How to Know if a Dual-Diagnosis Program is for You

Real life is complicated. Our minds, our bodies, our feelings, even our experiences – on paper, it seems things should be so clear-cut. We think this, we want that, we feel X, Y, or Z…

In reality, of course, it’s rarely that simple. Feelings crash into thoughts which disrupt our plans which then change our feelings – we are complicated creatures, it seems.

Diagnostic Challenges

The same is true when it comes to diagnosing disruptions to living our best life. Mental health issues and behavioral disorders are very real, and often very damaging, conditions. We don’t choose them, and they don’t always each stay in their box. They interact and complicate one another without asking our permission.

Substance abuse is a harsh disruptor as well. Sometimes it’s just one thing, but it’s not unusual for substance use disorder (SUD) to take a variety of forms for the same individual. Like I said, real life is complicated.

People wrestling with mental health issues or behavioral disorders are more likely than the general population to seek relief or solace through the misuse of alcohol or drugs, whether they come from pharmacies or neighborhood dealers. That’s certainly not a good thing, but it makes sense – things feel messed up and out of control. We don’t always know what to do or how to feel, and the false promise of whatever substance is available can prove overwhelming. And sometimes, mental health issues just plain make it harder to make our best choices.

Conversely, individuals struggling with substance abuse are more likely than the general population to have mental health issues or behavioral disorders. The disruptions of addiction can lay the groundwork for latent issues to manifest themselves unexpectedly, or otherwise trigger thoughts and behaviors which otherwise might have remained dormant.

The cause-and-effect of it all isn’t always clear, but the correlations are undeniable. And if you’re the individual, your chances of sorting it all out by yourself are statistically slim. You need someone with training and experience in just this sort of difficulty.

Dual Diagnosis Experts

The good news is, you’re not alone. You’re not even some rare exception to how struggle is supposed to work. There’s a name for what you’re experiencing: “co-occurring disorders,” sometimes referred to simply as “dual-diagnosis.”

Either term simply means you’re dealing with a combination of substance use disorder (SUD) and mental health or behavioral issues. It’s unlikely you’ll find your way out on your own, but there is a way through this to a better version of you. And we can help you get there.

Dual-diagnosis situations require experts with both the training and experience to recognize and understand the many factors at play in the same individual. The symptoms for many types of substance abuse and many varieties of mental health or related issues overlap and impact one another in innumerable ways.

How Do I Know If I Need Help?

That’s a great question, although there’s not a single, simple answer. In general, however, there are common warning signs that should at least prompt a phone call or setting up an appointment:

  • You no longer enjoy the things you used to enjoy (and maybe you don’t enjoy much of anything).
  • Your mood or overall attitude has changed dramatically without obvious external reasons.
  • Anger, depression, defensiveness, paranoia, or any other intense emotions or perceptions “take over” from time to time
  • It’s hard to think clearly or to focus for extended periods of time.
  • You’re no longer motivated to take care of yourself or your surroundings.
  • You used to “self-medicate” to deal with stress or extreme situations; now you do it just to feel “normal.”
  • Friends or family members have started asking you a lot of questions about what’s going on with you or commenting that you don’t “seem like yourself.”
  • You have strong thoughts, feelings, or urges, which are destructive or dangerous or which drive you to do things that don’t make sense
  • Performance at work or school drops off suddenly, or you find yourself having trouble with things that used to be easy – keeping up with the bills, buying the right groceries, etc.
  • You’ve become impulsive or unpredictable.
  • You find yourself thinking about suicide or self-harm or talking about suicide even without intending to.
  • You have a family history of mental illness or substance abuse.
  • Friends, family, or co-workers urge you to get professional help, even if you don’t think you need it or don’t understand why.

When In Doubt…

If any of these describe you, or if you’re still not sure, don’t wait. Reach out. Let us help you figure out the best way forward to confront mental health challenges as well as providing effective addiction treatment. No matter what you’ve done or how you feel, you are not alone.

The Link between Depression and Substance Abuse

The relationship between substance abuse and depression is bidirectional. This means that individuals who have depression do experience an increased chance of having a substance abuse problem and those with addiction are at a greater risk of having depression.

