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People living with a “dual diagnosis” are experiencing a mental health condition alongside a substance use disorder, such as alcohol addiction or drug addiction. Dual diagnosis is a complex condition that requires careful assessment, comprehensive treatment and ongoing aftercare support to help a person navigate their recovery from addiction.
At Smarmore Castle, our team understand the impact that a dual diagnosis can have, which is why we provide support for patients who come to us for addiction treatment. This page explains what dual diagnosis is, why it matters, and how our approach to addiction treatment at Smarmore Castle can support mental health issues that are experienced alongside a substance use disorder.
What is Dual Diagnosis?
Dual diagnosis, also known as co-occurring disorders or comorbid disorders, means the condition of a mental health issue and a substance misuse problem that is experienced at the same time. Dual diagnosis might involve, for example, depression and alcohol use, anxiety and cocaine use, or other combinations of mental health issues and addictive disorders. It is common, and it is treatable, but when a person is seeking addiction treatment, it requires integrated care. Those with a dual diagnosis will require more support to manage their symptoms.1
How Common is Mental Health and Addiciton in Ireland?
In Ireland, evidence shows that as many as 30-50% of those with a mental health issue also suffer from substance misuse. In one study of patients taking part in a community mental health treatment programme, 44% of patients reported drug misuse and/or harmful alcohol use in the previous year. 85% of those attending an alcohol service and 75% attending a drug service also reported suffering from a psychiatric disorder in the previous year.2
Mental health problems and addiction often develop together. For some, drug or alcohol misuse can often begin as a way to cope with an undiagnosed mental illness. For others, substance use can trigger or worsen underlying mental health issues. Recognising and addressing both simultaneously is essential to recovery. Dual diagnosis treatment helps address both the mental health condition and the addiction through coordinated care.
If you are facing the symptoms of a dual diagnosis, remember that you are not alone and that support is available. Contact a member of the team at Smarmore Castle on +353 41 986 5080.
Why Dual Diagnosis Is Often Overlooked
Symptoms of one condition can sometimes mask those of the other. For example, withdrawal symptoms may resemble a mental health condition, or a mental health condition may exacerbate symptoms of an addiction. Traditionally, addiction services and mental health services are often separate, creating only fragmented care instead of integrated treatment or support.
The stigma around addiction and mental illness can also prevent people from seeking help, especially if their problems are rooted in self-harm, personality traits, or common risk factors such as trauma.
Symptoms, Causes, and Risk Factors of Dual Diagnosis
The causes of dual diagnosis are often complex, involving a mix of genetic traits, environmental influences, and social factors. For example, someone with a family history of mental health problems or substance use may be at higher risk. Stressful life events, trauma, and ongoing social pressures can also contribute to the development of both mental health and substance use disorders.
Common symptoms of dual diagnosis include:
- Sudden or persistent changes in mood
- Increased anxiety or depression
- Hallucinations
- Delusions
- Noticeable shifts in behaviour or personality.
Sufferers of dual diagnosis may also experience difficulties in daily functioning, such as problems at work, in relationships, or with self-care. Symptoms of mental health disorders and substance use disorders can mimic or mask each other; a thorough and accurate diagnosis by your GP is essential for effective treatment and recovery.
Contact Smarmore Castle About Dual Diagnosis Support
If you or your loved one is struggling with and mental health issue as well as an addiction, you do not have to feel alone. Support is on hand to help you manage your mental health symptoms whilst you undergo treatment for addiction. Contact a member of our team today to find out more at +353 41 986 5080.
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Why Substance Use and Mental Health Often Go Together
The relationship between substance use and mental health is complex, and sometimes, overlapping symptoms may obscure the true nature of your struggles. Since individuals with dual diagnosis are at increased risk for relapse, emotional and social support is a key part of the recovery process. Substance use disorders affect the brain and behaviour, often causing risky behaviours or impacting relationships at home or at work.3
Having both a mental health condition and an addiction can make daily life overwhelming. With the right treatment, it’s possible to manage your symptoms, remain sober, and rebuild your life.
Smarmore Castle provides a safe, structured environment where you can focus fully on recovery. Relapse prevention is part of every treatment plan. Patients learn how to recognise triggers, navigate stress, and use emotional and social support to maintain progress. Addressing substance misuse and mental health conditions together helps prevent negative consequences and supports long-term well-being.
Questions About Mental Health and Addiction?
Contact us about addiction treatment and information on support for dual diagnosis.
