If you have a mental health disorder and a substance use disorder (SUD) simultaneously, you have what is called a dual diagnosis. Dual diagnoses require specialized, integrated care to manage overlapping symptoms, avoid conflicting treatments, and provide comprehensive treatment.

At Rubicon Mental Health Center, we provide evidence-based, whole-person-centered mental health care, including dual diagnosis treatment, near you in Watchung, NJ. We serve individuals with mental health disorders from New Jersey, Pennsylvania, and New York with personalized, integrated care for co-occurring disorders. Learn more about our dual diagnosis care, what it entails, and what it’s used to treat.

Key Takeaways

• A dual diagnosis is when a person experiences a mental health disorder and a substance use disorder simultaneously. It requires integrated care to treat both disorders concurrently.
• Common co-occurring disorder pairings include depression and alcohol use, PTSD and opioid use, bipolar disorder and stimulant use, and anxiety and benzodiazepine use.
• Integrated treatment is the standard of care for treating dual diagnoses. It involves providing care for both the mental health disorder and the substance use disorder at the same time with one care team and one treatment plan.
• Rubicon Mental Health Center offers dual diagnosis treatment near you in Watchung, NJ, with treatments like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and more.

What Is Dual Diagnosis?

A dual diagnosis, also known as a co-occurring condition, refers to a person experiencing a mental health disorder, such as depression, anxiety, or bipolar disorder, and a substance use disorder, such as alcohol use disorder or opioid use disorder, simultaneously. Dual diagnoses are often related to 3 main factors:

• Self-medication: People with undiagnosed or untreated mental health disorders often use drugs or alcohol to cope with their symptoms, try to feel better, or because proper mental health treatment is not accessible.
• Substance-induced disorders: Heavy or prolonged use of certain drugs and alcohol can trigger underlying genetic predispositions, resulting in a mental health issue.
• Shared risk factors: Since both mental health and substance use disorders have common risk factors, including genetics, severe stress, and early childhood trauma, there is often an increased vulnerability to both in people with these risk factors.

The mental health and substance use conditions interact and often cause overlapping symptoms, making diagnosis, treatment, and recovery more complex. Therefore, individuals with dual diagnoses require specialized care from providers experienced in treating co-occurring disorders.

What Are Common Co-Occurring Pairings?

Although a dual diagnosis can be a combination of any form of a mental health and substance use disorder, there are certain pairings that commonly occur together. They include:

Depression and Alcohol Use

Depression is a common mental health disorder that causes symptoms like persistent feelings of sadness and emptiness, fatigue, a loss of interest in activities, sleep disturbances, and more. Depression and alcohol abuse frequently co-occur, with research showing that nearly a third of people with major depressive disorder also struggle with alcohol use disorder.

The relationship between depression and alcohol use is bidirectional, which means that one often drives the other. People with depression may drink alcohol to self-medicate their symptoms, while chronic alcohol use leads to altered brain chemistry that can trigger or aggravate symptoms of depression. This dual diagnosis can also complicate treatment, as excessive drinking can lessen the effectiveness of antidepressant medications.

Post-Traumatic Stress Disorder (PTSD) and Opioid Use

Post-traumatic stress disorder is a mental health condition triggered by witnessing or experiencing a terrifying or traumatic event. It leads to symptoms like intrusive thoughts, avoidance behaviors, and negative changes in mood and behavior. PTSD and opioid use are common dual diagnoses, with studies suggesting that people with PTSD use opioids at substantially higher rates than the general population.

This dual diagnosis is mainly influenced by self-medication, as individuals frequently rely on opioids to aid in sleep, relieve anxiety and emotional pain, and cope with hypervigilance. Traumatic stress can also change the body’s natural opioid system, the endogenous opioid system, which can make people with PTSD have a higher risk of chronic pain and opioid dependence. Using or withdrawing from opioids can also overstimulate the nervous system and aggravate PTSD symptoms.

Bipolar Disorder and Stimulant Use

Bipolar disorder is a mental health disorder characterized by cycles of high energy and mood (mania) and low energy and sadness (depression). People with bipolar disorder are at a significantly increased risk of struggling with substance use, and cocaine and other stimulants are among the most abused substances.

Like other dual diagnoses, the relationship between the mental disorder (bipolar) and the SUD (cocaine/stimulant use) is often driven by self-medication. When individuals are experiencing depressive episodes, they may use stimulants to cope with their depressive symptoms or chase the highs of their manic episodes. Although cocaine and other stimulants can provide a short-term mood boost, they can severely heighten bipolar symptoms long-term. Other studies have shown that individuals with co-occurring bipolar disorder and cocaine addiction are substantially more vulnerable to medication noncompliance, frequent hospitalizations, and increased suicide risk.

Anxiety and Benzodiazepine Use

Anxiety disorders are common, and they lead to symptoms like feelings of dread, panic, or impending doom, irritability, intrusive thoughts, avoidance, restlessness, and poor concentration. Anxiety is often dual diagnosed with benzodiazepine misuse. Benzodiazepines are a class of medication that works to slow down the central nervous system, providing fast-acting calming effects.