Many people who suffer from depression will abuse drugs or drink in order to boost their mood or escape feelings of misery or guilt. However, certain substances, including alcohol, have depressant properties, which escalate feelings of sadness. Using substances to alter any negative feelings can become part of a cycle, which hinders the ability to get treatment for depression.

Does Depression or Substance Abuse Come First?

It can be hard to say which comes first since the results will vary from person to person. Some will develop drug addiction or alcoholism while others develop depression first. A study published in the National Institute of Health’s U.S. Library of Medicine shows that alcohol can actually induce depression. This is because it alters the level of serotonin. When serotonin levels rise, the symptoms of depression can sometimes decrease. Those who have depression can sometimes self medicate in order to treat the problem. Over time, substance abuse will worsen depression. Alcohol dependence and drugs can cause a lot of hardships across every aspect of life and these hardships can make depression worse.

Both alcohol use and mental illness will have a similar underlying cause. Genetics play a role in both substance abuse and depression. Someone who has a sibling or parent with depression can be two to three times more likely to develop it than an average person. Both addiction and mental illness can stem from issues in the brain. When someone is vulnerable to one type of brain disease, they can also be vulnerable to other conditions as well. Both mental health disorders and addiction affect the same chemicals and molecules in the brain. Trauma and childhood stress can put a person at a greater risk for depression and substance abuse. Further research is needed to determine the exact reasons why this can occur. Stress can be triggered by neglect, domestic violence, sexual or emotion abuse, or the death of a parent at a young age. Regardless of a person’s age, stress can be a risk factor for depression. When the body releases the stress hormone cortisol, it stimulates symptoms that are similar to depression.

Can Drug Abuse Be a Cause of Depression?

Drug addiction and alcoholism may be able to cause mental illness because they change the chemical balance in the brain. If a mental health specialist doesn’t diagnose and treat the mental illness quickly, it can also encourage the use of substances. Addiction can be a dangerous cycle once it starts.

How Drug Abuse Can Hinder Depression Treatment

Those who have co-occurring substance abuse disorders and depression usually receive specialized treatment to manage both disorders to be able to improve symptoms and increase the effectiveness of rehab. If someone with depression is getting treatment, such as therapy or medication, and notices that drinking numbs feelings, he or she may still be inclined to continue engaging in that activity and avoid evidence-based treatment. This patient may think that substance use works better than medicine or therapy and stop prescriptions or therapy visits. The substance abuse can then create other symptoms of depression, making it even harder to treat the individual.

Effects of Substance Abuse on Depression

Using drugs or drinking to wind down at the end of the day can lead an individual to think that symptoms are improving. Instead, this can just be creating more health problems. Reaching for alcohol or drugs to help lift spirits can cause depression symptoms to worsen. Depression poses risk such as a suppressed immune system, self-harm, a weakened body, and accidental injury. When a mental illness occurs alongside substance use, risks to emotion and physical health increase.

How Having Both Affects Treatment

When an individual suffers from both depression and substance abuse, this is called a co-occurring disorder. These disorders require a more comprehensive treatment plan that will effectively address both disorders. One shouldn’t be treated without the other since an individual that isn’t treated for both can have a higher rate of relapse.

It can be common for people to be unaware of either condition. If only the substance abuse is treated then a person can go back to abusing substances whenever they feel depressed. When only the depression is treated, an individual can continue using substances, which can lead to more depression symptoms. Drugs that are used to treat depression can be affected by alcohol intake. The person can still feel depressed and even develop anxiety when drinking and taking the medication. Alcohol can also cause an individual to become sedated or feel drowsy. Treatment for both substance abuse and depression will usually involve a combination of therapy and medications.

The Link Between Panic Disorder and Alcohol Abuse

When it comes to exploring the connection between panic disorder and alcohol abuse, one is faced with a quandary; which disorder emerged first, the alcohol abuse or the panic disorder? This is a logical question, as there is evidence that either scenario may be valid. Someone who suffers from anxiety, in the form of panic attacks, may self-medicate using alcohol as a panacea for the intense fear response that is common with panic disorder. On the other hand, alcohol abuse itself has been linked with stoking panic attacks. Evidently, alcohol abuse is detrimental to individuals struggling with anxiety or panic disorder.

