Dual Diagnosis: What It Is


An individual with a mental health diagnosis and an alcohol or drug related diagnosis is said to have a dual diagnosis.

A dual diagnosis typically involves the psychiatric problems of anxiety, mood, personality disorders or schizophrenia. An accurate psychiatric diagnosis can only be made after an individual has gone through withdrawal from the addictive substances.

A National Institute of Mental Health study indicates that people who have schizophrenia, bipolar disorder (mania) and antisocial personality disorder are at 10 to 15 percent higher risk for abusing substances. Those with phobias, OCD or major depression have a 2.5 to 4 percent higher risk factor.

Either Diagnosis Can Come First

Mental health issues cause people to reach for substances to mask or relieve psychiatric symptoms and help them feel better. This is called self-medicating. If this self-medication is repeated, it may lead to a psychological dependence on the substance.

Drug and alcohol use can also contribute to, and possibly trigger, mental health problems. Substance abusers might begin experiencing psychotic symptoms such as delusions or hallucinations, descend into a depression, or have uncontrollable mood or emotional swings.

A study in the American Medical Association’s journal states that approximately 53 percent of drug abusers also have at least one serious mental health issue. The percentage is a little less for alcohol abusers, but still high, at 37 percent.

Treatment for Dual Diagnosis

The two illnesses need to be treated simultaneously, but it is critical for good, long-term results that individuals go through a detoxification period first. This is best accomplished under medical supervision. It is also more easily accomplished under a doctor’s care since they can prescribe medications that lessen the difficult symptoms of substance withdrawal.

Depending on the psychiatric diagnosis, treatment may involve inpatient or partial hospitalization or outpatient treatment. Individual and group therapy are common recommendations, and some people also use psychiatric medication. Support groups are known to be very beneficial.

Treatment for substance abuse can involve group and individual therapy, education concerning substances and creating a healthy lifestyle, and utilizing recovery groups such as Alcoholics Anonymous. It is also important to create a personal network of resources and support if that is not already in place.

Getting treatment also depends on financial realities such as whether you have medical insurance or what social benefits are available to you if you do not. State agencies can supply you with information, but also look into community mental health resources available in your city or township.

For Families and Friends

If you are related to or involved with someone who has a dual diagnosis, you will benefit from education about the diagnoses, support groups, and perhaps counseling services. Your knowledge and understanding will help you maintain the patience and courage required to stand by someone through a recovery.


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