The only way to find out is to get a diagnosis from a medical professional. If a patent has a dual diagnosis each co-occurring condition needs to be diagnosed independently according to the relevant medical criteria, usually those listed in the current Diagnostic and Statistical Manual of Mental Disorders (DSM).

In this article we cover the following topics related to dual diagnosis

  • What is a co-occurring mental health disorder?
  • What is dual diagnosis treatment?
  • Do I need to be an inpatient for dual diagnosis treatment?
  • Why is dual diagnosis treatment important?
  • Is dual diagnosis treatment successful?

If you or a loved one is concerned about addiction, mental health or dual diagnosis the first step is to reach out to the team at Hacienda Paradiso for a private, helpful and friendly conversation about options. 

Any conditions can co-occur. However, the most frequent conditions that will appear in a dual diagnosis with addiction are depression and anxiety. Other frequently seen conditions included bipolar disorder, borderline personality disorder, post-traumatic stress disorder, eating disorders and schizophrenia.

treatment. dual diagnosis. depression. anxiety

While it might seem overwhelming to receive a dual diagnosis for most people it can be a relief. Instead of being overwhelmed by a set of symptoms and difficulties, a dual diagnosis can mark the beginning of recovery. The dual diagnosis can help the patient improve their understanding of their condition. It also makes recovery a realistic goal, of addressing specific, individual diagnoses rather than a single, overwhelming, mental health challenge.

What does it feel like to have a co-occurring mental health disorder?

In short, having a co-occurring disorder feels exactly the same as having a regular disorder because it is a regular disorder. One of the reasons so many people are relieved, even pleased, about a dual diagnosis is because it means they can understand the cause of specific symptoms, identifying which are a result of an addiction and which are a result of a mental health condition. This will generally be accompanied by awareness of how the individual symptoms affect each condition, depression for example, might affect an addiction because the low mood is a trigger for addictive behavior.

Our addiction treatments

Detox @ Purifyâ„¢
Detox, the first stage of becoming free from drug and alcohol dependency, is both physically and psychologically uncomfortable. Purifyâ„¢ by Hacienda Paradiso was created to ease this discomfort. Restoring the body and mind in safe and comfortable surroundings, under medical supervision. The detox process will be complete within seven to ten days, with many clients beginning a successful programme of recovery after the detox process is complete.
Alcohol Addiction
Hacienda Paradiso is an award-winning alcohol treatment facility where the process of treating addiction is grounded in care, compassion and recovery. The process of treating alcohol addiction usually goes through four stages: admission, detox, rehab, and lasting recovery. We adopt an approach that is discreet, non-judgmental and individual. Our priority is to look beyond the symptoms of alcoholism and treat the causes of the condition, delivering successful lasting recovery and remission.
Bipolar Disorders & Depression

Childhood trauma, stress, grief, structural brain changes, hormonal imbalances and other neurological indicators have a proven link to Bipolar Disorder & Depression. Treatment at Hacienda Paradiso is highly effective and helps sufferers gain valuable insight and increased control over mood swings and other symptoms. It is essential to seek treatment as early as possible.

At Hacienda Paradiso, you will meet our Consultant Psychiatrist on admission. They will help you describe the symptoms you have experienced, and together with the exceptional therapeutic team, will create a treatment plan with you. If you have been using alcohol or substances, we will help you to safely detox in comfort, while we assess your care plan and recovery.

Our addiction treatments

Detox @ Purifyâ„¢

Detox, the first stage of becoming free from drug and alcohol dependency, is both physically and psychologically uncomfortable. Purifyâ„¢ by Hacienda Paradiso was created to ease this discomfort. Restoring the body and mind in safe and comfortable surroundings, under medical supervision. The detox process will be complete within seven to ten days, with many clients beginning a successful programme of recovery after the detox process is complete.

Depression
Hacienda Paradiso luxury residential depression clinic takes an individualized deep dive with clients on a therapeutic led journey of recovery. The World Class treatment teams deliver long term remission from all forms of depression, depressive episodes and previously treatment resistant cases of major depressive disorder. Award-winning therapists and psychiatrists at the Hacienda work with clients to identify and treat and heal underlying problems. If the causes of depression are not identified, treated and healed, sufferers of can continue to experience symptoms throughout their lives.
Drug addiction

Drug addiction is a very complex, multi-faceted disorder. Major indications of drug addiction include cravings, withdrawal and unsuccessful previous attempts to stop or reduce use. The drug addiction experts at Hacienda Paradiso treat all forms of addiction including cocaine, cannabis and prescription medication. Hacienda Paradiso takes a pragmatic and highly individualized approach to drug addiction by treating the underlying factors and any co-existing mental health issues. The team at Hacienda Paradiso has been recognized internationally for their success and dedication to long term successful recovery.