In the first example, of using alcohol to help alleviate the severe feelings of distress experienced during a panic attack, alcohol can become addictive. The individual begins to anticipate the need for alcohol in the event of another attack, so they might reflexively reach for it at the slightest sign of fear or worry. Over time, this thought-behavior pattern has the potential to morph into alcohol use disorder, adding an additional layer of complexity to the existing mental health disorder.

In the second example, alcohol use or abuse may trigger panic attacks due to resulting physiological conditions, such as dehydration, low blood sugar, and increased heart rate. In addition to the physical cause for possibly initiating a panic attack, alcohol abuse leads inevitably to serious negative consequences that themselves could spark the intense fear response. Alcohol withdrawal may also cause anxiety and symptoms related to panic disorder.

The correlation between panic disorder and alcohol abuse is an important one to explore. Each of these disorder on its own lead to isolating behaviors, so when they coexist there is the risk of serious impairment in functioning due to social withdrawal and isolation.

Dual diagnosis are more complex conditions to treat, necessitating a specialized treatment approach that addresses both of the issues, the anxiety disorder and the substance use disorder, simultaneously. This approach has been shown to yield higher recovery success rates than treating the disorders one at a time.

About Panic Disorder

Panic disorder is under the anxiety umbrella of mental health conditions, impacting approximately 2.7% of American adults each year, according to the National Institute of Mental Health. When someone initially experiences a panic attack, they may seek medical attention thinking they might be having a heart attack. This is due to the similarity of symptoms between these two events. Panic disorder episodes typically involve the following symptoms:

  • Racing heart
  • Palpitations
  • Shaking
  • Chest tightness or pain
  • Shortness of breath
  • Sweating
  • Hot or cold flashes
  • Dizziness
  • Abdominal distress, diarrhea

When a panic attack occurs it often happens with no warning and with no cause or dangerous situation present. Although research has not yet determined the cause of panic disorder, there is some indication that panic disorder has a genetic component. Significant and stressful life events may also be causal in developing this mental health disorder.

About Alcohol Use Disorder

While most adults can use alcohol responsibly, some may find themselves leaning on the substance and consuming more alcohol than is healthy for them. When someone consistently exceeds the guidelines established by the Centers for Disease Control (CDC), this constitutes an alcohol use disorder. The CDC defines moderate alcohol intake as no more than one alcoholic beverage per day for women or two per day for men.

The number of symptoms an individual experiences will dictate the level of severity of the alcohol use disorder, ranging from mild, to moderate, to severe in acuity. Symptoms of alcohol use disorder include:

  • Drinking more than you intend
  • Try to stop drinking, or cut back, and cannot
  • Engage in high risk behaviors while intoxicated
  • Increased tolerance to alcohol, leading to higher consumption
  • Continue to drink regardless of negative consequences
  • Spend increasing amounts of time drinking
  • Withdrawing socially, isolating
  • Legal problems due to drinking, such as a DUI
  • Neglecting responsibilities and obligations
  • Experience withdrawal symptoms when attempting to quit drinking

Comprehensive Treatment for the Panic Disorder and Alcohol Abuse

Treating the co-occurring panic disorder and alcohol use disorder requires a dual diagnosis treatment program. These specialized programs are equipped with the expert staff that is trained to manage the sometimes unpredictable issues that may emerge during treatment. Both disorders should be treated concurrently for the best recovery outcome.

If the individual with panic disorder has developed alcoholism, the first step in recovery will be to undergo a medical detox process. Alcohol detox can present certain health risks, so it is advisable to seek a medically supervised detox program where symptoms and vital signs can be closely monitored and treated.

Treatment for the two conditions will involve psychotherapy, medication, such as antidepressants or naltrexone, and experiential and holistic adjunctive therapies. Cognitive behavioral therapy (CBT) is helpful for both disorders by guiding the individual to make fundamental shifts in their behavioral response to triggers. CBT also helps individuals develop new coping skills and a more productive mindset.

