Veterans with Co-Occurring Disorders: Dual Diagnosis Treatment Explained
Coming home from service doesn’t always mean that the battle is over. For many veterans, life after the military can bring unexpected challenges like flashbacks, anxiety, or a dependence on unhealthy ways of coping to get through the day. If you’re struggling with your mental health, know that you are not alone – support and guidance are available.
Dual diagnosis in veterans, or co-occurring disorders, is more common than you might think. For instance, around 80% of people with post-traumatic stress disorder (PTSD) have at least one other mental health diagnosis, such as sleep problems or substance use.1 What’s more, veterans’ mental health challenges don’t always show up during military service – they can also arise after deployment.
Professional mental health treatment is available to help you feel better and look forward to your future again. This guide can also help you better understand dual diagnoses in veterans, as it covers:
- What a dual diagnosis in veterans is
- Why veterans are more vulnerable to dual diagnoses
- Treatment for dual diagnosis mental health issues
- How to overcome barriers to treatment
- Professional mental health resources for veterans
What Is Dual Diagnosis in Veterans?
As a veteran, you may have returned home with more than you signed up for. You might be surrounded by the comforts of home and family rather than being out in combat, but now you may be fighting a battle in your mind. And this battle likely can’t be won with physical discipline. You may already be aware of mental health challenges, such as depression or bipolar disorder, but what about dual diagnosis? Let’s take a look at what dual diagnosis means.
Dual Diagnosis in Veterans
Dual diagnosis means you have a mental health condition and a substance use disorder (SUD), both at the same time. Another name for dual diagnosis is co-occurring disorders. Either way, it isn’t a single diagnosis – it’s a combination of two or more. An example of co-occurring disorders would be veterans with PTSD and addiction.
In other words, you may have a mental health condition such as PTSD, anxiety, or depression, as well as an SUD where you misuse alcohol, smoking, drugs, or other addictive substances.
One disorder doesn’t necessarily come before the other, or lead to the other – either can come first. Plus, co-occurring disorders are far from rare; around 17 million U.S. adults had a combination of mental health and substance use disorders in 2020.2
Why Is Dual Diagnosis Complex?
If you have a dual diagnosis, the effects of each can make the other worse. For example, if your mental health condition isn’t being treated, you may increase substance use to self-medicate, which could worsen your SUD.
Likewise, if you use substances more regularly, your mental health problems can get worse. For instance, studies have shown that alcohol and drugs can worsen symptoms of mental health issues.3
For these reasons, veterans with mental health and substance abuse disorders can find themselves in a vicious cycle, with each problem feeding into the other until the cycle quickly becomes a downward spiral.
Common Dual Diagnosis Combinations
Some of the most common co-occurring conditions in veterans alongside SUDs are:1,4
- PTSD
- Depression
- Anxiety (including generalized anxiety disorder)
And some of the most commonly misused substances in SUDs include:5
- Alcohol
- Cannabis
- Opioids
- Stimulants
Remember that whatever struggles you are experiencing, help and treatment are available, and it is possible to recover and live your best life.
Why Are Veterans More Vulnerable to Dual Diagnosis?
If you’ve been in military service, you may wonder why veterans are affected more than the general public when it comes to substance misuse and mental health conditions. Well, serving in the military can have a big effect on mental health – going some way toward explaining dual diagnosis in veterans.
For example, in the military, you go through experiences in training and active duty that impact you emotionally, mentally, and physically. And these effects can stay with you even after you’ve finished service.
To break it down, training by itself is an intense process, with strict discipline and separation from loved ones. It’s a tough situation to be in and can be very physically and mentally stressful.6 Then, once in combat, you go through the stress and trauma of being in life-or-death situations – and surviving them. However, you may also have come back with PTSD, anxiety, or depression as an unwelcome companion. For instance, studies show that being deployed can make you three times more likely to get PTSD than those who were not deployed.7
Finally, you finish your service and return to civilian life, but even that can feel challenging. It’s a much slower pace of life, often requiring a search for a new job. Plus, you even wonder who you are outside of the military.
Whatever you did to get you through tough times in the field, you now might end up turning to a substance to help you cope – whether it’s drinking, smoking, or using drugs. You’ve been through so much more than the average person, and these experiences have become a part of who you are. Yet, sadly, they’ve also affected your mental health and how you cope with the challenges it can bring.
Treatment for Dual Diagnosis
When exploring your options, it’s important to look for services that offer tailored, holistic approaches to your mental health recovery. The following information talks through some of the treatment options recommended by the National Alliance on Mental Illness (NAMI) for people with co-occurring disorders.8
Integrated Care
When treating dual diagnosis in veterans, it’s important to remember that you are treating two (or more) issues. Therefore, because of the complexity of having multiple mental health conditions, it’s vital to adequately care for both mental health issues and substance use – often called “integrated care.” Integrated care involves taking all challenges into account when planning treatment so that the best outcomes are reached.
Detoxification
When looking for substance abuse treatment for veterans, you may hear of detoxification, which is a process of removing toxins (drugs, alcohol, and so on) from your body.
Detoxing may be offered as an inpatient treatment, meaning you stay in a medical or therapy center for several days and are monitored while the substance leaves your body. This process removes you from the usual places where you would have access to substances or people who would encourage you to use them, and ensures your physical and emotional safety.
Inpatient Rehabilitation
Dual diagnosis recovery programs may offer an inpatient treatment option if you have a serious mental illness and are dependent on substances to cope. An inpatient program would allow you to benefit from 24/7 medical care, including things like therapy, medication, and health services. Therefore, it’s a good option if you are looking for PTSD and substance abuse help.
