Residential at the Ranch

Extended Care (PHP)

Intensive Outpatient Therapy (IOP)

Sober Living


The Full Continuum

Our Mission

Meet the Team







San Antonio

Willow Bend

Cedar Park

Art Therapy

Accelerated Resolution Trauma Therapy

Boxing & Body Movement

CBT Therapy

DBT Therapy

Family Dynamic Therapy

Family Therapy

Group Therapy

Individual Therapy

Motivational Interviewing

Relapse Prevention Therapy

Spiritual Therapy

Medication Assisted Treatment

Chapter 8

What is Dual Diagnosis? Rehab & Treatment Options

A psychologist talking to a patient with his head in his hand.

Updated on

26 Apr, 2024

In the complex world of mental health and addiction, dual diagnosis stands out as a vital aspect that deserves our attention and understanding. The combination of mental health disorders and substance use poses unique challenges that require a thoughtful and integrated approach to treatment.

We aim to contribute to the conversation about dual diagnosis, combatting stigma, and promoting a compassionate and effective treatment approach. Let’s explore the complexities of dual diagnosis and the paths to recovery.

Dual Diagnosis Overview: Understanding Dual Diagnosis

How can we start to understand dual diagnosis as a concept in treating substance abuse disorder? We’ll share plenty of details about dual diagnosis treatment and rehab throughout this article. However, let’s start with a simple and foundationally important fact.

Some people with mental health issues turn to substances to escape or manage difficult emotions and thoughts. That behavior can lead to a substance use disorder. Dual diagnosis definition in substance use treatment: Dual diagnosis involves the presence of both a mental health concern and substance use disorder.

A wide range of mental health concerns often co-exist with substance use disorder. These include, but aren’t limited to, anxiety disorders, post-traumatic stress disorder, bipolar disorder, schizophrenia, and major depressive disorder.

These conditions often cause feelings that are hard to manage and deal with. Turning to substances to calm uncomfortable feelings or thoughts is unfortunately common. This kind of self-medication is dangerous and ineffective in the long term, but the initial motivation is relatively easy to understand.

As we’ll discuss at greater length later on in this article, substance use can also trigger new mental health concerns or contribute to existing ones.

What is Dual Diagnosis?

Dual diagnosis is a term that specifically refers to the combination of a mental health disorder and substance use disorder, as the Cleveland Clinic explains. Co-occurring disorders is a similar term that’s also used to identify the same combination of issues.

You may also hear co-morbidity used in relation to, or used instead of, dual diagnosis. This is a more general medical term used to refer to two or more health issues occurring at the same time.

Dual diagnosis involves a specific medical condition (substance use disorder) and a wide range of mental health concerns. Substance use disorder is the one constant in this diagnosis.

For that reason, the specific symptoms related to one person’s dual diagnosis may not completely align with the symptoms of another diagnosis. For example, a dual diagnosis including schizophrenia will include different symptoms as compared to a dual diagnosis including bipolar disorder.

However, symptoms related to substance use disorder are more consistent across individuals. Common symptoms of substance use disorder include:

  • Tolerance. More and more of the abused substance is needed to achieve the same effects over time.
  • Increasing use over time. More of a substance is used than is originally intended over a period of time.
  • Time commitment. A significant amount of time is spent finding, buying, using, and recovering from the use of a given substance.
  • Strong urge. There is a strong, continuing desire to use a given substance.
  • Withdrawing from commitments and activities. Substance use becomes an increasingly higher priority, leading a person to stop or reduce their participation at work, in social situations, and in recreational activities they enjoy.
  • Harm to relationships with others. Use continues despite its negative effects on interpersonal relationships.
  • Harm to personal and professional life. Use continues even though it interferes with or negatively affects school, work, or home life.
  • Desire to stop using or moderate use. Although often not successful without professional treatment, a drive to stop or moderate the use of the substance is present.

An addiction support group engages in a discussion.

What are the Challenges of Dual Diagnosis?

Drugs and alcohol can offer what feels like short-term relief from the symptoms of some mental health concerns. Unfortunately, using those substances can cause changes in the brain, leading to a substance use disorder.

In other words, some mental health issues can encourage substance use and, eventually, addiction.

In the big picture, the opposite can also be true. Substance abuse can sometimes trigger a new mental health issue. Abusing alcohol and drugs can also make certain existing mental health concerns worse.

The National Institute of Mental Health points out three possibilities as to why substance abuse and mental health issues can happen at the same time:

  1. Alcohol and drugs may be used to self-medicate when dealing with mental health issues.
  2. Genetic and environmental factors can act as a trigger for substance use disorder and many mental health concerns.
  3. Substance abuse and existing mental health issues can both contribute to the development of new mental health concerns.

One key issue to keep in mind with dual diagnosis treatment is that substance use disorder and some mental health conditions can mask each other. In everyday life, for people without medical backgrounds, it can be difficult to tell which concern is causing a specific issue.

The good news is that medical professionals can provide an accurate diagnosis and work together to build an individual treatment plan. This is a key part of what makes dual diagnosis rehab and treatment effective.

Treating more than one issue at the same time may seem complicated or involved. It’s true that dual diagnosis rehab centers and treatment facilities need qualified medical professionals and caring, compassionate staff to fully address all of a patient’s co-occurring issues.

However, dependable and effective treatment centers focus on dual diagnosis treatment, day in and day out. They have the knowledge and experience needed to identify specific issues in individuals and provide truly holistic treatment.

What Separates Dual Diagnosis and Single Diagnosis?

