Differentiating Between Dual Diagnosis and Co-Occurring Disorders

Alcohol and drug addiction often go hand in hand with other mental health disorders. It is not uncommon for individuals with a mental health condition to also struggle with substance abuse. In fact, research shows that people with a mental disorder are more likely to have issues with substance abuse compared to those without a mental health disorder. To address these complex cases, treatment programs often incorporate mental health services alongside substance abuse treatment. In this article, we will explore the difference between dual diagnosis and co-occurring disorders, and how understanding these distinctions can help individuals anticipate the type of treatment they can expect in a substance abuse program.

What Are Co-Occurring Disorders?

Co-occurring disorders, also known as dual diagnosis, refer to the presence of both a mental health disorder and a substance use disorder simultaneously. These mental health disorders can include mood disorders, personality disorders, anxiety disorders, and more. It is important to note that the symptoms of a mental health disorder and a substance abuse issue may not always manifest at the same time. In some cases, individuals may have underlying mood disorders that have been hidden, and they may discover these co-occurring disorders during addiction treatment. Additionally, withdrawal symptoms from substance abuse can sometimes mimic or mask symptoms of an underlying mental disorder.

Common Co-Occurring Mental Health Disorders

Several mental health disorders frequently occur alongside alcohol and drug abuse. Some of these disorders include:

  • Bipolar disorder
  • Post-traumatic stress disorder (PTSD)
  • Borderline personality disorder
  • Social anxiety disorder
  • Panic disorder
  • Traumatic brain injuries
  • Depression
  • Schizophrenia
  • Attention-deficit/hyperactivity disorder (ADHD)

It is essential to recognize and address these co-occurring disorders during addiction treatment, as they can complicate the recovery process. While treating both the substance use disorder and the co-occurring mental health condition can be challenging, integrated treatment approaches have been designed to effectively handle these complex cases.

The Link Between Co-Occurring Disorders and Substance Abuse

The link between co-occurring disorders and substance abuse is complex. Individuals with mental illnesses may turn to drugs or alcohol as a way to cope with their symptoms. This self-medicating behavior may provide temporary relief, but it can lead to substance abuse disorders as individuals become unable to manage their mental health symptoms in healthier ways.

Furthermore, substance abuse can also contribute to the development of mental health disorders. For example, individuals who abuse drugs or alcohol may experience changes in their brain chemistry, which can lead to the onset of mental health symptoms. It is crucial to address both the substance use disorder and the co-occurring mental health disorder simultaneously to ensure comprehensive and effective treatment.

Understanding Dual Diagnosis

Dual diagnosis refers to the diagnosis of two or more disorders occurring concurrently. While the terms dual diagnosis and co-occurring disorders are often used interchangeably, dual diagnosis typically encompasses a broader range of health issues, including mental health conditions and other medical conditions such as heart disease, cancer, or HIV. It is important to note that addiction itself is considered a mental health disorder. Therefore, a dual diagnosis may include addiction and one or more additional co-occurring conditions.

The term comorbidity is also relevant when discussing co-occurring disorders. Comorbidity refers to the interrelationship between two or more diagnosed conditions. In the context of co-occurring disorders, comorbidity may indicate that the mental health condition developed as a result of drug abuse or that drug addiction developed as a coping mechanism for a pre-existing mental disorder.

Why Do Co-Occurring Conditions Develop?

Co-occurring disorders can develop for various reasons. In some cases, substance abuse can cause changes in the brain that lead to the development of a co-occurring disorder. In other cases, individuals may already have an underlying mental health condition that predates the substance use disorder.

Self-Medication and Co-Occurring Disorders

Self-medication is a common phenomenon among individuals with mental illnesses. They may turn to drugs or alcohol as a way to alleviate their symptoms temporarily. However, self-medication can lead to a worsening of mental health conditions and the development of substance abuse disorders.

The following mental health disorders are commonly associated with substance abuse:

Attention-Deficit Hyperactivity Disorder (ADHD)

People with ADHD often have a higher risk of substance abuse. Stimulant medications prescribed for ADHD can be habit-forming and contribute to problematic substance abuse patterns.

Bipolar Disorder

Approximately half of individuals with bipolar disorder also struggle with addiction. The intense emotions associated with bipolar disorder can drive individuals to self-medicate with drugs or alcohol.

Borderline Personality Disorder (BPD)

BPD and addiction often co-occur. Nearly two-thirds of people with BPD have a history of substance abuse.


Depression affects around one in ten adults in the United States. Individuals diagnosed with depression may turn to drugs or alcohol as a means of self-medication. However, substance abuse usually exacerbates the symptoms of depression.

