Originally Posted by
soberlicious 
As far as mental illness goes, many mental illnesses do require medical management, and many people with mental illnesses do have substance addictions. I think that the quitting for good message is especially important for someone with a mental illness and has to be done first, since treating for mental illness while using alcohol or other drugs is pretty much not going to work. Don't you think it's kind of hard to Dx a mental illness when someone is a heavy user? I wonder how medical professionals can do that effectively. I know that I developed severe symptoms over the years of heavy use. I was Dx with depression, anxiety, and even had psychotic breaks when using alcohol and benzos, but I did not have symptoms after the alcohol and drugs were removed. I've had sadness, deep grief, and even times I was seriously anxious about what to do about problems I was facing, but nothing that required medical management. I don't think my story is uncommon at all.
In a dual diagnosis, it's crucial to work with both the substance disorder and the mental health diagnosis.
Depression and anxiety can absolutely be potentiated by substance use. Sometimes medication is useful at first and the issues can eventually be managed without medication using other methods, once the substance use is curtailed. In some cases continued medication can be valuable.
Bipolar disorder nearly always needs some sort of medication management. In my case the mood swings interact strongly with substance use, and tend to make the mood disorder worse.
There are others, of course. Psychiatric intervention is a crucial part of my sobriety. My outpatient program was dual diagnosis, and was far more effective than it would have been for me if it had just dealt with addiction and sobriety.