Dual Diagnosis Treatment Center | Mental Health and Addiction

DUAL DIAGNOSIS

What Is Dual Diagnosis (aka Co-Occurring Disorders)?

In the rehab context, co-occurring disorders – also referred to as dual diagnosis – are when a person suffers from both substance addiction and a mental disorder.

Those who are afflicted by a mental health disorder often turn to substances like drugs and alcohol to either cope with their pain or because the substance temporarily alleviates the symptoms of the mental illness. In fact, research suggests that more than half of those struggling with addiction also have a co-occurring mental disorder.

Understanding whether someone’s addiction is due to a mental illness or some other cause is critical, because it greatly affects the type of treatment a person needs.

At Reflections Recovery Center, our admissions screening and intake processes help us understand the unique needs of every person so that we can make sure they get the appropriate treatment, and our staff is highly qualified to serve dual diagnosis clients.

Is It Just Addiction or a Mental Illness?

It can be difficult to determine if a mental disorder is behind a substance abuse problem, because symptoms of addiction can be confused with symptoms of mental illness, and vice versa.

People who know they have a mental disorder may not recognize that substance use has gotten out of hand – because they’re focused on the mental illness. They may feel better when they are using, especially if it involves prescription drugs, such as a benzodiazepine that treats anxiety.

On the other hand, people who don’t know they have a mental disorder because they’ve never been formally diagnosed may think that their substance abuse issues are due to personal failings when, in fact, there is more going on under the surface.

Those with mental health disorders who self-medicate with drugs or alcohol may find temporary relief from their symptoms, but this prevents the person from getting professional help, and over time can make the mental illness even worse.

What Are the Most Common Co-Occurring Disorders?

Substance abuse can occur in conjunction with any type of mental disorder. However, some of the most common mental health issues that we see paired with addiction are:

Depression
Personality disorders
Anxiety disorders
Bipolar disorder (a form of depression)
Other mood disorders
Trauma (including PTSD)
ADHD (attention deficit and hyperactivity disorder)
OCD (obsessive-compulsive disorder)
Schizophrenia

How a Dual Diagnosis Affects Addiction Treatment

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All substance abuse has an underlying cause. In some cases, that cause is a mental health disorder such as depression, anxiety, a personality disorder or any number of other mental illnesses.

Effective addiction treatment always seeks to not only rid the person of the physical addiction, but also to address whichever emotional and psychological factors led the person to substance abuse in the first place. But when a mental disorder is present, things get more complicated.

Mental illnesses not just “in your head” like other psychological causes of substance abuse. Mental disorders have a physical component that affects the brain’s normal functioning, which then impacts the person’s thoughts and feelings.

As a result, dual diagnosis treatment centers must address the physical aspects of the mental illness as well as the physical addiction and its emotional and behavioral components.

For a person without a co-occurring disorder, addiction treatment typically proceeds in this linear order:

Detox program to rid the body of the harmful substance
Therapy/counseling to discover and address the psychological factors and possibly trauma that led the person to substance abuse
Life skills education to build better habits for long-term wellness, while constructing a social support group

However, for those with a co-occurring mental disorder, both the addiction and the mental illness must be treated at the same time. This requires specialized expertise that not all treatment centers can provide.

Mental Health and Addiction Treatment FAQs

Learn more about the best practices for treating co-occurring disorders by reading our answers to a few frequently asked questions. Click on any question to see our response:

What Are the Signs Someone Is Suffering from Mental Illness Alongside Addiction?

When someone has a full-blown addiction, it can be tough to distinguish whether any signs of mental illness are all symptoms of the addiction or it’s a legitimate mental disorder in its own right.

At Reflections, when we do an initial evaluation on a new client, we observe and ask about mental illness signs such as:

Racing thoughts and trouble concentrating
Frequent irritability
Lack of energy
Disinterest in hobbies and everyday tasks
Risky behavior
Suicidal thoughts
Sleeping too much or too little
Major changes in appetite or weight
Frequent feelings of hopelessness, worthlessness, fear or panic

Next, we will try to determine if the client meets the criteria for a psychiatric disorder. This involves digging into his substance use history and determining if the mental health symptoms existed prior to the addiction – and if they got worse as the substance use increased.

If our team does diagnose a client with a mental health disorder in addition to his addiction, that will impact how we build out his unique treatment plan – from detox and inpatient to aftercare. This typically entails more frequent and more intensive therapy sessions, education about mental health issues, and specific techniques that address the mental health symptoms.

How Do Mental Illness and Addiction Impact the Brain?

When a mental health disorder begins to develop, it starts altering the way the brain functions – with some permanent and some reversible effects. The same goes with addiction as it begins to form.

