Dual diagnosis and co-occurring disorders: what are they?

Dual diagnosis and co-occurring disorders are remarkably similar medical terms that often get overlapped. However, there is a slight difference between the two; having a dual diagnosis means having two or more mental health problems existing simultaneously, such as anxiety and depression. In contrast, co-occurring disorder means having a specific substance addiction alongside a mental health disorder. Unfortunately, it is difficult to accurately detect a dual diagnosis and co-occurring disorders because substance abuse often masks an underlying mental illness or vice versa. However, doctors and therapists have made great strides in the field and can often detect it at its early stages.

Adults and young people who deal with severe mental illness and substance abuse are some of the most vulnerable people in our society because treating someone with co-occurring conditions requires specialist treatment. Therefore, a unique treatment programme tailored to both addiction and any co-occurring disorders must be applied if they are to experience eventual success in overcoming both the illness and source of addiction.

What are the most common co-occurring disorders?

There is no one-size fits all when it comes to co-occurring disorders, as they can be a mixture of any mental health problem alongside addiction. However, some of the more common examples are listed below:

  • Social anxiety and addiction
  • PTSD and addiction
  • Depression and addiction
  • Bi-polar disorder and addiction
  • Personality disorder and addiction

What are the most common signs of co-occurring disorders and dual diagnosis?

If you are concerned someone you love has a co-occurring disorder alongside substance dependency, look at the following quiz. If you answer yes to any questions, it may indicate that your loved one needs to receive co-occurring disorder treatment.

  • Do they frequently withdraw from social events?
  • Have they recently undergone a breakdown in relationships and friendships?
  • Have they started engaging in risky behaviour that may threaten their safety?
  • Have they lost interest in things they were once passionate about?
  • Are they unable to cope with day-to-day tasks?
  • Have they neglected their hygiene?
  • Are they worrying or fretting frequently?
  • Have you witnessed an emotional change in their behaviour (more anger, crying, frustration)?
  • Do they experience notable mood swings?
  • Since using addictive substances, has their behaviour been noticed by others as ‘out of character?

The vicious cycle of co-occurring disorders

The impact of mental health on addiction

Just like the classic chicken and the egg, it isn’t known which came first, the mental illness or the addiction. But one thing is clear; both disorders feed off one another, so you can’t recover from one unless you work on healing the other as well.

If someone is experiencing a mental illness, this can give way to substance addiction in the form of self-medication. Many people use drugs and alcohol to escape painful emotions, get better sleep, or get them through work and duties. As a result, the person comes to rely on the substance to function. Thus, a substance dependency is born. Furthermore, with a person’s tolerance getting more substantial, they require larger quantities more frequently to maintain that sense of normality.

Substance abuse can also give way to mental health issues in turn. For example, if a person has found themselves dependent on drugs, they may develop paranoia or extreme anxiety, and in some cases, psychosis purely as a reaction to the chemicals in the body. Additionally, the more people consume the drug, their vulnerable mental state will be exacerbated.

There is a chemical aspect to addiction and mental health; a person with a mental health issue may also have changes in the brain that make them more predisposed to a substance use disorder.

Co-occurring disorder and dual diagnosis treatment

Should you enrol in a dual diagnosis treatment programme, one of the first things you’ll experience is a professional assessment of your current condition. Your doctors and therapists will want to differentiate between pre-existing conditions and your substance abuse. Differentiating between conditions allows doctors to understand cause and effect. It enables them to effectively create treatment plans that address substance abuse without negatively impacting their mental health.

Attempting to deal with co-occurring disorders via a self-help strategy is discouraged. As a general rule, self-help is effectively unlikely for long-term recovery. Remember that dual diagnosis issues are complex and require understanding addiction and mental disorders. We urge you to seek professional help rather than trying to do this on your own.

We also advise you to seek out group support. We cannot overstate the value of group support for both addiction and mental disorders, as it provides mutual accountability, educational opportunities and a safe environment where you can discuss your issues with others who understand what you are going through.
There are three main components of dual diagnosis treatment to help alleviate the challenges presented. These are detox, counselling and personal ownership.


The need for detox is often present with substance addiction, as it’s essential to rid your system of any toxic chemicals. In addition, the benefits of drug detox will have an ever-increasing positive effect on your mental and physical health. By removing the substance from your body, you have given yourself the best possible chance of growing and achieving your goals because it cannot play with your mind and hinder your progress.


Both addiction and mental illness utilise counselling as a part of treatment. In both cases, clients train new ways of thinking to avoid falling back into the same pitfalls that led to the problems in the first place.

Counselling provides you with skills that are applicable in your everyday life. When presented with a challenging situation where you are at risk of relapse, you can rely on the skills learnt during counselling to overcome the temptation and keep moving forward with your recovery.

Personal ownership

Both addiction and mental illnesses require personal ownership if clients are to maintain recovery. It is easy for someone caught in a dual diagnosis situation to blame one condition on another and expect, incorrectly so, that solving one problem will mean permanent recovery. Both issues must be addressed, and if addiction is your primary condition, this must be dealt with first. Overcoming addiction is not easy and requires dedication, and rehab will only work if you are willing to use the tools taught to you to make positive change.

How UKAT can help you

UKAT is resolute that co-occurring disorders aggravate addiction, and substance addiction worsens mental health. For many people under the influence of drugs and alcohol, their mental state is controlled by their drug dependency. Moreover, a person’s thoughts and feelings can feel wholly tangled up in their mind, depriving them of clarity and awareness. Our job is to carefully help clients untangle their thoughts and emotions so they can gain a healthy perspective.

Dual diagnosis and co-occurring disorders are efficiently treated by combating the primary issue first. For example, if your mental health disorder results from your addiction and doesn’t need urgent care, we offer world-class support for addiction as a primary issue. Our various treatments and workshops help you address multiple problems that may contribute to your secondary condition. Our therapists understand the need for custom treatments for every individual, and we typically recommend residential treatment as the best course of action for these cases. Remember that dual diagnosis involves co-occurring conditions that are more challenging to treat. While it is possible to handle a co-occurring scenario using outpatient treatment, residential treatment is preferred because it offers more concentrated care in an environment more conducive to getting well.

UKAT is the leading provider of bespoke addiction treatment in the UK and will give you the best possible opportunity for recovery. With the skills gained during our treatment programmes, you will know how to stay on the road to recovery and avoid a relapse. If you or someone you know requires some help, please know that you are not alone. We are ready and waiting to offer you the best possible chance at a successful recovery.

Facts on dual diagnosis and co-occurring disorders

UK studies have reported dual diagnosis in 20–37% of people across all mental health settings. This is further supported by UK statistics that 86% of Britons receiving alcoholism treatment had a co-occurring disorder, and around 44% of Britons with drug dependency also had a mental illness.

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