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Treatment–And Hope–for People With Co-Occurring Disorders

Addiction doesn’t happen in a vacuum. For some people, drug abuse is related to another mental health diagnosis. If you have a co-occurring disorder, you may need specialized care during rehab.

Pre-existing mental health conditions can make addiction more likely. And, some addictions can also cause emotional problems. If either of these applies to you, it’s important to find highly specialized care. Even if a rehab treats both your conditions separately, they may not be qualified to help you heal from both at once.

Because of this, it’s very important for you to find a rehab facility that specializes in treating co-occurring disorders.

Do You Have an Underlying Mental Health Condition?

You may have more than one condition and not even know it. Many people turn to drug use to self-medicate their underlying mental health issues. And what’s more, the symptoms of drug abuse can mimic those of other conditions. This can make it hard to diagnose and treat substance abuse co-occurring mental illness.1 Fortunately, once you have the right diagnosis, both addiction and mental health issues are highly treatable.

Experts estimate that about 50% of people with an addiction have a co-occurring disorder.2 If you think you might be 1 of those 50%, there are some signs to watch out for. According to the team at White Manor River, some common signs of dual diagnosis include the following:

  • withdrawing from relationships
  • sudden behavioral changes, including erratic or risky behavior, and changes to sleep and appetite
  • feelings of confusion, hopelessness, despair
  • anxiety that is only relieved by ritualistic behavior
  • trouble at work
  • mood swings and emotional dysregulation
  • coping with any of the above symptoms by taking drugs

If you notice these signs, you should get a formal assessment from an addiction or mental health expert. They’ll be able to guide you toward the right type of treatment.

How Mental Health Affects Addiction—And Vice Versa

Many people with mental health issues take drugs to self-medicate. While that can make you feel better in the short-term, it only makes your condition worse over time. This creates a vicious cycle. You might take drugs to control symptoms, and then feel worse, leading right back to drug use. Without professional support, it can be very hard to break free of this pattern.

What’s more, long-term drug use can change your brain chemistry.3 No matter why your addiction started, you can develop mental health issues because of this behavior. Substance abuse can interfere with every part of your life, including your relationships, career, and physical health. Co-occurring disorders can make those effects even worse. They also make it harder to seek treatment.

Recovering from your co-occurring disorder4 might be complex, but it’s not impossible. Kara Anne’s story is proof of that. “Major depressive disorder became my dark cloud reality around 6th grade,” she says. “To an outside observer, my life seemed more than fine; if only they were right.”

In college, Kara Anne found alcohol. “Drinking at the pubs became my established norm,” she says. She spent the next several years going in and out rehab, caught in a cycle of recovery and relapse. Finally, “recognizing that treatment of each disease separately was not showing success,” she tried dual diagnosis treatment.

With the right kind of support, Kara Anne found relief. “Finally, I have found freedom, peace, gratitude, acceptance, purpose, introspection, and self-awareness. My recovery is my new beginning.”

There are countless stories like Kara Anne’s. And there are plenty of different treatments to help you write your own recovery story.

Starting Recovery From a Dual Diagnosis

People with co-occurring disorders usually need specialized care. It’s also possible to have more than just 2 diagnoses. The more conditions you have, the more complex your treatment will need to be. And your treatment plan may change over time, especially if you undergo medical detox. This is because your emotional state will likely change after you stabilize your brain chemistry.

Remember that you’re a whole person, and so much more than your symptoms. Treatment for co-occurring disorders honors not only the complexity of your diagnoses, but the complexity of your needs for long-term recovery.

Talk Therapy

Almost any rehab experience includes 1:1 talk therapy. In these private sessions, you’ll build a close relationship with your provider. They’ll help you understand your emotions, work through triggers, and set goals for recovery. Over time, you can also process the feelings that come up during other types of therapy.

This treatment is often the cornerstone of residential treatment. Your therapist may even design your overarching plan of care.

Behavioral Therapies

Behavioral therapies can be used to treat co-occurring addiction and mental health disorders.2 Once in rehab, a team of specialists will evaluate you, and help you determine the best form of treatment. The list below is an example of some psychotherapies that are commonly used to treat people with a dual diagnosis. However, the experts at your rehab center will ultimately help you choose the most effective therapies for your unique needs.

  • Dialectical behavior therapy (DBT): Participants learn mindfulness strategies to help them regulate difficult emotions. You’ll also practice tolerating triggers, and building healthy relationships.
  • Contingency management (CM): Patients get rewards for healthy behaviors, like testing negative for drug use.
  • Cognitive behavioral therapy (CBT): This form of talk therapy helps you work through negative beliefs, thoughts, and behaviors.
  • Assertive community treatment (ACT): This program offers personalized mental health services to people in their own homes or communities.
  • Family therapy: Involving the entire family can be beneficial for recovery. Family members learn how to best support the person with an addiction. They also work through their own issues, learning how to build stronger relationships.

Medications That Can Treat Dual Diagnoses

In some cases, people with co-occurring disorders benefit from medication.5 For example, research suggests that the antipsychotic drug clozapine works best to treat patients with addiction and schizophrenia. In addition, lithium and quetiapine have been helpful for some patients with bipolar disorder and addiction. If you’re curious about medication, start by talking to your mental health team about what options are safe for you. Every person has unique brain chemistry. Just because the meds listed here can be helpful, it doesn’t mean they’re right for everyone.

