Dual diagnosis: when addiction is accompanied by a mental disorder

In the practice of addiction medicine and psychiatry, it is increasingly common to find situations when one patient is diagnosed with addiction and a mental disorder at the same time. This can be depression, anxiety disorder, bipolar affective disorder, schizophrenia or post-traumatic stress disorder (PTSD). This condition is called a dual diagnosis.

In a dual diagnosis, addiction and mental illness reinforce each other: mental instability increases the risk of substance use, and substance use in turn exacerbates the course of mental illness. This is a vicious circle that is extremely difficult to break without professional help.

At the Renaissance Centre in Poland, we develop programmes that take into account both aspects - the addiction and the mental state of the patient. Only a comprehensive approach gives a real chance for sustainable recovery.

What is a dual diagnosis

A dual diagnosis (dual diagnosis, co-occurring disorder) is a condition in which a person is diagnosed with two serious conditions at the same time: addiction (to alcohol, drugs, psychoactive substances, gambling) and a mental disorder.

The most common combinations are:

alcoholism + depression;
drug addiction + anxiety disorder;
stimulant addiction + bipolar disorder;
cannabinoid use + schizophrenia;
addiction to psychotropic drugs + PTSD.

It is important to realise: a dual diagnosis does not mean that one condition is secondary. Both conditions require attention and therapy.

If only the addiction is treated, the mental disorder will trigger relapse. If only the mental disorder is treated, the addiction will destroy the mind and body.

Why it's important to identify both conditions

According to research, 30 to 50% people with addiction have a co-occurring mental health disorder. However, it is not uncommon for doctors or family members to focus on only one of the diagnoses. This leads to a number of problems:

Incomplete treatment. For example, in treating depression caused by alcoholism, without giving up alcohol, improvement will be temporary.
Risk of relapse. An untreated mental disorder often pushes a person back to using.
Misdiagnosis. Withdrawal symptoms may mimic mental disorders, and mental disorders may appear to be a consequence of use.
Lack of motivation. A patient who does not get relief from one therapy loses faith in the treatment as a whole.

Example: A person with PTSD may use drugs to drown out flashbacks and anxiety. If only the drug addiction is addressed, but not the trauma, the risk of disruption remains high.

Approaches to the treatment of dual diagnosis

Treatment of dual diagnosis patients requires a multidisciplinary team: psychiatrist, addiction therapist, psychotherapist, nurses, and sometimes a neurologist or endocrinologist.

Basic principles of treatment:

Simultaneous therapy for both conditions.
At Renaissance Centre, we do not separate treatment into «first one and then the other». We work with addiction and mental health in parallel.
Personalised medication selection.
Antidepressants, mood stabilisers or antipsychotics are selected with the patient undergoing detoxification and rehabilitation.
Psychotherapy work.
- Cognitive behavioural therapy (CBT) helps to change destructive thoughts.
- Acceptance and Responsibility Therapy (ACT) teaches how to deal with emotions without substances.
- Family therapy builds support from loved ones.
Social Rehabilitation.
Help with social skills recovery, training, employment.
Long-term follow-up.
Monitoring of the patient's condition even after discharge to avoid recurrences.

An example of a comprehensive plan:

Medical stabilisation and detoxification.
Selection of psychotropic medications.
Individual sessions with a psychotherapist.
Group sessions on relapse prevention.
Art therapy, yoga, meditation.
Educational lectures on addiction and mental health.

Support and long-term therapy

Treatment for dual diagnosis does not end with discharge from the clinic. It is a long-term process that requires continuous self-management and external support.

Why long-term therapy is important:

Mental disorders are chronic and require regular monitoring.
Addiction can resurface even after years of sobriety.
Life crises can be a trigger for relapse.

Forms of long-term support:

Outpatient follow-up. The patient meets regularly with a doctor and a psychotherapist.
Support groups. Networking with people who have travelled a similar path.
Family Involvement. Family members are trained to respond appropriately to changes in the condition.
A relapse prevention plan. Clear actions to take at the first sign of a breakdown or deterioration in mental health.

At Renaissance Centre, we structure therapy in such a way that the patient can safely return to life: regain their health, improve their relationships, find their place in society and maintain their results for years to come. The path to a fulfilling life is possible!

Dual diagnosis is a challenge for both the patient and the specialists. But with the right approach and comprehensive therapy, it is possible not only to stabilise the condition, but also to restore a person to a full, conscious and happy life.

At Renaissance, we believe: every patient deserves not just treatment, but quality support at every stage of recovery.