Depression and Rehab

April 3, 2020

At one time, not so long ago, treatment for a substance addiction (either drugs or alcohol) was considered to be a separate treatment process from treatment for a mental health disorder. In other words, if you were seeking treatment for one or undergoing treatment for one, therapy for the other had to come at a later date. In many cases, treatment and care were delivered at different facilities altogether. Additionally, treatment for a substance addiction utilized significantly different therapeutic models than those treatments for a mental health disorder. Consequently, many people who suffered from depression, schizophrenia, obsessive-compulsive disorder, bipolar disorder, or a litany of other serious mental health conditions never received treatment for their substance use disorder or substance addiction. Conversely, many people who successfully completed treatment for substance use disorders or substance addictions may never receive or seek treatment for a preexisting mental health condition. This scenario became an even more considerable concern for those who developed or for whom a mental health condition such as depression was discovered while completing an inpatient rehabilitation stay for substance use.

Fortunately, mental health treatment and treatment for co-occurring disorders (such as depression and addiction) has changed. Addiction treatment specialists and mental health clinicians view co-occurring disorders treatment as a field that requires its own special attention. Over time, the number of people who suffer from at least one mental health issue in addition to drug or alcohol addiction has grown. The U.S Department of Health and Human Services estimates severe mental health disorders affect up to five percent of the American population. As many as one in five American citizens struggle with mental illness at some level at some point during their lives. Within that group, just under eight million also suffer from drug or alcohol addiction.

The ability to treat these disorders together is key to not only recovery and stability but to protecting these individuals from future illness, isolation, and other potential negative issues associated with the inability to treat both disorders during the same treatment process.

The Importance of Integrated Care

In recent years, studies of rehabilitation programs for people with co-occurring disorders have shown that integrated treatment is the most effective approach.  Other studies by the Substance Abuse and Mental Health Services Administration have shown that combining treatment models from both the fields of psychiatry and addiction treatment can help to significantly reduce the relapse rate among individuals who have completed an addiction treatment program. Additionally, the cases of long-term abstinence or “total” recovery tend to increase when mental health disorders and addiction are treated together. Finally, the number of suicides attempts due to lack of treatment for one concern or the other (either mental health or substance addiction) are also reduced when both conditions are addressed in a concurrent treatment plan.

There are several reasons why developing treatment plans that address both addictive disorders and co-occurring mental health disorders at the same time is essential. These include:

  • Group therapy is often part of the treatment plan for both mental health disorders as well as addiction treatment when treated as separate concerns. Group therapy for people who are experiencing co-occurring disorders offers a more robust support network as they are in a group setting with people who are sharing their experiences around dealing with both a mental health disorder and addiction.
  • Treating an addictive disorder at the same time as an underlying or co-occurring mental health disorder can help an individual address unique relapse triggers that may not be as prevalent in someone who is not dealing with a co-occurring disorder such as depression, mood swings or anxiety and panic attacks.
  • Recovery plans for co-occurring disorder treatment are often more integrated and designed to overcome many of the adverse side effects of mental health disorders, which can cloud and limit success in rehab. This can include reduced attention span, low motivation levels, and social anxiety, or social isolation.
  • Medication therapy is also much more effective when the plan addressed both mental health disorders and substance abuse disorders. Additionally, when treating co-occurring disorders, many of the traditional concerns or hesitations around prescribing psychotherapeutic medications to substance abuse treatment cases are no longer of increased concern.
  • Finally, in facilities that emphasize treatment for co-occurring disorders, the staff members have received specialized training and are qualified in dual diagnosis treatment. Staff members who have this training, such as those here at Hillcrest, understand that clients who experience co-occurring disorders face challenges to recovery due to their mental illness.
  • When treatment for co-occurring disorders is combined with treatment for addiction, therapy sessions and group therapy sessions can be structured to reflect the needs of those who are mentally ill as well as trying to combat addiction. Symptoms like social anxiety, feelings of hopelessness, or compulsive behavior don’t have to become an obstacle to care if these programs are tailored to the needs of clients with co-occurring disorders.

Approaches to Treating Co-Occurring Disorders

Since the 1990s, the field of co-occurring disorders treatment has continued to grow as facilities, and individual providers alike have come to see the benefits of treating these conditions as part of a combined treatment plan. As noted above, treatment for mental health and substance use disorders as a combined effort is more likely to see people seek and complete treatment for both as opposed to only receiving treatment for one or the other. When seeking a treatment center, there are a few standards of care the center should follow when it comes to assessing individuals with potential or diagnosed co-occurring disorders. Below are the things you and your family should experience when you are searching for or enrolling in a treatment program.

