Alcohol and Dual Diagnosis

“Dual Diagnosis” means you’re dealing with addiction and a mental health disorder at the same time.A complete guide on how to treat these two here.

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ARTICLE SUMMARY: A person who has a mental health problem and abuses alcohol is known to have dual diagnosis. Is there a treatment for this condition? YES! Integrated treatment addresses both at the same time. Learn more about dual diagnosis and its treatment options here.



Dual Diagnosis means you’re dealing with a drinking problem and a mental health disorder at the same time.

What Is “Dual Diagnosis”?

A person diagnosed with dual diagnosis suffers from both a mental disorder and a drinking problem at the same time. Often, the two conditions contribute to one another, feeding a loop of suffering and self-medication. Other terms that are used for this condition are:

  • Dually diagnosed
  • Co-occurring disorder
  • Co-morbid disorder
  • Comorbidity
  • Concurrent disorders
  • Multiple disorders

Dual diagnosis occurs frequently. In fact, according to SAMHSA’s national survey, 7.9 million Americans suffer from both a mental and substance use disorder. [1]

By far, alcohol is the most abused substance among people diagnosed with dual diagnosis. The connection between alcohol use and mental health is complex. Many people with mental health issues choose to drink as way of dealing with their problems or escaping from reality. Simply put, drinking is their coping mechanism.

However, certain mental health disorders make it more difficult for people to stop drinking. This increases the risk factors of developing alcohol dependence.

Common Dual Diagnosis Conditions with Alcohol

Drinking increases the risk of making a mental health disorder worse. But, some conditions are more likely to occur with alcohol use disorder than others. These include mental health issues such mood disorders, attention disorders, PTSD, or personality disorders. Recently, BioMed Central journal’s study has estimated that risk factors range from 25-80% [2]:

  • More than 25% of people with major depression can develop a drinking problem.
  • More than 40% of people with bipolar disorder can develop a drinking problem.
  • More than 45% of people diagnosed with schizophrenia can develop a drinking problem.
  • More than 80% of people with anti-social personality disorder can develop a drinking problem.

Depression and problem drinking have a causal relationship: one condition can cause the other.


Depression is a brain disorder that affects your mood, causing distressing symptoms.The Americans Psychiatric Association reports that depression affects 1 in 15 adults yearly, while 1 in 6 people experience depression at some point in their life. [3] Many people who have depression may turn to drinking to lighten their mood or to try to beat the constant feeling of sadness.

However, alcohol use can worsen depression. As a depressant, alcohol blocks stress hormones, and lowers mood-regulating chemical in the brain. So, instead of beating the blues, alcohol may bring more sadness to your depression.

So, which comes first? Drinking or depression?

This study reports that alcohol and depression have a causal relationship: one condition doubles the risk of developing the other. [4] Moreover, if you deal with alcohol problems, you may develop depression if you cannot stop drinking.

Nearly one in five Americans deal with some type of anxiety disorder.


Anxiety is a feeling of worry, nervousness, or fear about an event or situation. Even though it is part of life, and a normal reaction to stress, anxiety may involve into a mental health disorder that may interfere with your daily activities stopping you from having a normal life.

About 19% of Americans deal with some type of anxiety disorder. [5]

Alcohol may seem like medication for anxiety. It can be perceived as a powerful beverage that will make you feel better. Temporarily, alcohol can relax you and bring you confidence, but prolonged drinking makes anxiety even worse.

One study conducted by the University of North Carolina School of Medicine shows that heavy drinking can rewire your brain making you more susceptible to developing anxiety disorders. [6] This shows that anxiety and alcohol abuse are linked to each other.

Bipolar Disorder

Know as manic-depressive illness, bipolar disorder is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to complete daily tasks. This disorder is commonly paired with alcohol abuse. The National Institute of Mental Health’s Epidemiologic Catchment Area study [7] revealed that:

  • 46% of people with bipolar I disorder had alcohol use disorder.
  • 39% of people with bipolar II disorder had alcohol use disorder.

So, a person with bipolar disorder is at risk of developing alcohol use disorder. However, numerous studies have shown that drinking worsens the symptoms of bipolar disorder as well as its treatment.

