People who struggle with mental health disorders such as depression, bipolar disorder, or anxiety are at an increased risk of “self-medicating” with drugs or alcohol and developing a substance abuse problem.
Dual diagnosis programs understand the sensitive nature of how mental health challenges can drive addiction. They focus on providing tailored, evidence-based treatment that addresses both mental health and substance abuse. Detox from drugs and alcohol can cause several distressing mental health effects, and these are more prevalent in patients with co-occurring disorders.
Effective dual diagnosis detox programs will address these challenges to provide patients with a foundation for long-term recovery.
What is Dual Diagnosis Detox?
Dual diagnosis detox is the same as standard, supervised detox, except the clinical team will also take into account one’s co-occurring mental health problems. For example, if someone is already on prescribed mental health medication, this regimen may need to be continued while the body detoxes from illicit substances.
Detox is the safe physical stabilization of those withdrawing from addictive substances. After detox, patients are recommended to enter an inpatient residential rehab program where they continue receiving treatment that addresses both symptoms of substance abuse and underlying mental health problems.
During the detox process, patients’ vitals are monitored to ensure they are safe and comfortable. Medication may be prescribed to alleviate withdrawal pain or cravings. The detox process is guided by a clinical team, usually consisting of a licensed Medical Doctor (MD) or Nurse Practitioner (NP).
Mental Health Challenges During Withdrawal
The physical symptoms of drug and alcohol withdrawal are often mentioned as the primary reason for enrolling in a supervised detox program. However, several mental health challenges also arise during the withdrawal process that increase the risk of relapse.
As the brain becomes accustomed to drug or alcohol use, several regions such as the pre-frontal cortex (PFC), basal ganglia, and amygdala are affected. These essential regions control cognitive processes like mood, emotional regulation, problem-solving, decision-making, and reasoning skills.
When drug use suddenly stops, these brain areas become out of balance and increase the risk of mental health challenges such as depression, anxiety, or psychosis. Research has found that those with co-occurring disorders are nearly 36% more likely to struggle with severe mental health challenges that arise during withdrawal [1].
Depression
According to the National Institute on Drug Abuse, depression is the most common co-occurring mental health problem in those recovering from substance abuse. During withdrawal, essential brain chemicals such as serotonin and dopamine are affected. These play a key role in mood, appetite, and sleep [2].
Drugs and alcohol slow down brain activity and communication in the PFC. This can lead to low energy, lack of motivation, fatigue, and lack of desire for building or maintaining relationships.
Anxiety
Drugs like alcohol, benzodiazepines, and other sedatives increase the neurotransmitter GABA. This promotes feelings of relaxation in the nervous system and reduces activity in the amygdala—easing symptoms of anxiety.
However, when use is abruptly stopped, it can cause adverse effects, quickly spiking amygdala activity and activating the fear response that causes anxiety, dread, and panic attacks [3].
Cravings
During withdrawal, it’s common to experience intense cravings that are almost impossible to overcome on one’s own or with “self-discipline”. Addictive substances hijack the basal ganglia, a region of the brain that controls pleasure, motivation, and habitual behaviors.
After detox and throughout treatment, as one learns tools for stress management, cravings will subside. However, it’s always possible to experience cravings for drugs and alcohol, and a key part of dual diagnosis is teaching patients how to manage those through therapy, peer support, and lifestyle changes.
Psychosis
Drugs like alcohol, benzodiazepines, and cocaine all carry an increased risk of causing drug-induced psychosis and severe psychiatric symptoms during withdrawal, such as delusions, paranoia, and auditory hallucinations.
Drugs like alcohol and benzodiazepines carry an increased risk of psychosis because they block NMDA receptors. One study found that drugs that block NMDA receptors are more likely to cause psychotic behaviors, physical injury, and even death of brain neurons [4].
