A substance abuse disorder and a mental health disorder are not always mutually exclusive. Sometimes, someone can live with both at the same time.
According to the Substance Abuse and Mental Health Services Administration, about 21.5 million people in the U.S. suffer from this problem, known as co-occurring disorders. Also called co-morbidity, it’s when mental health and addiction issues exist together, interacting in ways that can worsen and intensify their severity.
Co-occurring disorders share a complex relationship. Do you treat one condition at a time? It can be challenging to find addiction treatment for mental illness when drug and alcohol abuse are involved.
By receiving a dual diagnosis — being diagnosed with both conditions together — you can work to address the intertwining issues of a co-occurring disorder. Dual diagnosis rehab centers do this best because they specialize in treating mental illness and substance abuse simultaneously, with neither problem neglected at the expense of the other.
What Is Dual Diagnosis Treatment?
Dual diagnosis treatment is a specialized form of care designed for individuals who experience both a substance use disorder and a mental health condition, with the mindset that both conditions stem from the same foundational problems.
The path to dual diagnosis is not uncommon — in fact, studies show that 50% of people with a substance abuse disorder will also experience a mental health disorder, and vice versa, sometime in their lives, notes the Cleveland Clinic.
“The more severe the mental illness, the greater the likelihood that the person will also use or abuse an illicit substance,” says The National Alliance on Mental Illness (NAMI), adding that substance abuse becomes a complicating factor in nearly every facet of care for a person struggling with mental illness.
To suffer a co-occurring disorder can pose wide-reaching consequences. More than one in nine adults, notes the Pew Charitable Trusts, are arrested annually, a dozen times more than adults with no substance abuse or mental health issues — and half a dozen times more than people with just a mental illness.
But with a co-occurring disorder, which one comes first? It can seem like a real chicken-and-egg scenario, the Cleveland Clinic adds, making it difficult to determine which disorder may have caused the other.
The truth is that a substance abuse disorder may contribute to a mental health disorder, and a mental health condition can influence the development of a substance abuse problem.
Risk Factors for Co-Occurring Disorders
Some common risk factors for developing a co-occurring disorder, according to the National Institute on Drug Abuse (NIDA):
- Genetic predispositions can play a part. If there’s been a family history of substance abuse or mental health problems, your risk of inheriting them may be more likely, including the chance of developing a second disorder following the first.
- Environmental triggers — like stress or childhood trauma like physical or sexual abuse — can pose an influence on developing a substance abuse or mental health disorder, or both.
Neurological changes in the brain caused by an addiction like alcoholism or opioid abuse, notes NIDA, can make someone more likely to develop a mental health disorder. Likewise, a mental health disorder can lead one to self-medicate in place of proper treatment programs.
What Is Self-Medicating?
A mental health condition might lead someone to turn to drugs or alcohol to feel better or manage their symptoms.
For example, someone dealing with chronic anxiety might drink alcohol to calm their nerves, or someone struggling with depression might use opioids to numb emotional pain or regulate their mood. A veteran with PTSD might abuse drugs to lower their maladaptive fight-or-flight response.
While this type of self-medication — abusing substances as an unhealthy coping mechanism — might offer temporary, fleeting relief, it can turn into dependency. Mental health disorders can also mutate the way the reward centers of your brain work, increasing the likelihood of developing a drug addiction or substance abuse problem.
Self-Medicating Can Make Things Worse
Self-medicating with alcohol and drugs, notes NIDA, can worsen the symptoms of a mental illness and raise the underlying risks for developing one. NIDA notes that people with mental illness consume 38% of all alcohol, 44% of cocaine, and over 50% of opioids.