  • You should feel welcome- regardless of the primary reason for seeking treatment (whether mental health or a substance abuse disorder), you should feel welcomed into the treatment program. You should not feel excluded or unwelcome at a substance abuse treatment program due to an underlying mental health condition and vice versa.
  • Disorders should be treated equally-both your addictive disorder, and the co-occurring mental health disorder should receive the same level of attention, care, and treatment during the therapeutic and rehabilitation process. They should receive the same level of concern during the post-treatment and recovery planning process as well. Finally, both the substance use disorder and the co-occurring mental health disorder should be addressed and treated as chronic conditions with the potential for relapse that will likely require long-term support.
  • Trained staff- it is essential that the care being provided is provided by a treatment team that is trained in addressing the nuances and concerns around co-occurring disorder treatment.
  • Early assessment-when you enter a treatment facility for substance use (or for a mental health condition), it is critical that you are also assessed for any potential co-occurring disorders as early on as possible. This will help to assure treatment for both disorders can begin promptly.

Options for Co-Occurring Disorder Treatment

A program that specializes in treating co-occurring disorders (such as depression and substance addiction) should offer a full range of treatment options for its clients. The reason for this is simple; everyone responds to different treatment models in different ways. For some people, individual therapy sessions with one on one treatment will be the most beneficial. For others, group therapy sessions offering a robust social network of people to communicate with will work best. That said, a comprehensive treatment plan designed specifically for you and a supportive, highly trained team of treatment providers is essential to long term success.

Treatment for co-occurring disorders can come in a variety of ways. Some of the most common are discussed in further detail below.

Outpatient treatment options:

Many rehabilitation programs offer outpatient options for clients who may benefit from a non-residential, less restrictive treatment program. These programs also work best for individuals who do not need twenty-four-hour supervision, such as younger teenagers and parents or individuals with commitments that do not lend themselves to a residential program. For these types of people (again assuming their condition or addiction does not require strict monitoring or medical intervention), an outpatient setting may be the best treatment option.

Outpatient therapy can occur in group or individual settings. Individual treatment for co-occurring disorders often centers on tasks associated with improving quality of life, such as building motivation, identifying self-defeating thoughts, and learning positive new behaviors. These new behaviors and increased motivation can also help to assist in the rehabilitation process when triggering events that lead to depressive thoughts that can lead to relapse can occur.

Group therapy sessions or peer support organizations are also a part of both outpatient treatment and ongoing recovery and maintenance. Mental health disorders often lead to social withdrawal and isolation. When coupled with an addiction to drugs and alcohol, the isolation can increase significantly. Group therapy and peer support groups (such as traditional twelve-step programs) can help individuals know that they are not alone in their efforts to beat addiction and lead a healthy, more stable lifestyle.

Medication Therapy

Psychotherapeutic medications, including anti-depressants, anti-psychotic medications, and anti-anxiety medications, are often prescribed as part of the treatment plan for co-occurring disorders. This is beneficial as it can help the individual to manage their mental health symptoms while also trying to control the inevitable symptoms associated with withdrawal and cessation of substance use. For this reason, anti-addiction medications may also be prescribed to help minimize cravings and reduce the unpleasant and sometimes painful symptoms associated with withdrawal. It is important to note that medication therapy is best carried out in a residential setting where a team of trained healthcare professionals can monitor the effects of medications and withdrawal.

In Therapy - Depression - Hillcrest

Residential Treatment Programs

For some individuals, an intensive, inpatient residential treatment program such as that offered here at Hillcrest is the best (and safest) choice for the treatment of co-occurring disorders. A residential treatment program provides individualized, structured, and supervised support through all stages of the rehabilitation and treatment process. This is especially beneficial for those who require medical assistance through the detox and withdrawal process. Detoxing from substance use (especially long-term use) can be dangerous for some people. At Hillcrest, we have a full team of on-site medical professionals who can help your family members through these challenging times with any medical support they may need. Additionally, a residential program such as Hillcrest helps to remove the person from the daily stresses and triggers associated with their typical living environment. This allows them to focus on their recovery and the treatment of their co-occurring mental health disorder without the distractions of day to day life, which could slow, hinder, or cease their recovery process.

After the initial rehabilitation and treatment program are complete, the recovery journey is only just beginning. At Hillcrest, we provide comprehensive aftercare services that are equally as important and vital to your success as the initial care process. You will be provided access to counselors, support groups, and other essential recovery resources to help you maintain your progress.

Having a mental health disorder such as depression (schizophrenia or bipolar disorder) is no longer considered a barrier to or reason for excluding someone from substance abuse treatment. Similarly, patients who have a substance use disorder should not be excluded from the necessary mental health treatment due to their addictive disorder. Unfortunately, the fact remains that many facilities lack the ability to treat co-occurring disorders successfully. Be it a lack of trained personnel or lack of resources, there are many facilities that simply are not equipped to treat co-occurring disorders with the appropriate level of care and success.

The thought of trying to recover from a mental health disorder like depression (or similar mental health disorder) can be overwhelming and scary. The feelings of fear and despair are only heightened when you are also faced with the work of recovering from addiction. If you are seeking help for a co-occurring disorder such as depression and substance use, at Hillcrest Adolescent Treatment Center, we offer the specialized care you are looking for. Reach out today to discuss your treatment options.