When you have both a substance abuse problem and a mental health issue such as depression, bipolar disorder, or anxiety, it is called a co-occurring disorder or dual diagnosis. Dealing with substance abuse, alcoholism, or drug addiction is never easy, and it’s even more difficult when you’re also struggling with mental health problems, but there are treatments that can help. With proper treatment, support, and self-help strategies, you can overcome a dual diagnosis and reclaim your life.

In a dual diagnosis, both the mental health issue and the drug or alcohol addiction have their own unique symptoms that may get in the way of your ability to function, handle life’s difficulties, and relate to others. To make the situation more complicated, the co-occurring disorders also affect each other and interact. When a mental health problem goes untreated, the substance abuse problem usually gets worse as well. And when alcohol or drug abuse increases, mental health problems usually increase too.

Doctors say they are increasingly seeing patients from all walks of life who suffer from a combination of substance abuse and mental health problems. Experts estimate that at least 60% of people battling one of these conditions are battling both. 

Which occurs first—chronic drug abuse or serious mental illness? It depends. In some cases, people suffering from serious mental disorders (often undiagnosed ones) take drugs to alleviate their symptoms—a practice known as self-medicating. According to the American Psychiatric Association, individuals with schizophrenia sometimes use substances such as marijuana to mitigate the disorder’s negative symptoms (depression, apathy, and social withdrawal), to combat auditory hallucinations and paranoid delusions, or to lessen the adverse effects of their medication, which can include depression and restlessness. In other cases mental disorders are caused by drug abuse. For example, MDMA (3,4-methylenedioxymethamphetamine, commonly known as ecstasy), produces long-term deficits in serotonin function in the brain, leading to mental disorders such as depression and anxiety. Chronic drug abuse by adolescents during formative years is a particular concern because it can interfere with normal socialization and cognitive development and thus frequently contributes to the development of mental disorders.

The best treatment for co-occurring disorders is an integrated approach, where both the substance abuse problem and the mental disorder are treated simultaneously.  Whether your mental health or substance abuse problem came first, recovery depends on treating both disorders.  Your best chance of recovery is through integrated treatment for both the substance abuse problem and the mental health problem. This means getting combined mental health and addiction treatment from the same treatment provider or team. Relapses are part of the recovery process. Don’t get too discouraged if you relapse. Slips and setbacks happen, but, with hard work, most people can recover from their relapses and move on with recovery.  Peer support can help. You may benefit from joining a self-help support group like Alcoholics Anonymous or Narcotics Anonymous. They give you a chance to lean on others who know what you’re going through and learn from their experiences.

As with a substance abuse program, make sure that the program is appropriately licensed and accredited, the treatment methods are backed by research, and there is an aftercare program to prevent relapse. Additionally, you should make sure that the program has experience with your particular mental health issue. Some programs, for example, may have experience treating depression or anxiety, but not schizophrenia or bipolar disorder.