Dual Diagnosis


A dual diagnosis is given to an inpidual who has both a mental disorder and an alcohol or drug problem. These conditions occur together frequently. Trying to manage just one of these problems can be extremely stressful. To complicate things further, add to the mix multiple symptoms that overlap and mask the ability to make a diagnosis, and what you are left with is a difficult and complex challenge to find a successful treatment. To achieve the best possible outcome, both disorders must be treated simultaneously because the cumulative effect influences all aspects of the inpidual’s life and greatly increases their risk for relapse.

The relationship between mental illness and substance abuse

Which develops first, the emotional issues or the substance abuse problem?

Often the psychiatric problem occurs first. In an attempt to feel better the inpidual self-medicates with alcohol or drugs which can lead to chemical dependency. In other cases, the alcohol or drug dependency is the primary condition which over time can lead to depression, anxiety and more severe emotional and mental problems. Regardless of the cause, the first step to living a more healthy life is to cleanse your system of the substances. Ideally, detoxification should take place under medical supervision and the process can last from a few days to more than a week, depending on what substances the person abused and for how long.

Dual diagnosis is also referred to as…

  • Co-morbid disorders
  • Co-morbidity
  • Co-occurring disorders
  • Concurrent disorders
  • Dually diagnosed
  • Multiple disorders

Statistics on dual diagnosis indicate…

  • Fifty-three percent of drug abusers and 37% of alcohol abusers have at least one serious mental illness
  • Roughly 50% of inpiduals with severe mental disorders are affected by substance abuse
  • Twenty-nine percent of all people diagnosed as mentally ill abuse either alcohol or drugs
  • Sixteen percent of jail and prison inmates are estimated to have severe mental and substance abuse disorders

The difficulty in identifying dual diagnosis

Dual diagnosis can be difficult to identify because the symptoms of one disorder often mimic the symptoms of the other disorder. Many of the symptoms of drug abuse, such as extreme anxiety, depression, paranoia, delusions and hallucinations are similar to symptoms of mental illness. The impact that the symptoms have on a person’s life causing severe decline in self-care and functioning can also be a symptom of a psychiatric problem.


The families of people afflicted with a mental illness and the professionals who treat these cases can easily underestimate the severity of the person’s problem with drugs or alcohol for several reasons:


  • Drug abusers can covertly use substances without their families knowing
  • The behavioral signs of drug use look like the signs of a mental illness and it may be difficult to separate the two
  • It takes time to unravel the interacting effects of substance abuse and mental illness