Common Mental Health Conditions Experienced During Addiction
There are several mental health conditions that can be connected with substance misuse and experienced alongside addiction. Conditions such as depression, anxiety, ADHD, trauma, grief, and bipolar disorder are often seen alongside depression, causing substance misuse or making it worse.
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Depression and Anxiety
Nearly half of all individuals facing substance use disorders also experience depression and anxiety, highlighting the critical need for integrated treatment to help manage the symptoms. When you’re dealing with these co-occurring disorders, it is essential to understand that you’re not alone and that a path to recovery is achievable with the right support.
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Attention Deficit Hyperactivity Disorder (ADHD)
ADHD often goes hand-in-hand with substance use disorders, presenting unique challenges in treatment and recovery. If you’re navigating this co-occurring disorder, it’s important to understand that your impulsivity, a hallmark of ADHD, might contribute to the complexity of managing substance use issues.
ADHD can mean you have difficulty concentrating, impulsivity, and restlessness. Accessing support will help you navigate your dual diagnosis treatment with the help you need to focus on your addiction treatment.
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Bipolar Disorder
Bipolar disorder often co-occurs with substance use disorders, presenting its own set of challenges in diagnosis and treatment. If you’re dealing with both, you’re not alone – it is a common dual diagnosis. Understanding the relationship between bipolar disorder and substance misuse problems is essential for effective care.
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Post-Traumatic Stress Disorder
If you are struggling with PTSD and substance use disorder, you may be hypervigilant, experience flashbacks, and even experience emotional numbing following trauma.
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Eating Disorders
Disordered eating patterns that often co-occur with substance misuse can make recovery difficult. Finding support to live a healthier lifestyle whilst accessing treatment will provide the long-term tools needed to manage your dual diagnosis.
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Autism Spectrum Disorder
Autism is sometimes accompanied by emotional distress that can increase the risk of addiction and relapse. With support in place and a relapse prevention programme, you can access support whenever you need it.
Mental health disorders, when paired with substance misuse problems, require careful assessment and diagnosis. Dual diagnosis can involve individuals who misuse alcohol or prescription medications, as well as those who use illicit drugs. The Diagnostic and Statistical Manual (DSM-5) guides these assessments to identify complex dual-diagnosis cases.
Treatment for Mental Health and Addiction in Ireland
When you’re living with both a mental health condition and a substance use disorder, finding the right treatment can be difficult. Many services focus on just one or the other, which means your needs may not be fully met. At Smarmore Castle, addiction is always the primary focus of treatment, but co-occurring mental health issues like anxiety, depression or trauma are recognised and supported throughout your care.
Smarmore Castle offers medically managed, psychiatrist-led care that supports both mental health and substance use disorders. Treatment is built on:
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Multidisciplinary Teamwork
Psychiatrists, therapists, nurses, and addiction specialists collaborate on your care plan and support your dual diagnosis.
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Integrated Treatment
The impact of mental health and substance use is considered together, not in isolation, and treatment to support your mental health can be provided.
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Trauma-Informed Care
Recognising that past trauma often underlies both mental health problems and addiction.
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Evidence-Based Methods
Including behavioural therapy, medication, one-to-one or group therapy, and a range of treatments tailored to co-occurring conditions.
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Group Therapy
Group therapy and support groups, including 12 Step programmes and peer-led meetings, offer a welcoming and non-judgmental environment where individuals can share their experiences and challenges. These groups often provide a sense of community and belonging as well as motivation and encouragement when it feels hard to go on; something which is especially important for those who may feel isolated by their mental health and substance use disorder.
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Complementary Therapy
Including things like equine therapy or aquatherapy to provide a holistic approach to treating the whole person.
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Family Involvement
Support and therapy for loved ones, to create a strong network for long-term recovery.
Treating the Whole Person at Smarmore Castle
Dual diagnosis care at Smarmore Castle goes beyond recognition. The programme draws from a range of evidence-based treatments and talk therapy, including 12 Step facilitation, and offers holistic treatment that addresses your physical, psychological, emotional, and spiritual needs.
Patients are supported in building personal resilience and developing meaningful emotional and social support networks. A key part of the process is helping you understand how your mental health symptoms and substance use interact.
Alongside this, the team supports each patient to create a structured relapse prevention aftercare plan for after residential rehab, which will aim to support the individual based on their needs.
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Taking the first step in seeking help can be very difficult, our team is here to help you.
Relapse Prevention in Dual Diagnosis
Recovery from dual diagnosis is a long-term process that requires the right support, consistent care, and personal commitment. At Smarmore Castle, relapse prevention is central to treatment. You’ll learn how to manage triggers, cravings, and high-risk situations with tailored strategies that you will develop alongside your therapist.
