How Does Addiction Treatment Address Co-Occurring Mental Health Disorders?

A co-occurring disorder, also known as a dual diagnosis, is when an individual concurrently experiences addiction and a mental health condition, such as anxiety or depression. According to the National Institute on Drug Abuse (NIDA), co-occurring disorders are relatively common.(1) In fact, data from the 2022 National Survey on Drug Use and Health reveals that 21.5 million adults in the U.S. have a co-occurring disorder.(2)

While these figures may seem troubling, help and hope are available via integrated treatment that addresses both disorders at the same time. In fact, NIDA reveals that this dual-pronged treatment approach is consistently superior to treating each disorder separately.(1)

Facilities such as Immersion Recovery Center provide a comprehensive approach to sobriety and mental health. Offering various evidence-based addiction treatment programs in Delray Beach, FL—including everything from medical detox and inpatient care to individual therapy, group and family counseling, and medication-assisted treatment—Immersion Recovery Center provides effective co-occurring disorder treatment for Floridians and nonresidents alike.

Common Co-Occurring Mental Health Disorders

Substance use can exist alongside several different mental health conditions, which can range from mild to severe and have various causes. Treatment programs endeavor to identify these disorders and unravel the way in which they are intertwined.

Common Co-Occurring Disorders Include:

  • Depressive disorders, such as major depressive disorder (MDD) and seasonal affective disorder (SAD)
  • Anxiety disorders, such as generalized anxiety (GAD) and panic disorder
  • Attention deficit and attention deficit hyperactivity disorder (ADD/ADHD)
  • Bipolar disorder (BD)
  • Borderline personality disorder (BPD)
  • Post-traumatic stress disorder (PTSD)
  • Schizophrenia and schizoaffective disorder

While these conditions are among the most commonly associated with co-occurring disorders (aka dual diagnoses), other mental health disorders can arise and often occur in combination with substance use.

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Integrated Treatment Approach

Often employed to treat co-occurring disorders, an integrated treatment approach involves developing a comprehensive and coordinated strategy to simultaneously address multiple interrelated conditions. It is characterized by a collaboration between specialists of different fields (e.g., addiction experts and medical professionals) to provide seamless, organized treatment under a unified, personalized plan.

Importance of Treating Both Addiction & Mental Health Disorders

A number of benefits are associated with treating mental health conditions and substance use concurrently. Most experts and professional organizations (e.g., the Substance Abuse and Mental Health Services Administration) agree that concurrent treatment is the most effective approach to providing care and support for those who experience co-occurring disorders.(3)

Holistic & Person-Centered Approach

Holistic approaches address individuals with complex needs from a whole-person perspective instead of their independent diagnoses. They also recognize that mental health conditions and addiction are often interconnected and compound upon each other in a unique way. A person-centered approach acknowledges that an individual’s mental, emotional, social, physical, and spiritual aspects all contribute to and are affected by these conditions.

Key Areas of Holistic Treatment Include:

  • Individual, group, and family therapies, such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), help to identify mental health issues, develop coping skills, and manage triggers.
  • Trauma-informed care, such as eye movement desensitization and reprocessing  (EMDR),  address traumatic experiences and their adverse effects on one’s life.
  • Stress management, such as mindfulness meditation and breathing exercises, help to regulate emotions and reduce stress.
  • Nutrition and exercise education and support promote mental and physical well-being.
  • Sleep hygiene improvements aid well-being.
  • 12-step programs or other forms of group support can provide a sense of community and accountability.
  • Spiritual and faith-based practices promote recovery and connection to a higher power.
  • Complementary activities also offer support via yoga, art and music therapy, recreational activities, and massage.

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Comprehensive Screening & Assessment of Mental Health & Substance Use

Screening and assessment tools are used by addiction professionals to gather detailed information about an individual, identify diagnoses, and develop a personalized treatment plan. These tools commonly include interviews, questionnaires, tests, and observations.

Common Areas Addressed in an Assessment Include:

  • Background information, such as medical history, family history, social and cultural background, and significant life events
  • Present circumstances, including living situations, support systems, and educational or occupational status
  • Cognitive functioning, usually including a mental status evaluation (MSE) that may address multiple cognitive functions, such as attention, executive functioning, memory, and thought processes and content 
  • Psychological issues (e.g., depression, anxiety), personality evaluations, and identification of behavioral patterns and potential diagnoses
  • Behavioral issues, including self-reported daily functioning and routines and an investigation of maladaptive behavioral or coping mechanisms

Addressing Dual Diagnosis With Psychotropic Medications

Psychotropic medications can help with treating mental health conditions, managing substance use-related withdrawal symptoms, and reducing cravings. It’s crucial to note that these medications are almost always most effective when combined with traditional therapies and other forms of support. 

