Recovering from addiction involves more than quitting substances. For many people, mental health challenges and substance use disorder occur together.
Some people begin using substances to cope with anxiety, depression, trauma, or other mental health challenges. For others, substance use contributes to the onset of mental health symptoms or worsens existing symptoms.
When addiction and mental health issues occur together, it’s known as a dual diagnosis. Getting sober isn’t simply a matter of willpower. Treatment can be more effective when both conditions are addressed simultaneously.
Learn more about dual diagnosis, including common signs and co-occurring disorders, why addiction and substance use disorder often co-occur, the treatments and therapies available at Bridge of Hope, and more.
Could Addiction and Mental Health Be Connected?
Not everyone with an addiction has a mental health issue. And not everyone with a mental health diagnosis struggles with addiction.
But, many people experience both mental health challenges and substance use disorder (SUD).
According to the 2023 National Survey on Drug Use and Health published by the Substance Abuse and Mental Health Services Administration (SAMHSA), 35% of adults in the U.S. with mental health disorders also have co-occurring substance use disorders.
People with mental health issues are also twice as likely to suffer from addiction, according to the National Alliance on Mental Illness (NAMI).
For people dealing with a dual diagnosis, there’s often the question of which condition came first. When it comes to treatment, what comes first matters less than developing a plan to move forward. Treating both conditions simultaneously is important because one can trigger or worsen the other.
Why do Mental Health Issues and Substance Use Disorder Often Co-Occur?
There are three reasons why mental health and SUDs are often comorbid, according to the National Institutes on Drug Abuse. These factors do not automatically mean that someone with mental health issues will develop an addiction, and vice versa, but they increase a person’s susceptibility to both conditions.
1 – Mental illness and substance abuse share risk factors.
Shared risk factors include:
- Adverse childhood experiences (ACEs)
- Trauma
- A family history of addiction or mental illness
- Chronic stress
- Impulsivity
- Difficulty coping with emotions
- Social isolation
- Lack of consistent support
- Environmental influences, such as poverty and unstable housing
- Medical conditions, such as sleep disorders and chronic pain
- Differences in brain development, including those affecting reward processing, impulse control and stress regulation
2 – Mental health symptoms play a role in substance abuse.
Without the knowledge of, or access to, tools needed to cope with mental health challenges, such as talk therapy and medication management, and a supportive environment conducive to healing, some people turn to substances for relief.
For example, a person with anxiety may drink alcohol to feel more comfortable in social settings. Another person with insomnia may abuse benzodiazepines in an attempt to fall asleep. Still another person may abuse opiates to feel detached from grief or emotional pain.
There’s a desire to feel better or increase productivity. Initially, drugs and alcohol may serve as a temporary escape from symptoms and make life seem manageable in the moment. However, self-medication is not sustainable, and what once offered temporary relief can become an all-consuming problem.
3 – Substance abuse can trigger the onset of a mental illness.
People can develop mental health issues or experience a worsening of existing symptoms as a result of substance abuse. Depending on the person’s biological makeup, the frequency and duration of use, and the substances involved, substance abuse may trigger an underlying mental health disorder or contribute to drug-induced psychosis.
Common Signs of a Dual Diagnosis
The signs of a dual diagnosis may vary from person to person, but there are some overlapping behaviors to look out for.
Some of the most common signs of a dual diagnosis include:
- Using drugs to cope with overwhelming emotions, difficult experiences, anxiety, depression, trauma, or sleep troubles
- Mental health symptoms worsening during intoxication, withdrawal, or a substance-related crash
- Substance use increasing when mental health symptoms fluctuate or stressful events occur
- Repeatedly trying to stop or reduce substance use but having difficulty managing mental health symptoms as a result
- Undergoing treatment for one condition without improvement
- Having difficulty determining whether symptoms are caused by a mental health issue or substance abuse
People with co-occurring disorders may also experience impulsivity, hallucinations, self-destructive thoughts, social isolation, and/or poor attention span. Symptoms may appear consistently or fluctuate based on substance abuse, withdrawal, sleep, stress, and other factors.
Common Mental Health Conditions That Comorbid With Substance Use Disorder
Several mental health conditions often co-occur with SUDs, according to the National Institutes on Drug Abuse. These diagnoses include:
- Generalized anxiety disorder
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Depression
- Bipolar disorder
- Attention-deficit hyperactivity disorder (ADHD)
- Psychotic illness
- Borderline personality disorder
- Antisocial personality disorder
- Schizophrenia
Many symptoms of mental health conditions and SUDs overlap. For this reason, it’s important to be assessed and diagnosed by a medical professional rather than relying on symptoms alone.
Again, not everyone with one of the conditions listed above will also develop a SUD. According to data from SAMHSA’s 2024 annual National Survey on Drug Use and Health (NSDUH), 68.5% of U.S. adults with mental health diagnoses do not have co-occurring SUDs.
Why Getting the Right Diagnosis Matters
Being accurately assessed and diagnosed helps inform a patient’s overall treatment experience.
Treating a SUD without also addressing co-occurring mental health challenges, or vice versa, may leave important aspects of recovery unaddressed. In some cases, substance use may be a way of coping with mental health symptoms. Without addressing the factors contributing to substance abuse, maintaining recovery can be more difficult.
Intoxication, withdrawal, and symptoms related to SUD can make diagnosis more complex.
Treating both conditions simultaneously is an important part of helping patients heal, grow, and rebuild their lives. Dual diagnosis treatment equips patients with tools to navigate triggers, manage difficult emotions, and cope with challenging people, places, situations, and thoughts without turning to substances or other self-destructive behaviors.
What Treatment Options Are Available at Bridge of Hope?
There are many treatment options and therapies of varying intensity levels for people with dual diagnoses at Bridge of Hope.
These treatments and therapies include, but are not limited to, the following:
Partial Hospitalization Program (PHP)/High-Intensity Outpatient Services (HIOP): PHP, also known as HIOP at Bridge of Hope, provides patients with a high level of support for six hours a day, five days a week, while allowing them to return home in the afternoons. Patients participate in individual and group counseling, meet weekly with a medical provider, attend creative and recreational group sessions, and build a sober support network.
Intensive Outpatient Treatment (IOP): IOP provides support to people who need more care than individual therapy alone can offer, while also maintaining their work, school, or family schedule. In IOP, patients participate in group counseling, individual therapy, relapse prevention planning, family support and education, and workshops focused on building emotional coping skills.
Outpatient Treatment (OP): OP is the least intensive outpatient treatment available at Bridge of Hope. Patients participate in scheduled counseling sessions throughout the week. OP is ideal for people with mild to moderate SUDs who need a lower level of care. It includes many of the same workshops as IOP but requires less of a time commitment.
Medication Management: a specialized service available to patients prescribed one or more psychiatric medications.
Community-Based Recovery Programs: Portland-based activities designed to help clients build a sense of community, rediscover themselves in sobriety, and have fun.
Integrated Care Can Support a More Sustainable Recovery
Treatment is available to help people with co-occurring disorders work toward sobriety and improved mental health.
Integrative care can help clients understand the connection between mental health and substance use disorder, develop healthier coping strategies, and address the underlying factors that contribute to substance abuse.
With the right care and tools, clients can grow, heal, and discover a new perspective on life and themselves. Contact Bridge of Hope today at 503-793-0443 to schedule an assessment and discuss your treatment options.