Understanding Dual Diagnosis

Posted on: November 1, 2019 by in Heroin Treatment
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What is dual diagnosis?

Doctors use the term dual diagnosis when a patient has a mental illness (depression or bipolar disorder, for example) and a substance abuse addiction. The patient has two separate, co-occurring illnesses and will need a treatment plan for each. In the case of dual diagnosis, either disorder (substance abuse or mental illness) can develop first. According to the National Survey on Drug Use and Health, 9.2 million U.S. adults experienced both mental illness and a substance use disorder in 2018.


Symptoms for dual diagnosis vary widely since there are many combinations of illnesses for each disorder. Here are some symptoms:

  • Angry, violent, or reckless behavior
  • Appetite or weight changes
  • Changes in sleep patterns, such as insomnia or excessive sleep
  • Delusions or hallucinations
  • Difficulty holding a job or other priorities
  • Dramatic shifts in moods or energy levels
  • Inability to concentrate
  • Intense or prolonged feelings of despair, hopelessness, and worthlessness
  • Internal anxiety that can only be relieved by behaviors or rituals
  • Severe tension or worry
  • Social withdrawal
  • Trouble maintaining relationships because of behavior or mood swings
  • Uses drugs and/or alcohol as coping mechanisms

Why is it important to treat both the mental illness and substance abuse?

The best treatment for dual diagnosis is integrated intervention, which is when the patient receives care for both mental illness and substance abuse. When neither illness is treated, one can make the other worse. If only one illness is treated, treatment is less likely to be effective. The chances for a lasting recovery are greatly improved when both illnesses are treated simultaneously.

Treatment Options

Treatment planning will not be the same for everyone who receives a dual diagnosis, but there are several common methods used as part of the treatment plan:

  • Inpatient Rehabilitation –These centers provide therapy, support, medication, and health services 24/7.
  • Detoxification – Inpatient detoxification is generally more effective than outpatient for initial sobriety.
  • Residential treatment centers – "Group homes" or "sober houses" are supportive house centers that provide some support and independence. Be sure to do your research when sleeking a group home or sober house as not all staff licensed professionals.
  • Psychotherapy – Cognitive behavioral therapy (CBT) help people with dual diagnosis learn to cope and change harmful patterns of thinking.
  • Medications – Certain medications are useful for treating mental illnesses and helping those suffering from substance abuse ease withdrawal symptoms during the detoxification process.

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