Managing Dual Diagnosis in Recovery

Managing Dual Diagnosis in Recovery

Recovering from addiction takes time. It often involves detoxing, regular therapy sessions and doing a lot of soul-searching and difficult emotional labor. Co-occurring disorders, such as anxiety, depression or borderline personality disorder, can make these processes even more complicated.

Luckily, dual diagnoses are very common, and there are ways to mitigate the challenges that come with them. In fact, many in recovery have been able to treat both substance use disorder and a mental health disorder simultaneously through integrated treatment for addiction. These programs can make recovery easier, but there are also plenty of changes you can make in your daily life to support them, too.

Learn about the complications of dual diagnosis and ways you can navigate them.

What Is Dual Diagnosis?

The term “dual diagnosis” refers to a diagnosis of both a substance use disorder and a mental health disorder. Essentially, it means that someone is dealing with both an addiction and something like anxiety or bipolar disorder. For example, let's say someone is navigating depression and addiction recovery simultaneously. The conditions are separate from one another, but they complicate each other. A depressive episode might make them more likely to relapse and use opioids to suppress stress, for instance.

Dual diagnoses are extremely common, as half of those who experience mental illness will also deal with substance use disorder and vice versa. It can be difficult to diagnose both conditions at times, however, due to overlapping symptoms. This is especially true if substances are used to cope with and mask the underlying mental health condition. It may only become clear that there is an underlying mental health condition after a period of detox.

What Makes Dual Diagnosis So Challenging?

The diagnostics challenges we discussed above are not the only ones. Both treatment and recovery can be more difficult as a result of a dual diagnosis. Here are some of the most impactful effects:

• Simple treatment approaches may fail: Treating only the substance use disorder or the mental health disorder can be ineffective in the long term. Both disorders complicate each other and can make normally effective treatments impotent. Even if one is treated successfully, the other disorder may make it harder to retain that progress over time. All these problems are made worse if no one is aware that the co-occurring disorder exists.
• Cravings may be more intense: Those in dual diagnosis recovery often experience cravings. These cravings may occur as a result of internal or external triggers, or they may happen periodically with no particular rhyme or reason. A co-occurring mental health disorder can heighten the intensity of cravings or even act as a trigger itself. As a result, the cravings may be harder to resist. 
• It may be harder to engage with recovery: Detox, therapy and other activities vital to recovery can be challenging on their own. They often require a tremendous amount of mental and emotional energy and can be physically uncomfortable as well. Adding a mental health disorder into that mix can increase the challenge significantly, as depression, anxiety and other conditions can make it harder to take risks and drain emotional energy so that it can't be used elsewhere.
• There may be a higher risk of relapse: All of these factors combined can increase the risk of relapse overall. They can result in feelings of hopelessness and powerlessness, both of which can make relapse more appealing.

The Integrated Treatment Approach

The best way to address these challenges is with an integrated approach to treatment, one that addresses both the substance use disorder and the mental health disorder simultaneously. A proper integrated treatment approach typically includes the following components:

• A comprehensive assessment: At the outset, an assessment of mental health and substance use history will be conducted. This assessment will allow for a dual diagnosis to be made if it hasn't already and will inform the treatment methods going forward. It also gives the person in recovery time to discuss their unique experiences and how the substance use disorder and mental health disorder interact.
• An individualized treatment plan: The assessment serves as the backbone for treatment going forward. It will inform the therapies, medications and general treatment methods that are used, as each can be tailored to address the effects of the dual diagnosis in question. Each of these will be planned in advance with the goal of treating both aspects of the diagnosis.
• Therapy: Various therapies may be applied, depending on the nature of the dual diagnosis. Cognitive behavioral therapy (CBT) may be used to address negative thought patterns that play into both addiction and mental illness. Dialectical behavior therapy (DBT) may be used to impart emotional regulation skills to those struggling with intense feelings due to borderline personality disorder and other issues. Trauma-informed care and other therapies may also be used as necessary.
• Medication: In some cases, medication may aid recovery. Antidepressants and mood stabilizers, for example, can help with managing mental health symptoms and make participating in other recovery processes easier.
• Support groups: No one needs to go through the recovery process alone. This is why many treatment approaches recommend support groups. They give those in recovery a way to talk about their feelings with those who can understand them best. They can also learn from the experiences of those further along in the recovery process. Support groups are thus an extremely helpful processing tool and can give those involved context and strength they might not have otherwise.
• Family involvement: Support from loved ones is also a vital part of an integrated treatment approach. Family members can be educated and supported by recovery staff, which helps them support their loved one more effectively. They can even join family therapy sessions if necessary.

Together, these practices often lead to improved health outcomes and reduced relapse rates because they address the specific, multi-layered needs of the individual in question. They adapt to them rather than forcing them into a generalized treatment program that may not be equipped to help them. Addiction and mental health treatments are made more effective as a result.

Strategies for Managing Dual Diagnosis in Daily Life

Recovery doesn't end with a treatment plan. It also extends into daily life and involves active forethought and participation, especially when dealing with a dual diagnosis. Some of the best day-to-day management strategies include:

• Consistently attending scheduled therapy sessions
• Taking prescribed medications on time and in appropriate dosages
• Generally adhering to the integrated treatment plan
• Engaging in hobbies that support recovery, such as exercise, reading and meditation
• Eating and sleeping properly
• Building and spending time with a support system of family and friends
• Identifying triggers and learning how to avoid or deal with them
• Monitoring and making note of feelings and cravings

Making these practices part of day-to-day life can make recovery smoother and easier. That said, perhaps the most important thing to do is set realistic expectations for recovery. Setbacks happen, and they don't represent failure. They are a normal part of the recovery process that everyone experiences. The best thing to do is to keep trying and focus on all the progress that has already been made, even if it's small. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), over 50 million Americans are walking a similar path, so no one is alone.

The support system is also extremely important. Friends and family can do what few others can because they have a deeper connection to the person in recovery. That intimate connection and the support it provides is so effective that it can even lead to a decreased risk of relapse after treatment. Managing mental health in sobriety is made much easier as a result.

Embrace Holistic Recovery at The Sanctuary at Sedona

At The Sanctuary at Sedona, we understand that recovery is about more than just treating symptoms. It's about finding healing for the mind, the body and the soul. Our holistic residential non-12-step addiction recovery and trauma treatment center is designed with this philosophy in mind. We combine Indigenous wisdom traditions with peer-reviewed science in order to get at the root cause of addiction and treat it. We practice a wide range of approaches and therapies so the experience can be tailored to your needs.

In order to learn more about our facility and its offerings, fill out our contact form or give us a call at (928) 325-7212