Important Things to Know About Dual Diagnosis and Co-occurring Disorders

Terminology that sounds clinical in nature can seem daunting, but most treatment terms are really easy to understand. For example, “dual diagnosis” simply means “two diagnoses” and is used to describe a situation in which a person struggles with both a substance use disorder and mental illness or at the same time. Additionally, the term “co-occurring disorders” has become a popular way to describe this same condition. Many professionals prefer “co-occurring disorders” because it allows for more than two possible diagnoses as well as multiple paths to healing. Even factoring in personal preferences, most professionals understand and uses both terms interchangeably.

And they’re terms we definitely need to be talking about, since experts estimate that nearly 8 million US adults experience dual diagnosis/co-occurring disorders each year. In fact, this number may be larger, as many people go undiagnosed and untreated.1 Research reveals that people who struggle with mental illness are at nearly twice the risk to become addicted to drugs or alcohol than the general population. Further, even people who develop substance addictions before they experience any mental health concerns will almost always begin to exhibit psychological and physical changes after the use of drugs and alcohol.2

What is the Relationship Between Mental Health and Addiction?

Many people wonder if poor mental health causes addiction or if addiction causes mental illness. Research surrounding genetics and addiction are still trying to determine if (and exactly how) these issues truly cause or are genetically linked to each other.

We do know one thing for sure: there is a correlation between substance use and mental health concerns. For whatever reason, these two devastating problems tend to happen at the same time.

Mental health and substance use may occur together for a number of reasons. Both mental health conditions and addiction disorders tend to run in families, so there may be a clear genetic component to co-occurring disorders. It is also possible that some people who experience mental health distress try to self-medicate with drugs or alcohol. Unfortunately, the effect is just the opposite. The misuse of alcohol and other drugs is proven to worsen mental health.1

There is no doubt that addiction changes a person’s behaviors, impulse control, logical thinking and goals. Without treatment, substance use disorders usually change a person’s life and persist despite negative consequences. Addicted people experience both physical and psychological setbacks because of their substance use, and constant use of drugs or alcohol alters the brain, often disrupting important neurochemicals like serotonin and dopamine.2 All of these struggles and changes can impact relationships, hopes and mental health.

The Dangers of Self-Diagnosis

The Internet offers a wealth of resources, and you are wise to research your condition (or the condition of someone you love). Knowledge is power, but it is also important to seek out a professional opinion. Every person is different, so every addiction experience is different.

As innocent as it seems, self-diagnosis and self-treatment can actually be dangerous. In fact, determining the differences and nuances of a mental health condition can even be challenging for professionals! The truth is, many substance “highs” can mimic mental illness. Similarly, some physical illnesses may lead to disorganized thinking or erratic behavior. When you avoid the assistance of a trained professional team, you may miss out on a very important underlying cause of your misery.

For example, did you know that stimulant use, such as the use of cocaine, can mimic bipolar mania? Or that mood swings or anger may be caused by substance withdrawal? Vitamin deficiencies related to alcohol use disorder may look like depression. Drugs like methamphetamine or LSD may cause delusions or hallucinations.

Things become even more serious when people miss deadly diseases. Brain tumors can cause personality changes or anger problems. Irregular heart beat or thyroid disorders may lead to panic attacks and be mistaken for anxiety. Digestive disorders can be associated with depressed mood.3

When a problem becomes noticeable, it is important to evaluate all possible causes. Often, a simple blood test can help you determine if you have an underlying physical condition that may be causing deeper problems. Similarly, don’t let a potential physical or mental health condition be overlooked because of past substance use. Initial online research is helpful, but a good team including a rehab program, a licensed counselor and a trusted physician can work wonders and possibly even save your life.

Resources in The Greater New York Area

Would you like to explore your options for help and support around substance use or mental health concerns? We have compiled a handy list of resources that can help connect you with professionals and groups in your area.

Clinician Directories- Find a Clinician or Group Near You:

Community Support Groups

  • Double Trouble in Recovery is a 12-Step collaborative designed for people with co-occurring disorders.
  • Smart Recovery is a non-faith-based recovery support group for people seeking recovery from a variety of addiction issues.
  • Alcoholics Anonymous and Narcotics Anonymous are among the most well-known 12-Step support groups for people who want to recover from addiction. These groups vary, so it is important to seek a group that acknowledges the role that good physical and mental healthcare play in recovery.1


  1. National Alliance on Mental Illness. Dual Diagnosis. Aug 2017.
  2. Addiction & Mental Illness: Does One Cause the Other? N.d. Web. Retrieved 22 Mar 2018.
  3. Pillay, S. The Dangers of Self Diagnosis. Psychology Today. 03 May 2010.



By Kathryn Millán, MA, LPC/MHSP

A writer for Heroes in Recovery.

Heroes in Recovery has a simple mission: to eliminate the social stigma that keeps individuals with addiction and mental health issues from seeking help, to share stories of recovery for the purpose of encouragement and inspiration, and to create an engaged sober community that empowers people to get involved, give back, and live healthy, active lives.

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