What is Dual Diagnosis?

With the right combination of support, dually diagnosed people can and do recover. The Dual Diagnosis Hub aims to help everyone to find the best dual diagnosis support and resources available.

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What is dual diagnosis and how common is it?

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What having concurrent mental health & addiction Issues means

Dual diagnosis will be used interchangeably with the terms:

  • Co-morbidity
  • Concurrent disorders
  • Co-morbid disorders
  • Co-occurring disorders
  • Dual disorders

Still, they all mean someone has concurrent mental health and addiction issues.

But what we are particularly referring to are people who suffer from some form of complex mental health problem and a concurrent addiction issue.

dual diagnosis is when someone is experiencing mental illness alongside substance misuse issues.

Some examples of co-occurring disorders are:

  • a mental health problem or disorder leading to (or associated with) problematic alcohol &/or other drug use
  • a substance-use disorder leading to or associated with a mental diagnosis
  • alcohol &/or other drug misuse worsening or altering the course of a person’s mental illness.

There can be a number of problems that may result from having multiple disorders & addiction issues simultaneously.

Dual Diagnosis Symptoms

  • Health symptoms may mask or hide alcohol or drug use
  • Alcohol or drug use or the withdrawal from alcohol or other drugs can mimic or give the appearance of some psychiatric illness
  • Untreated chemical dependency can contribute to a reoccurrence of psychiatric symptoms
  • Untreated psychiatric illness can contribute to an addiction relapse.

Other Common Dual Diagnosis Symptoms:

  • Health symptoms may mask or hide alcohol or drug use
  • Alcohol or drug use or the withdrawal from alcohol or other drugs can mimic or give the appearance of some psychiatric illness
  • Untreated chemical dependency can contribute to a reoccurrence of psychiatric symptoms
  • Untreated psychiatric illness can contribute to an addiction relapse.

How common is having some form of co-occurring disorder?

Drug or alcohol abuse by those with mental health problems is on the rise but has always been a problem.

Academics & the medical profession are starting to realise that as many as 50% of people with bipolar disorder and up to 80% of people with BPD will go on to have an addiction issue, but that’s only two diagnoses out of dozens of possible conditions.

Check out our dual diagnosis statistics page to find some of data that we found about the different mental health conditions and how common concurrent addiction issues are with some of the main diagnoses.

You can use the rough estimate of 1 in 50 people in this country who have a diagnosis of bipolar disorder and 1 in 100 have some form of schizophrenia.

If that statistic is accurate, that means that there might be as many as 600 thousand people may be struggling with bipolar or schizophrenia & some form of addiction in the UK.

I spoke with a leading BPD organisation recently and they believe that in the USA, 80% of people with BPD (aka EUPD) are likely to go on to abuse drugs or alcohol and risk the commonly associated problems with heavy drug and alcohol use.

If you include depression in the stats, that number becomes even more significant. One-third of adults who suffer from some form of addiction suffer from major depression.

In 2014, roughly 20% of people in the UK aged 16 and over displayed symptoms of anxiety or depression.

16.5% of people with recurring major depression also have some form of alcohol abuse problem, and 18% have some form of drug use problem.

These statistics mean that a lot of people have co-occurring mental health and substance abuse (or difficulties with alcohol dependence). People who present with these difficulties don’t always experience the easiest of times in either traditional 12 Step Programmes or the mental health system.

(How often have we heard about someone on medications being told that they shouldn’t be on medications in some 12 Step meetings? Or heard about someone with severe mental health problems and addiction issues getting passed between addiction and mental health services?)

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Understanding the Origins and Risk Elements of Dual Diagnosis:

Developing an understanding of the origins and risk elements associated with dual diagnosis is a key step towards effective prevention and management strategies. The genesis of dual diagnosis is typically a complex interweaving of genetic, environmental, and psychological influences.

The Influence of Genetics:

Scientific studies have highlighted genetics’s significant role in dual diagnosis.

Some people may be genetically susceptible to mental health and substance use disorders. For instance, a family history of mental health conditions such as depression, bipolar disorder, or schizophrenia can increase the chances of someone developing these disorders. 

Similarly, the propensity for addiction can also be inherited, with a higher likelihood of substance use disorders developing in individuals with a family history of such issues. When these genetic susceptibilities intersect, the probability of a dual diagnosis escalates.

The Impact of Environment:

Environmental influences are also important in the onset of dual diagnosis. These influences include early exposure to drugs or alcohol, high-stress levels, lack of social support, and socioeconomic factors such as poverty. For example, individuals raised in unstable households where substance abuse is common are at a heightened risk of developing substance use disorders and, potentially, co-existing mental health disorders.

Likewise, individuals exposed to high-stress environments or significant life challenges may resort to substance use as a coping mechanism, leading to addiction and amplifying underlying mental health problems.

Trauma's Role:

Some things that could help:

The lack of ‘joined up’ dual diagnosis treatment is a huge problem that needs addressing by mental health professionals. It is time for the mental health system and traditional 12 Step Fellowships to start working together to help more with this problem.

It is extremely useful when a treatment programme includes addiction treatment but also provides a support plan around a psychiatric condition or mood disorder.

Service users with serious mental health conditions should be encouraged to use tools like WRAP (Wellness Recovery Action Plan) and crisis plans to help them learn how to manage unpleasant symptoms.

There is currently limited support for those with concurrent mental health and addiction problems. Still, in the UK, Dame Carol Black recently wrote a report on how the UK as a country needs to tackle substance abuse and alcohol treatment and as a result, the UK is about to embark on spending more money to treat drug abuse than it has done in years.

Long-term use of alcohol can obviously seriously affect someone’s health, and substance use has its own risks (such as overdose or contraction of HIV or hepatitis, to name but a few), so Dame Carol Black’s report and the action that followed is welcome to the medical profession and patients alike.

However, some help is available in specific dual diagnosis groups such as Dual Diagnosis Anonymous or Dual Recovery Anonymous.

There are treatment centres that can provide a high level of support to people with complex mental illnesses. They usually help create a treatment plan that includes mental health services in discussions about their longer-term care. A good one for dually diagnosed people is called Broadway Lodge. It’s a truly remarkable place, and I would trust some of the staff there with my life.

If you’re an addiction or mental health professional interested in dual diagnosis, then we hope you’ll contact us to get involved with developing new tools and content for this site.

Our aim at the Dual Diagnosis Hub is to help more people with complex mental health addiction recovery difficulties develop addiction-free lives and spread the message that recovery is possible if you have complex needs with the right information and support!concurrent 

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What is Dual Diagnosis?

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