What is Dual Diagnosis Treatment?

In a 2017 study, physicians diagnosed 42.1 million adults with a mental health disorder, but they found that 18.2% of this group also had a substance use disorder. In contrast, 20.3 million adults experienced substance use disorders, and 37.9% also developed mental health disorders. In total, 7.7 million adults were experiencing substance use and mental health disorders at the same time.

What Is a Co-Occurring Disorder?

When physicians are helping patients with mental health disorders, they cannot neglect to treat this illness while treating their patients’ substance issues. A patient diagnosed with a mental health disorder and a substance use disorder at the same time is said to have a co-occurring disorder. This is also known as a dual diagnosis.

A person can have one or more mental health disorders and a substance use disorder at the same time. The medical community cannot necessarily tell which disorder presented itself first. Although one does not necessarily cause the other, studies have repeatedly shown that substance use and mental health disorders are linked. Most importantly, the existence of one can be the reason that the other gets worse.

Three reasons that mental health and substance use disorders occur together include common risk factors, the existence of the mental health disorder and the substance use. The following external factors may also lead to the development of a substance use disorder:

Negative Childhood Experiences and Trauma

When people have been physically or emotionally traumatized, they are at a greater risk of developing substance use and mental health disorders. Those diagnosed with PTSD are of particular concern. For example, soldiers from the wars in Iraq and Afghanistan are at a high risk of using substances to calm their anxieties and deal with the trauma that they experienced. The medical community found that more than 20% of soldiers diagnosed with PTSD also had a substance use disorder.

The Effect of Stress

Stress is a risk factor for the development of several mental health disorders. It is also a link to substance use disorders. Stress causes increased activity in the brain that further causes people to be more impulsive and less able to control their behavior. The hypothalamic-pituitary-adrenal or HPA axis would ordinarily be in control of a person’s motivation, but chronic stress alters this axis in the long term. Along with motivation, it also takes part in a person’s ability to adapt to circumstances and learn, but substance use and mental health disorders impair this process.


Negative experiences during childhood, traumatic experiences and chronic stress are all risk factors for both mental health and substance use disorders.

The Development of the Brain

The use of substances and mental health disorders both affect the brain. For example, mental health disorders or the use of substances can interfere with the brain’s ability to experience emotions, control the person’s impulses, make good decisions and mediate rewards.

Common Risk Factors

Mental health and substance use disorders have common risk factors that may cause both conditions. According to research, 40% to 60% of whether someone is susceptible to developing a mental health condition or a substance use disorder is attributable to the person’s genetics. Several genes are involved in the process, but they may also interact with environmental influences to cause these disorders. The vulnerability arises when several genes are interacting with each other and the environment. For example, some people with the gene variant are more likely to develop psychosis if they engage in marijuana use during their adolescent years.


Epigenetics refers to how genes are regulated and expressed, but this isn’t dependent upon the gene sequence. This means that the genes are producing changes in the manner that the body’s cells read and act on genetic information. For example, drug exposure, trauma or chronic stress may cause stable changes in the way that genes express themselves. This alters how the neural circuits function and influence the person’s behavior.

The Existence of a Mental Health Disorder

Some mental health disorders have been determined to be risk factors for developing substance use issues. Many medical professionals believe that people begin to use substances when they are disturbed by the symptoms of a mental health disorder that hasn’t been diagnosed yet.

Changes that occur within the brain, when someone is experiencing a mental health disorder, may increase a person’s susceptibility to developing a substance use disorder. For example, mental illness may enhance the pleasurable effects that substances create. It may also decrease the person’s awareness of any negative consequences of the drug use. Lastly, it may reduce the prevalence of the symptoms of the mental health disorder.

The Existence of a Substance Use Disorder

When a person has a mental health disorder, their brain’s functioning can be disrupted. These disruptions occur in the same brain areas that substances target. Therefore, the alterations in the structure and functioning of the brain can lead to a substance use disorder.

Symptoms of Mental Health Disorders and Substance Use Disorders

The symptoms for mental health and substance use disorders can be similar, so it is difficult for the medical community to diagnose many mental health issues. If you believe that your loved one may have a mental health disorder, this person would have to go through a detoxification process at a treatment center so that there aren’t any traces of drugs in the body. Then, the medical professionals can make an accurate diagnosis.

What Are the Symptoms of Mental Health Disorders?

Although every mental health disorder has its own symptoms, the following list of symptoms may be indicators that your loved one is experiencing one:

• Your loved one tried to commit suicide in the past or thought about doing so
• He often complains of several physical ailments that seem to exist for no reason
• She is acting recklessly
• He experiences paranoia, delusions or hallucinations
• She isn’t paying attention to her personal hygiene
• He isn’t interacting with friends or family members
• She has a lack of, or even an increase in, sexual desire
• He is more irritable than usual
• She is unaware that these changes are occurring
• He can’t think clearly
• She is always terrified of unknown causes
• He experiences extreme highs and lows
• She no longer engages in activities that were important to her
• He isn’t eating or sleeping the same amount that he did in the past

What Are the Symptoms of a Substance Use Disorder?

