Substance abuse disorders very frequently occur in individuals with undiagnosed and/or untreated mental illness. In the majority of cases, an individual who is struggling with the disruptive and uncomfortable symptoms of mental illness will turn to drugs and alcohol as a means of self-medication. When these two illnesses occur at the same time (mental illness and addiction), it is known as a dual diagnosis addictive disorder. It is possible for either one of the disorders to precede the other – it is sometimes difficult to tell which came first. Dual diagnosis disorders are extremely common. The National Survey on Drug Use and Health reported in 2018 that 9.2 million American adults struggled with both an addiction and mental illness. Because dual diagnosis disorders will vary so significantly on a person-to-person basis, it is difficult to pinpoint specific symptoms. Despite the fact that symptoms vary so significantly, there are several symptoms of substance abuse that can be easily observed in an individual struggling with mental illness – it is often easier to identify addiction before any additional, underlying disorders.

Symptoms of substance abuse and addiction include:

  • Sudden and unexplainable behavioral changes
  • An increase in risk-taking behaviors
  • Increased isolation/avoidance of close friends and family members
  • Developing a tolerance
  • Experiencing withdrawal symptoms upon ceased use
  • Feeling anxious when substances are unavailable
  • Feeling unable to function without the use of a substance

Symptoms of mental health disorders will always vary greatly, depending on the specific disorder and personal background. There are some commonly experienced symptoms of mental illness, however, including quick shifts in mood or energy, a lack of motivation, avoidance of social situations and activities, problems concentrating, and a steep decline in overall quality of well-being.

Treatment for Dual Diagnosis Disorders

The National Alliance on Mental Health suggests, “The best treatment for dual diagnosis is integrated intervention, when a person receives care for both their diagnosed mental illness and substance use disorder.” It is important that all existing issues are addressed simultaneously. Up until the mid 1990s, dual diagnosis treatment did not exist. For example, if an individual was depressed, they would be treated exclusively for depression – regardless of how much they were drinking. This proved to be counterproductive. It was also previously believed that mental health concerns could not be properly diagnosed if an individual was actively using substances. Psychiatric patients would be told things like, “Quit drinking and come back in two weeks.” Of course, this never worked – these patients would be unable to control their drinking, thus they would never receive the professional care they needed for their existing mental illness. It is important that both you and your treatment provider understands the ways in which all of your co-occurring disorders affect one another. At Princeton Detox and Recovery Center, we understand the value of highly individualized and integrated care. No two treatment programs will be the same – all will be personalized based on unique needs. While treatment planning will be developed based on each unique case, there are some common components.

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These components are as follows:

  • Medical detoxification. Those struggling with a substance abuse disorder will need to attend a medical detox facility, geared towards safe withdrawal and preparation for transfer to an inpatient rehab. A team of medical professionals will work to alleviate symptoms of withdrawal while considering potential medical health concerns. If a patient is believed to have a dual diagnosis disorder, he or she will transfer to a dual diagnosis rehab.
  • Inpatient, dual diagnosis rehab. In an inpatient (or residential) treatment center, professional medical and psychiatric help will be available around the clock. Because dual diagnosis disorders are often difficult cases to treat, intensive care in a designated facility is extremely beneficial.
  • Medicinal intervention. In most cases, medication will be necessary in treating mental illness. On-staff psychiatrists will help each individual patient find a non-narcotic, non-addictive prescription medication that works – whether that be an antidepressant, an antipsychotic or a mood stabilizer. In some cases medication assisted treatment will be used in treating those struggling with a severe substance abuse disorder as well. For example, those overcoming a severe heroin addiction will frequently be prescribed Suboxone, which will help alleviate cravings and lessen painful symptoms of withdrawal.
  • Psychotherapy. Individual therapy is crucial for those struggling with mental illness or with substance abuse. Many varieties of psychotherapy will be utilized in conjunction, such as cognitive behavioral therapy (CBT) and dialectic behavioral therapy (DBT).
  • Aftercare planning, including supportive housing. Sober living houses help those new to recovery maintain sobriety and continuously achieve treatment goals while making the slow transition back into independent living. Supportive housing situations have been proven to reduce the risk of relapse.
  • Support groups and continued group counseling. Group counseling is beneficial to those struggling with substance abuse or mental illness. Other support groups, such as 12 step programs, are extremely beneficial when used in conjunction with additional therapeutic care and medication.
  • Additional holistic treatment options. Holistic treatment options could include nutritional counseling, yoga and meditation, regular exercise and vocational training. Participating in holistic treatment methods helps build structure and self-esteem, which are both valuable to addiction recovery and mental well-being.

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The Importance of Dual Diagnosis

At Princeton Detox &Recovery Center, we completely understand that unless all existing disorders are thoroughly treated, the risk of relapse increases significantly. In an article titled Dual Diagnosis: The Importance of Simultaneous Treatment, Kim Dennis, MD, CEDS, explains how crucial it is that mental health and addiction are addressed in the same facility. Dennis explains that mental illness comes in many forms. While anxiety disorders and depression are amongst the most common comorbid concerns, dual diagnosis can also refer to things like post-traumatic stress disorder (PTSD) or eating disorders. “Eating disorders, for example, commonly co-occur with substance abuse,” Dennis writes. “Up to 35% of alcohol or illicit drug abusers have eating disorders compared to only 3% of the general population. Similarly, up to 50% of those with eating disorders have a concurrent problem with alcohol or drug abuse.” While accredited and reputable dual diagnosis treatment centers do exist, it can be difficult to find one. Many treatment centers will still only focus on one disorder or another, without offering a more comprehensive continuum of care.

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At Princeton Detox & Recovery Center, we ensure that you will be receiving the level and type of care you need and the quality of care you deserve. Our staff is made up of therapists, psychiatrists and addiction specialists, all dedicated to getting you started on the lifelong journey of recovery as quickly as possible. If you believe that you may be struggling with an undiagnosed mental illness, or if you have been diagnosed and you feel that previous treatment options have not worked for you, dual diagnosis addiction treatment is an ideal choice. For more information on our comprehensive recovery program or to learn more about dual diagnosis disorders, reach out today. If you are still unsure as to which treatment option will best suit your needs, we will gladly conduct a brief pre-assessment, free of charge and non-binding. We look forward to speaking with you soon.

Amanda Hilzer

Reviewed for accuracy by:

Amanda Hilzer M.Ed, CAADC, IADAC, ICCS, LCADC, CCS


Amanda graduated from Lehigh University with both an undergraduate degree in Psychology and a Master’s of Education degree in Counseling Psychology and has worked in the field of substance use disorder treatment and mental health treatment as a counselor and as a clinical manager for over 14 years.