How Dual Diagnosis Treatment Programs Work Together
Part of what makes co-occurring disorders so complicated is that the symptoms of each distinct disease are so similar and overlapping, making it difficult to distinguish which is causing what symptoms. The relationship between co-occurring disorders is an intricate combination of environmental, biological, and genetic factors unique to each individual. Among the most common dual diagnoses are substance use disorders and the following mental health conditions:
Anxiety disorders
Anxiety disorders, such as generalized anxiety disorder, panic disorder, and social anxiety disorder, frequently co-occur with substance use disorders (SUDs) as individuals may use substances to self-medicate their overwhelming feelings of worry, fear, or panic. Anxiety treatment typically involves a combination of psychotherapy, particularly cognitive-behavioral therapy (CBT) to address anxiety-provoking thoughts and behaviors, and sometimes medication (e.g., antidepressants, anxiolytics) along with integrated SUD treatment.
Bipolar disorder
Bipolar disorder, characterized by extreme mood swings including manic/hypomanic highs and depressive lows, has a high comorbidity rate with SUDs, as individuals may use substances to regulate their intense mood fluctuations or cope with the distress associated with their symptoms. Treatment for bipolar disorder involves mood stabilizers and atypical antipsychotics, often combined with psychotherapy (e.g., psychoeducation, family-focused therapy) to manage mood episodes and concurrent integrated treatment for the SUD.
Depression disorders
Depressive disorders, including major depressive disorder and persistent depressive disorder, commonly co-occur with SUDs, with individuals often turning to substances to alleviate feelings of sadness, hopelessness, anhedonia, and low energy. Depression treatment typically involves antidepressant medications, various forms of psychotherapy (e.g., CBT, interpersonal therapy), and integrated substance use disorder treatment to address both conditions simultaneously.
Post-traumatic stress disorder (PTSD)
PTSD, arising from exposure to a traumatic event, is highly comorbid with SUDs, as individuals may use substances to numb intrusive thoughts, flashbacks, nightmares, or intense emotional distress associated with the trauma. PTSD treatment often includes trauma-focused psychotherapies like Eye Movement Desensitization and Reprocessing (EMDR) or Prolonged Exposure (PE), sometimes coupled with medications (e.g., antidepressants), and integrated treatment for the SUD, focusing on coping mechanisms and trauma processing.
Personality disorders, including BPD
Personality disorders, enduring patterns of inner experience and behavior that deviate markedly from the expectations of the individual’s culture, frequently co-occur with SUDs, as individuals may use substances to cope with intense emotional dysregulation, unstable relationships, impulsivity, or identity disturbances. For Borderline Personality Disorder (BPD), a highly prevalent co-occurring disorder, Dialectical Behavior Therapy (DBT) is the gold standard, focusing on mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness skills, alongside integrated SUD treatment. Treatment for other personality disorders may vary but often involves long-term psychotherapy to address underlying dysfunctional patterns and integrated SUD treatment.
Recognizing and acknowledging the need for help is not easy. Many who suffer from co-occurring disorders believe they are alone in their struggles, so they isolate themselves and suffer in silence. However, studies show that nearly eight million Americans suffer from dual diagnoses. At the Harmony Hills dual diagnosis treatment center, we understand that successful treatment focuses not on your diagnosis but on you as a person.
