When it comes to mental health and substance use, things are rarely black and white. Many people who struggle with addiction are also dealing with an underlying mental health condition, and vice versa. 

An estimated 13.5 million adults in the United States live with both a psychiatric disorder and a substance use disorder — a combination known as dual diagnosis. Understanding how these two components come together is an important part of feeling like yourself again. 

Below, Dr. Hadi Estakhri explains what dual diagnosis is and how our Allied Psychiatry & Mental Health team in Newport Beach, California, can help you find relief from both conditions. 

What is dual diagnosis?

Dual diagnosis means you have a mental health disorder and a substance use disorder at the same time. For this reason, you might also hear dual diagnosis described as co-occurring disorders.

Dual diagnosis can look different from person to person. It could describe someone with depression who self-medicates with alcohol, or a person with anxiety who becomes dependent on prescription medications or cannabis to feel calm.

Common combinations include:

• Depression and alcohol use disorder
• Anxiety and benzodiazepine misuse
• PTSD and opioid addiction
• Bipolar disorder and stimulant use
• Schizophrenia and cannabis use disorder

Regardless of which condition came first, dual diagnosis can be difficult to untangle. Effective treatment requires addressing the mental health and substance use disorders together.

How common is dual diagnosis?

Dual diagnosis is more common than many people realize. According to the National Institute on Drug Abuse (NIDA), 35% of adults with a mental disorder also have a substance use disorder.

And people with mental illness are more likely to develop a substance use disorder compared to the general population.

Despite its frequency, dual diagnosis can go unrecognized for years. That’s because symptoms of one disorder may overshadow the other or because patients and providers are only focused on one piece of the puzzle at a time.

Why is dual diagnosis so challenging?

Treating only the addiction without addressing the underlying depression or anxiety is like putting a bandage on a deeper wound. On the other hand, treating mental illness without recognizing the impact of substance use may limit progress and lead to relapse.

Here’s why dual diagnosis needs a comprehensive approach:

Symptoms overlap

Fatigue, irritability, insomnia, and concentration issues can stem from either condition.

Substance use can mask or mimic mental illness

Alcohol, drugs, or even misuse of prescription medications may seem like short-term solutions, but often worsen symptoms long-term.

Stigma and denial

Some people may feel ashamed to talk about one issue or might not realize the two are connected.

The stigma and shame can be even stronger if you have a history of trauma. About 30% of adults with substance use disorder have a history of emotional or sexual abuse, emotional neglect, physical neglect, or other forms of trauma.

Treating dual diagnosis 

Dr. Estakhri takes an integrated treatment approach. That means we treat mental health and substance use disorders together, not separately. Research consistently shows that this method leads to better long-term outcomes.

Treatment may include:

• Thorough psychological evaluation to determine the right diagnoses
• Medication management for depression, anxiety, bipolar disorder, PTSD, or other psychiatric conditions
• Substance use treatment, including detox referrals or ongoing relapse prevention support
• Therapy, such as CBT or trauma-informed counseling, to develop healthier coping strategies
• Supportive care, such as group therapy, family education, or lifestyle coaching

We also recognize that healing isn’t just about stopping substance use; it’s about rebuilding a life with stability, connection, and purpose.

Hope and healing are possible

Dual diagnosis can feel overwhelming, but you’re not alone, and it’s absolutely treatable with the right support. If you or someone you love is struggling with addiction and mental health concerns, help is available.

Call our office at 949-945-0927 or book an appointment online today.