Treatment for Co-Occurring Disorders [A Guide to Specialized Care]
Dual diagnosis treatment centers are a specific type of drug rehab facility which specialize in treating both substance abuse issues as well as other co-occurring disorders like depression, anxiety and PTSD. These co-occurring disorders can make treating substance abuse issues more complicated, which is why dual diagnosis treatment centers offer specialized and individualized treatment programs for their patients.
For many people who struggle with substance abuse, there are underlying issues which were either present before they began using drugs or sometimes developed because of drug use. Either way, these associated difficulties are typically closely related to the drug and alcohol abuse meaning they must be resolved in order for treatment to be effective. Unfortunately, treatment methods for things like anxiety, depression and PTSD can require considerably different treatments than substance abuse alone. This means that a standard drug rehab may not offer the appropriate level of care for someone with co-occurring disorders. For these people a dual-diagnosis program is the best option.
The Substance Abuse and Mental Health Services Administration estimates that around 8 million adults currently struggle with both substance abuse and mental health issues, meaning there is a growing need for dual-diagnosis treatment centers. Thankfully, these types of facilities are becoming more common and the substance abuse treatment industry has begun to realize the many benefits that they can offer for the outcome of their patients. These dual diagnosis programs are usually able to offer higher success rates and more fulfilling patient experiences because they focus on treating every single issue a person is struggling with and not just substance abuse.
Not every person is right for a dual diagnosis treatment center. Although they are becoming less common, there are individuals who don’t have any auxiliary medical, behavioral or mental conditions which require dual diagnosis treatment. For these people a traditional rehab program might be appropriate, however it is important to remember that some issues like depression and anxiety are hard to diagnose when someone is abusing drugs or alcohol and they may be present but difficult or impossible to identify until someone stops drinking or using drugs.
Deciding if you need treatment for co-occurring disorders
The sad reality of the situation regarding substance abuse is that most people who abuse drugs or alcohol have some sort of mental or behavioral health issues as well. These issues can either predate the substance abuse, or many times they can be a result of it. Regardless of how these co-occurring disorders originally present themselves, it is crucial that they are addressed during treatment. Unresolved issues like anxiety, depression and trauma can leave a patient at high risk for relapse. If you or your loved one is struggling with co-occurring disorders like anxiety, depression, trauma or other mental health issues then a dual diagnosis treatment center is almost always the right choice.
The three most common co-occurring disorders which present themselves in those who also struggle with substance abuse are:
- Anxiety – Feelings of nervousness, panic or fear are the most common symptoms of anxiety. Many people use drugs or alcohol as a way to self-medicate their anxiety, which is what got them to start abusing substances in the first place. This leads them down a path of progressive substance abuse, eventually spiraling out of control and creating a situation where even more anxiety can occur. Anxiety can also be common for those who abuse drugs or alcohol even if it was not an issue for them before they began using, this is why it is one of the most common co-occurring disorders.
- Depression – Depression is another very common co-occurring disorder for people who are struggling with substance abuse. While depression can come in many forms it often presents itself as a lack of motivation, feeling “empty”, loss of interest and difficulty sleeping. While many of these symptoms are also associated with substance abuse, it is important to understand that depression is a separate diagnosis that requires specified treatment which can often differ from substance abuse treatment.
- Trauma (PTSD) – Trauma is also a very common issue for those who abuse drugs and alcohol. PTSD is among the most common co-occurring disorders and can be quite debilitating to individuals both during their addiction and, if left untreated, can continue to cause serious issues which could potentially lead to relapse. Trauma can happen in many different ways, sometimes people have childhood trauma which causes them to self-medicate using drugs or alcohol. Other times, the dangerous lifestyle which can be associated with drug abuse may place people in situations where they can experience trauma after they have started using drugs as well. Regardless of the origin of the trauma, treating it in conjunction with substance abuse is crucial to long term sobriety.
While these three issues are the most common co-occurring disorders, they certainly are not the only ones. Other issues like bi-polar disorder, ADHD and borderline personality are other issues which often times present themselves together with substance abuse. The key here is that if you or your loved one are afflicted with one or more of these issues, then finding the appropriate dual diagnosis treatment center is crucial. Failing to treat co-occurring disorders during inpatient rehabilitation is one of the most common causes for relapse when someone completes a drug and alcohol treatment program.
