“Dual diagnosis” is a term used when two medical conditions are present at the same time.

In mental health and psychiatry dual diagnosis means that you are going through both a mental health challenge and substance misuse issues at the same time. The article below explains dual diagnosis in that context.

Dual diagnosis is a term used when a person experiences both a mental health challenge, such as anxiety, depression, mood disorder, bipolar disorder, PTSD – etc., and a substance misuse issue at the same time.

A UK study found that 75% of drug users and 85% of alcohol users engaged in addiction services experienced mental health problems while 44% of mental health service users reported drug use. From Temmingh, H. et al (2018)  https://pubmed.ncbi.nlm.nih.gov/29355909/

Both substance misuse and mental health challenges can negatively affect and impair each other – for example, if someone’s anxiety increases this may increase their alcohol use as a method of coping with the change in their mental health.

Dual diagnosis is underdiagnosed and it is difficult to identify the co-occurring issues due to the overlapping of symptoms and presentations.  This often leads to continual distress for people experiencing co-occurring issues.

Substance misuse is often described as a coping mechanism, which is a method for a person to manage and cope with their life quoting Gabor Maté “Not why the addiction but why the pain.”

Another recognised way for dual diagnosis to form is risk factors such as experiencing trauma, and is described by Maté as ‘‘trauma is not what happens to you, trauma is what happens inside you as a result of what happens to you’’.

See Gabor Maté here:  The Wisdom of Trauma – https://drgabormate.com/the-wisdom-of-trauma/

Regardless of how a dual diagnosis is formed it is essential for both issues to be worked on together and for a collaboration of services and care.  This means the pathway forward for best outcomes is for integrated treatment addressing the holistic needs of people experiencing both addiction and mental health together.

Pathway to Services

Dual diagnosis Ireland provides a list of services nationally and a range of information for understanding the presentation of both an addiction and mental health issue https://www.dualdiagnosis.ie/

A study in 2004 found that 75% of those surveyed felt a fully integrated service as the most effective. https://www.drugsandalcohol.ie/5908/

In Mayo for example, if a person has primarily a drugs issue they can self-refer or be referred by a support person into the HSE drugs counselling service based in Castlebar.  If someone has primarily a mental health issue or mental health issue with alcohol misuse, they can be referred by their local GP into HSE mental health or can self-refer through the emergency department.  HSE mental health services are based in the primary care centres and community mental health centres in County Mayo.

There are also residential treatment centres such as Hope House and Cuan Mhuire has a number of centres in Ireland.

The local General Practitioner GP can support and guide people to services available for anyone impacted by dual diagnosis. Other sources of information and supports are Recovery Colleges which you can find at this link for Galway, Mayo and Roscommon (CHO2) recoverycollegewest.ie

West be Well can also support people and their website has lots of helpful information.