Dual diagnosis is a common issue across the US. The Substance Abuse and Mental Health Services Administration conducted a survey in 2022 that found about 21.5 million adults in the country have this kind of co-occurring disorder.

While dual diagnosis is frequent, it’s not the only type of substance abuse diagnosis. Some people who suffer from substance abuse disorder do not also have a related mental health issue.

We want you to remember that you shouldn’t diagnose yourself or your loved one before seeking treatment. Dual diagnosis treatment centers can support people with both single and dual diagnoses.

A patient has a conversation with their therapist.

Dual Diagnosis: Impact on Mental Health and Addiction

We know that there’s a relationship between substance use disorder and many mental health concerns. Either one of these issues may contribute to the other, either through the development of a new issue or making an existing one more intense.

However, we’ve also pointed out that effective, evidence-based dual diagnosis rehab and treatment providers help people with both issues each and every day.

These providers focus heavily but not exclusively on substance use disorder treatment. Their other major area of focus is on the mental health issues that contribute to, but also exist independently from, substance use disorder.

This type of treatment goes further in addressing all of a patient’s needs. That approach can help them move toward not only sobriety but a more fulfilling and manageable life.

Treating only substance use disorder in people who also have mental health concerns, like anxiety or depressive disorder, only addresses part of the issue. If someone’s mental health contributes to substance use disorder, a motivating factor for substance use is left untreated when addiction itself is the only concern addressed through treatment. They may still feel the need to self-medicate to manage the distress caused by a mental health concern.

Dual diagnosis rehab and treatment consider the whole person. This holistic approach:

  • Recognizes the lifelong, ongoing nature of treating substance use disorder.
  • Identifies the underlying patterns that push people toward substance use and addresses them.
  • Utilizes treatment strategies that help people address both mental health concerns and substance use disorder at the same time.

Is Treatment for Dual Diagnosis More Complicated?

In a very limited and specific way, it may be somewhat more difficult to treat two medical conditions at the same time as opposed to just one.

However, for dual diagnosis rehab, treatment is not more complex or difficult than treating substance use disorder by itself. That’s true for effective, evidence-based treatment centers that use the dual diagnosis model.

Because mental health issues and substance use disorder can interact with each other, it’s important to treat both concerns. Only addressing substance use disorder by itself won’t help to manage the impact of mental health issues that lead to substance use.

By viewing both issues together, it’s easier to see the complete picture and deliver effective treatment. Identifying all of a patient’s needs can set the stage for better outcomes in the future.

Individualized treatment is also important to keep in mind. Treatment providers who develop individualized plans for patients always take a variety of needs and circumstances into account. Including related mental health issues in a diagnosis is just one example of this approach to treatment.


wo members hug during a support group meeting.

Dual Diagnosis Treatment & Rehab Options

Evidence-based and individualized dual diagnosis treatment considers the whole person. It delivers therapy, counseling, support, education, and medication as needed to promote sobriety along with more stable mental health. The key goal is to address underlying issues that drive people to use substances.

Treatment Levels for Dual Diagnosis

Everyone is different, so a treatment plan including a dual diagnosis won’t be exactly the same for everyone. However, stages of treatment often include:

  • Detox. Patients safely and comfortably stop using substances and receive support related to withdrawal and other symptoms. This stage also includes individual patient evaluations and the creation of a personalized long-term treatment plan.
  • Residential or inpatient treatment. After stabilizing during detox, patients receive treatment and support for both mental health and substance abuse issues in a supervised, safe, and tranquil environment focused on sobriety.
  • Outpatient treatment. Patients build on their inpatient progress as they begin to transition back to everyday life. Support and treatment for mental health and addiction issues continue, including group and individual therapy and medication management.
  • Sober living. Sober living communities provide additional support and accountability for patients as they adjust to staying sober during everyday life.

How Infinite Recovery Supports Patients with a Dual Diagnosis

At Infinite Recovery, we assess all patients for the possibility of a dual diagnosis. Whether or not a patient has a mental health concern that influences their substance use disorder, we provide compassionate, evidence-based treatment.

That includes maintaining a full roster of medical professionals and support staff to address the full spectrum of treatment. Masters-level psychologists, licensed chemical dependency counselors, licensed professional counselors, nurse practitioners, registered nurses, aftercare specialists, and other professionals all play key roles in our approach to treatment. Dr. Keith Garcia, our medical director, brings decades of experience to his role.

That includes individual and group therapy, counseling sessions, development of healthy coping skills, medication when appropriate, education, and support groups. Dual diagnosis therapy is especially important in this context. It helps patients identify triggers for both conditions and build tools that help them avoid a relapse.

Accelerated resolution therapy (called ART therapy, not to be confused with art therapy) is another type of therapy that can be helpful for patients with a dual diagnosis. This form of therapy guides patients in replacing negative mental images that can cause symptoms of post-traumatic stress with positive images.

Many ART therapy treatments can be completed in a single session, offering closure for patients and helping them address both sides of their dual diagnosis.

Moving Forward with Dual Diagnosis Rehab and Treatment

Dual diagnosis is an effective way to treat people with substance use disorder in a more complete and holistic way. This approach to treatment is no different than any other medical situation where more than one condition must be managed and treated at the same time.

The goal of dual diagnosis is to address all of the issues that contribute to substance use disorder. Ultimately, this approach empowers patients to live not just a sober life, but a more stable, fulfilling, and manageable life as well.

If you or a loved one are dealing with substance abuse, remember that effective, compassionate, evidence-based treatment is available. You can make a positive change. Infinite Recovery is here to guide you or your loved one through this transformative process.

Ready to transform your life? Reach out to us today.

Call Now ButtonCall Now