Medication
Medication can be valuable for treating mental health issues and might play a big role in your co-occurring disorders treatment. For instance, medications such as antidepressants can help manage conditions like depression or anxiety. Plus, some drugs can help control withdrawal symptoms experienced when giving up a substance – such as during the detox process.
Psychotherapy
Disclaimer: We do not offer treatment for substance use disorders at Mission Connection. However, we’re happy to help connect you with trusted services and professionals who specialize in this area, if necessary.
Overcoming Barriers to Treatment
What potentially stops veterans from getting the help they need and deserve when faced with co-occurring conditions? Veterans may face a few barriers to receiving treatment.
One barrier might be that they fear being judged by others for seeking help for mental health or substance use problems. Another could be that they internalize this judgment and have negative views of mental health treatment or feel shame about needing it. Also, they might not realize they have a problem, need help, or can be helped. Finally, cost can be a significant concern for people when looking for mental health treatment.9
Dual diagnosis in veterans doesn’t need to be a lifelong challenge. Help is available if you take the courageous step of seeking support. Plus, a mental health professional can talk you through the option of insurance if cost is a concern.
Mental Health Resources for Veterans
If you’ve read this far, you’re probably wondering how to get started when it comes to understanding and treating dual diagnosis in veterans. Too much information can be overwhelming, so the following outlines resources you can access when you need them most.
- Veterans Crisis Line: pen 24/7. Call 988, then press 1. They also have a confidential online chat service, and you can text them at 838255. If you have hearing loss, you can call TTY, dial 711, then 988.
- VA resources: The VA has a variety of resources and information available to veterans, including VA programs for co-occurring disorders.
- National Centre for PTSD: For information about PTSD, treatment, and locations, visit their website or call (802) 296-6300.
- National Institute of Mental Health (NIMH): They offer information about mental health topics, including PTSD, depression, anxiety, and medications. Call (866) 615-6464.
- Co-occurring Disorder Support Groups: Check out Mission Connection’s page on peer support for veteran mental health recovery.
Ready to Get Help With Your Mental Health? Start Today
If you feel like life has been an uphill struggle since returning home, please know that you are not alone. Many veterans experience emotional and psychological challenges after leaving military service, and recovery is possible with the right care. At Mission Connection, we’re here to walk alongside you if you’re struggling with mental health difficulties.
Our team of experts understands the unique experiences of veterans, and we’ll work with you to create a care plan that honors your story. Whether you’re managing PTSD, anxiety, depression, or you’re simply feeling stuck right now, we offer personalized mental health support and guidance to your needs.
Everyone experiences mental health challenges differently, which is why we offer a range of treatment options to help you recover in the way that feels right and best for you, including:
- Residential treatment, for when you need round-the-clock care and support.
- Outpatient treatment, which allows you to go about your daily routine and still get the help you need.
- Intensive outpatient treatment, involving a high level of treatment and support, with the ability to return to the comfort of your home every night.
- Virtual therapy, confidential and compassionate care that you can access without having to leave your living room.
While we do not offer treatment for substance use disorders, we understand how closely these challenges can be linked to mental health. If you’re seeking support for addiction, we’re more than happy to help connect you with trusted services and professionals who specialize in this area.
For some people, the cost of mental health treatment can be a concern. We believe that you should be able to receive the support you deserve, which is why we offer a range of payment options. These include finance plans, insurance payments, and even sliding scale fees based on your financial need. Click here to find out more.
Reach out to us today to talk with one of our friendly advisors about treatment options. You’ve served your country. Now let us help you heal.
References
- U.S. Department of Veterans Affairs. (n.d.). Co-occurring conditions. National Center for PTSD. Retrieved June 3, 2025, from https://www.ptsd.va.gov/professional/treat/cooccurring/index.asp
- National Alliance on Mental Illness. (2024, April 30). Substance use disorders. https://www.nami.org/about-mental-illness/common-with-mental-illness/substance-use-disorders/
- National Institute of Mental Health. (n.d.). Substance use and co-occurring mental disorders. https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health
- Committee on the Assessment of Ongoing Effects in the Treatment of Posttraumatic Stress Disorder. (2012, July 13). Co-occurring psychiatric and medical conditions and psychosocial complexities. In Treatment for posttraumatic stress disorder in military and veteran populations (pp. 115–130). National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK201109/
- U.S. Department of Veterans Affairs. (n.d.). Substance use. https://www.mentalhealth.va.gov/substance-use/index.asp
- Bonner, M., & Ellender, G. (2022). Military training: Does it predispose service personnel to negative mental health issues? Journal of Mental Health Disorders, 2(1), 11–18. https://doi.org/10.33696/mentalhealth.2.012
- U.S. Department of Veterans Affairs. (n.d.). Common problems veterans face. https://www.ptsd.va.gov/understand/common/common_veterans.asp
- National Alliance on Mental Illness. (2015). Dual diagnosis [Fact sheet]. https://www.nami.org/NAMI/media/NAMI-Media/Images/FactSheets/Dual-Diagnosis-FS.pdf
- Hitch, C., Toner, P., & Armour, C. (2023). Enablers and barriers to military veterans seeking help for mental health and alcohol difficulties: A systematic review of the quantitative evidence. Journal of Health Services Research & Policy, 28(3), 197–211. https://doi.org/10.1177/13558196221149930
