because you don’t realize you are addicted doesn’t mean you are safe.

If you’ve identified yourself as being addicted to one or more substances, before you can obtain the proper treatment, you need to consider whether you also suffer from another mental illness. The most common illnesses that co-exist with addiction are depression, anxiety, and bipolar disorder.

Symptoms of DepressionSome symptoms of depression include:

  • Changes in sleep patterns
  • Feelings of hopelessness
  • Loss of interest in daily activities
  • Problems concentrating
  • Reckless behavior

Symptoms of Bipolar DisorderIf you are bipolar, you are likely to experience some of these manic symptoms:

  • Increased energy
  • Rapid speech
  • Racing thoughts
  • Hyperactivity
  • Rage
  • Unrealistic beliefs

Symptoms of AnxietyCommon signs of anxiety include:

  • Tension
  • Jumpiness
  • Trembling
  • Dizziness
  • Headaches
  • Insomnia
  • Edginess
  • Nausea

Depression, anxiety and bipolar disorder — as well as any other mental illnesses — require a clinical diagnosis. But recognizing the signs can let you know there is something wrong and that you should seek professional diagnosis and treatment.

Treatment for Dual Diagnosis

When two different conditions afflict the brain, treatment can be confusing. You must sort out which condition is causing what symptoms, a task that can be somewhat like untangling a knotted ball of twine.

The most obvious instinct would be to stop all medication, prescribed and illicit, to let the brain clear up. The treatment of addiction in a dual diagnosis, however, is not nearly that simple.

Dual Diagnosis Treatment PlanMany people describe addiction recovery like peeling an onion: You deal with what you find on the surface and that process leads you to deeper issues. As you address problems they reveal other issues that need to be addressed. It is a process that can only be clearly mapped in hindsight.

When dealing with a dual diagnosis, the path to recovery is even more complicated. The addiction and other mental illness are intricately intertwined, so changing one affects the other. The brain chemistry of mental health is a natural balance that has been distorted by substance abuse. Removing the substance, however, may be even more difficult because of the existence of another mental illness.

Treatment for dual diagnosis must address the whole picture, not just the addiction. Unfortunately, addiction recovery with a dual diagnosis cannot be a step-by-step process in which one treats the addiction first and then deals with the other issues. You must first try to understand the relationship between the two illnesses you are dealing with.

If the underlying mental illness provided an impetus for the addiction, it will continue to do so, thwarting genuine efforts to overcome addiction. Sometimes people experiencing mental illness try to self-medicate to alleviate their symptoms or escape the discomfort they feel. Never a good idea, self-medication often leads to an addiction which will continue to be fed by the desire to escape the underlying condition.

Adding drugs or alcohol to a mental illness can worsen that condition. As the condition worsens, you increase your use of drugs and alcohol to try to control the symptoms. This just becomes an unending cycle. You must understand as much as you can about how drug abuse has affected the underlying condition. It can be reassuring to know that once you overcome your addiction, your other mental illness might not be so bad and could be managed without self-medicating.

It is also possible that your drug and alcohol abuse created a mental illness that did not exist before. In this case, there is some chance that once you are in recovery for your addiction, you will enter recovery for the other condition as well. It is still more difficult to overcome an addiction under these circumstances, but it can be done. Knowing that the damage you have done can be reversed might be the inspiration you need to get through recovery.

Dual Diagnosis Rehab — the Importance of Treatment

If you suspect you or someone you love has a dual diagnosis, getting the right treatment is important. You can overcome addiction and either cure or manage the underlying mental illness, but you cannot do that alone. With a dual diagnosis, medical supervision during recovery is critical.

Addiction happens in your brain when drugs alter the chemical balance that controls your thoughts. This is a tricky area to be experimenting in, since some of those thoughts support your vital organs that keep you alive. The additional mental illness means that your brain chemistry has a very delicate, unique make-up. In some ways, your brain’s response to certain stimuli does not match everyone else’s. It was risky enough introducing foreign substances to this delicate environment, but removing them can be even more dangerous and should always be managed by qualified medical personnel.

In a dual diagnosis, two mental illnesses are entwined together. In some ways, each one supports the other. By trying to remove one disease without addressing the other, you are tipping a scale that is just going to tip back the other way when you let it go. As you work towards untangling these issues and resolving both of them, you must be careful not to inflict any more damage on your brain.

Dual diagnosis treatment programs should include the following:

  • An opportunity to understand the role that drugs and alcohol play in your life. A safe discussion of how, when and where you used drugs and how they may have been involved in your family or culture before you started to use helps put your situation into perspective. It may also give you some insight to the mental illness and how it is related to the addiction.
  • Educational opportunities to understand how drugs and alcohol affect mental illness. You should learn how different drugs interact, what they do to your brain, and how some of the symptoms of addiction are similar to other mental illnesses.
  • Building a support network in the recovery community. It will be important for you to have the support of other people who are going through recovery, who can help you understand what you are experiencing. A good treatment program helps you build this recovery network and shows you how to rely on it when you need help.
  • Support in creating your own recovery goals. Mental illness makes people feel out of control. Recovering from addiction and mental illness means regaining some sense of control over your life. That control can start in recovery when you participate in setting your own goals. While everyone comes to rehab with the same general goal — to get off drugs — each individual has a different journey to travel. People with a dual diagnosis must recognize their options and choose their own path forward.
  • Individualized special counseling. Treating dual diagnosis requires special training and understanding of the nuances of co-existing mental illnesses. An addiction recovery program needs to be specially equipped to handle a dual diagnosis because treating just the addiction will not work and may result in frustration and a feeling of failure. Mental illness is tough enough to deal with. You don’t want the treatment to add to your problems.

Treatment for dual diagnosis can be successful. In some cases this means overcoming the addiction and noticing the underlying mental illness clearing up at the same time. Some chronic mental illnesses cannot be cured but they are manageable at a level that still affords you a good quality of life. Drugs and alcohol aggravate mental illnesses and often exacerbate their symptoms. Getting those toxins out of your system will almost always result in an improvement.

Getting the diagnosis right and choosing the right treatment program is key to a successful recovery. While you may be able to use the information presented here to figure out what issues you are dealing with, a professional assessment is needed for a dual diagnosis. Getting the diagnosis right is important because it affects treatment options.

Knowing more about the possibility of a dual diagnosis, you can begin to investigate treatment options. Our list of top-ranked rehabs makes your research easy. We’ve gathered the basic details of several highly ranked rehab centers around the world for you to compare.

Our rehab center rankings show the location, cost, and client-to-staff ratio, helping you sort through the market and find the rehab facility that is right for you. The contact information for each facility is part of the listing, so you can call and ask questions about their dual diagnosis treatment options.

Taking the first step toward treating your dual diagnosis can be hard. A lot of information is out there, and it is difficult to know what to do. That’s why we assembled all of the pertinent information in one place for you. When you’ve decided you are ready to change your life by ending your addiction, you must get the support you need right away. With our top-ranked rehab list, you can focus on the details that matter in order to focus on your recovery.