Getting sober is a challenge. Achieving sobriety when there is a co-occurring issue makes the process more difficult. Substance abuse can mask mental illness. Mental illness may be conflated with addictive symptoms. Often, individuals with mental health problems don’t adequately address their substance abuse as they don’t think drinking or drugging is relevant to their problems.

The term ‘dual diagnosis’ is used when an individual has a mental health disorder with substance abuse also known as dual diagnosis. Someone with a dual diagnosis has two distinct illnesses. Each illness requires its unique plan of therapy.

There is Hope

Both mood disorders and addiction problems are treatable. They are not moral weaknesses and can impact anyone, regardless of age, sex, ethnicity or economic standing. Research has indicated that over half of the population with depression or bipolar disorder use drugs or alcohol as well — sometimes both.


Often persons may use alcohol or drugs to cover up symptoms of a mood disorder. If a person’s mind is racing due to mania, a drink may slow it down. If a person is experiencing extreme hopelessness from depression, a drug may help change that for a season. ‘Self-medicating’ appears to help for a while, but in the end, it makes matters worse. When the temporary effects of the alcohol or drugs fade, an individual’s symptoms may be worse than before. Self-medicating might cause an individual’s mood disorder to stay screened and delay an accurate diagnosis.

Why Treat Both?

If neither disorder is treated, one can make the other worse. If only one illness is cared for, treatment is unlikely to be effective. When both are treated, the odds of a full and sustained recovery are improved.

Stay Clean and Sober

Mixing alcohol and drugs can have dangerous effects, especially when mixed with medicines. Multiple medicines, including over-the-counter ones, react with alcohol and illicit drugs in significant ways — none of them good.

What To Expect

More than one physician and more than one support group are to be expected. Each of your therapists should be made aware of your dual diagnosis. Treatment for mood disorders might include psychotherapy, medication and a support group. Addiction treatment might include a recovery group, inpatient or outpatient rehab and a support group.

Depending on substance abuse history, a person may be required to check into a hospital to be ‘detoxed.’ When detoxification is complete, then is the time to start rehab.


The label, ‘dual diagnosis,’ has turned into a buzz term used in substance abuse rehab. Many therapeutic centers have caught on and claim to address both substance abuse and mental illness. Too often, these centers fail to deliver.

When selecting a rehab program, look for:

  • Properly formed psychiatric evaluation
  • Both maladies are treated at corresponding times through integrated treatment
  • A treatment team consisting of a psychiatrist, psychiatric nurses and grad-level therapists
  • Weekly case management
  • Aftercare and relapse prevention programs

Sobriety for people with a dual diagnosis is possible. Persons successfully recover all the time. The underlying secret is no secret: Take it one day at a time.