Different substances can cause a range of symptoms, but the following general symptoms may indicate that someone has a substance use disorder:

• Taking longer amounts of time procuring a substance, using it and recovering from the use
• Taking greater risks
• Ingesting a large amount of the substance and not appearing to be intoxicated
• Being late or frequently missing school or work
• Not spending time with family or friends and instead spending it with friends you don’t know
• The inability to stop the substance use even after negative consequences result from the use
• The inability to perform at work, school or home
• The inability to handle stress without using substances
• The inability to refrain from using substances
• Experiencing withdrawal symptoms after stopping use of the substance

Integrated Treatment for Co-Occurring Disorders

With integrated treatment, a trained medical staff will assess your loved one for a mental health and substance use disorder at the same time. The integrated treatment specialists tailor their treatment programs so that the patient can receive treatment for both conditions without becoming confused. Therefore, the messages they receive about their mental health and substance use disorders will be consistent and integrated.

Integrated treatment is superior to treating one condition and not the other. If a patient receives treatment for the mental health disorder, they will lose the incentive to use substances. Also, the substance use exacerbates the symptoms caused by the mental health disorder. To experience the best results, your loved one’s mental health issues must be treated along with the substance use throughout the entire treatment process.

What Are the Benefits of Integrated Treatment?

Scientists performed several research studies in the 1990s, and they found that treating substance use and mental health disorders simultaneously is very effective. They discovered that integrated treatment improved the subjects’ quality of life, caused fewer arrests, created increased housing stability, decreased the number of hospitalizations, improved the subjects’ psychiatric functioning as well as their symptoms and reduced their abuse of substances. People of different ages and ethnicities all benefited from integrated treatment.

An Example of an Integrated Treatment Plan

In order to create an efficacious treatment plan, patients must determine what their goals will be. Of course, they want to maintain their sobriety over the long term and ensure that they can manage their mental health symptoms. Research discovered that the behavioral therapies are effective in treating substance use and mental health disorders at the same time. Your loved one may also need medication in conjunction with these therapies.

The following therapies are examples of treatments:

• Contingency Management – Patients receive rewards for exhibiting positive behaviors.
• Dialectical Behavior Therapy – This therapy teaches patients to be aware of the present moment and what is currently going on. It also teaches them to be aware of their emotions and how they can regulate them. Lastly, they learn that it is important not to be self-destructive in order to have better relationships.
• Cognitive-Behavioral Therapy – Patients learn how to navigate difficult times by exploring their thoughts and beliefs.
• Assertive Community Treatment – This therapy combines community outreach with individual therapy.
• Motivational Enhancement – This therapy helps people increase their motivation to make positive changes throughout the treatment process.
• Therapeutic Communities – This is a type of therapy that inpatient treatment centers use to develop more positive behaviors, attitudes and values.
• Mutual Support Groups – These are support groups that Alcoholics Anonymous, Narcotics Anonymous and others hold on a regular basis.

Mental Health Disorders that We Treat at First Recovery Center

At First Recovery Center, we can offer your loved one treatment in our dual diagnosis program. We begin by screening your loved one for a mental health disorder and then evaluate your loved one’s substance use disorder. The treatment may include medication.

The mental health disorders we treat at First Recovery Center include the following:

• Bipolar Disorder
• Borderline Personality Disorder
• Depression
• Obsessive-Compulsive Disorder
• Post-Traumatic Stress Disorder

Our psychiatrists, counselors and therapists will develop a treatment plan specifically for your loved one.

Treatment at First Recovery Center

The picture may seem a bit bleak, but there is hope for your loved one. Addiction is a chronic disease, but it is also a treatable disease. It cannot necessarily be cured, but this is similar to other physical diseases that also do not have cures. Addictions can be managed, and this is what we do at First Recovery Center.

You may have heard that people experiencing substance use disorders may relapse and return to their substance use. Your loved one may be in this category, but relapse does not mean that treatment for a substance use disorder is useless. It means that your loved one needs to obtain additional treatment.

If you are ready to get your loved one help for a substance use disorder, contact us at First Recovery Center.

Your Recovery Begins Today

You probably have a lot of questions, which is absolutely normal. Our compassionate staff is available around-the-clock to take your call and address any concerns you might have. Many of us have been right where you are and understand what you’re going through.
Don’t wait – call us today!

First City Recovery Center

317 W Jefferson Street

Kokomo, Indiana 46901


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