How Dual Diagnosis Treatment Supports Recovery
Dual diagnosis programs often create tailored treatment programs to address the individual mental health needs of patients, rather than a 12-step approach. Individuals will participate in standard substance abuse counseling, while also receiving treatment such as therapy and psychiatric care to address underlying mental health problems.
- Substance abuse counseling addresses strategies for managing cravings, behavioral interventions, and connection to peer support.
- Individual mental health therapies treat co-occurring disorders such as depression, anxiety, trauma, bipolar disorder, and personality disorders.
- Group therapy gives patients a space to be heard, seen, and validated. Dual diagnosis programs may offer support groups for addiction, and separate groups to address mental health challenges like trauma, grief, isolation, and resilience.
- Medication management and weekly check-ins with a clinical psychiatrist can be helpful for those who require mental health medication, such as antidepressants or antipsychotics.
What To Expect At Restorations HealthCare
Restorations HealthCare is committed to addressing all factors that increase the risk of substance abuse, offering several levels of care, evidence-based mental health therapies, therapeutic activities, group therapy and peer support, life skill workshops, case management services, and more.
- Multiple Levels of Care: We offer a range of treatment services to meet you or a loved one wherever you are in recovery. These include supervised medical detox, inpatient residential rehab, partial hospitalization program (PHP), intensive outpatient (IOP), and outpatient therapy.
- Mental Health Therapies: Evidence-based psychotherapies like CBT, DBT, and EMDR help patients reframe negative thoughts that drive substance abuse, process trauma or emotional distress, develop positive coping skills, and set treatment goals.
- Group Therapy & Peer Support: Dual diagnosis programs at Restorations emphasize the importance of connection and community. Group therapy allows those in recovery to share stories and experiences. This fosters mutual understanding and reduces feelings of isolation, which often drive addiction.
- Life Skill Workshops: These are training sessions designed to improve basic functioning skills for when individuals transition out of treatment. These might include cooking, household tasks (laundry, changing a lightbulb), car maintenance (changing a tire, oil, etc), financial planning and budgeting, and stress management.
- Psychoeducation: Providers share information with clients and their families about addiction and mental health to improve understanding, support, and relationships with loved ones.
- Family involvement: We offer family therapy to address dynamics in the home, such as boundaries, hierarchies, relational patterns, and communications. This helps understand and resolve issues within the family unit that may contribute to a loved one’s substance abuse or mental health challenges.
- Case Management and Aftercare: Case management services support those transitioning out of treatment into lower levels of care or back home. This may include helping patients attain stable housing, enroll in ongoing therapy or medication-assisted treatment, or connect them with a peer support program like AA or NA.
- Recreational Activities for Sober Fun: Our inpatient rehab programs offer engaging opportunities such as beach volleyball, basketball, fitness classes, yoga, guided meditation sessions, and therapeutic outings.
- Holistic Approaches: Holistic healing approaches like mindfulness practices, yoga, and meditation are beneficial parts of our programs at Restorations. These teach clients the power of staying in the present and can provide helpful tools to relieve stress or curb cravings.
- Strong Alumni Network: Restorations has an active alumni network throughout the Southern California region to help individuals stay connected to positive social supports and events.
Personalized Dual Diagnosis Treatment in Anaheim
Restorations Health Care can help you or a loved one on the recovery from addiction and mental health issues. Our mission is all about saving lives. We offer detox and inpatient treatment programs that help people get back on their feet. Our dedicated team of trained addiction professionals and licensed counselors provides individualized addiction treatment programs for recovery.
Reach out to our Admissions team now.
Sources
[1] Determinants and prevalence of relapse among patients with substance use disorders: case of Icyizere Psychotherapeutic Centre. 2021. National Library of Medicine.
[2] The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence. 2012. National Library of Medicine.
[3] The role of GABA receptors in mediating the effects of alcohol in the central nervous system. 2003. Journal of Psychiatry and Neuroscience.
[4] Alcoholic Hallucinosis. 2017. Handbook of Clinical Neurology.
