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Originally Posted On: https://www.marylandrecovery.com/blog/dual-diagnosis-comprehensive-treatments

Dual Diagnosis: Mental Health and Addiction

Nearly 40% of Americans who struggle with substance use disorders also have a mental health disorder. Unfortunately, treating only substance use and the physical effects it causes does not truly address the many facets that link SUD and associated mental health disorders. That’s why acknowledging dual diagnoses and developing treatment to address both the addiction and underlying mental health issues is so crucial to recovery.

A treatment program devised to address both aspects of a dual diagnosis can treat SUD and mental health disorders concurrently. Maryland Recovery’s compassionate team of professionals offers treatment to individuals who are struggling with a dual diagnosis.

What Is Dual Diagnosis?

If you have a substance use disorder and a mental health disorder at the same time, you have what is known as a dual diagnosis. A dual diagnosis is given due to what medical professionals call comorbidity, the condition of having two disorders at the same time. While a dual diagnosis may be alarming at first, substance use disorders and health disorders commonly occur together.

For example, some people who have an existing mental health disorder later develop a substance use disorder as they attempt to numb, eliminate, or ignore mental health symptoms. Other people who have long-standing substance use disorders later develop depression, anxiety, and other mental health problems due to the chemical changes caused by substance use and the various stressors that come along with SUD.

Regardless of origin, it is crucial to address both disorders during SUD treatment. Such treatment is frequently referred to as “dual diagnosis treatment” or a “dual diagnosis program.”

What May Cause a Co-occurring Disorder?

The same risk factors can contribute to substance use disorders and co-occurring mental health disorders. The three most common, which may result in a dual diagnosis, include stress, genetics, and trauma.

Stress

Chronic stress can lead to mental health disorders by overwhelming the body’s ability to cope with daily stressors. This can cause prolonged anxiety or depression. Over time, stress can alter brain chemistry, disrupting the neurotransmitter balance that is essential for mood regulation and worsening anxiety and other mental health symptoms. Stress can also impair cognitive functions like memory and decision-making and often leads to unhealthy coping mechanisms such as substance use or social withdrawal. Stress can also compromise the immune system, which can further deteriorate mental health because physical and mental health are often intertwined.

Genetics

Research has enabled us to develop a better understanding of how environments and life situations can turn certain genes on and off, though more work needs to be done before genetic tests can better predict mental disorder risks. Researchers are still learning how genes contribute to or protect against these conditions. For example, genes that have been linked to mental health disorders only slightly raise the risk that the person will develop enough characteristics to receive a diagnosis, meaning genetics plays a role but not a decisive role in causing mental health problems.

It’s important to recognize that science is still not able to develop a genetic test for diagnosis or treatment. That’s why family mental health history remains a significant source of information. The key is to understand that having a relative with a mental disorder increases the risk of developing bipolar disorder, depression, and other mental health problems. Knowing your family history can help healthcare providers identify early signs and suggest ways to reduce other risks.

Trauma

Trauma often results in heightened stress levels, leading to anxiety, depression, and other mental health issues; at the same time, some individuals develop an affinity for substance use to mitigate lingering trauma or the mental health symptoms that accompany it. One of the best-understood examples of this is military veterans who experience or witness acts of violence and destruction. These individuals frequently develop post-traumatic stress disorder (PTSD) which can cause symptoms like intrusive thoughts, disruptive nightmares, and a heightened state of arousal – all of which may lead the individual to seek a way to self-medicate with a substance. Similarly, trauma that occurs early in childhood can lead to a wide range of mental health problems later in life by disrupting normal brain development and stress response systems.

Why Is Understanding a Dual Diagnosis Important?

Traditional drug and alcohol addiction treatment programs that focus on achieving sobriety from substance use without addressing mental health issues often experience high relapse rates and low long-term success rates. Dual diagnosis facilities and treatment programs consider the treatment of mental health disorders to be just as important as eliminating substance use. Treating both concurrently can help ensure individuals enter recovery with mental health symptoms in check, as well as with tools to achieve long-term recovery.

Treating mental health problems on their own can be futile without also treating the behaviors and physical effects behind substance use disorder. Similarly, helping someone end their patterns of substance

use would be difficult if not impossible without simultaneously treating existing mental health conditions. Thus, an understanding of the two and how they are linked is crucial.

Mental health disorders can lead to substance use and eventually substance use disorders as individuals self-medicate to temporarily alleviate their symptoms. The brain changes caused by prolonged substance use can increase SUD risk and worsen mental health symptoms. At the same time, substance use and SUD can alter the brain and cause their own mental health symptoms.

By fully understanding the relationship between substance use disorders and mental health disorders and how to treat them in tandem, the team at Maryland Recovery can help many individuals from a variety of circumstances.

Examples may include:

• Someone using alcohol to numb the symptoms of anxiety
• Someone with alcohol use disorder suffering from depression
• Someone misusing Xanax and failing to address bipolar disorder
• Someone misusing prescription pain medication who has not addressed personality disorders

• Someone with ADHD who began misusing Adderall and other drugs
• A military veteran who uses painkillers to numb the symptoms of PTSD
• Someone with alcohol use disorder who has never addressed childhood trauma they experienced

The combinations of co-occurring disorders and individual circumstances are limitless, but each scenario involves multiple mental health issues. When substance abuse intertwines with these problems, dual diagnosis treatment is necessary to address all issues simultaneously.

Treatment Options for People Who Undergo a Dual Diagnosis

Maryland Recovery offers individuals the chance to recover on their own terms via a variety of affordable extended-care treatment options. We use research-backed treatment methods for clients with substance use and co-occurring mental health conditions.