Alcohol doesn’t help. Instead, it makes mental conditions even worse.

Obsessive Disorders

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by recurrent, unwanted thoughts and/or repetitive behaviors. It comes in many forms, such as:

  • Counting items
  • Constantly arranging items in a specific way
  • Excessive hand washing

OCD makes people with this condition to try distract their thoughts with the help of an alcoholic drink. But when you rely on alcohol top cope, you can develop a dependence. In fact, about 24% of OCD individuals deal with alcohol use disorder. [8]

Impulse Disorders

Impulse control disorders (ICDs) are characterized by urges and behaviors that are excessive and/or harmful to oneself or others and cause significant impairment in social and occupational functioning, as well as legal and financial difficulties. [9]Some of these disorders include:

  • Intermittent explosive disorder
  • Kleptomania
  • Pyromania

It seems that drinking and impulse disorders have many similarities. In fact, at one point, alcoholism and ICDs were considered to be in the same category of mental health issues. [10] Both disorders are characterized with selfless-control behaviors with negative consequences to the health.

While drinking may be seen as a cure for this disorder, their combination can result in increasing the negative effects of the two. A lack of self-control for someone suffering an ICD may lead to developing alcohol use disorder. About 20-50% of people with impulse control disorder have problems with substance abuse. [9]

Call us to learn about treating Dual Diagnosis. We understand integrated care.

Post Traumatic Stress Disorders

Post Traumatic Stress Disorder (PTSD) is a mental health disorder that develops in some people who have experienced a shocking, scary, dangerous, or traumatic event. Some examples of events include a car accident, crime victimization, death of a lived one, childhood trauma, or being witness to a life-threatening or fatal incident.

About 7-8 out of 100 people experience PTSD in their lifetime [11]

The brains of people with PTSD produces less endorphine which makes them more likely to start using substances in order to feel happy. But drinking when you have mental issue leads to more serious dangers to person’s life including addiction.

In fact, people with PTSD are between two and four times more likely to deal with addiction problems. [12] Moreover, the combination of PTSD and drinking problems is a common among veterans and the military community. According to the Veterans Affairs Department:

  • More than 2 of 10 veterans with PTSD deal with addiction issues.
  • About one-third of veterans who seek addiction rehab also have PTSD.
  • Nearly 75% of veterans who experienced a violent/traumatic event during combat report repetitive alcohol abuse.

You don’t need to suffer alone. Call us for help.


Schizophrenia is a serious mental illness caused by chemical imbalance in the brain that affects how a person feels, thinks, and behaves. People with this disorder may seem like they have lost touch with reality. They hear, see, or even smell things that are not there.

Usually people with schizophrenia start drinking to self-medicate, hoping that the voices in their head will quiet down. But, constant drinking puts them at high risk of developing alcohol dependence, and worsening their symptoms. It can intensify the schizophrenic symptoms causing more psychotic episodes that may put the person in hospital, prison, or worse to have suicidal attempt.

According to a study published in Schizophrenia Bulletin, the rate of developing substance dependence is higher for 50% among people with schizophrenia than the general population. [13] Despite the fact that schizophrenia causes dramatic symptoms to person’s thoughts and behavior, sometimes these symptoms are hard to recognize because alcohol use can mask them. The same applies for the other condition: schizophrenia may mask symptoms of alcohol dependence.

Schizophrenia may mask symptoms of alcohol dependence.

Attention Disorders

Attention deficit-hyperactivity disorder (ADHD) is a neuro-behavioral disorder that interferes with a person’s ability to focus, stay on track, and had difficulties in controlling their behavior.

ADHD affects 3-5% of the children in U.S.

Many studies show that the reduced impulse control may contribute to an individual with ADHD to turn to using alcohol and/or drugs. This puts people with ADHD at high risk of developing alcohol use disorder. In fact, attention disorder is 5-10 times more common among adults who have AUD, while about 25% of people who seek addiction treatment have ADHD.

Symptoms of Dual Diagnosis

Symptoms of dual diagnosis vary by mental health issue. As we know, every mental health disorder has own set of symptoms, but what happens if we put alcohol in the picture? They will vary even more.