Many other medications are effective for various co-occurring disorders. It’s just a matter of finding what works best for you. You may even continue taking them after you complete rehab. If you have a history of addiction, though, ongoing medications have some risk. To guard against relapse, you should stay in close contact with your prescriber whenever you’re taking meds.

Social Support from Your Network

Your community can make a huge difference throughout recovery. Your loved ones can inspire you, motivate you, and help you live a happy and fulfilling life–that’s also a sober one.

Relationships With Friends & Family

Social support is an important part of treatment for dual diagnoses.6 As Don Lavender, the program director at Camino Recovery says, “If you don’t have family involvement, you run the risk of clients returning to an environment where they don’t have support or understanding.” If you’re no longer in touch with your family of origin, most rehabs also offer support for chosen family members.

In addition to family therapy, social support can have a huge impact on your healing journey. You may be able to repair long-term relationships by practicing the interpersonal skills you learn in rehab. And if that’s not possible, you can always build a new support network.
Support Groups for Co-Occurring Disorders
Self-help groups can provide invaluable support for people with co-occurring disorders.. For example, Dual Diagnosis Anonymous (D.D.A.) is a 12-Step group specifically for people with multiple conditions, including addiction and mental health concerns. You can attend their frequent online meetings from anywhere in the world. Membership is free.

Recovery is not a cure, but rather, a new way of life. As you build healthy habits, it can be inspiring to surround yourself with people who share your experience. Groups like D.D.A. can help you transform into a new version of yourself—a version that’s happy, healthy, and drug-free.

Recover in a Sober Living Home

Sober living homes, or therapeutic communities (TCs), are a great fit for some people. You may be able to attend rehab in this type of environment, or join 1 for longer-term residential support. Sober living helps reinforce positive behaviors, like attending therapy and refraining from substance use2. The people you meet there can become mentors, friends, and even chosen family.

Research suggests that therapeutic communities are beneficial for people with a multiple conditions7. A meta analysis reviewed 4 different studies on TCs, and found that people with co-occurring disorders had better outcomes after living in these communities than from standard care alone.

Choosing the Right Rehab

Before starting treatment, look for a rehab center that specializes in your specific diagnoses. For example, a rehab facility that treats bipolar disorder may or may not be qualified to treat post-traumatic stress disorder (PTSD). The following questions can help you choose the best facility for your particular needs. Don’t be afraid to discuss them at length with the admissions team.

  • How do you evaluate clients for dual diagnoses?
  • If I complete detox at your facility, will I be reevaluated for co-occurring disorders before beginning inpatient treatment?
  • Which specific mental health concerns do you treat most often?
  • Which mental health diagnoses does your staff specialize in treating?
  • What experiences does your team have in treating my specific diagnoses?
  • What types of therapy do you offer for various co-occurring disorders?
  • Do you create individualized treatment plans for each client? If so, how involved is the client in co-designing their treatment plan?
  • For clients with dual diagnoses, how do you integrate different types of therapy to address each person’s unique needs?
  • Do you prescribe psychiatric medication for clients with dual diagnoses?
  • How do you manage medications for clients detoxing from substance misuse?
  • How do you help clients with co-occurring disorders plan for ongoing mental health care after residential rehab?

No matter how many diagnoses you have, healing is possible. Remember to be patient and kind to yourself during your recovery journey. This road may not be easy, but it’ll certainly be worth it.

Dual diagnoses are highly treatable. Visit our directory of co-occurring disorder rehabs to search by price, insurance, specializations, treatments offered, and more and connect with a treatment center today.

Reviewed by Rajnandini Rathod

 

  1. Myrick, H., Cluver, J., Swavely, S., & Peters, H. (2004). Diagnosis and treatment of co-occurring affective disorders and substance use disorders. The Psychiatric Clinics of North America, 27(4), 649–659. https://doi.org/10.1016/j.psc.2004.06.003 []
  2. Substance use and co-occurring mental disorders. (n.d.). National Institute of Mental Health (NIMH). Retrieved from https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health [] [] []
  3. Abuse, N. I. on D. (2020, August 20). Commonly used drugs charts. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/commonly-used-drugs-charts []
  4. Chance, K. (2020, September 9). Kara anne. Faces & Voices of Recovery. https://facesandvoicesofrecovery.org/story/kara/ []
  5. Murthy, P., Mahadevan, J., & Chand, P. K. (2019). Treatment of substance use disorders with co-occurring severe mental health disorders. Current Opinion in Psychiatry, 32(4), 293–299. https://doi.org/10.1097/YCO.0000000000000510 []
  6. Horsfall, J., Cleary, M., Hunt, G.E., & Walter, G. (2009). Psychosocial treatments for people with co-occurring severe mental illnesses and substance use disorders (dual diagnosis): a review of empirical evidence. Harv Red Psychiatry, 17(1), 24-34. https://sites.bu.edu/sswhrsaseminar/files/2013/09/Psychosocial-Treatments-for-People-with-Co-occurring-Severe-Mental-Illnesses-and-Substance-Use-Disorders-Dual-Diagnosis-A-Review-of-Empirical-Evidence.pdf []
  7. Abuse, N. I. on D. (–). How do therapeutic communities treat populations with special needs? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/therapeutic-communities/how-do-therapeutic-communities-treat-populations-special-needs []

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