Addiction rarely happens in a vacuum.
For some people, substance use begins as a way to cope with anxiety, depression, trauma, overwhelming stress, or another mental health condition. For others, mental health symptoms develop or become more difficult to manage after prolonged substance use. Sometimes, the two develop around the same time.
What Is a Dual Diagnosis?
When someone has both a substance use disorder and a mental health disorder, this is known as a dual diagnosis or co-occurring disorder. Treatment may look different because both conditions need to be considered when developing a recovery plan.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 21.2 million U.S. adults had a co-occurring mental illness and substance use disorder in 2024.
The relationship between mental health and substance use is often complex. In some cases, symptoms of a mental health condition may contribute to substance use as a way of coping. In other cases, substance use may contribute to or worsen certain mental health symptoms. Sometimes, both conditions develop in the context of shared factors, such as trauma, chronic stress, genetics, or environmental circumstances.
These factors can also interact over time. For example, someone may use alcohol to cope with anxiety, experience worsening anxiety as their alcohol use increases, and then rely on alcohol more heavily to manage those symptoms.
What Happens During Traditional Addiction Treatment?
Traditional addiction treatment primarily focuses on helping a person stop using alcohol or drugs and develop the skills needed to maintain recovery.
Depending on the program and the person’s needs, care may include:
- Individual therapy
- Group therapy
- Addiction counseling
- Relapse prevention strategies
- Peer support
- Medication when appropriate
- Family education and support
- Aftercare planning
These approaches can be helpful whether or not someone has a co-occurring mental health condition, but the key difference is what happens when significant mental health symptoms are also present. If depression, anxiety, trauma, or another condition is contributing to substance use or making recovery more difficult, those concerns need attention alongside addiction treatment.
What Does Dual Diagnosis Treatment Involve?
Dual diagnosis treatment uses many of the same tools found in addiction treatment, but it also incorporates care for co-occurring mental health concerns. The exact approach depends on the person’s symptoms, substance use history, medical needs, and recovery goals.
1. A More Comprehensive Assessment
Some symptoms of mental illness and substance use can overlap. Difficulty sleeping, irritability, anxiety, mood changes, and problems concentrating may be related to a mental health condition, substance use, withdrawal, or a combination of factors.
A comprehensive assessment can help providers understand the person’s history, current symptoms, substance use, medications, medical needs, and mental health concerns. This information can help the treatment team determine which concerns need to be addressed and how they may be connected.
2. Care for Both Conditions
With dual diagnosis treatment, mental health and substance use concerns are considered as part of the same recovery plan.
For example, someone receiving care for alcohol use and depression may participate in therapy for depression while also working on relapse-prevention skills. Someone with trauma and substance use may receive trauma-informed care alongside support for maintaining sobriety.
Other services may include coping-skills training, behavioral therapies, medication management, and education about substance use. The combination depends on the individual’s needs.
3. Medication Management
Medication may be part of care for either a mental health condition or a substance use disorder.
When someone has both types of conditions, medication management may require additional consideration. Certain medications can interact with substances or with other medications, so providers need an accurate understanding of everything a patient is taking.
The treatment team can then consider potential interactions, symptoms, medical needs, and other factors when determining whether medication is appropriate.
4. Learning New Ways to Cope
Recovery involves more than stopping substance use. It can also mean learning healthier ways to respond to emotions, stress, triggers, and situations that previously led to substance use.
For example, someone who has been using alcohol to manage social anxiety may work on strategies for handling uncomfortable social situations. On a similar note, someone coping with trauma may need tools for managing distressing memories or emotional triggers.
Cognitive behavioral therapy (CBT), motivational interviewing, group therapy, family interventions, and other evidence-based approaches may be incorporated into care depending on the person’s needs. Regardless of the specific approach, the goal is to help people develop coping strategies they can use without relying on drugs or alcohol.
How We Can Help
At Raleigh Oaks Behavioral Health in Garner, North Carolina, our team provides integrated care for people experiencing co-occurring mental health and substance use concerns. Treatment is tailored to each person’s needs, with a focus on building stability, developing healthier coping skills, and supporting long-term recovery.
If you or someone you love is struggling with substance use and mental health concerns, you don’t have to figure out what comes next on your own. Contact us today to request a free, confidential assessment and learn how our team can help.
