Dual Diagnosis: Anxiety,Depression, and Addiction

young scared and worried teenager girl using mobile phone and computer laptop as internet stalked victim abused and cyberbullying or cyber bullying stress concept in black background
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By Arlie Adonis

According to a recent survey in 2010, over 45% of individuals struggling with addiction, have also been diagnosed with a co-occurring disorder. Co-occurring disorders, also known as dual diagnosis, refer to the combination of substance abuse and the presence of a mental disorder. Over 16% of individuals receiving substance abuse treatment have also been diagnosed with a co-occuring mental disorder. Anxiety and depression are most commonly diagnosed alongside with addiction. More often than not, these disorders are diagnosed as two completely separate issues. One not relating to the other, if left untreated, the symptoms of both disorders can increase in severity and be almost impossible to manage.



Anxiety is defined as “a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.” Millions of Americans have been diagnosed with some form of anxiety. Medically speaking, there are more complex mental disorders categorized under the umbrella of anxiety.


Generalized Anxiety Disorder (GAD) is the constant sense of worry or fear that often affects an individual’s quality of life. Typically this disorder is caused by genetics, brain chemistry, and/or trauma.

Social Anxiety Disorder (SAD)  is the debilitating fear of any social setting that requires performance and could cause an individual to experience humiliation. The individual may obsess and avoid social interactions, months in advance, due to extreme fear of failure and inadequacy.

Panic Disorder is characterized by recurring panic attacks. A panic attack is an influx of fear which can ultimately lead to physical symptoms as well. Heart palpitations, shortness of breath, dizziness, trembling, can lead to thoughts of death are common signs of a panic attack.

Post Traumatic Stress Disorder (PTSD) is often caused by experiencing a serious injury or witnessing a disturbing,stressful experience. PTSD is the aftermath of the trauma experienced by an individual that can last for years or even a lifetime. Most individuals experiencing symptoms of PTSD feel helpless and out of control.

Obsessive Compulsive Disorder (OCD) is characterized by an individual’s obsessive thinking that results in compulsive rituals and behaviors that interrupt the quality of life. OCD is believed to be linked to genetics, serotonin deficiency in the brain, trauma, and even intense depression. An individual suffering from OCD will experience a total lack of control over participating in the compulsive behaviors.


The overwhelming emotional and physical symptoms of anxiety often times lead to substance abuse for many reasons. The limbic system is responsible for an individual’s “fight, flight, or freeze” response. Mood, attention, rage, sex, and even addiction are partly regulated by the limbic system. The correlation between anxiety and addiction stem from the commonplace of correspondence in the limbic system. An individual may turn to mood/mind altering substances to escape, to self medicate, or even as an impulsive response to anxiety.



Depression is defined as “feelings of severe despondency and dejection.” The World Health Organization estimated that over 300 million individuals worldwide have experienced depression, and almost 6.7% adults have experienced a major depressive episode within the last year. Depression is one of the most commonly diagnosed mental health disorders.


Major Depressive Disorder (Clinical Depression/MDD) is often characterized by feelings of depression, fatigue, lack of motivation, changes in appetite/sleep, and even feelings of hopelessness that may lead to thoughts of suicide. In order for proper diagnosis, these symptoms must be present for two weeks or longer.

Atypical Depression may often times be misdiagnosed. Atypical depression is characterized by symptoms that do not correlate with your “typical” depression diagnosis such as overeating, excessive sleep, weight gain, sensitivity to rejection, and can oftentimes spark irrationally reactive moods based on circumstance.

Seasonal Affective Disorder (SAD) mimics the symptoms of Major Depressive Disorder but is triggered by an interruption in an individual’s circadian rhythm. The time change that is directly associated with the changing of the seasons cause disruption and ultimately lead to seasonal depression.

Postpartum Depression is diagnosed, in women, in the onset of pregnancy or after the birth of a child. Hormonal changes in women can often lead to chemical imbalances that lead to postpartum depression.

Bipolar Disorder (Bipolar Depression) is characterized by abnormally manic mood swings. From feelings of hopelessness to elation, the mood swings are often unpredictable and unprovoked. These side effects can range from mild mood swings to severe demolition of an individual’s sense of reality. Fatigue, rapid shifts in appetite, sudden increase and decrease in motivation, indecision, irritability, and even anxiety.


Just like anxiety, depression is an imbalance within the limbic system. An individual struggling with depression may feel hopeless, helpless, suicidal, fatigue, and unmotivated. Struggling to find a way out, many individuals turn to drugs/alcohol to relieve the symptoms of depression. The dangers of substance abuse and depression lie within the central nervous system. As the user indulges in other substances the central nervous system can be “depressed” leading to mimicking symptoms common amongst clinical depression. The individual will constantly seek more mood/mind altering substances thus creating a fatal cycle.


Integrated treatment for co-occurring disorders requires an individualized recovery plan. An onsite psychiatrist is crucial for success. Untreated anxiety and depression can increase the likelihood of relapse. A psychiatrist can aid in diagnosis, medication, and any necessary psychiatric therapy. Incorporating the psychiatric resources along with group, educational, and creative therapy proves to be the most effective remedy for dual diagnosis individuals. The stigma of mental disorders have been smashed when merging dual diagnosis treatment into the recovery process.

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