Crisis Support

National Suicide Prevention Lifeline

1-800-273-8255


Crisis Text Line

Text NAMI to 741-741 to connect with a trained crisis counselor to receive free, 24/7 crisis support via text message.


NAMI HelpLine

Call 1-800-950-NAMI (6264) M–F, 7 a.m.–3 p.m. PT for free mental health info, referrals and support.


Find a Local NAMI

Facts About Dual Diagnosis

Substance use disorders — the repeated misuse of alcohol and/or drugs — often occur simultaneously in individuals with mental illness, usually to cope with overwhelming symptoms. The combination of these two illnesses has its own term: dual diagnosis, or co-occurring disorders. Either disorder (substance use or mental illness) can develop first.

9.5 million U.S. adults experienced both mental illness and a substance use disorder in 2019 (The National Survey on Drug Use and Health).

Symptoms of Dual Diagnosis

Many combinations of dual diagnosis can occur, so the symptoms vary widely. Mental health clinics are starting to use alcohol and drug screening tools to help identify people at risk for drug and alcohol abuse. Symptoms of substance use disorder may include:

  • Withdrawal from friends and family
  • Sudden changes in behavior
  • Using substances under dangerous conditions
  • Engaging in risky behaviors
  • Loss of control over use of substances
  • Developing a high tolerance and withdrawal symptoms
  • Feeling like you need a drug to be able to function

Symptoms of a mental health condition can also vary greatly. Warnings signs, such as extreme mood changes, confused thinking or problems concentrating, avoiding friends and social activities and thoughts of suicide, maybe reason to seek help.

Treatment and Support for Those With Dual Diagnosis and Their Families

The best treatment for dual diagnosis is integrated intervention, when a person receives care for both their diagnosed mental illness and substance abuse. The idea that “I cannot treat your depression because you are also drinking” is outdated—current thinking requires both issues be addressed. Treatment options include detoxification, inpatient rehabilitation, psychotherapy, supportive housing, medications, and support groups.

We also recommend our NAMI support groups and classes for those living with mental health conditions, as well as their families and loved ones; find a local support group run by a California affiliate.

Find out more from NAMI National’s website.

Community Voices

Stories and posts about living with or being impacted by dual diagnosis coming soon. Telling personal stories of recovery can be one of the most effective ways to diminish stigma and help individuals and families who are facing challenges related to mental health conditions. Submit your story for consideration.