Dual Diagnosis Treatment

Orange County Dual Diagnosis Treatment Center

If you’ve received treatment for a drug addiction or mental illness or if you’ve considered researching such treatment, you may have heard the term “dual diagnosis.” If you’re like many people your first thought is “what is dual diagnosis and how does it impact me?” This article will provide a definition for the term and explain what it is and how it is treated.

What Defines a Dual Diagnosis?

A dual diagnosis refers to someone who suffers from two separate but intertwined conditions. One is a substance abuse problem such as cocaine or heroin addiction. The other condition is a mental illness like depression, bipolar disorder or severe anxiety.


Being able to determine if someone has a dual diagnosis is often difficult because substance abuse can mask or mimic the symptoms of mental illnesses.

It may be hard to provide an accurate diagnosis of the mental condition even if one is suspected. A person with a mental condition is often adept at hiding problems so they may be a highly-functioning addict with few signs for others to see.

The Cause of a Dual Diagnosis

These two conditions may happen for many reasons. In most instances, the mental illness comes first, and the substance abuse happens because of self-treatment. The person tries to disguise their symptoms through alcohol or drug abuse.

For example, someone may suffer from severe anxiety to the point where they are unable to function in group settings. To counteract the problem, they have a few drinks to calm the nerves.

While it may work to help them feel more comfortable and avoid the panic that comes with the anxiety, over time it takes more alcohol to achieve the same effect. In time, they develop an addiction to the alcohol.

In other cases, the substance abuse may actually come first. While this happens in fewer cases, it is still a problem. A person who abuses drugs may actually alter the chemicals in the brain to the point where it develops a condition.

The Challenges of a Dual Diagnosis

Treating someone with a dual diagnosis, also referred to as co-existing or co-occurring disorders, is more challenging than treating substance abuse alone. Some of the issues include not following prescribed treatment, relapse and an increased risk for other medical conditions.

People with a mental condition often use drugs or alcohol as a way to cope with the problem or hide it from others. They may not be committed to treatment because it will allow their mental illness to surface.

If the substance abuse is the only aspect treated, the person has an increased likelihood of relapse whenever the mental illness symptoms surface. With each relapse, it can be harder to get the person to enter treatment again because it seems destined to fail.

Common Conditions with a Dual Diagnosis


While a person with any mental illness can turn to substance abuse, certain conditions seem to be more inclined to be paired with addictive substances. In addition, many different substances may be used. In some cases, it starts out with prescription medications which have a risk for abuse, such as anti-depressants or anti-psychotic medications.

When these drugs lose their effectiveness because the person has developed a tolerance for them, they turn to illegal substances, such as marijuana, heroin or methamphetamines. Alcohol is often used to deal with mental illness symptoms as well.

Mental illness often carries with it a stigma and no one wants to be perceived as different, so they attempt to hide the symptoms of the condition through drug use. Some examples include the following:

  • Cocaine and Anxiety – the drug provides euphoria and feelings of power, which counteracts anxiety
  • Marijuana and Schizophrenia – marijuana provides a calmness that people with this mental disorder may be lacking
  • Opioids and PTSD – people with post-traumatic stress disorder often use prescription pain medication to deal with serious physical injuries, which can become addictive
  • Heroin and Depression – heroin provides feelings of euphoria for the short-term to counteract the feelings of depression
  • Alcoholism may be paired with mania, dementia, and anti-social personality disorders

One of the issues with addiction for people with mental illness is while initially the substance hides the signs of the condition, withdrawal symptoms are often similar to the symptoms of the illness. The person must then seek out more of the substance to avoid withdrawal, which increases the condition they wish to avoid.

Here is a list of mental conditions and the symptoms the person tries to disguise or alleviate:

  1. Bipolar Disorder – intense mood changes from depression to mania
  2. Post-Traumatic Stress Disorder – hypervigilance, nightmares, constant distress, detachment after a trauma
  3. Attention Deficit Hyperactivity Disorder – inability to focus, inattention, inability to complete tasks, distracted behavior
  4. Anxiety Disorder – constant worry, apprehension
  5. Obsessive-Compulsive Disorder – constant obsessions with certain tasks, compulsions do things to an extreme
  6. Depression – continual sadness, feelings of hopelessness, loss of energy and interest in hobbies or interests
  7. Panic Disorder – multiple panic attacks which are evidenced by trembling, sweating, chest pain, feeling dizzy, nausea and even fear of dying
  8. Schizophrenia – hallucinations, delusions, disorganized behavior and conversations

Treatment for Dual Diagnosis


The vast array of conditions and symptoms from the mental conditions and substance abuse make diagnosing the presence of both difficult. However, once the two conditions have been diagnosed, treatment is possible.

Treating co-existing disorders must be different from treating substance abuse alone or the person is likely to relapse. Treatment often comes in one of two forms. First, it may be treated separately but at the same time. One doctor treats the mental illness while the other treats the substance abuse. Each person creates their own plan for treatment with the hope of not making the other condition worse. This is not a very effective method of treatment.

The second is treatment in sequence, which means the two conditions are treated one after the other. Substance abuse is treated first with the underlying mental condition treated next. Unfortunately, the person often relapses after addiction treatment before getting the help they need for the mental illness.

The most effective method of treatment is when the person is treated for both conditions at the same time at the same treatment center. While more than one doctor may be on the case, they share information and work together on a comprehensive treatment plan. Because of the complexity of the two conditions, many people attend inpatient rehabilitation programs to give them the support they need for success.

An assessment of the person’s psychiatric health will be conducted for an accurate diagnosis of the mental condition. The person will begin treatment for the drug addiction, taking into consideration how it will impact the mental illness. Detoxification or removing the substance from the person’s system may move at a slower pace to avoid triggering symptoms of the mental condition.


Once initial detoxification from drugs or alcohol has been completed, a plan will be put into action to treat the mental condition and the triggers which cause drug use. Medication is often prescribed to control the symptoms of the mental condition while behavioral modification therapy is used to avoid substance abuse in the future. The person may attend support groups and participate in individual counseling. Alternative therapies, such as yoga, massage therapy, music therapy, nutritional counseling and more are commonly used in a dual diagnosis treatment plan.

A key component of treatment in this situation is relapse prevention. The person will often stay in therapy sessions long after they have been released from the rehab program. They will need continual support to help them avoid relapse and to ensure they continue the prescribed medication for their mental illness.

Treating two conditions in a dual diagnosis can be a complicated and lengthy process. However, if you find the right program that understands this situation, recovery is possible. If you or someone you love is struggling with dual diagnosis issues, please call Lighthouse Treatment Center today for help. Our caring team is highly specialized in dealing with dual diagnosis treatment. We are happy to provide a no-cost, no-obligation consultation with one of our experienced treatment advisors. You don’t have to fight this alone, we can help.