If you’ve read our other blogs, you probably know by now that substance abuse disorder often goes hand-in-hand with mental illness, often referred to as dual-diagnosis. Mental illness is usually either the cause or a result of addiction. On one hand, a person who was previously struggling with mental illness may turn to substances that numb the emotional pain they are in or to forget about the stressors in their life. On the other hand, someone who becomes addicted to substances is likely to experience negative emotional side effects because of the isolating nature of addiction, among other things. 

What is Dual-Diagnosis?

Dual-Diagnosis (also referred to as co-occurring disorders) is a term for people who are experiencing one or more mental health or behavioral issues simultaneously. According to the National Survey on Drug Use and Health (NSDUH), 45 percent of people with addiction have a co-occurring mental health disorder. 

Common Mental Health Disorders that Co-Occur with Addiction

Attention-deficit hyperactive disorder (ADHD)

Approximately 25 percent of adults that go to a treatment center for alcohol and substance abuse also live with ADHD (Addiction Center). ADHD may cause a person to experience difficulty paying attention, staying still, coping with boredom, performing tedious tasks, and they may be impulsive or hyperactive. ADHD is usually treated with stimulants, which can be highly addictive. People with ADHD may also turn to other kinds of drugs and alcohol to calm their busy minds.
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Bipolar Disorder

There are two kinds of bipolar disorders:

Bipolar I

In a study of people with bipolar disorder, approximately 60 percent had some history of substance abuse (Addiction Center). Bipolar I (sometimes also referred to as manic-depressive disorder or manic depression) is characterized by a person having had at least one manic episode in their lives. A manic episode is usually accompanied by a feeling of intense euphoria and/or invincibility that may lead the person to doing things that they wouldn’t normally do. Sometimes the actions taken while in a manic episode can be life-altering, often for the worst. A person with Bipolar I is at risk for substance abuse during their lows and highs. They are susceptible during their lows just as someone with depression is, they are often seeking out ways to numb the emotional pain and forget about their problems for a while. But during their highs, the feelings of invincibility may lead them to try dangerous substances that they may not normally even think to do when their mood is stable. 

Bipolar II 

Bipolar II (also known as Bipolar Depression) is like Bipolar I in that the affected person will experience mood cycling. However, with Bipolar II, the person experiences hypomanic episodes as opposed to full mania. Hypomanic episodes are accompanied by elevated moods, usually followed by a period of depression. 

Borderline Personality Disorder (BPD)

People with borderline personality disorder (BPD) can experience distorted self-image, impulsiveness, extreme emotions, and intense, unstable relationships. Aside from substance abuse disorder, these individuals are also susceptible to other mental health struggles such as anxiety, depression, eating disorders, etc. Over two-thirds of people with BPD have turned toward substance abuse at some point in their lives (Addiction Center). 


Depression can make a person feel extremely sad, hopeless, empty inside, etc. It can have severe effects on a person’s capabilities to take care of themselves and maintain relationships. People with depression may use drugs or alcohol to escape the deep feelings of sadness that they may be experiencing. This is why an estimated one-third of people with major depression also have an alcohol problem (Addiction Center).

Eating Disorders

Eating disorders are generally defined as abnormal eating patterns. This can be a severe restriction of food, or on the opposite end, over-consumption of food. Either way, an unhealthy relationship with food and emotional disturbances usually accompanies these kinds of disorders. An eating disorder can be an addiction in and of itself. A person could be addicted to counting calories, or conversely addicted to consuming large amounts of food.

Generalized Anxiety Disorder (GAD)

People with a generalized anxiety disorder (GAD) are often plagued by constant, irrational worry about everyday occurrences. Reality can become very exhausting, especially in social situations. For this reason, these individuals may use drugs or alcohol to “shut off” their worries for a while. It is estimated that around 20 percent of those who have an anxiety disorder also have a substance use disorder (Addiction Center).

Obsessive-Compulsive Disorder (OCD)
OCD is an anxiety disorder that causes a person to develop recurring thoughts that cause irrational fears and anxieties. People with OCD usually form “rituals” such as tapping, washing hands, organizing, etc. They can feel as though if they do not perform these rituals, something bad will happen. The Journal of Anxiety Disorders estimates that over 25 percent of those who seek treatment for OCD also meet the criteria for a substance use disorder.

Post-Traumatic Stress Disorder (PTSD)

A person develops PTSD from witnessing a traumatic event which causes emotional disturbances for the individual long-term. PTSD is seen most commonly with victims of serious accidents or injuries, natural disasters, acts of terrorism, sexual or physical assault during childhood or as an adult, military combat, or death. According to the U.S. Department of Veteran Affairs, nearly three-quarters of those surviving violent or abusive trauma report alcohol use disorders.


Individuals with schizophrenia have difficulty in distinguishing the imaginary from reality. They may experience hallucinations or delusions that affect their ability to function in society. People with schizophrenia are very susceptible to forming a dual-diagnosis with substance abuse disorder: An estimated 50 percent of individuals suffering from schizophrenia have a history of substance abuse.

What does a dual-diagnosis mean to those who have them?

Having one disorder or mental health issue is challenging enough, but dealing with more than one can leave one feeling frustrated and hopeless. If you are fighting one or more mental health issues, know that there is help out there. Just make sure that you choose a therapist or treatment center that believes in holistic, individualized treatment, as dual-diagnoses require different methods of addressing the disorders as they all work together in varying ways. Not everyone experiences mental health struggles in the same way, and you deserve professional care that will take this into consideration.

Talk to Someone Who’s Been There. Talk to Someone Who Can Help. Scottsdale Recovery Center holds the highest accreditation (Joint Commission) and is Arizona’s premier rehab facility since 2009. Call 602-346-9142.