Dual Diagnosis Treatment
Dual diagnosis is a term when a mental illness and substance misuse disorder coexist simultaneously. Often depression and anxiety may lead to alcohol and drug addiction and vice versa. The complexities of Dual Diagnosis is to establish the specific order of coexisting conditions to effectively treat the underlying causes to create successful, lasting and long term recovery from addiction and remission from coexisting mental health conditions.
Anxiety Disorders

Anxiety is an emotion that is okay to feel. Experiencing it occasionally is common and normal. However, anxiety disorders are much different to feeling the occasional bout of anxiety. Anxiety disorders can be paralyzing to those who experience them. They can leave a person feeling unable to cope with life.

Residential treatment at Hacienda Paradiso Clinic allows you to live, learn, and understand your anxiety disorder. Often clients experience significant and rapid reduction in anxiety and in many cases complete remission from a debilitating condition.

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Gambling Addiction
The World Class team at Hacienda Paradiso are experts at treating pathological gambling addiction. Our unique and highly individualized programme of recovery equips you with the tools to break the cycle of addiction. We will create a unique treatment plan to heal the symptoms and address your own specific root-causes. Gambling addiction often coexists with other addictions or mental health issues so it’s imperative to assess any dual diagnosis concerns that may have previously been undiagnosed.
Gaming Addiction
Video game addiction is a very real mental health condition impacting many millions of people around the world, across all ages. The most addicting games include Fortnite, League of Legends, PUBG, Minecraft and other household names. This is because video games are designed to be addictive. Gaming addicts may experience significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Gaming disorder is a process addiction and help is available from the team at Hacienda Paradiso. The friendly, non-judgmental therapeutic help develop a healthy relationship with technology and devise ways to ensure long term recovery and remission from video game addiction.
Sex Addiction
Dr Ruth Arenas leads our award-winning residential sex and love addiction clinic. Hacienda Paradiso is the only treatment center in Europe to separate love and sex addiction. While we recognize the similarities, we identify and treat each as standalone unique issues that may be triggering compounded emotional distress. Dr Ruth is one of the Worlds foremost authorities in compulsive sexual disorder and hypersexuality. Residential treatment at Hacienda Paradiso boosts self-esteem and rebuilds mechanisms to increase resilience. Our World Class professionals help clients achieve freedom from destructive, compulsive and obsessive behaviors.
Prescription Medication Addiction
If you or a loved one has developed a prescription drug addiction, help is available. At Hacienda Paradiso our prescription drug addiction treatment is focused on complete and lasting long-term recovery. Our approach is non-judgmental and highly therapeutic. Our medical experts and clinicians will design a treatment plan specific for your situation, and the nature of your prescription drug addiction. The exact treatment depends on the specific prescription medications, while at same time identifying and addressing the issues and reasons underlying the addiction.
DNA Testing for Addiction
The clinical team at Hacienda Paradiso are able to use cutting edge DNA testing to identify which drugs would be safer and more effective for use in a client’s recovery. As one of the only treatment clinics in Europe to offer DNA testing the team are able to quickly find which medically assisted treatment works best in each unique and individual case. This groundbreaking approach reduces the potential for uncomfortable side effects and greatly speeds a client’s recovery.
Transcranial direct current stimulation (TDCS)
Transcranial direct current stimulation is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. TDCS is successfully used in the treatment of depression, PTSD, anxiety and other persistent psychological issues. Transcranial direct current stimulation at Hacienda Paradiso is particularly successful when a client presents with treatment resistant depression.
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This also means that the effects on the individual are, simply, the same effects as the conditions. In some cases these will overlap or be exacerbated. Using the example of an addiction accompanied by depression, cravings, and withdrawal symptoms will be the result of the addiction, while symptoms like feelings of low self-worth are more likely to be the result of depression (although they might be worsened by the addiction). However, in this example, self-neglect might be a consequence of either condition or both.

What is dual diagnosis treatment?

There is no standard treatment for dual diagnosis, and it will depend on the conditions diagnosed. Ultimately, the conditions will be treated individually, so a patient with drug addiction and post-traumatic stress disorder, for example, would receive two sets of treatment in parallel. However, although the treatments will be separate, they will have regard to the possible impact they are having on the other condition.

And while there will be two treatments, having a dual diagnosis adds complexity and this can have an effect on exactly how the treatments are managed and how long recovery might take. The two main reasons for this are that the treatments will take account of the other condition, and sometimes it is hard to disentangle the conditions from each other.