This type of substance abuse can also further exacerbate a mental health disorder, as dependency on drugs or alcohol can lead to anxiety, hopelessness, and helplessness. Self-medicating is self-defeating because it only serves to mask the root causes of emotional distress without addressing it. It can also pose some dangerous risks depending on the substance being abused, including:
- Poor or impaired decision making while intoxicated or high
- Incorrect drug usage or dosage
- Developing a dependency on the substance
- Adverse, sometimes serious, reactions to the abused drug/substance
- Health risks, such as liver, heart, cardiovascular or neurological issues
- Overdose
Sadly, without proper intervention, many people who self-medicate attempt to incorrectly self-diagnose themselves and may continue abusing a substance to ameliorate their pain. This can lead to procrastination s,eeking real help, where tomorrow never comes.
Why Is It Important to Treat Both?
With a dual diagnosis of co-occurring disorders, treating one condition with the hope that it will cancel out the other is an ineffective method of dual diagnosis treatment since, without proper care, the cycle of mental health struggles and substance abuse can spiral out of control.
To recover fully from a mental health and substance abuse disorder, special treatment is necessary for both problems since concentrating on one problem doesn’t improve the chances of the other going away. NAMI states that dually diagnosed individuals often don’t respond well to Alcoholics Anonymous or Narcotics Anonymous groups — despite their effectiveness — because they target one disorder and not the other.
Not Many People Seek Treatment
The National Institutes of Health report that while many people with either mental health or substance abuse disorders received treatment for those individual conditions, only 9% of people with co-occurring disorders sought treatment for both.
Dual diagnosis rehab centers integrate treatment tailored for both conditions, but diagnosing and treating co-occurring disorders can sometimes prove challenging since many surface symptoms — like anxiety, depression, insomnia, mood changes or irritability, or a racing heartbeat — can overlap.
“People who have co-occurring disorders often have symptoms that are more persistent, severe, and resistant to treatment compared with patients who have either disorder alone,” says NIDA, but obtaining a full assessment from qualified treatment centers for dual diagnosis can minimize the chances of a missed diagnosis.
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What Can Dual Diagnosis Rehab Centers Help With?
Thankfully, over the past few decades, researchers have made considerable strides in treating co-occurring disorders. With a focus on treating mental health conditions and addiction together, dual diagnosis rehab is person-focused and trauma-informed.
Addiction Treatment
Some of the addictions treated at inpatient dual diagnosis treatment centers that are part of a co-occurring disorder include:
- Alcohol addiction: Many people drink to cope with anxiety or depression, but over time, chronic, heavy drinking can lead to dependency on time of worsening one’s mental health state. Dual diagnosis treatment helps address both problems without ignoring how both conditions impact each other.
- Opioid addiction: Prescriptions painkillers like fentanyl or drugs like morphine and heroin are highly addictive and can fuel existing mental health issues, leading one to abuse substances more.
- Cocaine and meth addictions: Stimulants like amphetamines are often sought out to give a “boost” for low energy or for focus, but what many people who abuse these drugs may not realize is that they’re looking to offset an undiagnosed mental health problem they may be unaware of, like ADHD or bipolar disorder. Dual diagnosis rehab centers aim to treat these issues in a complete, comprehensive way.
- Benzodiazepine addiction: Xanax or Valium are commonly misused and abused by people with anxiety or who suffer panic attacks. Even when diagnosed with an anxiety disorder, drug abuse can persist and worsen both problems without the right treatment.
Mental Health Disorders
There are numerous mental health disorders commonplace among addicts and alcoholics that can lend to a dual diagnosis:
- Depression: Dysthymia can turn to depression — and a dual diagnosis — when chronic feelings of sadness or hopelessness lead someone to turn to alcohol or drugs to cope. But by addressing both conditions, ideally through residential dual diagnosis treatment centers, you can regain a sense of purpose.
- Anxiety disorders: Generalized anxiety disorder (GAD), panic disorder, social anxiety, agoraphobia and others often coexist side by side with substance abuse.
- Bipolar disorder: The extreme mood swings inherent to bipolar disorder may make one more susceptible to substance abuse disorder — in fact, studies show that the lifetime prevalence of substance abuse is found in 40% of bipolar sufferers.
