Comorbid mental health issues are incredibly common among people with substance use disorder (SUD). About a third of all SUD cases in Boston rehab centers involve at least one other mental health issue, usually depression, anxiety, or trauma. This situation is sometimes described as a “dual diagnosis” in addiction treatment circles, even in circumstances where more than two conditions are present.
Mental Health Issues- When such a situation presents itself in a drug or alcohol rehab situation, it may complicate treatment and make it difficult for patients to avoid an early relapse. Here we’ll explore why so-called dual diagnosis cases can be difficult to treat as well as how they might typically be addressed at a rehab program.
Mental Health Issues: What Is It – Symptoms, Causes & Treatments
The Challenge Of Treating Comorbid Mental Health Problem In Rehab
Mental Health Issues- Compared to situations where a patient only has a SUD or only has one known mental health issue, dual diagnosis cases can be trickier to address. Though a SUD can cause another mental illness and an existing mental illness can also cause a SUD, comorbid health issues often contribute to each other, sometimes in unexpected ways.
Mental Health Issues- In a rehab setting, that makes a straightforward treatment difficult, if not altogether impossible. For instance, if only the SUD is treated, the patient may remain at a high risk of relapse throughout their life.
Mental Health Issues- Especially if their other mental health condition was the main contributor to the SUD. Likewise, if only the mental illness is treated, the patient may continue to find it difficult to resist cravings for their former drug of choice.
Will Any Rehab Program Treat A Co-Occurring Mental Health Issue?
Unfortunately, this cannot always be guaranteed. Even though comorbid mental health disease may be involved in perhaps a majority of all SUD cases, not all rehab programs will address co-occurring mental health issues, even when they are identified.
Additionally, due to the scale of the drug and mental health problems in the US, there is an ongoing shortage of mental health professionals, especially those qualified to handle dual diagnosis cases involving a SUD.
Mental Health Issues- While things tend to be much better here in Massachusetts, many counties in other states even lack access to qualified mental health professionals of any kind, let alone teams of clinicians who can specifically treat SUDs and comorbid mental health issues.
However, there are at least, a good number of options throughout most of New England, including programs that specialize in these specific situations.
What Is The Process For Treating Co-Occurring Mental Health Issues?
It all depends on the specific case. Most physicians will identify one of the conditions as the “primary illness”, which can affect the treatment strategy they will use.
Mental Health Issues- If the SUD is the primary illness, the focus may just be purely on treating that specific condition, since the accompanying illness may resolve once the SUD is treated.
If the accompanying mental health condition is the primary cause of the SUD, then chances are that both will be treated so that a relapse will be less likely. Again, it all depends on the specific circumstances of the patient.
In any case, the overall process is similar to the standard treatment of SUD. The main difference often rests in the specific types of psychotherapy approaches used. The process usually goes as follows:
1. Medically-Supervised Withdrawal/Detoxification
Mental Health Issues-As with regular drug and alcohol treatment, it’s critical for the patient to be stabilized before they can receive therapy. At this stage, the patient is usually confined to an inpatient facility for a few days or weeks so they can safely withdraw and detoxify from their drug of choice.
Mental Health Issues- If a complete withdrawal is unsafe, attending clinicians may start drug tapering or drug substitution to stabilize the patient enough to receive therapy.
2. Psychotherapy
Mental Health Issues- This stage of treatment involves the use of appropriate psychotherapy approaches to directly address one or all of the mental health conditions involved.
Mental Health Issues-Even though the recovering individual should be relatively stable at this stage, their cravings and emotional triggers are likely to remain strong. Psychotherapy can be done in an inpatient or outpatient setting, though severe cases will often need to be done inpatient to avoid relapse.
3. Continuing Medication And Supplemental Therapy
Once the attending clinicians have decided on a specific course of treatments, patients may be prescribed medications and other types of therapy to help them with their recovery. The types of interventions done at this stage will vary from case to case and may be adjusted as the individual progresses.
4. Aftercare
Mental Health Issues- Once the patient completes the rehab program, it may be recommended that they check in with their therapist regularly as well as attend specific support groups for people with similar dual diagnosis cases.
They may also need to continue with some medication for preventing withdrawal symptoms, or for controlling signs of their mental health disorder.
Summary:
Mental Health Issues- As it is, the system for addressing comorbid SUD and mental health issues is still in need of improvement. Thankfully, there is a growing number of rehab programs specifically designed to address the needs of people who have SUDs and co-occurring mental health problems.
If you or someone close to you has been confirmed to have a SUD and a co-occurring mental health issue, these programs are the ones to prioritize. Not only will they be able to address the more immediate problems of a substance use disorder.
But they can also help address mental health conditions that may potentially be the ultimate cause of the drug or alcohol problem. In such situations, these dual diagnosis rehab programs tend to offer the best chance of good long-term outcomes. Good luck, and be well!