It is not uncommon for people with mental illnesses to use substances to self-medicate, or for people to manifest or exacerbate a mental illness for the first time after using alcohol or other drugs. Regardless of which condition arrived first, when a person suffers from a mental health diagnosis and a substance abuse disorder, they become one of over 9 million Americans with co-occurring diagnoses.

What Are Co-Occurring Diagnoses?

Previously known as dual diagnosis or dual disorder, co-occurring diagnoses exist when a person has both a mental health and a substance use disorder simultaneously. Because both can be the result of genetics and environmental factors, it makes sense that they could occur together.

While substances may temporarily alleviate or numb a person’s mental health symptoms, they typically cause the condition to worsen over time. For a person who already has the potential to develop a mental illness, introducing alcohol or other substances may activate a previously unseen mental health condition.

Why Does It Matter?

According to Psychology Today, it is even more important for individuals with co-occurring diagnoses to have a solid recovery plan because, without proper planning, they are statistically more likely than peers to experience:

  • relapses (of either substance use or mental health symptoms)
  • hospitalizations
  • struggles with money
  • isolation
  • homelessness
  • victimization
  • jail time


While it used to be popular to treat each condition one at a time, it is now generally agreed that both conditions need to be treated together, preferably in an integrated approach, for the most stable recovery to occur.

Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) are two of the preferred psychological interventions in such cases, because they help to build coping skills and reduce behaviors that aren’t productive. Both can also be used in conjunction with medication.

Ideally, the person with the co-occurring diagnosis would be educated about the interaction between their substance use disorder and their mental health condition, and be guided in making a recovery plan that keeps them both sober and in good mental health.

After Treatment

Treating both mental health and addiction doesn’t end when a person graduates from residential treatment. The focus on both conditions should continue as a person pursues long-term recovery, as relapse in one area can trigger a relapse in the other.

While it is completely appropriate for a person with dual diagnoses to attend NA, AA, Smart Recovery or other groups that focus primarily on substance use disorder, Double Trouble in Recovery is a recovery group created specifically for people with co-occurring diagnoses.

Learning More

It is not at all uncommon for a person to enter treatment for substance use disorder without knowing that they also have a mental health diagnosis. If you or a loved one has only recently learned that you meet criteria for a mental illness and you would like to learn more about that diagnosis, the National Alliance on Mental Illness (NAMI) is a great resource.

NAMI not only has volumes of information online and opportunities to gain support via virtual communities, but it also has an in-person presence in many communities, where local chapters offer support groups, classes, and speakers who can talk on a variety of mental health topics.

If you are concerned that you or a loved one could be struggling with co-occurring mental health and substance use disorders, talk to your family doctor or contact our admissions counselors at Safe Harbor Recovery Center in Portsmouth, VA. We provide a comprehensive assessment that addresses your medical/biological needs, mental health, nutritional guidance, spirituality, emotional health, physical exercise, life skills, and ongoing support.

For more information about programs at Safe Harbor Recovery Center, co-occurring disorder treatment in Virginia, contact us at (888) 932-2304. We are ready to help you make a new beginning.