- PTSD: Experiencing or witnessing a traumatic event, like physical or sexual abuse, or wartime combat for veterans, can manifest itself as PTSD, and can compel some to abuse substances to deal with the resulting emotional and mental stress.
What Therapies are Offered at Dual Diagnosis Rehab Centers?
Dual diagnosis rehab centers, like the one at the Haven, are staffed and equipped to address the often-complicated mix of symptoms found in co-occurring disorders. It could be an opioid addiction with an anxiety disorder; alcohol abuse with depression; or meth abuse with elements of PTSD — the combination of disorders means that treatment must focus on getting to the heart of one’s problems, how they work against each other, and how you can build resilience, improve emotional dysregulation and foster long-tern recovery.
This happens through two very important methods of dual diagnosis treatment:
Evidence-Based Psychotherapy
Psychotherapy is a cornerstone of dual diagnosis treatment. When it’s evidence-based, that means research has proven the treatment is effective and that they work in helping people with co-occurring disorders. Here is a sample of the types of evidence-based therapies used in dual diagnosis treatment:
- Cognitive behavioral therapy (CBT): Working alongside a therapist, CBT helps you to identify and change negative thought patterns, feelings and behaviors that can contribute to the addiction and mental health symptoms of a co-occurring disorder. CBT encourages self-reflection and accountability so you can take charge of your own recovery.
- Dialectical behavioral therapy (DBT): Mindfulness, emotional regulation, interpersonal effectiveness and distress tolerance are just some of the valuable skills taught with DBT, empowering you to develop healthy coping mechanisms, enhance communication skills and foster meaningful relationships when dealing with a co-occurring disorder.
- Exposure therapy: Fear often stems from trauma, one reason someone may turn to abusing substances and come to a dual diagnosis disorder. The best dual diagnosis treatment centers utilize exposure therapy to face your fears to heal from the self-imposed limitations of anxiety that may lead one to drink or use drugs.
Holistic Therapy
Just as co-occurring disorders contain two elements of mental health and substance abuse symptoms, more than one type of therapy helps to better treat then in a dual diagnosis scenario. At residential dual diagnosis treatment centers, holistic therapies work to heal the mind, body and spirit to support your well-being and recovery:
- Yoga and meditation: Powerful recovery tools, they work to develop mindfulness in the present moment, relaxation techniques to manage stress and healthy coping mechanisms for stress, negativity and worry. Yoga is also effective at identifying ways to utilize newfound body awareness to recognize triggers and warning signs of relapse.
- Expressive arts therapy: Creative outlets like art, music, writing and dance/movement help heal co-occurring mental health issues that often go together with addiction. They enable you to tap into your true essence in a safe, healing space, ideal for people who may seem uncomfortable at first in a talk therapy or group environment. By using your own creative skills, you may discover new talents you never knew you had and open the windows of recovery on your own.
- Adventure and Equine Therapy: By engaging with others in outdoors, nature-based pursuits, you stimulate the mind and body in ways that enliven your recovery journey in thought-provoking ways. And equine assisted therapy (EAT) is an effective treatment for individuals struggling with mental illness and substance abuse, since caring for a gentle therapy animal helps one develop trust, engagement, introspection and mindfulness for personal growth.
For dual diagnosis rehab centers, the Haven prides itself on being a full-service facility helping you overcome a co-occurring disorder with a continuum of care ranging from detox through aftercare and beyond. A substance abuse and mental health disorder requires treatment and support, but moreover, your own unwavering determination to begin a new chapter of your life with clarity and sobriety.
If you or a loved one struggles with either substance abuse or mental health issues, don’t be afraid to seek help from the right therapy program. Treatment programs at addiction treatment centers offer unique treatment plans, life skills training, and behavioral health recovery programs. One phone call holds the power to change everything. Contact us today; we’re here to help.