A structured aftercare plan may include therapy, support groups, and ongoing relapse prevention tools. With integrated treatment and strong support systems, people with co-occurring disorders can learn the tools that may reduce the risk of relapse and help them work towards lasting recovery.
A Comprehensive Addiction Treatment Programme for Mental Health
The treatment programme at Smarmore Castle is suitable for people diagnosed with both a substance use disorder and a mental health condition. It has also been beneficial for those who have struggled to make progress in other treatment settings, particularly if previous approaches did not address both aspects of their condition together.
- People often benefit from a form of therapy called cognitive behavioural therapy (CBT). This has been clinically shown to improve common mental health disorders like depression and anxiety.
- Other forms of therapy, such as dialectical behaviour therapy (DBT), addiction counselling, family therapy, and group therapy, may also be offered.
If you require psychiatric care alongside addiction therapy or have experienced frequent relapses or persistent withdrawal symptoms (and you are over the age of 16), the integrated addiction programmes at Smarmore Castle may provide the right environment to help support you during your stay.
Smarmore Castle’s approach helps treat those with complex disorders such as alcohol addiction and drug addiction, whilst providing support for any co-occurring mood disorders or dual diagnosis. The programmes, including alcohol rehab and drug rehab, suit people with personality traits that may increase the risk of substance misuse, or those who have tried to self-medicate with alcohol or drugs.
Admission for Dual Diagnosis Rehab in Ireland
The admissions process at Smarmore Castle is guided by our team of compassionate admissions staff. If you or someone you love has a dual diagnosis, our free pre-admissions assessment will help to identify whether the treatment programme Smarmore Castle will suit your needs. If we are unable to admit a person with a mental health condition that is too complex for our resources, our team will try their best to recommend an alternative.
To find out more or to ask about support for dual diagnosis, drug use, alcohol misuse, or behavioural addiction, contact us today on +353 41 986 5080.
Self-Help Resources for Mental Health and Addiction
If you are looking for an assessment on a suspected dual diagnosis or for treatment, contact your GP. For support for mental health, contact the Samaritans on 116 123, or email directly: jo@samaritans.org.
For support in your area for addiction, contact Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or Gamblers Anonymous (GA).
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Frequently Asked Questions
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What is dual diagnosis?
Dual diagnosis is when a person experiences both a mental health condition and a substance use disorder, such as drug addiction or alcohol addiction, at the same time. These co-occurring disorders interact and require treatment to support a person’s recovery.
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What is the best example of a dual diagnosis?
A common example of a dual diagnosis is depression combined with alcohol addiction. Other examples include anxiety disorder with cocaine misuse or bipolar disorder alongside drug addiction. These are just a few examples, and not everyone experiences a dual diagnosis in the same way. It is important to first reach out to a GP if you are concerned about yourself or a loved one, or if you are seeking a diagnosis.
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Is ADHD a dual diagnosis?
ADHD by itself is not a dual diagnosis. However, it often co-occurs with substance misuse, and when paired with a substance use disorder, it becomes part of a dual diagnosis.
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How do therapists manage dual diagnosis?
Therapists typically use integrated treatment and may even prescribe medication that addresses both mental health and substance misuse. This includes behavioural therapy, psychiatric medication, talk therapy (such as cognitive behavioural therapy (CBT) or motivational interviewing), and personalised treatment plans.
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How does the DSM define dual diagnosis?
The DSM-5 does not use the term “dual diagnosis” directly. Instead, it allows for two or more concurrent diagnoses, such as a mental health disorder and a substance use disorder.
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How do I get a dual diagnosis assessment?
A dual diagnosis assessment involves a full evaluation by a multidisciplinary team. It is important to seek advice from your healthcare professional first.
At Smarmore Castle, both mental health and addiction are assessed together to guide appropriate treatment during your addiction rehab.
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Why is dual diagnosis important?
Treating only one condition at a time may lead to relapse or cause ongoing struggles for the person affected. Addressing both and accessing support increases the chances of sustained recovery by making sure that all symptoms are addressed.
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References
- Woody G. The Challenge of Dual Diagnosis. Alcohol Health Res World. 1996;20(2):76-80. PMID: 31798155.
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Health Service Executive. Model of Care for People with Mental Disorder and Co-existing Substance Use Disorder (Dual Diagnosis). Dual Diagnosis. National Clinical Programme. [Accessed June 2025].
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National Institute of Mental Health. Finding Help for Co-Occurring Substance Use and Mental Disorders. [Accessed June 2025].
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