What makes treating co-occurring disorders different?
Because dual diagnosis treatment centers are offering care for multiple issues, they are often more intensive and detailed than a standard drug rehab. While these treatment programs utilize the common practices for the treatment of substance abuse, such as group counseling, family therapy and support group meetings, they also spend a lot of time focusing on the mental and behavioral health aspect of a patient’s needs.
Unlike a standard treatment facility, a dual diagnosis treatment center usually has a psychiatrist on staff in order to adequately address a patients mental health needs. Upon intake the patient will meet with the medical staff first in order to assess their medical and potential detoxification needs. Once the patient is deemed medically stable, then they will meet with the psychiatrist who will do a full analysis on their mental and behavioral health. Once they have been able to assess this, the psychologist will recommend a treatment plan for the patient to address their co-occurring disorders. While this treatment will differ from patient to patient depending on their individual situation, some of the potential treatment options include medication, individual therapy sessions and other forms of therapy like EMDR or behavioral therapy.
Dual diagnosis treatment centers also typically have a higher staff to patient ratio, meaning there are fewer patients and more staff. This is beneficial as the patients are able to receive more individual attention and care, allowing them to recover from their multiple issues. While many standard treatment centers can have more than 10 or 15 patients for every staff member, dual diagnosis programs typically have 5 or fewer patients for every staff. This can make a considerable difference in both the patient’s experience in treatment, but also their overall chances of success.
The final thing that makes dual diagnosis treatment centers considerably different from standard treatment centers is the average length of stay for a patient. Most standard programs follow the 28 day model, meaning the patient has only 4 weeks to recover from a drug or alcohol addiction which may have lasted many years. While 28 days can be adequate for some, it is not an appropriate length for those who are struggling with co-occurring disorders. This is because treating issues like anxiety, depression or PTSD can take considerably more time, especially when they are combined with a substance abuse issue.
Most dual diagnosis treatment centers have programs which are at least 90 days long, meaning they offer more than 3 times the length of stay for a patient with co-occurring disorders. This extra time allows for the psychiatrists, doctors and therapists to provide extensive and effective treatment for the patient. Because of this added length of time, dual diagnosis treatment centers often have considerably higher success rates for patients that complete their programs and lead to longer and more firmly established sobriety.
The benefits of treatment for co-occurring disorders
Whether the initial issue of a person’s struggles is substance abuse or a co-occurring mental illness, the most important factor to recovery is making sure that all of a patient’s issues are treated simultaneously. This is important because co-occurring disorders like depression and anxiety have a relationship with substance abuse that causes both of them to magnify each other, causing a progressively worsening downward spiral which can become desperate very quickly.
One error that many people make is thinking that they can just get treatment for one of their issues and that will automatically cure them of their other issues. In circumstances like these, sometimes people choose to seek treatment for their depression or anxiety but do not get help with their substance abuse thinking that they will be able to stop using drugs or drinking once they are no longer depressed or anxious. Other times, people will go to a traditional substance abuse treatment program to address their drug or alcohol abuse but they leave out the treatment for their other co-occurring disorders. In both of these situations the untreated issues can unfortunately lead to relapse.
This problem occurs because while substance abuse and issues like depression and anxiety are certainly interrelated, they are not the same thing. All of these co-occurring disorders are separate diagnoses which are made by a doctor and which require separate and individualized treatment methods. While treating one can be helpful, the untreated issue can linger and eventually pull a patient back into the way of life that they have worked so hard to escape from.
The good news is that dual diagnosis treatment centers have shown amazing results at treating both substance abuse and co-occurring disorders. Patients who complete these types of programs typically show higher success rates, with more firmly established foundations for recovery. This leads to fewer relapses which is the ultimate goal of substance abuse treatment. However quitting drugs or drinking is not the only benefit to dual diagnosis treatment, fixing other mental and behavioral issues like depression, anxiety and trauma can have their own massive impacts on the quality of someone’s life as well, especially when it’s also combined with sobriety. This is why patients who complete dual diagnosis programs often times report better moods, closer relationships with family and friends and more productive careers. This is in part due to their no longer drinking or using drugs, but it is also because these patients are no longer hampered by the effects of their co-occurring disorders and are able to live happy and fully productive lives.