Exposure therapy is helpful for treating the panic disorder in particular. Exposure therapy is what the title infers, involving incremental exposure to fear situations or sensations. Helping individuals to apply the coping skills learned in CBT, and utilizing deep-breathing techniques, while engaged in exposure therapy can help them learn how to better manage the intense fear and worry associated with panic disorder.

Treatment should also include activities that enhance relaxation, teaching individuals how to achieve relaxation as a lifestyle remedy for managing stress. These activities might include meditation, mindfulness, yoga, massage therapy, journaling, and regular exercise.

Quest 2 Recovery Provides Expert Dual Diagnosis Treatment in Los Angeles

Quest 2 Recovery is a leading provider of addiction and dual diagnosis treatment, offering an effective blending of evidence-based approaches with holistic adjunctive therapies. For individuals struggling with the co-occurring panic disorder and alcohol abuse, our compassionate team is here ready to guide you toward a successful recovery. For more information about our program, please visit our website or reach out to the Quest team at (888) 453-9396.

Self Medicating Depression With Opiates

People are depressed in this day and age. The prevalence of depressive disorder in the United States hovers around 16 million, or about 6.7% of the adult population according to the National Association of Mental Illness. Women are nearly twice as likely to suffer from depression, and young adults have the highest rates of all the age groups, with 11% affected by depressive disorder.

Sadly, a large percentage, about 37%, of individuals who battle depression, do so without getting professional help from a doctor. Barriers to treatment might include feelings of shame or stigma associated with mental health disorders, a sense that it would signify weakness in character to ask for help, and cost constraints for individuals without adequate insurance coverage.

Among those who chose to tough it out, a tendency to self-medicate the debilitating symptoms of depression with drugs or alcohol is common. By using a substance, the individual hopes to numb the difficult feelings that accompany a depressive disorder, such as feelings of despair, sadness, shame, and guilt. Self medicating depression with opiates is one such solution, while others may favor alcohol or another drug.

When it comes to self medicating depression with opiates, or any drug, it can be a two way street. Some individuals may have become addicted to opiates, such as OxyContin or Vicodin, following an injury or surgery where these prescription pain medications were used long enough to create a dependence on them. In other cases, the individual may have become addicted to an illicit type of opiates, such as heroin. Addiction to opiates can lead to depression, especially for individuals who use opiates for chronic pain for a certain duration of time. In fact, a study published in the Annals of Family Medicine reported that about 12% of patients who used opioid pain medications for 30 days or more developed depression. As for heroin use, the life-altering consequences of the drug can result in major depression.

Effects of Self Medicating Depression With Opiates

For those who have existing depression but seek the use of a substance to help hide the highly unpleasant symptoms of depression, they may lean on opiates. The reason for choosing an opiate, either a synthetic opioid or heroin, is due to the deep relaxation and sense of euphoria that the opiate provides. The individual virtually escapes from reality, meaning they escape from their depression symptoms.

Sadly, the effects of self medicating depression with opiates are short-lived. As the individual develops a higher tolerance to the drug, their need for more of it increases. Over time, opiate addiction can develop, creating long-term effects that are much worse than the initial struggle with depression alone.

Signs of Opiate Addiction

When someone begins self medicating depression with opiates they may initially enjoy the effects of the drug on their mental health. Opiates can alleviate pain, anxiety, and enhance relaxation in addition to masking the depression. However, once the brain’s neurotransmitters are impacted, and brain chemistry shifts to accommodate the influx of the drug’s dopamine response, the individual will begin to experience negative symptoms.

Signs and symptoms of opiate addiction include:

  • Needing to take higher or more frequent doses
  • Constipation
  • Impaired vision
  • Slowed thinking, cognitive issues
  • Ignoring obligations and responsibilities
  • Insomnia
  • Drug cravings
  • Memory impairment
  • Anoxia
  • Dry mouth
  • Difficulty concentrating
  • Doctor shopping
  • Obtaining the opiates off the street or Internet
  • When attempting to quit using the opiate withdrawal symptoms commence

These symptoms of the opiate abuse or addiction only compound the distress caused by the depression, creating a complex dual diagnosis.

