While the presence of a substance abuse problem or a mental health disorder can be challenging, when an individual struggles with both at the same time, treatment can prove to be even more complicated.

What is Dual Diagnosis?

The term dual diagnosis, also known as co-occurring conditions,   refers to the presence of both a substance abuse problem and a mental disorder. Alcohol and substance abuse problems often occur with such mental disorders as schizophrenia, anxiety disorders, depression, and personality disorders. In some instances, the mental health problem develops first. This can lead the individual to using drugs or alcohol in order to alleviate the symptoms of their mental disorder. Unfortunately, substance abuse only helps the individual to feel better temporarily. In other cases, the substance abuse takes place first. This can lead to mental and emotional problems over time.

Oftentimes persons with a diagnosable mental health disorder also have an addiction to alcohol and/or drugs. Furthermore, many individuals with a drug and/or alcohol addiction also have a mental illness.

Individuals with a dual diagnosis must receive treatment for both conditions. In order for treatment to be effective, the individual must stop using drugs or alcohol. Various forms of treatment may include medication, therapy, and support groups.

Dual Diagnosis (Co-occurring) Symptoms

Due to the fact that dual diagnosis may involve an addiction to any type of substance as well as may involve any form of mental illness, the symptoms of dual diagnosis can vary widely from one individual to another. Each type of disorder tends to exacerbate the other. In some cases, the symptoms of one disorder may mask the other or could even overlap the other condition. This can make diagnosis as well as treatment even more challenging.

Symptoms of Substance Abuse

The symptoms of addiction and substance abuse can vary quite a bit. In many cases, the symptoms may depend on the type of substance used. However, there are some general symptoms of substance abuse that may appear:

  • Inability to control the amount or rate of substance consumed
  • Repeated use of substance even in high-risk situations
  • Increased tolerance to the effects of substance consumed
  • Isolation from friends and family
  • Continued reliance on substance abuse in order to feel normal
  • Withdrawal symptoms when use of substance decreases or stops
  • Devoting significant amounts of time to attaining substance
  • Continuing to use substance even when usage creates significant social, personal, work, or school-related problems

Symptoms of Mental Health Disorders

Each type of mental health disorder has its own unique symptoms. Of the four mental health conditions most likely to be present in individuals with co-occurring substance use disorders, the following symptoms tend to be most common:

Major Depression

Symptoms of depression may include appetite changes, feeling down, feelings of sadness, changing sleep patterns, and suicidal thoughts. Such symptoms are usually experienced for a minimum of two weeks.

Bipolar I Disorder

Individuals with bipolar I disorder may experience periods when they feel up or happy as well as longer periods of time when they experience major depression. Symptoms of mania may include a reduced need for sleep, jitters, an inflated sense of self, and increased talkativeness.


The classic symptom of schizophrenia is a mental state known as psychosis that may include hallucinations, disorganized thoughts and speech as well as changes in normal body movement. Other symptoms may include problems with memory and attention.


Fear and worry are a very basic description of anxiety. Depression and anxiety have some of the same symptoms (sleep disturbance); additional signs of anxiety include restlessness, hard time relaxing, and being irritable.

Self-Medication of Mental Health with the Use of Substances Can Cause Problems

While a few social drinks may help you to feel more relaxed, individuals who experience social anxiety may have a greater tendency to become dependent on alcohol or other substances simply to function in social situations. As a result, they begin to rely on substances. This often occurs in individuals who do not have access to healthcare or who do not realize they suffer from a mental health disorder. Without proper treatment, this form of self-medication can evolve into addiction, which further exacerbates their mental illness.

Similar Effects on the Brain

Certain regions of the brain are affected in a similar manner by both mental illness and substance abuse. An example of this is dopamine, which is known as the happy hormone. A lack of this hormone is associated with certain mental health disorders, including schizophrenia and depression. When certain substances are used, the brain releases dopamine. Individuals with mental health disorders have a tendency to be more susceptible to substance abuse due to a need for that release of dopamine.

Mental Health Disorders Can Cause Substance Abuse and Vice Versa

Individuals with a mental health disorder may begin self-medicating in an effort to cope with the symptoms of their illness. This can result in the development of a substance abuse problem. The reverse can also be true. Individuals who have a substance abuse problem may eventually develop a mental illness as a result of their substance abuse problem.

Getting Help For Dual Diagnosis with Counseling

Not all treatment programs are the same. Many treatment programs are simply not equipped to cope with dual diagnosis. This means that an individual with dual diagnosis will only receive partial treatment. When only one is addressed, the other is likely to resurface at some point in the future. To ensure ones needs are met, it’s important to work only with a program that is capable of treating both substance abuse problems as well as co-occurring mental health disorders. For long-term recovery and optimal mental health, both the addiction and the psychological disorder must be treated. An experienced therapist will work to identify all of the issues one may be struggling with and develop a comprehensive treatment plan in order to address those needs. This type of treatment plan will take into consideration the intertwined relationship between substance abuse and mental health disorders.

If you find you relate to the information in this article and would like some help, please contact Rita with Sioux Falls Wellness Counseling at (605) 610-9228.