When a person has a dual diagnosis, that means they have both a mental disorder and a substance use disorder. Also referred to as co-occurring disorders, they’re far from rare, and outcomes tend to be better if they are treated together.
Dual Diagnosis Defined
A substance use disorder is when a person continues to use alcohol and/or drugs despite the resulting negative effects to their health, their work, their home, or social life.
Mental disorders affect the way a person thinks, their moods, and how they behave. They can vary from mild to severe and include anxiety, depression, post-traumatic stress disorder, schizophrenia, and more.
Addiction is viewed as a mental illness because of how it affects the brain. Drug or alcohol use changes the parts of the brain that oversee impulse control, decision-making, and rewards.
Around half the people with a mental disorder will also have a SUD at some point in their lives. The opposite is true, too.
Often one disorder can make the other worse or more intense. One may also generate the other. For example, a person abusing drugs for some time may develop bipolar disorder as a result. Or a person with bipolar disorder may use drugs to cope with the symptoms the mental illness produces.
have a co-occurring mental health disorder and substance use disorder disorder
of Dual Diagnosis Individuals
never receive mental health care nor substance use treatment
of Dual Diagnosis Individuals
said they did not know where to go for treatment.
There are some overlaps among co-occurring disorders. It’s not quite clear why mental and substance use disorders sometimes co-occur, but researchers suggest three potential links:
- Shared risk factors: Stress, genetics, trauma, or environment often can be found at the root of both disorders. Genetics can make a person more prone to mental illness, but genes can also determine how a person reacts to a certain drug. Trauma or stress, either passed from one generation to another or events personally experienced by an individual, can contribute to SUDs or mental illness.
- Mental disorders. These can increase the likelihood of SUDs. A person with a mental illness may resort to drugs or drinking to get some temporary relief — commonly referred to as self-medicating. Mental disorders also alter the brain, making a person more vulnerable to addiction.
- Substance use and addiction. These can factor into the onset of mental disorders. Drug and alcohol use, especially over time, can change the way the brain is wired, affecting impulse control, pleasure receptors, and decision-making. It also can raise the odds of developing mental illness.
Younger people also tend to be more vulnerable for a number of reasons. Many individuals first experiment with drugs or try alcohol during adolescence. Using at a younger age has been linked to the later development of SUDs. (It’s not a foregone conclusion, however.) Those years leading into young adulthood are also when mental illness symptoms often begin to manifest.
Common Mental Disorders Linked with Addiction
Around half of the people who have a mental illness also develop SUDs. The reverse is true, too. People can have more than one mental disorder along with an addiction to drugs or alcohol. It’s not just one or the other, or one and the other.
Mental disorders that have high comorbidity along with SUDs include:
- Generalized anxiety disorders
- Panic disorders
- Post-traumatic stress disorder
- Bipolar disorder
- Attention-deficit hyperactivity disorder
- Psychotic illness
- Borderline personality disorder
- Antisocial personality disorder
Serious mental illnesses like major depression, schizophrenia, or bipolar disorder — when they cause considerable impairment — tend to overlap more with SUDs. An estimated one in four people with serious mental illness also have substance use disorders. Because young brains continue to develop into one’s early to mid-twenties, particularly the areas governing impulse control, rewards, and decision making, they’re at higher risk.