Overcoming an addiction–to alcohol or another drug–is extremely challenging. And struggling with a mental health disorder is also very challenging. For people living with both substance use and mental health disorders, the challenges can become much greater.
This guide will explore three different types of dual diagnosis: substance use disorder and bipolar disorder; substance use disorder and borderline personality disorder; and bipolar disorder and borderline personality disorder.
Among mental health professionals, the term dual diagnosis refers to a situation in which an individual is diagnosed with two or more mental health or substance use disorders simultaneously. This term is commonly used by mental health professionals to refer to a situation where a patient experiences both a mental health disorder, such as depression or anxiety, and a substance use disorder, such as alcohol or drug addiction. The presence of dual diagnosis can complicate treatment and require a multidisciplinary approach for successful management. 1
While this list provides three examples of a dual diagnosis, it is not a comprehensive representation of all possible combinations of dual diagnosis. These are the three that we will be exploring in this guide:
Individuals with co-occurring SUD and BD may experience periods of mania, depression, and/or mixed episodes, as well as symptoms of SUD.
People with these co-occurring disorders may experience symptoms such as emotional dysregulation, unstable relationships, and self-destructive behavior in addition to the symptoms of SUD. The presence of both disorders can complicate treatment, and specialized care may be necessary to address the complex needs of the patient.
This condition, often abbreviated as BD/BPD, can result in a range of symptoms such as mania, depression, unstable relationships, emotional dysregulation, and self-destructive behaviors.
A substance use disorder is the official term for drug addiction. Alcohol use disorder is one type of substance use disorder. Tobacco, cannabis and other hallucinogens, heroin and other opioids, cocaine and other stimulants, and benzodiazepines and other sedatives are examples of substances that a person can develop a physiological or psychological dependence on.
The signs and symptoms of substance use disorder vary depending on the type and amount of substance used, as well as the duration and frequency of use, but may include but are not limited to: 2
Bipolar disorder is a serious mental health disorder belonging to the category of mood disorders.
The signs and symptoms of bipolar disorder vary depending on the individual but may include but are not limited to:3
The causes and risk factors of bipolar disorder vary depending on the individual but can include but are not limited to the following:
Borderline personality disorder is a serious mental health disorder that belongs to the category of personality disorders.
The signs and symptoms of borderline personality disorder (BPD) vary depending on the individual but may include but are not limited to: 4
The causes and risk factors of Borderline Personality Disorder (BPD) vary depending on the individual but can include but are not limited to the following:
The major difference between bipolar disorder and borderline personality disorder is that bipolar disorder is a mood disorder while borderline personality disorder is a personality disorder. Mood disorders are a category of disorders distinguished by serious changes in mood. Along with bipolar disorder, depression is also a kind of mood disorder. 6
Personality disorders are characterized by ways of thinking, feeling, and behaving that are markedly different from social expectations. Individuals with personality disorders have difficulty perceiving and relating to other people and situations. These behaviors often disrupt their personal, professional, and social lives. 7
Co-occurring substance use and mental health disorders are challenging in many ways. They are challenging for the people living with these conditions, for loved ones who are trying to help, and for mental health professionals who aspire to create the most effective treatment plan.
Living with a dual diagnosis can be isolating, as individuals may feel unable to relate to their peers and form meaningful connections with others. In addition, people with dual diagnosis often find that their mental health and substance use can cause them to be embarrassed, ashamed, or fearful of judgment from others, making it difficult to reach out for help or support.
The combination of mental health and substance use disorders can complicate treatment and make it difficult to find an effective plan of care. Additionally, many individuals with a dual diagnosis find that mental health and substance use professionals who are not familiar with a dual diagnosis can be unpleasant and ill-equipped to provide appropriate care.
The most effective psychotherapy modalities for SUD/BP include cognitive behavioral therapy, dialectical behavior therapy, mindfulness-based cognitive therapy, and motivational interviewing. These modalities can help individuals learn to identify and manage their symptoms, as well as the triggers that can contribute to substance use.
Similar to SUD/BD, individuals with SUD/BPD can benefit from the same psychotherapies but with the addition of schema-focused therapy. This type of therapy aims to help individuals with personality disorders by identifying and changing negative patterns of thinking and behavior that are rooted in early life experiences
Medications may be used to help manage the symptoms of both disorders and reduce the risk of relapse. Common medications used to treat SUD/BD include mood stabilizers, antipsychotics, and anti-anxiety medications.
For SUD/BPD, medications may include antipsychotics, anticonvulsants, and mood stabilizers.
Holistic therapies can be used to help individuals manage their symptoms and cope with the challenges associated with dual diagnosis. Examples of holistic therapies include meditation, yoga, acupuncture, massage therapy, and nutritional counseling.
The most effective psychotherapy modality for comorbid bipolar disorder and borderline personality disorder is dialectical behavior therapy. This can help individuals learn to identify and manage their symptoms, as well as the triggers that can contribute to mood swings or self-destructive behaviors.
To manage the symptoms of BD/BPD and prevent relapse, medications can be prescribed. These medications may include mood stabilizers, antipsychotics, and antianxiety medications, which are commonly used to treat individuals with BD/BPD.
Yoga and other mind-body practices may also be helpful in managing symptoms of BD/BPD. These practices can improve mood, reduce stress and anxiety, and promote relaxation and overall well-being.
Our directory features a range of mental health professionals and treatment centers in Southern California, each committed to providing compassionate, personalized care using evidence-based methods. The highly trained therapists at these centers offer a variety of therapeutic approaches, ensuring that you can find a program that aligns with your needs. These include:
The treatment plans available through our listed providers may encompass a combination of medication management, psychotherapy, and holistic therapies, tailored to address your specific needs and goals. We recognize the complexity of co-occurring disorders and the importance of finding the right support and resources for effective management and recovery.
Explore our directory to connect with skilled mental health professionals who can guide you towards a path of recovery and an improved quality of life, utilizing these proven therapeutic modalities.