Dual Diagnosis Treatment for Depression and Opiate Addiction

When someone has been self-medicating depression by using opiates, or any substance, that has resulted in a substance addiction, they will need expert dual diagnosis treatment. Successfully treating someone with co-occurring disorders requires a specialized program with both psychiatric and addiction professionals available to treat both disorders simultaneously.

Depression treatment follows a conventional protocol of combining antidepressants with psychotherapy. The antidepressants aim to regulate brain chemistry, namely serotonin, dopamine, and norepinephrine, but the effects take about a month to be noticeable. Many times, the initial prescription, selected from about 25 types of antidepressants, may need to be adjusted or switched to another antidepressant if the individual doesn’t experience relief by the 6-week point.

Psychotherapy is useful in treating both the depression and the addiction. Psychotherapy is a core treatment element for both disorders, helping individuals communicate their underlying emotional issues, past traumas, or difficult life circumstances with an objective therapist. In addition to assisting the client in processing these sources of pain, a psychotherapist can also point out a client’s distorted thought patterns—“I can’t function without Oxy, I can’t handle life without it—that lead to a reflexive behavioral response to reach for the drug. Using cognitive behavioral therapy (CBT) the therapist can suggest replacement thoughts—“I am feeling sad today so I will take a brisk walk and feel better”—leading to positive and more constructive behavioral results.

To further treat the addiction piece of the dual diagnosis, there are various additional treatment elements provided in a dual diagnosis program. These might include:

  • Addiction education. Classes that teach clients how addiction develops in the first place can be effective in deterring future use of drugs, as well as assisting in relapse prevention planning.
  • Experiential activities. Because a dual diagnosis impacts all aspects of one’s being it is helpful to augment therapy with holistic therapies such as mindfulness meditation, journaling, art therapy, music therapy, equine therapy, yoga, and acupuncture.
  • Medication-assisted treatment. Some individuals may benefit from a drug that is designed to reduce cravings and improve recovery outcomes. For opiate recovery, this might include buprenorphine, Suboxone, or methadone.

Individuals struggling with both depression and opiate addiction can greatly benefit from dual diagnosis treatment, going on to enjoy a fulfilling and productive life.

Quest 2 Recovery Offers Dual Diagnosis Treatment in Los Angeles

Quest 2 Recovery is unique among addiction treatment providers. At Quest 2 Recovery, we have created a comfortable, intimate home setting for individuals struggling with depression and a co-occurring substance use disorder, including opiate addiction. Our dual diagnosis program is holistic in scope, treating all aspects of the client—mind, body, and spirit. Situated in a serene location, Quest 2 Recovery offers new hope to those who need a quiet respite from the stressors of daily life in which to heal and restore overall wellness. For more information about the program, please contact Quest 2 Recovery today at (888) 453-9396.

Struggling With Addiction and Depression

When someone is struggling with persistent feelings of sadness and despair, it isn’t surprising that they may initially attempt to lift their mood or soften the pain of depression using drugs or alcohol. Recognizing the prevalence of self-medicating depression symptoms by using a substance, it could be said that depression is a gateway for substance abuse or addiction.

Unfortunately, using drugs or alcohol to mitigate symptoms of depression sets up a vicious cycle, as the use of the substance can exacerbate the symptoms. Over time, as tolerance builds and the drug use or drinking escalates, the risk of addiction becomes real. A dual diagnosis, or the co-occurring substance use disorder with a mental health disorder, can create a steeper treatment hurdle to clear.

For some individuals, however, the depression arrives as a consequence of drug or alcohol addiction, not the cause of it. As problems mount due to the consequences of addiction, depression can result. Maybe a relationship failed or a job was lost due to the drug or alcohol addiction, which could spark a major depressive episode. Whichever order it occurred, struggling with addiction and depression is extremely difficult.

Signs of Depression

Major depressive disorder (MDD) is a complex mental health disorder that impacts more than 16 million adults each year in the U.S., according to statistics provided by the National Institute of Mental Health. There are many known factors that can cause depression, but even so, depression remains a mysterious and difficult mental health disorder with much still to be learned. Some of the known factors that contribute to MDD might include a genetic component, if there is a strong family history of depression, brain chemistry, temperament or personality traits, trauma, grief, and stressful life events.

