“Dual diagnosis” is a term used to describe a person who has both a mental health disorder and a substance abuse disorder. This condition is also known as co-occurring disorder or comorbidity.

According to the National Survey on Drug Use and Health, approximately 9.2 million adults in the United States have co-occurring disorders. This shows that dual diagnosis is a real health concern despite its lack of wide recognition.

In this article, Sierra Vista Hospital explores everything you need to know about dual diagnosis, including its symptoms, causes and treatment options.

What Are the Symptoms of Dual Diagnosis?

Normally, people suffering from a co-occurring disorder present a combination of mental health and substance abuse disorder symptoms.

Mental health disorder symptoms

The symptoms of a mental health disorder can vary depending on the specific disorder. However, some common symptoms include:

  • Changes in mood, such as feeling sad, anxious or irritable
  • Difficulty concentrating or making decisions
  • Changes in sleep patterns, such as sleeping too much or too little
  • Changes in appetite or weight
  • Loss of interest in activities once enjoyed
  • Social withdrawal or isolation
  • Suicidal thoughts or behaviors

Substance use disorder symptoms

The symptoms of a substance use disorder can also vary depending on the substance being abused. However, some common symptoms include:

  • Using the substance in larger amounts or for longer periods than intended
  • Difficulty cutting down or controlling substance use
  • Spending a lot of time obtaining, using or recovering from the substance
  • Cravings or strong urges to use the substance
  • Neglecting responsibilities at work, school or home due to substance use
  • Continuing to use the substance despite negative consequences
  • Giving up important activities or hobbies in favor of substance use

What Are the Causes of Dual Diagnosis?

As with any other behavioral health condition, the causes of dual diagnosis may vary. However, our experience shows that there are some common factors in patients with co-occurring disorders.

Biological factors

Research has shown that there is a strong link between genetics and the development of mental health and substance use disorders. This means that if a person has a family history of either disorder, they may be more likely to develop a dual diagnosis.

For example, someone with a family history of depression and anxiety may have a genetic predisposition to developing those conditions too. This may lead the person to start exhibiting symptoms of those mental health conditions at a young age. If untreated, the person may turn to substances to relieve their emotional pain. This is one of many paths that can lead to dual diagnosis.

Environmental factors

Environmental factors, such as trauma, stress and exposure to substance abuse, can also contribute to the development of dual diagnosis. Environmental factors may include:

  • Physical or sexual abuse in childhood or adulthood
  • Exposure to violence, whether that be within the family or community, or witnessing an act of terrorism
  • Natural disasters
  • Involvement in accidents or serious injuries
  • Combat or military service-related trauma
  • Loss of a loved one, especially if sudden or unexpected

For example, a person who has experienced a sudden loss may turn to substance abuse as a coping mechanism, leading to the development of both disorders.

What Is Dual Diagnosis Treatment?

Dual diagnosis treatment typically involves a combination of therapy, medication and support services.

Integrated treatment

Integrated treatment is one of the most common approaches to treating dual diagnosis. This approach involves simultaneously treating both the mental health and substance use disorder the person is suffering from. By treating both conditions at the same time, this approach addresses the underlying causes of both conditions and provides comprehensive care. This treatment is effective in preventing relapse, as it promotes holistic healing. Integrated treatment is a common approach in both inpatient and outpatient programs.

Medication-assisted treatment (MAT)

Medication-assisted treatment (MAT) is another common treatment method. It involves the use of medication with therapy to treat co-occurring disorders. MAT is offered in both inpatient and outpatient programs. Medications such as methadone, buprenorphine or naltrexone may be prescribed to help manage cravings and withdrawal symptoms, and reduce the risk of relapse.

Cognitive-behavioral therapy (CBT)

Cognitive-behavioral therapy (CBT) is a widely used therapy that focuses on identifying and changing negative thought patterns and behaviors. It helps individuals develop coping strategies, improve problem-solving skills and manage triggers for substance use. CBT is a common treatment approach in outpatient programs, as it helps patients learn how to change their responses to negative thoughts in an independent environment.

For example, someone can practice the coping mechanisms and skills learned in outpatient CBT at home, as outpatient programs do not require 24/7 monitoring.

Motivational interviewing

Motivational Interviewing is a counseling technique that aims to enhance an individual’s motivation to change their behavior. It involves a collaborative and non-confrontational approach, helping people explore and resolve their ambivalence towards treatment. Motivational interviewing offers patients a judgment-free environment and teaches them vital personal skills. These skills include the ability to engage in self-reflection, using affirmations, and the ability to weigh the pros and cons of their behavior.

Motivational interviewing treatment is common in inpatient programs, outpatient programs and outpatient counseling.

Dialectical behavior therapy (DBT)

Dialectical behavior therapy (DBT) is an evidence-based therapy that combines elements of CBT with mindfulness techniques. It helps individuals regulate emotions, manage distress and improve interpersonal skills. This approach is constructive for patients experiencing intense emotions they struggle to control and who turn to substances as a result. DBT is a common treatment option in outpatient settings.

Support groups

Participating in support groups, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), can provide individuals with dual diagnosis a sense of community, encouragement and accountability. Joining a support group can be especially beneficial after completing an inpatient or outpatient program, as it enables those in recovery to be surrounded by people who share similar experiences.

Support groups can be particularly helpful to those in the beginning stages of recovery and sobriety. This is because they are now suddenly surrounded by people in all phases of sobriety, including people who have been sober for years. This can give people hope for a healthier, happier future.

Support groups can also help people find mentors who can give them advice, be there for them if relapse urges arise and provide accountability.

How Can You Support Someone With a Dual Diagnosis?

If you have a loved one who is struggling with dual diagnosis, there are several ways you can support them:

  • Educate yourself about dual diagnosis and the specific disorders your loved one is facing.
  • Encourage your loved one to seek professional help and offer to help them find a treatment program.
  • Be patient and understanding. Recovery from dual diagnosis takes time and may involve setbacks.
  • Offer emotional support and be a listening ear for your loved one.
  • Avoid enabling behaviors, such as giving them money or covering up for their substance abuse.
  • Take care of yourself and seek support from friends, family, or a therapist if needed.

Help Is Available at Sierra Vista Hospital

Dual diagnosis recovery is not always as easy or straightforward as we would like it to be, but it is not impossible either. By educating yourself on what dual diagnosis is and what causes it, you can understand more about your or your loved ones’ condition. As we have shown, there are plenty of options for dual diagnosis treatment and plenty of communities that can provide guidance and support.

Sierra Vista Hospital, in Sacramento, California, is here for your mental health needs. Our inpatient program and outpatient program for adults and adolescents provide the support you need when you need it.

Learn more about how we can help by giving us a call at 916-288-0300 or get in contact with us by using this form.


If you are in crisis and need assistance immediately, call 911 or 988 for the Suicide Prevention Hotline or go to the nearest emergency room.