Examples of Medications Used for Dual Diagnoses Include:

  • Depression and Substance Use — Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) can improve mood and reduce stress, thereby aiding in the recovery process.(4)
  • Anxiety and Substance Use — Benzodiazepines are anti-anxiety medications sometimes used on a limited basis to manage severe withdrawal symptoms. However, they’re not generally recommended for long-term use due to their addictive potential. Moreover, medications such as antidepressants are often preferred. 
  • Opioid Use Disorder (OUD) Medication-assisted treatment for OUD includes buprenorphine, naltrexone, and methadone. SAMHSA indicates that these medications not only help to normalize brain chemistry but also block the euphoric effects of alcohol and opioids, relieve psychological cravings, and normalize body functions.(5)
  • Alcohol Use Disorder (AUD) — Naltrexone, acamprosate, and disulfiram are often used to reduce cravings and the urge to consume alcohol.(5)

Sometimes multiple medications are prescribed to treat co-occurring disorders, including antidepressants and those that treat addictions to opioids or alcohol.

Evidence-Based Therapies for Dual Diagnosis

Although substance use and mental health issues can be treated independently, the most effective way to treat these disorders is to address them via an integrated approach employing various forms of therapies.

Cognitive Behavioral Therapy (CBT)

CBT is a goal-oriented form of individual therapy used to address a wide range of mental health disorders. It focuses on present issues and endeavors to teach effective skills to alter harmful thoughts and behavior patterns. The overarching goal of CBT is to help those with substance use and mental health issues adopt healthier and more functional coping mechanisms so they can better deal with life’s stressors and challenges.

Dialectical Behavior Therapy (DBT)

DBT is a form of CBT tailored to help individuals with intense emotional experiences who may have difficulty managing emotions and behaviors, such as self-destructive tendencies, impulsivity, and substance use. Originally designed to address borderline personality disorder, DBT is now used to help with a variety of mental health conditions, such as depression, anxiety, PTSD, and others.

Trauma-Informed Therapies & Eye Movement Desensitization & Reprocessing (EMDR)

Trauma-informed therapies consist of therapeutic approaches intended to address the challenges of those who’ve experienced trauma. They recognize the impact of the profound emotional and behavioral effects that trauma can inflict on one’s life and how the individual uniquely experiences the world. They also focus on increasing resilience while helping individuals understand and process their traumatic experiences. EMDR, a common and effective form of trauma-informed therapy, employs eye movements to help individuals process traumatic experiences.

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Anyone who experiences a mental health disorder or a substance use disorder understands the  dramatic impact either one can have on all aspects of their health, well-being, and relationships. However, those who struggle with both conditions concurrently often face even more severe and complex issues, making it difficult for them to understand the many factors that have contributed to the challenges they encounter every day.

Despite the added challenges of co-occurring disorders, Immersion Recovery Center can help by providing each individual with the care, support, and tools they need to promote long-term sobriety and mental health. Our licensed professionals understand the complexity of co-occurring conditions and how to address them simultaneously to prevent a relapse related to one or both disorders. 

Reach out today for a free, no-obligation health insurance benefits check and to learn more about our straightforward admissions process and full spectrum of care.

  1. National Institute on Drug Abuse. Common Comorbidities with Substance use Disorders Research Report. Part 1: The Connection Between Substance Use Disorders and Mental Illness. Available at: https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness.
  2. Substance Abuse and Mental Health Services Administration. 2022 National Survey on Drug Use and Health (NSDUH). Table 6.10A. Available from: https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/co-occurring-disorders.
  3. Substance Abuse and Mental Health Services Administration. Co-Occurring Disorders. Available from: https://www.samhsa.gov/co-occurring-disorders.
  4. Mayo Clinic. Selective Serotonin Reuptake Inhibitors. Available from: https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825
  5. Substance Abuse and Mental Health Services Administration. Medications for Substance Use Disorders. Available from: https://www.samhsa.gov/medications-substance-use-disorders.

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Susan-Shirley

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Serving as the Inpatient Clinical Director at Immersion Recovery Center, Susan will work directly with staff members, clients, and family members to ensure the clinical program remains as effective and individualized as possible. Susan is no stranger to the fields of behavioral health and addiction. She has over 25 years of experience, working in an inpatient setting, an outpatient setting, acute stabilization and nearly all other settings in the realm of addiction recovery.