Imagine the difficulty of living with not only a substance use disorder, but suffering with a mental health disorder at the same time. Co-occurring disorders, the presence of both a substance use disorder and a mental health issue, are affecting a growing number of people. In fact, according to the National Alliance on Mental Illness, approximately 8 million adults have such co-occurring disorders. Certain co-occurring disorders are more common than others, such as substance use disorder with depression or bipolar disorder with substance use disorder.

It is often unknown which disorder emerged first, the mental health disorder or the substance use disorder. For example, an individual suffering from social anxiety may begin using marijuana for relief, eventually developing a substance use disorder. Conversely, the marijuana use may become severe enough to cause symptoms of paranoia that then lead to social anxiety.

Symptoms of a dual diagnosis disorder are diverse, depending on which disorders are present. However, there are some general signs and symptoms that an individual is struggling with a dual diagnosis, including:

  • Erratic, impulsive, high-risk behaviors
  • Cognitive impairments
  • Declining performance at work or school
  • Neglecting personal hygiene
  • Inability to maintain healthy relationships
  • Sudden personality changes
  • Mood swings
  • Mismanagement of personal finances
  • Difficulty managing responsibilities and daily obligations
  • Avoidance of social events, isolating behaviors
  • Thoughts of suicide and death
  • Mounting legal problems
  • Non-compliant with mental health treatment
  • Exhibits signs of withdrawal symptoms

Co-occurring disorders tend to cause the symptoms of each to become enhanced. For example, someone struggling with PTSD will experience its symptoms, one of which is substance use. If he or she develops a substance use disorder, the PTSD symptoms will be intensified due to the SUD, and the symptoms of PTSD may cause the symptoms of an SUD to worsen.

After a careful review of the presenting symptoms, mental health history, medical history, and guidance of the DSM-5, a clinical staff is able to make the proper diagnosis. This results in an individualized treatment plan that is tailored for the specific co-occurring disorders.

Integrated Treatment for Co-Occurring Disorders

Treatment for co-occurring disorders requires a specific expertise that involves psychiatric support as well as the input of addiction professionals and clinical psychologists that treat substance use disorders. A dual diagnosis treatment program is equipped to provide the appropriate care and support for individuals with co-occurring disorders. Treating a dual diagnosis is complicated, requiring an integrated approach that will address both the substance use disorder and the co-occurring mental health disorder simultaneously.

Treatment elements for co-occurring disorders include:

  • Detox support. Before treatment for the dual diagnosis can proceed the individual must first complete the detox and withdrawal process.
  • Psychotherapy. Evidence-based psychotherapies are an essential core treatment element for co-occurring disorders. During therapy the individual examines life events that may be contributing to both disorders, and begin the process of healing. Cognitive behavioral therapy helps individuals to identify thought distortions that have perpetuated substance use and emotional instability.
  • Group therapy. Group support is an essential aspect of rehabilitation as these sessions offer an opportunity to bond with others in recovery and a safe place to share personal experiences.
  • Medication. Medication Supported Recovery helps the individual stabilize and reduce relapse risk. Psychotropic medications may be prescribed for managing the symptoms of the mental health disorder.
  • Recovery meetings. 12-step or SMART Recovery meetings are a source of social support and inspiration. 
  • Psychosocial skills. Treatment for a dual diagnosis entails providing the individual with essential recovery skills, such as better communication skills, emotion regulation techniques, and conflict resolution strategies. 
  • Complementary activities. A holistic approach to dual diagnosis treatment includes experiential activities such as mindfulness meditation, art and music therapy, therapeutic massage, acupuncture, and yoga.

Ongoing Aftercare for a Dual Diagnosis

The dual diagnosis treatment program will have provided a foundation for the individual’s successful recovery, but treatment doesn’t end there. Recovering from a dual diagnosis is a fluid and ongoing process that necessitates recovery support moving forward. There are several steps that can help safeguard newfound sobriety and prolong an improved mental state after the program is completed.  

Some individuals find that residing in a sober living environment for a few months following treatment can help them transition back to their regular life with a more solid grasp on their recovery. Sober living allows time to adjust to a sober lifestyle while establishing new healthy habits. Also, ongoing participation at 12-step meetings can offer an additional layer of peer support following treatment. Likewise, weekly outpatient therapy sessions can provide psychological support in early recovery. Therapy helps to fine-tune coping skills, teaches relaxation techniques, and acts as a sounding board while processing difficulties or challenges encountered.

While co-occurring disorders somewhat complicate the treatment picture, it is possible, with ongoing support both during treatment and post-treatment, to overcome a dual diagnosis and enjoy a full and satisfying life. 

Ashley Addiction Treatment, formerly Father Martin’s Ashley, is a nationally recognized nonprofit leader in integrated, evidence-based treatment for substance use disorders and is accredited by The Joint Commission. We offer both inpatient and outpatient programs, holistic addiction treatment, drug detox, relapse prevention plans, family wellness programs and a variety of other services tailored to each patient’s needs. Our driving principle — “everything for recovery” — reinforces our mission to heal each individual with respect and dignity, and reflects on our ongoing commitment to meet new challenges. For information about our comprehensive programs, please call (866) 313-6307.