The 5 Most Common Dual Diagnoses

It is not uncommon for a person struggling with substance use disorder (SUD) to have an underlying mental health condition. Studies have found that approximately 50% of people with severe mental illness also have SUD, resulting in a dual diagnosis.

The following five mental health conditions are the ones that most commonly co-occur with SUD in a dual diagnosis.

#1. Major Depressive Disorder (MDD)

MMD is more than sadness. It is a chronic illness that leaves the afflicted person with persistent feelings of despair and suicidal ideation. If this mental illness is not treated, it can significantly impact the individual’s ability to go about their daily lives and can end in the person taking their own life.

Depression is also often a factor in substance use.

Symptoms of MMD include:

• Insomnia or sleeping too much

• Hopelessness

• Feelings of emptiness

• Loss of appetite or eating

• Loss of pleasure or interest in activities that used to bring joy

• Persistent sadness or anger

• Chronic pain

Treatments for MMD, depending on the severity of the condition, can range from:

• Psychotherapy

• Medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)

• Electroconvulsive therapy (ECT)

#2. Anxiety Disorders 

Anxiety disorders come in many forms ranging from generalized anxiety disorder (GAD), panic disorder, phobias, and social anxiety. Extreme anxiety can make everyday tasks incredibly difficult, as these disorders cause the mind to race and can prevent people from doing necessary daily tasks.

Although each condition has its nuances, anxiety disorders typically involve these symptoms:

• Restlessness

• Anxiety attacks 

• Unknown pain or stomach aches

• Excessive worry

• Insomnia

Treatments for anxiety disorders include:

• Psychotherapy

• Medications such as SSRIs and SNRIs

• Exposure therapy

#3. Post-Traumatic Stress Disorder (PTSD)

PTSD is one of the most common mental health conditions associated with addiction, as both have roots in unresolved traumatic events. Often, people will develop drug addictions because they are trying to deal with the symptoms of PTSD.

PTSD is categorized by: 

• Flashbacks

• Isolation

• Mood swings

• Insomnia

Treatments for PTSD include:

• Cognitive-behavioral therapy (CBT)

• Medications

• Exposure therapy

• Eye movement desensitization and reprocessing (EMDR) therapy

#4. Personality Disorders

The personality disorders most commonly associated with addiction are borderline personality disorder (BPD), antisocial personality disorder (ASPD), and histrionic personality disorder. Each of these personality disorders hails from the cluster B personality disorder family. They are characterized by unpredictable, dramatic, and overly emotional thought or behavioral patterns. 

Cluster B personality disorders can be complicated to treat because many people with these disorders do not believe anything is wrong or destructive about their behavior. As such, it takes commitment from the individual and their therapist to work together for actual change.

Symptoms of Cluster B personality disorder include: 

• Impulsiveness

• Unstable relationships

• Risk-seeking behavior

• A deep fear of being alone

• Angry outbursts

• Black and white thinking

• Threats of suicide

Treatment for personality disorders includes:

• CBT

• Dialectical behavior therapy (DBT)

• Other forms of psychotherapy

• Medications such as mood stabilizers, antipsychotics, antidepressants, and antianxiety medications

#5. Bipolar Disorder

All forms of bipolar disorder involve mood episodes that can impede a person’s ability to reason or tackle everyday tasks. Mood episodes can either be described as manic or depressive. Manic episodes are marked by periods of high energy and increased activity, while depressive episodes are characterized by symptoms similar to those of depression.

Manic episodes are characterized by:

• Euphoria

• High energy

• Quick speaking

• Grandiose behaviors

• Alertness

• Decreased sleep

• Impulsive or risk-taking behaviors

• Making decisions that are out of character

Depressive episodes are characterized by:

• Insomnia

• Fatigue

• Feelings of intense sadness and emptiness

• Lack of appetite

• Self-doubt

• Delusions or hallucinations

• Suicidal thoughts

Bipolar disorder comes in three forms: type 1, type 2, and cyclothymic disorder. Type 1 is the most extreme form of the illness, as intense manic and depressive episodes categorize it. While type 2 has similar depressive episodes to type I, people with type 2 do not have as extreme manic episodes as those with type 1. Cyclothymic disorder is the mildest form of the disorder, categorized by mood swings that are not as severe as those in bipolar types 1 and 2.

Treatment for bipolar disorders can include:

• Psychotherapy

• Medications

Treatment for Dual Diagnosis

If an individual has received a dual diagnosis, they will likely want to receive treatment at a rehab center that has demonstrated success in treating SUD and mental health disorders. This is because mental health disorders and addiction disorders exacerbate each other.

People will often use drugs and alcohol to self-medicate to ease the symptoms of their mental health conditions, and prolonged drug use adversely affects mental health. If the mental health disorder is not treated, the negative thought patterns and behaviors attached to the mental illness, including substance abuse, are likely to continue.

Conversely, if the SUD is treated, but individuals remain in poor mental health, they will remain in greater danger of relapsing.

Although receiving a dual diagnosis may be scary, with proper treatment, SUD and mental health conditions can be treated and managed. To obtain adequate treatment for a dual diagnosis, individuals should ensure that the treatment center they choose has a successful track record in treating their mental health condition and SUD.

The Forge Recovery Center Treats Addiction Holistically in Body & Mind

At The Forge Recovery Center, mental health plays a vital role in addiction recovery, especially if you have received a dual diagnosis.

Facing a dual diagnosis can be incredibly difficult as you must tackle your mental health condition and substance abuse disorder in tandem to ensure a successful recovery. Luckily, you do not have to go on this journey alone.

Our expertly trained staff at The Forge Recovery Center have years of experience treating mental health and substance abuse disorders. We will help you every step of the way to create a treatment plan that works for you, whether it involves medications or holistic methods.

After recovery, we will help you find resources to continue your mental health care. We believe you deserve a life filled with happiness and hope, and we can help you reach your destination.

For more information about the treatment options available to you at The Forge Recovery Center, contact us today.

Written by

Brian Moore

Content Writer

Reviewed by

Jeremy Arzt

Chief Clinical Officer

August 3, 2022