Diagnosis and Treatment of a Co-Occurring Disorder

What is a Co-Occurring Disorder?

A co-occurring disorder, also referred to as a dual diagnosis, is when an individual is experiencing a substance use disorder as well as a mental health issue.1 For example, a person may be suffering from addiction to alcohol or drugs, and the same person may also have a psychiatric disorder that could include bipolar disorder, an eating disorder, depression, borderline personality disorder or panic disorder.

How Does a Co-Occurring Disorder Develop?

Either disorder may precede the other. An individual who has a mental health disorder may turn to drugs or alcohol to self-medicate in an attempt to alleviate unpleasant symptoms. Alternatively, substance abuse can also lead to mental illness, as ongoing drug or alcohol use can affect a person’s moods, thinking, brain chemistry and behavior.

How Is a Co-Occurring Disorder Treated?

The key to treating a dual diagnosis is to address all disorders—both substance abuse and any mental health issues—at the same time. If one disorder is treated and the other neglected, the risk of substance use relapse or the return of mental health symptoms increases greatly.

Untreated mental health disorders can lead to a recurrence of alcohol or drug use. Untreated chemical dependency can lead to a return of psychiatric symptoms. Since there are many different scenarios, treatment needs to be customized to a person’s particular circumstances and needs2.

Dual Diagnosis Symptoms

Since the disorders involved in a dual diagnosis can vary widely, the symptoms cover a wide range as well. Generally, the symptoms of co-occurring disorders include:

  • Withdrawal and isolation from loved ones
  • Sudden behavior changes
  • Using substances under unsafe and unhealthy conditions
  • Taking part in risky behaviors when under the influence
  • Losing control over substance use
  • Unusual behavior (stealing, lying) to maintain a drug or alcohol habit
  • Developing tolerance and withdrawal symptoms
  • Feeling a need to take substances to simply function

Problems stemming from a dual diagnosis can include:

  • Relationship problems with coworkers or loved ones
  • Isolation and social withdrawal
  • Money problems
  • Workplace problems
  • Substance abuse issues requiring hospitalization
  • Psychiatric care requiring hospitalization
  • Increased emergency room admissions
  • Increased need for healthcare services
  • Legal problems

Treatment for a Dual Diagnosis

Diagnosis and Treatment of a Co-occurring DisorderMany people with a dual diagnosis can find the help they need through outpatient counseling services. If the co-existing disorders are severe, a detox and inpatient rehab may be needed first. Then outpatient services can be implemented for increased stability as these individuals return to home and work.

Outpatient counseling services are always a substantial part of an effective co-occurring disorder treatment plan. Clients learn about their disorders as well as how beliefs and behaviors influence thoughts and decision making. This knowledge helps clients manage symptoms of both mental health and substance use disorders.

Cognitive behavioral therapy is particularly effective in managing dual diagnosis symptoms. Clients learn coping skills and how to change destructive and ineffective thinking patterns.

A Successful Road to Recovery

People in dual recovery treatment are actively following a personalized program, which focuses on their recovery needs for both their substance use and psychiatric illnesses.


  1. https://medlineplus.gov/dualdiagnosis.html
  2. https://www.psychologytoday.com/blog/the-anatomy-addiction/201110/what-is-dual-diagnosis