How does dual diagnosis develop?
The relationship between mental health and substance misuse is complex and varies from individual to individual.
This information comes from the Rethink Advice and Information Service's Dual diagnosis factsheet
The Department of Health has described four possible relationships:
A mental illness can lead to substance misuse.
Rethink often hears reports of people using alcohol or drugs to ‘self-medicate’, because in the short-term they relieve symptoms or help with side effects of medication.
The use of alcohol or drugs can make a mental health condition worse or alter its course.
Substance misuse may mask symptoms so when the use is reduced the mental health problem is revealed. This could have implications for treatment as the sooner a mental health problem is treated the better the outlook.
Use of drugs or alcohol leads to psychological symptoms.
For example alcohol is a depressant and can lead to low mood.
Substance misuse can trigger mental health problems.
For example there is evidence that cannabis use increases the risk of developing a psychotic illness .
See our page on Cannabis and schizophrenia for more details.
Who is most at risk?
It is likely that a range of factors make some people more vulnerable to either or both mental health and substance misuse problems.
This might include genetic factors, the impact of the environment someone grows up in or difficult or traumatic life events such as bereavement or abuse.