Psychiatric experts now regard addiction as a brain disease, just like other forms of mental illness. Addiction and mental illness affect similar parts of the brain, and having one or both can lead to:

Altered dopamine activity (either heightened or lowered levels)
Impacted serotonin levels (higher or lower)
Changes in reward pathways (thus “rewiring” the brain)

Higher levels of dopamine (known as a “feel-good chemical”) create feelings of euphoria, pleasure and concentration. If the brain is used to inflated dopamine levels due to drug use, it will struggle mightily to adjust when the drugs are removed from the equation. On the other side of the coin, someone who has continuously low levels of dopamine will be at risk of depression.

Serotonin is another “feel-good chemical,” as it’s a neurotransmitter that helps regulate mood, appetite, memory and more. Someone with chronically low levels of serotonin will likely struggle with depression, as well.

Why do traits of bipolar personality disorder commonly overlap with addiction?

To the untrained eye, individuals who are suffering from an addiction may also concurrently be exhibiting symptoms of untreated bipolar personality disorder (BPD). For example, having either of these conditions may manifest itself in the following ways:

A concerning lack of care or interest in one’s personal well-being
Depressive or erratic moods
Narcissistic or manipulative behavior
Inability to hold a job or relationship
Poor money management

Those who may be seeking treatment may find difficulty finding proper care. Seeking the services of a dual diagnosis treatment center would benefit because they would have facilities that are well-equipped to combat both the addiction and the mental illness concurrently.

For more related reading, please check out “Borderline Personality Disorder in Men: A Common Co-Occurring Disorder.”

Which Treatment Techniques Help Most with Mental Health Issues?

At dual diagnosis treatment centers, therapists will have treatment techniques in their arsenal that will help with mental health symptoms specifically. These techniques all fall under behavioral therapy, and the types that therapists will use include:

Cognitive behavioral therapy (CBT)
Dialectic behavior therapy (DBT)
Integrated group therapy (as opposed to group therapy only focused on addiction issues)
Individual psychotherapy – customized to address the mental health issues

Reflections’ licensed therapists use all of the above techniques and more, and we believe in taking a trauma-informed approach to overall treatment. Learn more about CBT, DBT and trauma-informed care by clicking below.

See Our Clinical Therapy Methods

Can Mental Illness Be Treated Without Medication?

Although patients and doctors alike are usually quick to start a medication when a psychiatric disorder is diagnosed, that doesn’t always have to be the first option. Yes, there are some severe cases of mental illness in which there’s little getting around taking a prescription drug. But in several other cases, patients can improve their mental health by making significant lifestyle changes – such as more sleep, more exercise and eating better.

To see additional ideas on how to improve your mental health without drugs, see the list in our answer to the following frequently asked question.

What Happens After Dual Diagnosis Treatment Concludes?

After graduating rehab, and individual can use a number of techniques and lifestyle changes in order to manage mental health symptoms and substance cravings. Helpful measures include:

Exercise
Meditation
Yoga
Ongoing therapy
Proper nutrition
Spending more time with family
Reading
Trying new hobbies or revisiting old ones

Many recovery programs will stress the importance of each of these activities to their clients, and they will help clients take a genuine passion in overall wellness, either with education or hands-on experience with disciplines such as the ones listed above.

Besides the aforementioned tricks and techniques you can try at home, your recovery will benefit if the treatment center you chose offers a strong aftercare program, like the one available at Reflections. Read our answer to the next question to learn about what to look for in an aftercare program.

What Should an Aftercare Program for Mental Health and Addiction Include?

Aftercare programs sustain the progress that individuals made within a treatment program. A unique, robust aftercare plan is especially critical for those who are still overcoming addiction and mental health issues.

The best aftercare programs will include services such as:

Ongoing individual therapy sessions
Weekly group therapy or support group meetings
Transition to a sober living facility
Periodic drug testing

Reflections Recovery Center offers all of these options and more for individuals within the aftercare program. Aftercare completes the long-term continuum of care that our dual diagnosis treatment center offers.

Explore Our Aftercare Program

How Our Dual Diagnosis Treatment Center Addresses Both Conditions

Clients suffering from mental illness as well as addiction require an integrated treatment program – one that treats both the mental disorder and the drug or alcohol addiction at the same time.

Because the two issues are so closely interrelated, they can’t be addressed separately in an effective way. Relapse is common when treatment only addresses the addiction and not the mental disorder.

However, it is more challenging to treat co-occurring disorders than addiction alone, and this requires a psychiatrist who is experienced in differentiating the symptoms caused by mental illness vs. symptoms caused by addiction.

At Reflections Recovery Center, we employ a highly qualified team of psychologists and medical professionals who are able to meet the special requirements of our dual diagnosis patients. Because each client is unique, we tailor our treatment plans to each person so that we can give them the best possible chance of long-term recovery and wellness, no matter their mental health challenges.

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