The terms dual diagnosis and co-occurring disorder are often used interchangeably. Though they are close in meaning, they don’t actually refer to the same thing. In today’s post, we compare and contrast dual diagnosis vs. co-occurring disorder.
Defining Dual Diagnosis vs. Co-Occurring Disorder
For mental health experts and other treatment professionals, specificity can be essential.
For example, while most people might use the term “anxiety” in casual conversations to describe fear or worry, a clinician will want to provide additional clarity by referring specifically to one of the 11 anxiety disorders that are listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
This doesn’t mean that patients need to always describe their mental health challenges as “generalized anxiety disorder” or “social anxiety disorder” instead of simply saying they have anxiety. But for the purposes of diagnosing and treating a mental health condition, details like this matter.
Which brings us to today’s topic: dual diagnosis vs. co-occurring disorder.
As we mentioned at the top of this post, these two terms are often treated as synonyms. (To complicate the matter even more, a third term – comorbid condition – is also sometimes used in the place of either dual diagnosis or co-occurring disorder. We’ll briefly address this a bit later in this post.)
Both dual diagnosis and co-occurring disorder refer to the simultaneous presence of more than one behavioral health concern. The difference between these two terms involves which behavioral health concerns they refer to.
If someone is described as having a dual diagnosis, this means that they have developed both a substance use disorder (addiction) and a mental health disorder. The following are just a few examples of what dual diagnosis may look like:
- Alcohol addiction and major depressive disorder
- PTSD and opioid addiction
- Bipolar disorder and benzodiazepine addiction
- ADHD and stimulant addiction
Confirming which condition is primary and which is secondary is not necessary to identify someone as having dual diagnosis:
- In some cases of dual diagnosis, a person may struggle with a mental health condition first, begin to abuse drugs in order to self-medicate, and then develop an addition.
- In other cases, the person may become addicted to alcohol or another drug, the develop depression or another mental health concern as a consequence of the impact that addiction has had on their life
In both of these cases, dual diagnosis would be the correct term to use.
The term co-occurring disorder is usually used when a person has more than one mental health condition. For example, anyone who had one of the following combinations of illnesses could be accurately described as having co-occurring disorders:
- Generalized anxiety disorder (GAD) and persistent depressive disorder
- Bipolar disorder and obsessive-compulsive disorder (OCD)
- Attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD)
- Posttraumatic stress disorder (PTSD) and major depressive disorder
As with dual diagnosis, co-occurring disorders can develop in any order. When discussing these conditions, the primary disorder is usually mentioned first. For example, a clinician might describe a person as having GAD and co-occurring persistent depressive disorder.
The term comorbid (which we mentioned a bit earlier) may be used in place of co-occurring. This term appears frequently in the DSM-5 to describe conditions that often occur together. Thus, the example from the previous paragraph could also be described as GAD with comorbid persistent depressive disorder.
Treating Dual Diagnosis vs. Co-Occurring Disorder
Whether a person has dual diagnosis (addiction and a mental illness) or co-occurring disorders (two mental health concerns), the general focus of treatment should be the same:
- Treatment should be customized to meet the patient’s specific needs.
- Treatment should be comprehensive in scope to address each disorder.
Attempting to only treat one disorder may do nothing more than set the patient up for future struggles. For example, let’s consider a person who become addicted to alcohol after using this drug in a misguided attempt to cope with depression:
- If this person goes through detox and gets help (such as through a 12-Step program) to quit drinking, they may make some initial progress toward recovery.
- But if they never receive effective professional care to address their depressive disorder, the eventual re-emergence of these symptoms could quickly push them back into the downward spiral of compulsive alcohol abuse.
- If, on the other hand, this person enrolls in a program where they can get treatment for their depression and their dependence on alcohol, they may be much more likely to achieve sustained success.
In cases of either dual diagnosis or co-occurring disorders, treatment may occur on a residential or outpatient basis. Many people begin with a residential program, then step down to a partial hospitalization program (PHP) or an intensive outpatient program (IOP) for continued support.
Remember: There is no single perfect type of treatment for dual diagnosis vs. co-occurring disorders. No matter what type of mental or behavioral health challenges a person has been dealing with, what’s most important is finding a provider whose programming and treatment philosophy align with the individual’s needs, goals, and preferences.
Get Help for Dual Diagnosis or Co-Occurring Disorders in Tennessee
If you have been struggling with an addiction and a mental illness, or two mental health concerns, Arbor Wellness is here to help. Our treatment center near Nashville, Tennessee, offers personalized treatment and comprehensive support at the residential, PHP, and IOP levels. We also offer focused programming for veterans, along with robust support for alumni. To learn more or to schedule a free assessment, please visit our Admissions page or call us today.