Dual Diagnosis Treatment

Dual diagnosis: treating addiction and mental illness together

Dual diagnosis means a person has a substance use problem and a mental health condition at the same time, such as depression, bipolar disorder, anxiety or psychosis. The two often feed each other, so treating only one can leave the other to undo the progress. Dr. Gorav Gupta, a senior psychiatrist with 40+ years of experience, treats both together, with one team and one plan.

Who this is for

• People who drink or use drugs and also live with low mood, mood swings, anxiety, or experiences such as hearing voices.
• People whose symptoms began or worsened with substance use, or whose substance use began as a way to cope.
• Families who can see both problems and are not sure where to start.

Signs to look out for

• Alcohol or drugs used to manage low mood, anxiety, sleep or tension.
• Changes in mood or thinking that continue after the substance has worn off.
• Relapse after treatment for addiction alone, or symptoms that return after treatment for the mental illness alone.
• Withdrawal or intoxication that is hard to tell apart from the illness itself.

How assessment works

The first consultation looks at the substance use and the mental health symptoms together: what is used, how much and since when, and how mood, sleep, thinking and daily life have been. A diagnosis and a treatment plan follow. If someone is intoxicated or in withdrawal, some questions are asked again once things have settled, because the two can look alike.

Treatment

Most people are treated as outpatients, with medication, therapy and regular review, and with family sessions where they help. Admission is considered when it is not safe to withdraw at home, or when symptoms are severe. That is a clinical decision made after an assessment, with the family. Read when admission is needed.

How long it takes

It depends on both conditions and on how the person responds. Detoxification, where it is needed, is the first stage; the months of support that follow matter as much. Dr. Gupta explains what to expect at the first review.

How families are involved

Families are often the ones who notice first and who make the call. With the patient’s agreement, they are told about the plan, what to watch for, and what to do if symptoms worsen or use starts again.

Frequently asked questions