It’s possible for individuals to have both a substance addiction and a mental health disorder. This is called a dual diagnosis, and it’s not that uncommon.

If you suffer from substance addiction, the longer you have it, the more likely you are to develop a mental health problem. Addictive substances alter the functions of your brain, so it’s very possible to acquire a mental disorder later on.

On the other hand, having a mental health disorder may lead to substance abuse. People with conditions like bipolar disorder, anxiety, or depression may turn to illicit drugs to numb what they feel. Or, they could also abuse their prescribed medications hoping to get a stronger effect.

If you have a dual diagnosis, both the substance use disorder and the mental health disorder must be treated alongside each other. Otherwise, if just one of them is addressed, you are more likely to relapse.

Which came first?

A common question people ask is this: Which came first, the mental health problem or the substance addiction?

The answer is either one. The substance use disorder could have developed first, leading to a mental disorder. Similarly, you may have a diagnosed mental health disorder that you’ve been living with for a while, which later on caused you to abuse substances.

When you suffer from a mental health problem, using substances can be one way of coping with the symptoms. It’s not a good coping mechanism, though, because substances further damage your brain. Soon enough, your mental health problem could become much worse. It’s also possible that substance use can bring out a previously undetected mental health issue.

Similarly, because addictive substances alter the brain, abusing them can cause mental disorders. For instance, addiction to stimulants would make your brain hyperactive, which could turn into ADD or anxiety disorder. Abusing relaxants, sedatives, or tranquilizers, on the other hand, may cause you to develop depression or sleep disorders.

Regardless of which one came first, both conditions have to be treated at the same time.

Are a lot of patients affected with dual diagnoses?

Based on data from the Substance Abuse and Mental Health Services Administration, or SAMHSA, in 2014, almost 8 million adults had dual diagnoses. But only a small portion of those people seek professional help and get treatment.

If you have a dual diagnosis, though, the symptoms are often more severe, more persistent, and harder to treat than if you have just one disorder.

What are the signs of substance abuse?

If you’re addicted to a substance, you would usually exhibit the following behaviors.

1. You lose control of your drug use. Let’s say you just planned to take one pill, but you took three instead because you had the urge to take more.
2. You become tolerant to the drug. In other words, you need higher doses to get the effects you want.
3. You spend too much of your time finding and using drugs.
4. You ditch responsibilities at work, in school, or at home.
5. You’ve exposed your own life to danger just to get drugs.
6. You lose interest in your hobbies and other passions.
7. You experience withdrawal symptoms when you try to quit your drug use.

In summary, substance addiction means that you can no longer live a normal life without using those drugs.

What are the signs of a mental disorder?

Mental disorders are varied, and each one has a different set of symptoms. But they do have a few things in common, like these.

1. You lose interest in your usual daily activities.
2. You feel hopeless, worthless, guilty, or panicky
3. You often wake up in the morning feeling exhausted.
4. Your thoughts often bother you.
5. You find it hard to concentrate on tasks.
6. You take more risks than usual.
7. You get easily irritated a lot of the time.
8. Sometimes, suicidal thoughts cross your mind.

What treatments are used for dual diagnosis cases?

If you have a dual diagnosis, mental health professionals may recommend one or more of these treatments.

1. Integrated group therapy: This method aims to treat both the mental disorder and the substance use disorder at once.
2. Individual psychotherapy: Here, therapists work with you one-on-one. The objective is to address behaviors caused by substance abuse as well as mental health problems.
3. Cognitive behavioral therapy: This therapy helps you minimize behaviors and beliefs that contribute to an unhealthy mental state. In place of these, you are taught how to create healthy patterns of thought and behavior. That way, you won’t need to turn to drugs.
4. Dialectic behavioral therapy: This method is meant to reduce patterns of self-harm. Usually, if you have a mental health problem and a substance use disorder, the urge to hurt yourself may be quite strong. This therapy helps you stop those tendencies.

Doctors may also prescribe medications appropriate for your particular condition. You’ll be taking these medicines and going through therapies side by side.

Common medications include the following:

• Anticonvulsants
• Selective serotonin reuptake inhibitors (SSRIs)
• Anti-anxiety drugs

Do I have to stay in a rehab center for a dual diagnosis treatment?

Treatment programs may either be inpatient or outpatient. The choice depends on your particular needs and how severe your condition is.

If your dual diagnosis is a bit severe, you would benefit the most from inpatient treatment. Here, you have to stay in a rehab center for three to six months.

If your case is milder, then outpatient treatment can work. Here, you would spend 30 hours or more per week in the rehab center. After each session, you are free to go back home.

How do I find a rehab center that specializes in dual diagnosis?

SAMHSA has a helpline you can call anytime. Call them at 1-800-662-HELP (4357) and they’ll help you find a treatment center near you. Make sure to ask specifically for a center that gives treatments for dual diagnosis.