Mental Health

Dual Diagnosis: Mental Health and Addiction in a Frame

Written By

Dr. Amar Shinde

Published on: 15 Jan 2026

Living with a mental health disorder can be difficult. Moreover, having some sort of addiction makes it even worse. The struggle to deal with both at the same time becomes overwhelming, and this is known as dual diagnosis.

Dual diagnosis is a lot more than what people think. Known to affect individuals globally, dual diagnosis is often left untreated. Some people go for de-addiction programmes, while the others go for treating depression. This makes one of these go unnoticed and does not result in a long-lasting recovery.

In simpler terms, mental health and substance dependence are interlinked and both need to be treated simultaneously. This guide explains the meaning, causes, symptoms and how to deal with it.

Dual-Diagnosis: Substance Use and Mental Health

Dual-diagnosis is a medical term used for a person suffering from substance use disorder (SUD) and mental health disorder, at the same time. Depression, anxiety, bipolar disorder, schizophrenia, and ADHD are common mental health disorders. On the other hand, substance use disorders include alcohol consumption, drug addiction, misuse of prescription medication and polysubstance (more than one substance) use. 

The simultaneous occurrence of these two results in harmful interactions. It creates a cycle between the two disorders, pushing the affected individual towards each other. This makes it hard to break without expert help.

Symptoms and Risk Factors Behind Dual Diagnosis

The common symptoms of dual diagnosis in a person may vary according to the type. These are usually a combination of physical and emotional signs. They include:

• Excessive fear and panic
• Sleep disruption and appetite changes
• Mood swings and emotional imbalance
• Lack of interest in daily routine
• Increasing demand for substance use to overcome sadness
• Social withdrawal 
• Low decision making skills
• Constant guilt or shame
• Impulsive behavior

There are multiple causes that can lead to dual diagnosis. These include:

Biological Factors:

Genetic factors such as family history of addiction, early exposure to drugs or other substances, and brain chemistry imbalance are certain biological factors causing dual diagnosis.

Psychological Factors:

The psychological factors such as trauma, abuse, low self esteem, and chronic stress are also causes of dual diagnosis. 

Social and Environmental Factors:

Dual diagnosis is also caused by other social and environmental factors such as easy substance access, peer pressure, no emotional support, or financial stress. 

Dual diagnosis is a medical condition that requires care. Understanding the causes help to reduce stigma and encourage moral support.

Identification of Dual Diagnosis

The identification of dual diagnoses can be a bit challenging. The symptoms of substance use and mental health disorder might overlap, resulting in difficulty in specific diagnosis. Thus, a comprehensive evaluation by a trained medical professional is required for proper diagnosis and treatment.

The diagnosis may include detailed psychological and substance use history. The patient undergoes mental health screenings and physical examinations as a part of the assessment. Besides these, certain  laboratory tests are also performed for proper evaluation of the disorder.

The patients are kept under observation to monitor any change in symptoms. This helps to determine the type of symptoms when the substance use is reduced. If the diagnosis is not accurate, few key issues would be missed leading to relapse later.

Managing and Treating Dual Diagnosis the Right Way

An integrated treatment approach is required to treat dual diagnosis in the right manner. The treatment of either one of them will not work in the long run. So both mental health disorder and substance use disorder have to be treated simultaneously for complete recovery.

Integrated treatment approach

The dual diagnosis treatment includes certain effective approaches. These are:

Behavioral Therapy

Treatments such as Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Trauma-informed therapy and Motivational Interviewing help individuals understand their thoughts and emotions. These therapies promote healthy coping skills and regulate emotions.

Medication Management

A certain set of medications such as antidepressants, mood stabilizers, and anti-anxiety might be prescribed by therapeutics. These reduce cravings and help manage mental health symptoms. The consumption of these medicines are always monitored to avoid misuse.

Detoxification and Medical Support:

Detoxification is the first step to treat dual diagnosis. Detoxification under medical supervision helps manage symptoms of withdrawal, cravings and physical discomfort.

Inpatient/ Residential Treatment:

The inpatient rehabilitation treatment offers a safe and structured environment to the patient. Such living conditions encourage peer support, recovery, and have a reduced exposure to triggers. There is constant monitoring of the patients to notice any warning signs or discomfort.

Outpatient Treatment:

For those individuals who cannot opt for inpatient rehabilitation programs due to daily responsibilities, outpatient programs are recommended. These include individual and group therapy sessions, counseling and medication management.

Peer Support:

The support groups such as Alcoholic Anonymous, play an essential role in the recovery. These help to reduce isolation and build accountability. 

Importance of Family Involvement in Dual Diagnosis

The support of family members can play a vital role in improving the outcomes of the dual diagnosis treatment. Educating the families regarding dual diagnosis makes them understand how to deal with the patient. Family therapy improves communication, reduces conflict and builds a supportive environment for the loved ones.

Long-Term Outlook and Prognosis

It is important to understand that recovery for dual diagnosis is possible with the right treatment, even after years of struggle. Setbacks can happen during this process, but they do not indicate failure. With proper therapy and self-care, many people are able to manage mental health symptoms. 

The ongoing treatments help maintain sobriety and improve relationships. After recovery, the individual is able to return to daily routine and improve the quality of life. It just needs the right approach and early intervention to improve prognosis.

Recovery after Treatment and Aftercare

Self-awareness and care are key aspects to survive with dual diagnosis. Avoiding social gatherings with triggers, attending daily therapy sessions, following the proper treatment plans, and building a healthy routine are helpful strategies to adopt. Also, seeking professional help in case of relapse is a must. Recovery takes time and patience but becomes easy with the right care.

Dual Diagnosis is Complex but Treatable

With the right combination of therapy and support, recovery after dual diagnosis treatment is completely possible. If someone in your family is struggling with addiction of any substance or mental health issue, do not hesitate to ask for medical help.

Dr. Amar Shinde

Dr. Amar Shinde, founder of Jagruti Rehab, is a renowned psychiatrist in India with over two decades of experience in mental health, addiction recovery, and neuropsychiatry, dedicated to holistic, compassionate patient care.