Dual Diagnosis: Definition And What It Means To You

By BetterHelp Editorial Team|Updated April 2, 2022
CheckedMedically Reviewed By Whitney White, MS. CMHC, NCC., LPC

Psychology and psychiatry are full of jargon. This jargon allows professionals in the space to communicate with each other efficiently and effectively. However, it can also make it hard for patients and laypeople to understand what is going on.

One common and important piece of psychiatric and psychological specialist language that is both common and crucial is “dual diagnosis.” Here, we’ll explore what it means to professionals and what it means to patients and their friends and families. We’ll also explore some common examples of dual diagnoses.

What is Dual Diagnosis?

Dual diagnosis, or “co-occurring disorders,” is the name for when a person with a mental health disorder also has a problem with substance abuse.

For the individual’s healthcare team, this means a number of important things. For one, it means that they need to treat not only the disorder but also the addiction. Further, it may mean that medications that they may have used to treat the disorder will be less effective or dangerous for the patient.

What Causes Co-Occurring Disorders

Co-occurring disorders often arise when an individual – often undiagnosed – abuses a substance or substances in order to reduce symptoms of a mental health disorder. In most cases, substance abuse worsens mental health disorders, leading to further substance abuse.

This means that treating one condition will entail – and require – treating the other.

While the dual diagnosis may hardly seem like a blessing, in many cases – because substance abuse is more visible than mental health disorders – diagnosis of the substance abuse disorder is what ultimately leads to the diagnosis of the underlying mental health disorder.

In other words, many people who are treated for co-occurring disorders would not have otherwise had their mental health properly addressed.

How Co-Occurring Disorders are Treated

How co-occurring disorders are treated often has to do with the substance and the underlying condition.

Some mental and emotional health disorders are often treated with medication. Depending on the substance being abused by the patient, it may be necessary to treat the substance abuse first while the underlying disorder is treated with talk therapy.

Depending on the substance, prescriptions may be necessary to treat the abuse. This is often the case with hard drugs with heavy and potentially dangerous withdrawal symptoms.

Some mental and emotional health disorders are never treated with medication. These cases often play out like those above, wherein the treatment for the underlying condition relies solely on talk therapy.

Similarly, some co-occurring conditions can be treated without using medication to treat mental health conditions or substance abuse. We’ll look in a moment at common co-occurring conditions, but a common example of this sort is an anxiety disorder and alcohol abuse.

What Dual Diagnosis Means to You

Dual diagnosis means one thing to a healthcare team and something entirely different to the individual and their family and friends.

What Dual Diagnosis Means to the Individual

If you have received a dual diagnosis, it means a number of things. For one thing, it means that you’re going to get help not just for your substance abuse but also for the deeper problems that you might not have known were there.

It also means that committing to overcoming your substance abuse is very important to your treatment. Ideally, however, it will be easier to overcome your substance abuse now that you are receiving help with your underlying mental and emotional health conditions.

While a dual diagnosis may seem scary, it can actually be a good thing. A diagnosis is required for some treatments. Even if a diagnosis is not required for treatment, it often means that health insurance is more likely to pay for treatment. A great example is talk therapy. Anyone can talk to a therapist and counselor – no diagnosis required. However, many cannot afford to do so without insurance.

Using elective talk therapy to help in overcoming a co-occurring condition – and paying for that talk therapy, even without insurance – is a topic that we will return to toward the end of the article.

What it Means to Family and Friends

If someone you care about has received a dual diagnosis, there are some things that you should watch for and some things that you can do to offer support.

First, you should be on the lookout for behavioral changes. Some of these may be positive changes related to the help that the individual is getting for their mental and emotional health. In the short-term, some of these may be adverse changes that the individual is going through due to substance withdrawal. Over time, these negative changes should turn around.

Second, you should try to lend an eye to make sure that the individual isn’t relapsing in their substance abuse. It can be tempting to try to watch over them or spend more time with them while hiding your intentions. However, it is more productive – and more ethical – to vocally offer your support. Tell them that you want to help in whatever way you can and ask them how – or if – they want you to be involved.

When to Expect Co-Occurring Conditions

So far, we’ve talked about how substance abuse can be caused by and can worsen underlying mental and emotional disorders. However, the opposite may be exact, as well. Some drugs can be the cause of mental and emotional disorders that were not there before. As a result, anyone using alcohol for an extended period of hard drugs for any period at all is at an increased risk for co-occurring conditions.

There are also some emotional and mental health disorders that are more likely to lead to substance abuse. People with schizophrenia and borderline personality disorders are more likely to use drugs in general and alcohol in particular. People with an anxiety disorder are more likely to use depressants, including alcohol, while people with depression are more likely to use stimulants, including cocaine.

All of the conditions above are conditions that are typically treated with medication and/or talk therapy. However, many people with anxiety and depression choose to talk about therapy without medication.

This can become complicated because people with anxiety and depression may have their anxiety and depression because of still other conditions. For example, people with Autism Spectrum Disorders are more likely than others to have depression because ASD can make it difficult to form relationships. While depression may be treated with medication, ASD cannot be.

Managing Treatment Options

Depending on how you received your dual diagnosis, you may have little control in managing your treatment options. For example, many people who receive a dual diagnosis do so through the courts as a result of their drug abuse. In these cases, therapy and treatment may be a matter of court order.

However, many people receive their dual diagnosis through a care provider. These people often have much greater control over managing treatment options. We’ve already said that a formal dual diagnosis may give you access to resources and support systems that you wouldn’t otherwise have access to.

While we encourage you to utilize these resources, there are still a number of ways that you can take control over your dual diagnosis through various treatment options.

Community Resources

Depending on the cause of your mental or emotional health condition, you may be able to find appropriate community resources to help you cope without formal treatment or medication.

For example, many communities have free community support groups for those suffering from depression due to the loss of a loved one, or Post-traumatic Stress Disorder due to surviving a traumatic experience like combat, crime, or violent accidents.

Similarly, many communities have free community resources for people struggling with substance abuse. Perhaps the most recognizable of these is Alcoholics Anonymous. However, there’s also Narcotics Anonymous for those struggling with abuse of harder drugs.

The links provided for AA and NA have tools to help you find meetings near you. However, the best way to find many area support groups is to check the community calendar in your local newspaper.

Counseling and Therapy

Another option that you can explore is counseling and therapy. You can usually find counselors and therapists near you quickly enough through your favorite search engine. However, whomever your diagnosis came from should also be an excellent fit to help you find local resources.

As mentioned above, having a formal diagnosis usually also makes it easier for you to get financial assistance through health insurance. However, if you are uninsured or don’t wish to seek help in your community, there is another option.

Online therapy and counseling are private and affordable. It’s also flexible enough to fit a variety of different schedules. Text support and worksheets make it always available, and live video sessions make it as personal as seeing a counselor or therapist in person.

For more information on pursuing a meeting with a licensed and professional counselor online, visit BetterHelp.

Moving Forward

Receiving a dual diagnosis can be very scary. However, consider seeing it as a path forward. In many ways, it is creepy, but it is also a battle plan for how you can move forward to a happier and healthier life.

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