Written by Apurva Varakhedi, a NAMI CC 2025 Summer Intern.

Dual Diagnosis is a combination of diagnoses and is one of the most challenging types of cases in behavioral health treatment. But there is hope. Apurva talks about how people with Dual Diagnosis can take charge of their recovery.

Table of Contents

What is Dual Diagnosis and Integrated Treatment?

Dual diagnosis is a combination of diagnoses: when an individual is experiencing both a mental health disorder and a substance abuse disorder at the same time. Co-occurring disorder, co-morbidity, and dual disorder are other names for dual diagnosis.

Common examples of mental health disorders are anxiety, depression, post-traumatic stress disorder (PTSD), bipolar disorder, and more. Substance abuse can be defined as the excessive use of alcohol, drugs, or other addictive substances. The phenomenon of two conditions occurring together is fairly common, as researchers have found that about half of individuals experiencing substance abuse also have mental health disorders. And according to the 2022 National Survey on Drug Use and Health, about 21.5 million adults in the US have dual diagnosis.

Integrated treatment is a specific treatment plan for those with dual diagnosis. It targets both mental health and addiction. Such an approach is important because it acknowledges the intricate relationship between substance abuse and mental health disorders. This treatment is personalized as it addresses each person’s unique needs and the underlying causes of their disorders. Integrated treatment ensures that an individual receives the necessary therapy, medication, and support for their struggles.

Step 1: Recognize Symptoms

The first step to take care of yourself is to recognize the symptoms of dual diagnosis and whether you’re experiencing them. Because dual diagnosis can involve a number of combinations, the symptoms will vary from individual to individual. Sometimes, the symptoms may overlap or mask one another, making recognition more difficult.

Substance abuse, or drug addiction, is a disorder that affects a person’s brain. It prevents an individual from controlling the use of a drug or substance, leading to continuous use of it despite the harm it inflicts.

Symptoms of substance abuse include:

• Withdrawal from loved ones
• Feeling helpless without the drug
• Difficulty focusing
• High tolerance for the substance
• Withdrawal effects from the substance
• Spending money on the drug whether or not you can afford it
• Participating in risky behavior when on the drug

Symptoms of mental health disorders include:

• Feeling sad or down
• Severe mood changes
• Difficulty focusing and concentrating
• Withdrawal from friends and hobbies
• Severe changes in eating habits
• Significant tiredness
• Suicidal thoughts

If you notice any of these symptoms, understand that you are not alone. Talking to someone else is a big step towards healing.

Step 2: Ask for Help

If you recognize any of the patterns or symptoms indicating dual diagnosis, the next step is to talk to someone. Acknowledging that you’re struggling is hard, and talking about it to others can be even harder.

Many people delay treatment or brush it off from fear of being judged or isolated from others. But you can get past this barrier by opening up to a trusted person and making them aware of your situation. Reach out to a friend or family member and let them know that you need help. Whether it’s a close friend, relative, coach, teacher, or mentor, you should allow yourself to take the weight off your shoulders by approaching them. You don’t have to figure out everything on your own, so if you do have a reliable support system, open up to them.

Step 3: Meet With a Mental Health Provider / Doctor

Once you recognize the signs of possible dual diagnosis, the next step is to schedule an appointment with your primary care doctor, who can then lead you to the right mental health professionals. They’ll be able to assess your overall health, rule out separate causes, and refer you to the right path. From there, look for psychiatrists, licensed therapists, addiction specialists, and integrated treatment clinics. Here are specific types of providers that may help.

Psychiatrists are physicians who specialize in mental health. They can identify and treat mental health disorders, and prescribe medicine. Many are also trained to treat substance use disorders.
Licensed counselors or therapists are trained to identify mental health conditions and provide counseling for many conditions. This includes Licensed Marriage and Family Therapist (LMFTs), Licensed Clinical Social Workers (LCSWs), Licensed Professional Counselors (LPCs). They provide talk therapy and coping strategies for managing both substance use and mental health disorders.
Addiction specialists are professionals who focus specifically on substance use disorders. Some are doctors, certified in addiction medicine, while others are licensed counselors that will provide help in recovery.

Local and National Dual Diagnosis Resources:

• Contra Costa Behavioral Health
• John Muir Behavioral Health Center (Walnut Creek)
• FindTreatment.gov

Step 4: Ask About an Integrated Care Plan

Traditional care often separates mental health treatment and substance abuse treatment, which can lead to confusion and hindrance. This is why it’s important to ask for an integrated care plan, one that is designed to assess both disorders together.

Because integrated treatment often involves a team of professionals (psychiatrists, therapists, addiction counselors), patients receive specialized care. They’ll receive medication management, behavioral therapy, counseling, long term treatment, and an improved quality of life. The ultimate goal is to treat you as a whole person, not just your disorders in isolation.

Step 5: Find a Community That Will Support You

It’s incredibly important to surround yourself with people who are accepting and uplifting of you. Support groups are very beneficial to provide the emotional and social support that you need. These communities include other individuals just like you who can provide their story and offer their help.

Here are a few peer support groups:

SMART Recovery: SMART recovery is an organization that focuses on overcoming addictive behaviors and leading a more balanced life. They offer free, peer support meetings where people attend to help themselves and one another.

You can also look for any local community mental health peer programs. Everyone is different, so it’s important you find what suits you the best.

References

1. https://my.clevelandclinic.org/health/diseases/24426-dual-diagnosis
2. https://www.samhsa.gov/substance-use/treatment/co-occurring-disorders#:~:text=Co%2Doccurring%20disorders%20may%20include,%2C%20and%20Klonopin%2C%20among%20others.&text=common%20mental%20disorders:-,The%20most%20common%20mental%20disorders:,Attention%20deficit%20hyperactivity%20disorder
3. https://www.northstarbehavioralhealthmn.com/resources/what-is-dual-diagnosis-treatment#:~:text=Dual%20diagnosis%20treatment%2C%20also%20known%20as%20integrated,disorders%20often%20have%20underlying%20mental%20health%20conditions
4. https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
5. https://www.mayoclinic.org/diseases-conditions/mental-illness/symptoms-causes/syc-20374968
6. https://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/mental-health-providers/art-20045530
7. https://psyclarityhealth.com/the-importance-of-integrated-treatment-for-dual-diagnosis-and-addiction/