What Does Dual Diagnosis Mean?

A common term you may come across when researching addiction treatment options is dual diagnosis. But what does dual diagnosis mean?

A dual diagnosis refers to when someone is suffering from co-occurring mental health and substance abuse problems. These co-occurring disorders can be closely entwined, so it’s important to recognise and treat them at the same time. If not caught and treated correctly, both can have an impact on assessment, treatment and your ongoing recovery efforts.

Having a dual diagnosis may seem like the problem is too big, but support is available, and Addiction Advocates can help you access the right treatment.

 

What Does Dual Diagnosis Mean?

In addiction treatment, a dual diagnosis is when a person is suffering with addiction alongside a separate mental health issue. This is common in England and Wales, with 74% of people in treatment between 2024 and 2025 having a mental health need along with a substance problem.

In this context, these problems can also be referred to as co-occurring conditions because of how they can interact and affect treatment efforts. Dual diagnosis does not mean a person has two unrelated diagnoses or uses multiple substances.

Dual diagnosis can be a broad term, referring to co-occurring addiction and mental health issues, whilst some more specific guidelines use it to cover severe mental health issues and substance abuse problems.

 

Examples of Co-occurring Conditions

Some typical co-occurring conditions include:

• Depression and alcohol problems
• Anxiety and drug addiction (benzodiazepines, cannabis)
• PTSD and alcoholism and drug addiction
• Psychosis and substance misuse

Trauma can play a role in developing substance abuse issues, causing difficulties such as avoidance, distress and intrusive memories. These are symptoms of conditions such as PTSD but cannot be used as a confirmed diagnosis without a proper medical assessment.

Combinations are not set in stone, and the severity of issues may vary. There are also no set sequences, as mental health problems do not always lead to substance abuse issues and vice versa.

 

How Mental Health and Substance Use Can Interact

Mental health and substance use can be closely entwined for many reasons. In some cases, people gravitate towards substances to cope with distress and help them through difficult emotions. This can initially work but then has the opposite effect and begins to worsen mental health.

Despite this likely outcome, self-medication is a big driver in substance abuse. A study by Swansea University found that 70 per cent of young people with substance use mentioned in their health records also reported experiencing some form of mental illness.

But mental health issues like anxiety and depression alone aren’t responsible. Factors such as trauma, stress and social circumstances can all contribute to addiction. Even in these cases, it is not inevitable, but going through periods of poor mental health or dealing with trauma can increase the risk of substance abuse.

It works the other way as well. Intoxication and withdrawal can produce symptoms that point towards mental health conditions. Without a proper assessment, nothing can be properly determined.

 

Signs That Someone May Need Assessment

You can’t diagnose dual diagnosis without a professional assessment. Knowing you might need one, though, means being aware of symptoms that point in that direction.

Common dual diagnosis symptoms include:

• Persistent low mood
• Anxiety
• Unusual experiences (hallucinations, detachment from reality, confusion, paranoia)
• Disrupted sleep
• Depression

These types of symptoms will likely occur alongside signs of problematic substance use, which include:

• Loss of control over substance use
• Continued substance use despite the damage it is doing
• Changes in relationships or daily functioning due to substance use
• Experiencing withdrawal

These symptoms shouldn’t be used as a diagnostic tool. Some can overlap with other conditions; seek professional help to get a proper diagnosis.

 

How Dual Diagnosis Is Assessed

A thorough assessment or assessments are needed to make a dual diagnosis. This means answering questions about your mental health, substance use, physical health, medicines you take and what immediate risks there are.

It’s important to get a clearer idea of the timeline, as knowing when symptoms began, whether before, during or after substance use, can help make links and understand how symptoms may have developed and changed.

Healthcare professionals will also consider your social needs (housing, finance), past treatment and, with your permission, may ask for family input.

This may not all be figured out in one assessment. It can be an ongoing process to build up a clearer picture, but you can still receive the support you need even if not everything is certain.

 

What Does Treatment Involve With a Dual Diagnosis?

Coordinated care is critical, treating both mental health and substance use together and creating an approach that is right for you.

Dual diagnosis should involve psychological treatment (individual and group therapies), withdrawal support if required and practical support. This could involve helping with self-care and building routines, social support and accessing treatment.

With your consent and after clear care planning, there should be communication between mental health and drug or alcohol services to ensure the treatments complement one another.

To get to this stage, and decide what suits you, an assessment can help determine the appropriate community, specialist or residential care.

 

Why Ongoing Support Matters

Dual diagnosis support shouldn’t end when you leave rehab. It is important to engage in follow-up meetings, learn more about and practise relapse prevention and participate in continued mental health monitoring.

A proper care plan may also involve support for things such as housing, relationships and daily routines that will impact your mental health and addiction. Peer support, in the form of regular meetings, and family support are also considerations and can help as a positive support network in addition to professional treatment.

Recovery is a journey, one that lasts a long time, and there are no shortcuts. You should continue to engage in treatment, take the proper medications and understand that situations can change and be flexible about your care plan.

 

When and Where to Seek Help

If you do feel like you are struggling, there are many options to get proper dual diagnosis treatment in the UK.

You should consider contacting your GP for help via the NHS, your existing mental health team or a local drug and alcohol service for assessment.

The help you receive must be a coordinated response. Combining addiction and mental health support to ensure they are treated together and you are not excluded from the care you need due to substance misuse issues.

If you are experiencing a severe deterioration in your mental health, seek urgent support. Call 999 or go to A&E if you believe you are in immediate danger or doubt your ability to stay safe.

Symptoms such as severe breathing problems or seizures point towards an overdose. In this case, get immediate medical help.

 

How Addiction Advocates Can Help

Addiction Advocates is a rehabilitation referral service and helpline that helps connect you to a treatment centre that is right for you.

We can help you find a dual diagnosis treatment centre that suits your situation, ensuring you connect with a provider that has a thorough assessment before admission. This way, you can be reassured that the treatment centre you choose can properly treat both your substance abuse and mental health issues.

Addiction Advocates can verify a selected centre’s capability to help you. Alongside mental health treatments, specialist care such as medically assisted detox, personal counselling and cognitive behavioural therapy are the types of addiction treatment that are helpful for a dual diagnosis.

 

Need Support for Dual Diagnosis? Find the Right Help Today

Addiction and mental health issues can complicate treatment, but support is still available. If you are worried about yourself or a relative, talk to Addiction Advocates about how we can find you the dual diagnosis treatment that suits you.

In the case of needing urgent care, don’t delay and call 999 for emergency services.

Contact the team today for a confidential chat about your recovery.