At Maryland Recovery, our outpatient program includes: 

• Partial Hospitalization Program – PHP is a structured program where our clients receive intensive treatment for substance use disorders during the day but return to a sober living environment in the evenings. PHP provides comprehensive therapy and support without requiring overnight stays.
• Intensive Outpatient Program – IOP is a step-down level of care that offers structured treatment during the day. Intensive outpatient programs allow individuals to live at home or in a supportive environment.
• Outpatient Services – Outpatient services allow patients to remain in familiar, supportive environments between services so they can benefit from the company of friends and family. Our outpatient services include individual and group counseling, relapse prevention, life skills coaching, and medication management.
• Sober Living Services – A sober living home is a shared residence for individuals recovering from SUD that is governed by specific rules prohibiting drug or alcohol use. Living in a sober home is crucial for both treatment and recovery, offering a safe environment that fosters long-term sobriety.

Medication-Assisted Treatment and Other Services

Our focus on dual diagnosis treatment allows our staff to customize and adjust services based on the presence of certain mental health conditions. Patient-centered programming that considers dual diagnoses informs how strategies like medication-assisted treatment (MAT) using  FDA-approved medications like Vivitrol and Suboxone are completed.

These medications are an especially effective approach when treating opioid and alcohol use disorders. When combined with counseling and behavioral therapies, MAT can help ensure individuals reduce the severity of withdrawals and cravings and minimize the risk of a recurrence.

Vivitrol (an injectable form of naltrexone) blocks opioid receptors to reduce cravings. Suboxone (which contains buprenorphine and naloxone) eases withdrawal symptoms and cravings. Vivitrol and Suboxone are vital tools in supporting individuals on their journey to sustained sobriety, and treatments can be customized based on the results of a client’s dual diagnosis.

Other treatment services we offer include:

• Relapse prevention
• Life skills coaching
• Medication management
• Counseling
• Psychiatric services

• Meditation
• Frequent outings
• Animal therapy
• Supervised workout rooms

Dual Diagnosis FAQs

Many potential combinations of co-occurring disorders are possible for people who experience mental health disorders, and substance use only exacerbates these issues. The mental health professionals at Maryland Recovery can answer your questions about dual-diagnosis treatments.

Are Comorbidity and Dual Diagnosis the Same Thing?

The terms co-morbidity and dual diagnosis are often used interchangeably in modern addiction treatment. Either term refers to two or more disorders that occur consecutively. However, comorbidity refers to the state of having two or more simultaneous physical or mental health conditions, while having a dual diagnosis is more specific in that it states that one or more mental health disorders and substance use disorders have been diagnosed by a professional. While either can be used when referring to mental health disorders and SUD, dual diagnosis treatment is more commonly used in modern circles because it is more specific.

What Will SUD Recovery Look Like for Me?

Recovery looks different for different people, and the timelines can vary considerably. The first step often involves detoxification to remove the addictive substance from the body. This can be achieved more comfortably and more safely with medication-assisted treatment. Therapy and counseling can address the underlying causes of addictive behaviors. Ongoing support, lifestyle changes, and healthy habits are also part of the recovery process, designed to ensure lasting recovery.

Does Having a Mental Health Disorder Mean I’m More Likely to Develop SUD?

Having a mental health disorder like bipolar disorder or depression does not mean that you will have a substance abuse disorder. Many people with mental health problems never develop addictions to drugs and alcohol. However, many do and the two are often closely linked. As mentioned earlier, 40% of Americans with a substance use disorder have a mental health disorder as well.

Since there is often a correlation between the two, it is critical to assess an individual’s mental health as they enter SUD treatment. This is essential to understand the interaction between mental health and substance use disorders and use that information to guide treatment decisions.

Is It Possible to Have Multiple Mental Health Disorders?

It is entirely possible to have multiple mental health disorders. In fact, it is quite common. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) states that it is very likely for a person to have multiple mental health issues simultaneously, and some may have as many as six or more. For example, someone with anxiety might have several subforms, such as generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder. When beginning treatment for SUD, it is crucial to address all existing diagnoses.

Take the First Step Toward Recovery with Dual Diagnosis Treatment at Maryland Recovery

The dual diagnosis programs at Maryland Recovery focus on comprehensive treatment for SUD and any co-occurring disorders. Depending on your mental health and substance use disorder treatment needs, we can offer customized clinical and therapeutic treatments to address every aspect of your recovery. With multiple levels of outpatient treatment, you can experience the best SUD treatment has to offer without the inconveniences of residential care.

Our dual diagnosis recovery services have helped many people find recovery from SUD while managing their mental health. Long-term recovery for you or your loved one is possible with attention to all aspects of individual health. Contact our compassionate team to request more information today.

*Editor’s Note: This article was originally published Nov 10, 2014 and has been rewritten July 22, 2024.

Sources:

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596
2. National Institute of Mental Health. (n.d.). Looking at my genes. https://www.nimh.nih.gov/health/publications/looking-at-my-genes#:~:text=How%20do%20genes%20affect%20your,the%20onset%20of%20some%20diseases.
3. National Institute on Drug Abuse. (n.d.). Comorbidity: Substance use and other mental disorders [Infographic]. https://nida.nih.gov/research-topics/comorbidity/comorbidity-substance-use-other-mental-disorders-infographic#:~:text=Of%20the%2020.3%20million%20adults,also%20had%20substance%20use%20disorders.