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Dual Diagnosis
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Substance Use Disorders

Dual Diagnosis

A dual diagnosis occurs when an individual experiences both a mental disorder and a substance use disorder simultaneously, requiring integrated treatment for both conditions.

What is dual diagnosis?

If you have a dual diagnosis, that means that you have both a mental disorder and a substance use disorder (SUD), either with alcohol or drugs. A dual diagnosis is a type of comorbidity, which is when someone has two disorders at the same time. Another name for this is co-occurring disorders.

Mental and substance use disorders often occur together. Many people who develop SUDs are also diagnosed with mental disorders. And the reverse is true; many people with mental disorders will develop an SUD. Having both types of disorders is even more common in teenagers, people with serious mental illness, and people with certain mental disorders.

Why do substance use disorders and mental disorders occur together?

Although these problems often occur together, this does not mean that one caused the other, even if one appeared first. Researchers think that there are three possible reasons as to why they often occur together:

  • Common risk factors can contribute to both mental disorders and SUDs. These factors include:
    • Genetics.
    • Stress.
    • Trauma, especially in childhood. Veterans with post-traumatic stress disorder (PTSD) are also at risk for SUDs.
  • Mental disorders can contribute to drug use and SUDs. For example, people with mental disorders may use drugs or alcohol to try to feel better temporarily. This is known as self-medication. Also, mental disorders may change the brain to make it more likely that you will become addicted.
  • Substance use and addiction can contribute to the development of a mental disorder. Substance use may change the brain in ways that make you more likely to develop a mental disorder.

What are the treatments for dual diagnosis?

If you have a dual diagnosis, it is usually better to treat both conditions at the same time rather than separately. You and your health care provider can work on a treatment plan that fits your needs, taking into account your age, the substances you are misusing, and your specific mental disorder. The plan may include:

  • Behavioral therapy, such as talk therapy (psychotherapy), long-term residential treatment (which combines housing and treatment services), and therapies to help you stay motivated to stick with your treatment plan.
  • Medicines. There are effective medicines that treat opioid, alcohol, and nicotine addiction. There are also medicines that can lessen the symptoms of many mental disorders. Some medicines may treat more than one disorder.
  • A referral to a support group. Support groups can give you emotional and social support and provide a place to share tips about how to deal with day-to-day challenges.

Frequently Asked Questions

Dual diagnosis is often a chronic condition that requires ongoing management, similar to other chronic health issues. While there isn't a "cure," effective integrated treatment can lead to significant improvement, sustained recovery, and a better quality of life. Relapse prevention strategies are a key part of long-term management.
While only a professional can diagnose, signs might include worsening mental health symptoms despite efforts to manage them, increased substance use to cope with emotions or stress, difficulty maintaining sobriety due to underlying mental health issues, or mental health symptoms appearing or intensifying during periods of substance use or withdrawal.
Integrated treatment means that both the mental disorder and the substance use disorder are addressed at the same time by the same treatment team or in a highly coordinated way. This approach is crucial because the conditions often influence each other, and treating one without the other is less effective and can lead to relapse.
The first step is to seek a comprehensive evaluation from a healthcare professional specializing in mental health and addiction, such as a psychiatrist, psychologist, or an addiction specialist. They can accurately diagnose both conditions and recommend an appropriate integrated treatment plan.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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