Category: Understanding Needs

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Understanding the Link Between Addiction and Schizophrenia

Drug addiction and schizophrenia can feel pretty similar. And if you have both, it might be hard to tell where one condition ends and the other begins. Learning about that dynamic is a key part of recovery. That knowledge can empower you to find the right type of treatment for schizophrenia and substance abuse.

Does Drug Addiction Cause Schizophrenia?

In short: no, taking drugs won’t give you schizophrenia. But addiction and schizophrenia have similar causes—and similar symptoms. The same factors that make you vulnerable to one can also make you vulnerable to the other.

If you have schizophrenia, drug use can trigger your symptoms. And depending on what drug you’re taking, being high can even feel like psychosis. That’s because both drug use and schizophrenia tamper with your brain’s reward system. Here’s why.

The Similar Brain Chemistry of Schizophrenia and Addiction

Taking any drug has an impact on your brain’s reward system. And it doesn’t matter what the drug’s actual effects are. The very act of getting high increases your levels of dopamine, a neurotransmitter. So when you take drugs, you feel a sense of reward.

Over time, you’ll need more and more of a drug to achieve that feeling. Reward might be replaced with relief. And as your tolerance goes up, you’ll likely develop a more severe addiction.

Even if you never take drugs, schizophrenia still disrupts your reward system.  In some people, it decreases baseline levels of dopamine. Or, it can make you hypersensitive to dopamine, so doing drugs feels like an even bigger reward. And if you’re taking drugs that reduce the symptoms of schizophrenia, addiction is even more likely.

Self-Medicating to Manage Schizophrenia

While addiction is unhealthy, it often begins as a coping mechanism. You might feel like drug use helps you control the symptoms of schizophrenia. And, in some cases, that might even be true. For example, nicotine reduces psychotic symptoms. But that doesn’t mean cigarettes are good for you.

In the long term, addiction continues to destabilize your reward system. Because of this, ongoing drug use can exacerbate your schizophrenia symptoms. This complicates the process of recovery.

Treatment for Both Schizophrenia and Addiction

Quitting drugs isn’t a cure for schizophrenia. But for some people, it’s an important first step toward healing. And because of the overlap between addiction and schizophrenia, many of the same treatments might help with all your symptoms.

If you’re recovering from both these conditions, you might benefit from treatment for co-occurring disorders. Within that framework, there are several specific therapies that can help.

Motivational Interviewing

Motivational interviewing (MI) helps patients with schizophrenia commit to ongoing treatment. It’s an especially effective treatment for people with both addiction and psychosis.

MI isn’t technically a type of therapy. Instead, it’s a conversation style that many different clinicians apply to treatment. Therapists, doctors, nurses, and others can all use this approach. During MI, they’ll use active listening, pointed questions, and other techniques. This can help you find your personal spark of motivation to heal.

Contingency Management

For patients with both schizophrenia and addiction, contingency Management (CM) can make recovery more likely. This approach rewards your participation in treatment. For example, you might get a gift card, voucher, or even cash for going to a therapy session. You and your care team will write and honor a treatment contract, defining prizes for each activity. In most cases, the value of your rewards will go up over time. For many people, this agreement motivates positive changes.

Dialectical Behavioral Therapy

Dialectical behavioral therapy (DBT) was originally developed to treat borderline personality disorder. Today, it has many additional uses. For example, DBT can help patients with schizophrenia, addiction, and other mental health conditions.

Sessions of DBT can feel more like classes than therapy. You’ll meet with a group, go through a workbook, and even do homework. You might also have 1:1 sessions with your therapist. Patients learn practical skills in 4 modules: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. These coping strategies can empower you to live a healthier life.

Cognitive Behavioral Therapy

Like DBT, cognitive behavioral therapy (CBT) focuses on practical coping skills. CBT helps patients with addiction and schizophrenia manage their symptoms without drug use.

Instead of trying to change your feelings, CBT shows you new ways to respond. Future episodes of psychosis might always trigger drug cravings. But you’ll learn how to accept that feeling and move on, instead of falling back into addiction.

Specialized Care in Rehab

Schizophrenia is often a lifelong condition. Instead of “fixing” all of your symptoms, treatment empowers you to manage them. These strategies are far more sustainable than addiction. And in an effective rehab program, you can heal from both at the same time.

Browse rehabs that treat schizophrenia to see locations, photos, reviews, and more.

Reviewed by Rajnandini Rathod

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The Complex Relationship Between Addiction and Depression

Depression can be either a cause or symptom of addiction. Some people try to self-medicate their symptoms, which leads to addiction. Others get depressed because of their substance use. But there’s a reason these 2 conditions appear together so often. If you have signs of both, you might need specialized treatment at a rehab for depression and addiction.

