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Why Can’t I Quit? There May Be More Than One Problem

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT Meet The Team >

What is Dual Diagnosis?

Do you ever have bad days? Do you have lots of bad days in a row? Do they build up until you can’t stand it any longer? Until you need a release? Until you need something to numb the pain?

Everyone has a bad day now and then. Some days, you may feel like you can’t face the stress of everyday life. Other days, you may avoid friends just to get a little personal time. Just like adults, you have sad days, moody days, and days when everything irritates you for no apparent reason.

What most people will tell you is this: don’t worry: It’s just part of being human.

But when these kinds of feelings and behaviors occur daily or go on for weeks or months at a time, it might mean you have a problem. And when alcohol or drug use enter the picture, things get complicated. Alcohol and drugs can blur the lines between what’s normal, what’s the result of substance dependency or abuse, and what may be the symptoms of an underlying or undiagnosed mental health issue.

Mental Health and Substance Abuse: A Toxic Combination

Depression, anxiety, and substance abuse can create a negative feedback loop that exaggerates the negative symptoms and effects associated with each disorder. The whole becomes greater than the sum of the parts. If you’ve been feeling sad and hopeless for some time, you may reach for a drink, a smoke, take a pill, or use another substance to feel better.

But the feeling is only temporary. The negative emotions come back, and you reach for your drug of choice again. You can become addicted very quickly, and then you’re dealing with two things instead of one: the underlying emotional issue, and the new addiction.

Unfortunately, alcohol and drugs often intensify the very negative emotions you want to avoid, and create a vicious circle that’s difficult to break. Data from the American Psychological Association indicates 20% to 40% of people suffering from anxiety or depression also struggle with addiction.

If you’ve been diagnosed with schizophrenia, bipolar disorder, or antisocial personality, you’re even more likely to turn to drugs or alcohol. An estimated 40% to 80% of people with these mental illnesses are also addicts. Alcohol or drug use may even be the trigger that brings symptoms on for the first time.

Dual Diagnosis

Dual diagnosis is the term commonly used to describe those who suffer from both an addiction and a mental illness. Untreated, it can be devastating to you, your friends, and your loved ones. The people in your life may not recognize the symptoms of your mental illness, because they can be so similar to the symptoms of addiction.

Too often, addiction, substance abuse, and the inability to quit drinking or doing drugs is mistakenly labeled lack of will power or poor decision making. If you’re struggling with two problems at once, you know better than anyone will power and decision making aren’t the only factors. You might be working valiantly to change your behavior—i.e. quit drinking or doing drugs—but you can’t seem to make it stick. You’re fighting an uphill battle, because try as you might, there’s an underlying mental illness at work behind the scenes making it all but impossible to stop.

If this is happening to you, you can break the cycle, but you’ll probably need professional help. When mental illness is involved, standard treatment for addiction alone might not work. You need people trained in treating dual diagnosis, because it’s hard to identify and even harder to treat.

Don’t lose hope, though, because it can be done.

Find the Right Treatment

Specialized care by professionals familiar with dual diagnosis is critical. Programs that deal only with addiction often misinterpret mental health symptoms as resistance to treatment or mistakenly assume they’re signs of incomplete recovery. A program offering a multidisciplinary approach addresses both the addiction and the mental illness, which improves the chance of recovery and reduces the risk of relapse.

Both mental illness and substance abuse can disrupt lives. When they occur together, the results can be devastating. If you’re reading this and thinking that’s me—no wonder no one can figure out what’s happening with me or understand when I try to explain then please call us.

We can help.

At Evolve, we’re experts in identifying and treating dual diagnosis situations.

You just have to reach out and start the conversation.


Chambers, A. (2007, December 2). Mental Illness and Drug Addiction may Co-Occur Due to Disturbance in the Brain’s Seat of Anxiety and Fear. Retrieved April 4, 2015, from American Psychological Association:

National Alliance on Mental Illness. (2015). Dual Diagnosis: Substance Abuse and Mental Illness. Retrieved April 4, 2015, from NAMI: National Alliance on Mental Illness:

Reis, R. K. (2015). Dual Disorders: Concepts and Definitions. Retrieved April 4, 2015, from Psych Central:

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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