Still, some common warning signs that a person with dual diagnosis may exhibit include:

  • Avoiding social activities or events they once enjoyed
  • Changes in appetite
  • Cognitive impairment
  • Difficulty concentrating
  • Difficulty in managing daily tasks
  • Impulsive behaviors
  • Increased isolation
  • Making excuses for alcohol use
  • Poor health and hygiene
  • Reduced energy and motivation
  • Sudden change in behavior
  • Self-harming thoughts and/or behavior

Do you or a loved one express some of these signs? Talk to a specialist to be sure. Or, call our helpline. We can help you talk through the process of treatment and outline best treatment options for you.

Call now for a free and confidential talk about addiction issues.

Alcohol Rehabs for Dual Diagnosis

Dual diagnosis may seem to complicate treatment. After all, alcoholism by itself is complex. So, what kind of rehab is recommended for people with dual diagnosis?Specialized treatment known as “integrated treatment” is recommended for treating dual diagnosis.

Dual diagnosis treatment is effective when both disorders are treated simultaneously. In this way, the symptoms of both conditions will be reduced at the same time.

Integrated treatment is a comprehensive rehab program [14] that provides medical, therapeutic, and holistic treatment to help patients recover from mental health problems and substance use disorder.This type of treatment provides variety of services that will help the individual recover on all levels. The program is designed to address patient’s needs by creating unique plan for each of them.

Some of the services offered in an integrated treatment plan include:

  • Evaluation and diagnosis
  • Group therapy
  • Medical detox
  • Family therapy
  • Personal therapy
  • Pharmacotherapy
  • Psychotherapy
  • A unique treatment plan

It’s hard to deal with one condition, and even harder to deal with two. But, you can change your life, if you want to. Don’t do it by yourself. Let the experts help you! Call our helpline, and enroll into integrated treatment ASAP.

Integrated treatment is the proper treatment for dual diagnosis.

Dual Diagnosis and Alcohol Relapse

Mental health problems make addiction recovery more challenging. In fact, relapse risk is higher for people with dual diagnosis, but this doesn’t mean that treatment doesn’t work. Relapse is only a sign that your program doesn’t work properly, and it needs to be changed.

It is important to create an integrated relapse prevention plan that will give you guidance whenever you feel that you will fall off the wagon. Also, an aftercare plan is an excellent way to keep your recovery on track once you’ve completed rehab. Some of the after services may include:

  • Counseling sessions
  • Living in a sober house
  • Recovery support network.

Start Recovery Now

Dual diagnosis is very serious, but treatable condition. Recovery starts with proper diagnosis. When the diagnosis for the mental health disorder is right, the treatment will be more effective.

What do you need to do?

Start the road to recovery now?

The more you wait, the more you’ll suffer needlessly. So, don’t waste your time. Pick up the phone, and call us. We can help you find suitable treatment that fits your needs.

And, if you have any questions, post them in the comments section at the end. We do our best to answer them promptly and personally.

Reference Sources:
1. SAMHSA: Mental and Substance Use Disorders
2. NIH: The prevalence and significance of substance use disorders in bipolar type I and II disorder 
3. NIAAA: Alcoholism and Co-occurring Disorders 
4. Research Gate: Alcohol and Depression 
5. NIMH: Any Anxiety Disorder 
6. UNC Health Care: Heavy drinking rewires brain, increasing susceptibility to anxiety problems
7. NIAAA: Bipolar disorder and alcoholism 
8. NCBI: Substance Use Disorders in an Obsessive Compulsive Disorder Clinical Sample
9. NCBI: Impulse Control Disorders: Updated Review of Clinical Characteristics and Pharmacological Management 
10. Psych Central: What Are Impulse Control Disorders?
11. NIMH: Post-traumatic Stress Disorder 
12. NIH: Posttraumatic Stress Disorder and Co-Occurring Substance Use Disorders: Advances in Assessment and Treatment 
13. NIH: Substance Use Disorders in Schizophrenia—Clinical Implications of Comorbidity
14. NIH: Integrated Treatment of Substance Use and Psychiatric Disorders
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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