Eating Disorders

Individuals with eating disorders often struggle with feelings of inferiority. Appetite-suppressing drugs are prevalent among those with eating disorders.

Generalized Anxiety Disorder (GAD)

GAD affects approximately 18% of adults in the US. People with GAD may be more prone to drug and alcohol abuse, with benzodiazepines (prescription medications for anxiety disorders) being commonly misused.

Obsessive-Compulsive Disorder (OCD)

OCD is characterized by unwanted obsessions and compulsions. Drug and alcohol abuse can be used as a way to cope with the anxiety and stress associated with OCD.

Post-Traumatic Stress Disorder (PTSD)

PTSD can lead to a decrease in the brain’s production of endorphins, making individuals more susceptible to using alcohol or drugs to achieve a temporary sense of happiness. It has been reported that nearly 75% of soldiers and veterans who have experienced traumatic or violent events engage in alcohol abuse.


Schizophrenia is characterized by hallucinations and delusional thinking. The overlap between schizophrenia and addiction can make it challenging to diagnose and treat both conditions effectively.

Integrated Treatment for Co-Occurring Disorders

Integrated treatment approaches that address both substance abuse and mental health disorders simultaneously are considered the gold standard for treating co-occurring disorders. These approaches involve a comprehensive assessment of co-occurring mental health issues and the development of personalized treatment plans that target both the substance use disorder and the mental health condition.

Benefits of Integrated Treatment

Integrated treatment for co-occurring disorders offers several benefits. By addressing both the substance use disorder and the mental health condition simultaneously, integrated treatment:

  • Increases the likelihood of successful long-term recovery.
  • Reduces the risk of relapse, as untreated mental health conditions can lead individuals to resort to substance use as a coping mechanism.
  • Provides individuals with the necessary tools and support to manage both their substance abuse and mental health issues effectively.

Components of Integrated Treatment

Integrated treatment for co-occurring disorders typically combines therapy and medication, depending on the individual’s specific needs. The treatment team, consisting of medical professionals, psychiatrists, counselors, and addiction specialists, works together to develop a comprehensive treatment plan that addresses all aspects of the individual’s health and well-being.


Therapy is a fundamental component of integrated treatment. Various therapeutic approaches may be utilized, including:

  • Cognitive-behavioral therapy (CBT): This therapy focuses on identifying and changing negative thought patterns and behaviors that contribute to substance abuse and mental health issues.
  • Group therapy: Group therapy provides individuals with a supportive environment where they can share their experiences, learn from others, and develop coping strategies.
  • Psychotherapy: Psychotherapy helps individuals explore the underlying causes of their substance abuse and mental health issues and develop healthier coping mechanisms.
  • EMDR (Eye Movement Desensitization and Reprocessing): EMDR is a specialized therapy often used to treat trauma-related disorders. It helps individuals process and heal from traumatic experiences that may contribute to their substance abuse and mental health issues.


In some cases, medication may be prescribed to manage severe mental health symptoms that co-occur with substance abuse. The medical director and psychiatrist on the treatment team work closely with the individual to determine if medication is necessary and develop an appropriate medication management plan.

Seeking Help for Co-Occurring Disorders

If you or someone you know is struggling with co-occurring disorders, it is essential to seek professional help. Treatment programs like ReAlign Detox specialize in dual diagnosis and addiction detox, providing comprehensive support for individuals facing these challenges. ReAlign Detox offers trained staff, experienced medical directors, and 24-hour availability for follow-up visits and health concerns. Additionally, they accept referrals and work with major insurance plans, making treatment more accessible for those in need.

Telemedicine and Co-Occurring Disorders

Telemedicine has emerged as an effective way to access treatment for co-occurring disorders. It allows individuals to receive coaching, medical support, and therapy via secure video chat, all from the convenience of their smartphones. ReAlign Detox offers telemedicine services, making it easier for individuals to get the help they need, even from a distance.


Understanding the difference between dual diagnosis and co-occurring disorders is crucial for individuals seeking addiction treatment. Co-occurring disorders refer to the presence of both a mental health disorder and a substance use disorder simultaneously. Dual diagnosis encompasses a broader range of health issues and may include mental health conditions and other medical conditions. Integrated treatment approaches that address both substance abuse and mental health disorders simultaneously offer the best chance for long-term recovery. Seeking professional help from specialized programs like ReAlign Detox can provide individuals with the comprehensive support they need on their journey to recovery.

Remember, you don’t have to face co-occurring disorders alone. Reach out for help today, and take the first step towards a healthier, happier future. Call us today at 833-820-2922.