Since benzodiazepines provide quick relief from anxiety symptoms, people with anxiety disorders, such as panic disorder or generalized anxiety disorder, often use them to cope. Over time, this can lead to higher tolerance and a dependency on the medication to function normally. This may result in misuse or abuse, as well as worsening rebound anxiety that occurs when the medication wears off.

Why Does Integrated Treatment Beat Sequential Treatment?

To successfully treat co-occurring mental health and substance use disorders, integrated care is the clinical gold standard. Integrated treatment assumes that mental illness and addiction are deeply connected and must be treated simultaneously with a single treatment plan. It uses a collaborative, multidisciplinary approach where various medical professionals, including therapists, psychiatrists, and addiction counselors, work together to develop a personalized treatment plan.

This model of treatment is prioritized over the more outdated model of sequential treatment, which requires the patient to get sober from substances before addressing their mental health disorder. Integrated treatment is the gold standard for dual diagnoses because it:

• Addresses both disorders with one patient-centered treatment plan, preventing conflicting treatments
• Significantly improves psychiatric symptoms
• Reduces treatment drop-out rates caused by transportation and scheduling difficulties
• Helps break the self-medication cycle to reduce relapse rates
• Increases long-term recovery motivation

Compared to the sequential treatment model, relapse rates are much lower with integrated treatment, as both disorders are treated concurrently.

How Rubicon Treats Both Sides at Once

At Rubicon Behavioral Healthcare, we have 2 sides to our practice: Rubicon Mental Health Center and Rubicon Recovery Center. We collaborate to provide evidence-based dual diagnosis care for patients with co-occurring disorders. In both centers, we offer 3 main levels of care to meet patients where they are. They include:

• Partial Hospitalization Program (PHP): This program runs for 6 days per week, 6 hours a day. It generally lasts 30 to 45 days.
• Intensive Outpatient Program (IOP): This program runs for 3 hours a day, with patients attending 3 to 5 days per week. It typically lasts for 10 to 12 weeks.
• Outpatient Program: This program runs for 2 to 3 days a week, 1 hour a day. The program length varies, but it frequently lasts for several months.

Each of our programs is based on a threefold model that helps manage physical, mental, and spiritual health. Rather than treating mental health disorders and substance use disorders sequentially, we provide integrated care that addresses all aspects and symptoms.

Our team of master’s-level mental health professionals also looks beyond diagnosis or substance use to factor in real-life pressures, such as family life, work, and financial circumstances, that can affect recovery. With this approach, we can provide dual diagnosis care that treats both disorders at once, increasing chances of long-term recovery and improving mental and physical health.

What Therapies Are Used in Dual Diagnosis Treatment?

When a patient enters dual diagnosis treatment at Rubicon Mental Health Center, they will undergo a clinical assessment to help the team understand their symptoms, diagnoses, and needs for treatment. This helps our clinicians determine which program is best and what treatment modalities will be used to treat the co-occurring disorders. Although every patient in dual diagnosis treatment is different, some of the common treatment modalities used include:

• Cognitive Behavioral Therapy (CBT): This is a type of talk therapy that is highly effective for treating co-occurring disorders, as it helps address the negative thoughts and behaviors that commonly overlap in mental health disorders and SUDs. It also helps patients build coping skills and learn about relapse prevention.
• Dialectical Behavior Therapy (DBT): A subset of CBT, this type of talk therapy is designed for people with intense emotions. It is based on 4 pillars: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness, which help the patient to recognize the emotional pain that often leads to substance abuse.

Other modalities that we may utilize include group therapy, family counseling, holistic therapy, and motivational interviewing (MI). We also offer other helpful services for managing dual diagnoses, including addiction education and relapse prevention services, sober living homes, case management services, wellness recovery action planning (WRAP), and illness management in recovery (IMR).

Insurance and Admissions

Mental health and addiction treatment can be costly, and the cost often acts as a barrier to people who want or need help. Fortunately, insurance can often help cover some of the treatment costs. Your exact coverage and out-of-pocket costs will depend on your insurance provider, plan, and benefits. However, the Mental Health Parity and Addiction Equity Act (MHPAEA) mandates that health insurance plans treat mental health conditions on par with physical health conditions.

This means that most insurance plans will pay for at least part of the cost of treatment. At Rubicon, we accept most major insurance plans. Our insurance verification process is a quick and easy way to help you determine your coverage and potential out-of-pocket costs. Contact admissions@rubiconbhc.com to learn more.

Find Evidence-Based Dual Diagnosis Treatment Near You in NJ, PA, & NY

If you’re dealing with a mental health disorder and a substance use disorder, you’re not alone, and help is available. At Rubicon Mental Health Center, we serve individuals from New Jersey, Pennsylvania, and New York with evidence-based integrated care that addresses both disorders simultaneously. Here, wellness is just a phone call away, and we’re here for patients 24/7. Call 908-678-1870 or contact us online today to learn more about our dual diagnosis treatment near you in Watchung, NJ.