This is why its imperative top seek out only the best and most experienced Dual Diagnosis experts. Hacienda Paradiso is fast becoming one of the Worlds the leading clinics for our specialized treatment of Dual Diagnosis, at our Ecological rehab in Marbella.

It is now recognized that addictions have a profound effect on the brain, especially the pleasure pathways, but also more broadly on how the brain produces key chemicals, like GABA, serotonin, dopamine, and endorphins, that have wide-ranging psychological and physiological effects.

Treatment and recovery at Hacienda Paradiso rehab in Marbella manages the process of recovery taking into account both conditions and the effects of treatment. A common condition like depression, for example, can be treated with therapy or medication. Using medication, however, might be complicated by natural changes in the brain as a result of detox and recovery from addiction. Unfortunately, it’s impossible to know, for certain, how effective medications may be or what side effects they may have on an individual, and a co-occurring condition makes this even harder. A clinician would, therefore, have to consider several factors and monitor for the effects of any medications, constantly re-assessing to ensure the desired outcome was being achieved.

At Hacienda Paradiso we are pioneers of DNA testing for medication reactions. This means that with some simple tests we are usually able to refine and alter a patient’s medications by eliminating those that are genetically predisposed to adverse reactions and complications. 

More from our addiction treatment blog


Dual diagnosis also frequently creates a ‘chicken and egg’ problem which can impact on treatment. One of the reasons that dual diagnosis is so common is because addictions and mental health conditions affect the same part of the brain. Addictions frequently start because the patient is self-medicating with a drug. However, addicts also often develop mental health conditions because of the way the brain responds to addiction. Dual diagnosis treatment can be affected by this difference.

Do I need to be an inpatient for dual diagnosis treatment?

Dual diagnosis does not necessarily mean treatment as an inpatient at a residential facility is necessary, but it does make it more likely. Just like a single diagnosis the main factors will be the severity of the conditions and the length of time the patient has suffered from them. In some cases, just one of the conditions might indicate an inpatient stay is necessary. In other cases, where the conditions are mild or moderate it might be possible to treat both while the patient remains at home.

However, the added complexities of dual diagnosis might mean that a residential stay is preferable, even if it wouldn’t be necessary for the conditions individually. This will allow our professionals at Hacienda Paradiso to offer more care to manage any complexities. Dual diagnoses also present more risk, for example treatment for one condition might act as a trigger for the other condition. A stay in our world class residential facility means that there is always help on hand to safely manage any difficulties in the recovery process.

Why is dual diagnosis treatment important?

There is a much better chance of a successful recovery with dual diagnosis treatment than with sequential or independent treatment options. There are many possible connections between addictions and mental health conditions. The addiction might be the result of self-medication, the condition might have been caused by the addiction’s changes to the brain’s pathways, or both might be the result of a past trauma. Treating a single condition leaves the risk that the remaining condition triggers a relapse of the treated condition.

As well as the links between dual diagnosis conditions, there are additional risks associated with dual diagnosis if only one condition is not treated, especially when the treated condition is addiction. An example is depression. Withdrawal symptoms often include feelings of depression and anxiety, so if the patient does not have dual diagnosis treatment, there is a risk that an existed depression could be worsened, becoming severe and even resulting in suicidal ideation.

Additionally, there is a risk that dual diagnosis conditions can, untreated, increase the risk of developing worse conditions. This is particularly true if there has been a family history of poor mental health. An example might be a patent with an alcohol addiction and depression, who then develops bipolar disorder. The process by which this happens is not fully understood but may be related to the compounding effects the two co-occurring conditions have on the brain’s chemistry and networks.

Is dual diagnosis treatment successful?

There is no reason for dual diagnosis treatment to be any less successful than treatments for individual conditions. Indeed, although the conditions are treated separately, many patients will feel a holistic benefit, improving their self-awareness and leaving them feeling more empowered during their rehabilitation and recovery. It is certainly the case, where there is a dual diagnosis, that concurrent treatment is, overall, much more successful than individual or sequential treatment options.

However, it is important to use a facility or service such as Hacienda Paradiso that can offer a full dual diagnosis treatment. Many facilities will specialize in specific conditions. While they might offer treatment options that appear beneficial, they will not necessarily tailor for dual diagnoses conditions. For example, therapy for addiction may have some benefit for patients with other mental health conditions, but it is not a treatment for them. 

Hacienda Paradiso is the leading Dual Diagnosis clinic in Europe, pioneering affordable treatment in beautiful, natural surroundings.

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