Signs and symptoms of MDD include:

  • Persistent feelings of sadness, hopelessness, and despair
  • Fatigue, slowed motor skills
  • Changes in eating habits, weight gain or loss
  • Insomnia or hypersomnia
  • Loss of interest in hobbies and activities usually enjoyed
  • Withdrawing from family and friends
  • Feelings of guilt or shame
  • Irritability
  • Suicidal thoughts or attempts

When someone has five or more of the above symptoms that last for at least two weeks, he or she should be seen by a doctor.

Signs of Addiction

It may come as a surprise when the substance someone is leaning on to help them manage the symptoms of depression becomes a secondary problem that only enhances their suffering. Addiction can sneak up slowly, depending on the substance of choice, as tolerance to the effects begin to increase leading to ramped up use of the drug or alcohol.

Signs that an addiction is developing include both behavioral and physical symptoms:

Behavioral

  • Needing increasingly higher dosing to achieve desired result
  • Obsessing about drinking or using drugs, keeping an ample supply on hand
  • Lying about the drug use or alcohol consumption levels, in denial about encroaching signs of addiction
  • Being isolating from family and friends, or hanging out with new friends associated with the drug use
  • Impulsive actions, poor judgment, risky behaviors
  • Continue to use alcohol or drugs regardless of mounting consequences
  • Cannot stop using the substance, even if it is desired to do so
  • Withdrawal symptoms emerge if the substance is not available

Physical—these will differ depending to the substance, but some symptoms include:

  • Insomnia
  • Constricted or dilated pupils
  • Sudden weight loss or gain
  • Slurred speech
  • Lack of interest in personal hygiene
  • Bloodshot eyes
  • Bloated face or abdomen
  • Bloodshot eyes
  • Constant sniffing
  • Nodding off

Effects of Struggling with Addiction and Depression

When both addiction and depression are present it can make daily life very difficult. As tolerance builds and drug or alcohol use escalates, the individual will only feel physically worse on top of the depression. The consequences related to this dual diagnosis can upend an individual’s life, such as getting a DUI, enduring the breakup of a relationship or marriage, losing a job, experiencing financial hardship, or mounting legal problems. As the consequences compound, depression only worsens, and the addiction becomes entrenched.

How to Treat a Dual Diagnosis

It has been demonstrated that a dual diagnosis should involve both disorders being treated simultaneously once detoxification is completed. This will require a treatment program that specializes in dual diagnosis programming, which includes psychiatric expertise on the premises. Someone recovering from alcoholism who also battled depression will be attempting to now live without the crutch of alcohol, which can be a challenging process.

Managing the recovery of someone with a dual diagnosis takes special training, as unpredictable issues may arise during treatment.

In rehab the depression piece of the diagnosis will likely be treated with antidepressants. Antidepressant drug therapy takes 4-6 weeks for noticeable changes to emerge, so it requires patience. Meanwhile, the psychotherapy sessions will allow the therapist to guide the individual toward examining and processing any underlying emotional issues that might be contributing to both the depression and the addiction. Cognitive behavioral therapy is helpful in changing the distorted thought patterns and reflexive self-destructive behaviors that have fueled the addiction and/or the depression.

Dual diagnosis programs that incorporate holistic and experiential treatment elements compliment the psychotherapy by encouraging self-exploration, stress reduction, and relaxation. These types of activities might include mindfulness meditation, yoga, art therapy, or journaling. With professional dual diagnosis intervention, it is absolutely possible to overcome addiction and depression.

Quest 2 Recovery Treats Co-Occurring Addiction and Depression

Quest 2 Recovery is an integrated dual diagnosis addiction recovery program serving greater Los Angeles, California. Being well aware of the difficulties associated with co-occurring disorders, Quest 2 Recovery has strived to create a soothing, tranquil setting where our clients can heal and reclaim their lives. By offering an intimate home setting with a family-like therapeutic approach, clients struggling with addiction and depression will feel comfortable and cared for. At Quest 2 Recovery, we combine important evidence-based therapies with complimentary holistic and experiential activities to help clients explore the underlying causes of their emotional pain, and process it. Only then can recovery from addiction and depression take place. For more information about the program, please contact Quest 2 Recovery today at (888) 453-9396.