When addiction and mental illness collide: why treating both is key

October 14, 2016 | by Jillian Manza, LPC, CADC
Categories: Healthy Driven Minds

As a parent, watching your child suffer from either mental illness or addiction can be painful and frightening. But when your child struggles with both, it can be almost unbearable.

When a person has a mental health disorder – depression, anxiety, schizophrenia, etc. – and a problem with drugs or alcohol, we call this dual diagnosis or a co-occurring disorder. Unfortunately, this isn’t rare. In 2014, 39 percent of adults who had a substance use disorder also had a mental illness, according to the Substance Abuse and Mental Health Services Administration.

When a teen faces dual diagnosis, it’s imperative to treat both illnesses at the same time. It may seem overwhelming, but programs are available to help teens improve their health and quality of life.

We can’t treat one and not the other

Which comes first: the addiction or the mental illness? It can go either way.

Someone who suffers from anxiety or another mental illness may turn to drugs or alcohol to avoid or numb themselves from feeling certain emotions. For example, it may have started when they were prescribed a medication for their mental illness and they figured out, “Hey, I take one and it helps. I take three, and it’s even better.”

On the other hand, someone with a drug addiction may develop mental health problems because of the effects drugs can have on a person’s brain chemistry, mood and behavior.

No matter how it started, at the end of the day, the conditions exist together and must be treated together. If we treat a teen’s mental health problem only, the addiction may get worse. If we treat the substance use and don’t address his or her mental health, the teen may turn to a different unhealthy behavior to cope, such as self-injury, an eating disorder or theft.

When teenage patients have a history of substance use along with a mental health problem, we suggest they enter our dual diagnosis program. There can be push-back. They’ll say things like, “I’m suicidal, and I don’t want to feel this way anymore. I want to focus on my depression.” Many argue that they aren’t addicted, that the marijuana or another drug of choice helps relieve their symptoms, and they only need to work on the depression or anxiety to get better.

Parents also sometimes are hesitant to enroll their children in a dual diagnosis program. There is enough stigma attached to mental health disorders, but the negativity surrounding addiction often is worse. They fear people finding out. It’s easier to say, “My kid is struggling with depression,” than to say, “My kid is struggling with addiction.”

This is a tough conversation for some families, and we emphasize that the best thing they can do for their child is to treat both diseases. We can’t effectively teach teens alternative coping skills if they’re still using drugs to manage their symptoms. Being addicted to a substance means that a teen’s brain  isn’t functioning at its highest level, and learning and healing is stunted as a result.

Signs your child may have a problem with addiction or mental health

Parents often ask me, “My teen doesn’t want to talk to me. How do I know if it’s just typical teen hormones or if she’s depressed?” If you substitute “depressed” with “addicted to a drug,” the answers may be very similar.

The teen years often are a roller coaster of emotions, and it can be difficult to tell if your child is experiencing trouble beyond the normal trials and tribulations of growing up. However, there are a few signs that could indicate your teen needs help:

  • Attendance and performance in school begin to suffer.
  • Teachers report behavioral problems that didn’t exist previously.
  • They lose interest in activities, sports or clubs that they used to be passionate about.
  • They begin hanging out with a new group of friends or distancing themselves from long-time friends.
  • They withdraw from family or begin lying about where they were, who they were with, and what they were doing.
  • They spend an abnormal amount of time alone in their room.

Teenage patients in our dual diagnosis program typically use marijuana, Xanax and stimulants, such as Adderall. We see some alcohol use and other street drugs such as cocaine, but those cases are rare. Parents often say they want their child to stop hanging out with friends who are bad influences. Unfortunately, as long as your child is in school, they’ll likely have access to almost any drug they want, with kids selling their prescription drugs or those they stole from their family’s medicine cabinet.

This easy access means parents need to be vigilant in monitoring their children’s behavior and encourage open and honest communication. If you detect a problem, don’t hesitate to ask for help. There are professionals ready to help your teen and your family.

How our dual diagnosis program works

Our mental health and addiction professionals work together to treat all aspects of each patient’s illnesses. This can include a range of methods, including detoxification, behavioral modification therapy, and individual and group therapy. While some parts of the dual diagnosis program focus more on the mental health disorder or the addiction, we always talk about how one affects the other.

We want to teach our teens new methods to cope with their mental illnesses and to avoid triggers that may cause them to want to use drugs. To accomplish this, we offer three levels of care:

  • Full-day (partial hospitalization program/PHP): In this program, teens arrive at 7:30 a.m. and leave at 2 p.m. We remove them from school and focus on healing before slowly transitioning them back into their classes. We recommend this program for teens who struggle in the school environment.
  • Half-day (intensive outpatient program/IOP): Teens attend this program from 7:30 - 10:45 a.m. These participants may be stepping down from the full-day program or don’t experience the type of issues that require the full-day program.
  • Aftercare or maintenance: Returning to regular life can be scary. After teens complete a  comprehensive full-day or half-day program, we want to make sure they use their new coping skills and don’t slip back into unhealthy behaviors. We encourage them to attend weekly group and/or individual therapy sessions to provide support and accountability.

How long each teen stays in the program is unique to the teen. We often see patients start transitioning back into school part time or full time by the fourth or fifth week, but it all depends on each patient’s progress. We can’t know if they can use their new coping skills in the outside world until they go out and do it. This is where the aftercare comes in, and it can last anywhere from a month to more than a year depending on what the patient needs.

Family members, schools play integral role in treatment process

Teens can’t do this alone. Their support system outside of treatment is crucial to their success.

We recommend family sessions once a week while the teen is in a full-day or half-day program. During this time, we talk about what the teen  is working on in treatment and how things are going at home. We know these meetings aren’t always easy for working parents to schedule, but we see over and over that the more the family is involved, the better chance there is for a successful outcome.

I always find it amazing the lengths busy parents go to be part of their child’s treatment. We often see them not only making family counseling sessions, but also dropping their teen off and picking them up in the afternoon. This gives us more chances to interact with parents and facilitate conversations between them and their teen. At those times when a parent just can’t make it to a family session in person, we can do a phone conference instead.

Parents often are worried about what school officials will think and how being enrolled in a dual diagnosis program will affect their child’s academics. Teachers and school administrators have a much better understanding these days about the effects of mental illness and addiction on their students. We’ve developed good relationships with schools over the years and they’re almost always willing to work with us as a student gets the treatment he or she needs. We urge parents and schools to keep up an open, honest conversation.

Teens with mental health disorders and addiction face a difficult road to recovery. By confronting the two issues together, they have a much better chance of living healthier lives.

If your teen needs help to deal with a dual diagnosis, fill out this assessment form, and one of our team members will contact you. You also can call us at 630-305-5027.


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