How Do I Know if I Need a Dual Diagnosis Treatment Program?

Woman sitting next to her car

Dual Diagnosis is also referred to as co-occurring disorders and can be defined as when a person has both a substance abuse disorder and a mental illness at the same time.

Either disorder can develop first and typically symptoms worsen with the development of substance use to manage the symptoms of the mental health disorder.

Almost 8 million people in the United States have a dual diagnosis and over half of that number are men [1].

Symptoms can range from sudden changes in a person’s behavior, to include increasingly risky behaviors and withdrawal from loved ones, to using substances in dangerous situations and using substances to function in everyday life.

Treatment Involvement

Most often with the dual diagnosis the treatment involves multi-level care [1]. It is recommended that an individual needs to receive care for both the mental health illness and the substance abuse.

Typically treatment starts with detoxification, residential programming where individual and group therapy are utilized, supportive or transitional housing, outpatient therapy, and ongoing medical management to include psychiatric medicines that may be needed for recovery.

Even though the term ‘dual diagnosis’ if fairly new, treatment has come a long way. Prior to the 1990’s, co-occurring disorders were treated separately and symptoms overlapped which lead to frequent relapses.

New treatment, however, focuses on the blend of both mental health and substance abuse treatment. Professional treatment teams will work together to create a shared or complementary treatment plan that is unique for each person.

Key Indicators

Signs and symptoms of someone who has a dual diagnosis and are in need of treatment is when a loved one may abandon or ignore family and friends to spend time with others who use substances. They may struggle in academic or occupational roles.

Woman sitting by the seaThe individual may also begin to lie or steal in order to keep up with their substance abuse disorder. Having a mental health diagnosis is also a sign of the increase for a substance use disorder to develop.

Sleep, eating, and grooming patterns may change and become irregular.

Individuals may also report feelings of guilt, shame, or regret about their behavior and have difficulty stopping their addictive behaviors.

How to Know for Sure

Seeking an assessment or consultation from a clinical professional or treatment facility is highly recommended. Through an assessment, the facilitator can determine what level of care is needed for the dual diagnosis treatment.

Treatment works to provide simultaneous treatment of both the mental health disorder and substance abuse. Treatment also includes support through work on self-esteem and self-worth, group support, and skill building.

Often those who do seek dual diagnosis treatment have one or multiple of the following:

  • A mood disorder such a bipolar disorder, major depression, or other subcategory
  • An anxiety disorder such as post-traumatic stress disorder, obsessive-compulsive disorder, or generalized anxiety.
  • A personality disorder such as borderline, histrionic, or antisocial
  • An eating disorder
  • A psychiatric disorder such as schizophrenia

Denial of issues can be typical in those with co-occurring disorders especially when thoughts are distorted due to the mental illness. Symptoms can be debilitating, and substance use and abuse can be seen as the only way to cope to many individuals.

Of those struggling with dual disorders, approximately 55% do not receive treatment for either disorder [3]. When an individual is struggling with a co-occurring disorder, they are more likely to use drugs. According to SAMHSA, 26.7% of those with a mental health diagnosis abused drugs, compared to 13% of the general public [3].


Often those who turn to substances to manage their mental illness do so for various reasons. One such reason is that they may take medications that have undesired side effects and drugs and alcohol may alleviate the effects.

Woman reading in rehab center

For others who abuse substances for many years, can develop a mental illness due to the chemical brain changes that occur in the area that controls mood and pleasure/reward [3]. Use of substances can also increase the risk of mental illness due to genetic, environmental factors and major life stressors.

A study on the connection between schizophrenia and substances on over 3 million individuals found that there is a significant connection between schizophrenia and substance abuse [3].

How Do I Know It’s For Me?

When wondering if you need a dual diagnosis program it is best to start with an evaluation through a facility or outpatient therapist who is trained in dual diagnosis issues.

Often if you are struggling with a mental health disorder such as depressionDual Diagnosis provides challenging treatment plans to address both the mental health disorder and substance abuse.

Knowing your options is important., anxiety, bipolar, personality disorder, eating disorder, or other major concern and abusing substances to reduce or manage symptoms, then there is a significant chance you may need dual diagnosis treatment.

Struggling with multiple disorders can be overwhelming at times, and often feel like you may not have control over your life. With treatment, you are taking the first step forward to gaining control over your own self.

Your thoughts, feelings, behaviors, and reactions are all a part of learning how to recovery and life symptom-free.

Image of Libby Lyons and familyAbout the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.
Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.


[1] NAMI. (n.d.). Retrieved October 01, 2017, from
[2]Hall-Flavin, M. D. (2016, April 06). Bipolar disorder and alcoholism: Are they related? Retrieved October 01, 2017, from
[3] A. (2017, September 20). Mental and Substance Use Disorders. Retrieved October 01, 2017, from

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on November 2, 2017
Reviewed By: Jacquelyn Ekern, MS, LPC on November 2, 2017.
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About Jacquelyn Ekern, MS, LPC

Jacquelyn Ekern founded Addiction Hope in January, 2013, after experiencing years of inquiries for addiction help by visitors to our well regarded sister site, Eating Disorder Hope. Many of the eating disorder sufferers that contact Eating Disorder Hope also had a co-occurring issue of addiction to alcohol, drugs, and process addictions.