Common Causes of Depression and Addiction

Depression and addiction often occur at the same time. And in fact, having depression doubles your chance of developing addiction. But the link goes both ways. Taking drugs can also cause depressive symptoms.

What’s more, these 2 diagnoses have overlapping causes. The same factors that put you at risk for depression can also make you vulnerable to drug abuse:

Addiction and depression cause similar brain activity. And acute symptoms activate the same neural pathways over and over again. If you have depression, that happens during a depressive episode. With addiction, it happens when you take drugs. Both conditions make those pathways more and more sensitive over time. So without proper treatment, either one will continue getting worse. And, you’ll become even more vulnerable to the other.

Getting the Right Diagnosis

To get the right type of treatment, you first need an accurate diagnosis. And that can be more complex than it sounds. For example, if your depression is the result of drug use, your recovery will need to include addiction treatment.

Depression can co-occur with a wide variety of health issues. These can include mental health conditions, like anxiety, and even physical ones. For example, diabetes is linked to depression. And sometimes it’s just a symptom of a more complex diagnosis.

Depression as a Symptom of Bipolar Disorder

Bipolar disorder is a mood disorder that occurs in over 50% of people with addiction. People with this condition experience periods of depression interspersed with mania. And because it’s a primary symptom, bipolar is often misdiagnosed as major depression.

If you get the wrong diagnosis, it can interfere with your recovery. And it doesn’t just delay your progress—it can also make your symptoms worse.  For a person with bipolar, antidepressants can trigger manic episodes. They can also cause intense swings between mania and depression, called rapid cycling.

Addiction can exacerbate your mood disorder symptoms. That’s true whether you have bipolar disorder, major depression, or something else. If you’re healing from both addiction and any other mental health issue, you might consider going to rehab for co-occurring disorders.

Treatments for Depression and Addiction

Depression and addiction are receptive to similar types of treatment. That means you can heal from both simultaneously. You might even find that focusing on one condition helps you heal from the other. For example, data shows that most depressive symptoms resolve during addiction treatment. But that’s not true for everyone.

When you enter recovery, you might not know which condition came first. But you can work with your care team to answer that question. If your depressive symptoms fade after detox, you might just focus on healing from addiction. But if you do have clinical depression, there are several ways to approach treatment.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) teaches patients to cope with difficult thoughts. You’ll learn practical skills that help you live with and regulate even the most intense emotions.

CBT treats depression and addiction by helping people build self-confidence. And data shows that it has lasting effects, supporting your long-term recovery. You can also combine this therapy with other types of treatment, like medication.

Medication for Depression

Depending on your physical health, your care team may recommend prescribed medication. For example, it’s common to treat depression with selective serotonin reuptake inhibitors (SSRIs), like Prozac or Zoloft. Preliminary data shows that SSRIs may also support addiction recovery. Specifically, they might help people quit smoking or heal from sex addiction.

SSRIs typically take full effect after 6 weeks. And while they’re a common treatment for depression, they aren’t right for everyone. You may need to try a few medications before you find the right fit. Or, if you have treatment-resistant depression, you might need to take a different approach.

Alternative Treatments

If traditional therapy and medication aren’t working for you, there are many other ways to treat depression. Some of these methods are experimental, while others are highly researched but less well known.

These alternative treatments aren’t replacements for traditional medical care. But you can combine them with other therapies, or even attend a holistic rehab program. There’s no right or wrong way to plan your recovery—just the way that works best for you.

Clearing the Clouds

Depression and addiction have so much in common, it can be hard to tell which one has the greater impact on your life. But there’s a silver lining to their overlapping symptoms. With the right treatment, recovery can be straightforward. In the long term, you can use the same coping skills to manage any ongoing symptoms. But most importantly, healing means learning about the complex relationship between these conditions. And doing that will teach you more and more about yourself.

Browse rehab centers that treat depression to learn about their amenities, photos, and reviews.

Reviewed by Rajnandini Rathod

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Breaking the Cycle: How to Heal From Addiction and Anxiety

Anxiety can be more than a feeling. It also affects your behavior. And if it’s getting in the way of your daily life, it makes sense that you’d look for ways to cope. But not all coping strategies are healthy. Some—like drug use—can even make your anxiety worse. In rehab for anxiety, you can learn safer, more sustainable skills.

Recognizing Anxiety

Anxiety disorders ((What are the five major types of anxiety disorders? [Text]. 2013, February 9. HHS.Gov. https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-are-the-five-major-types-of-anxiety-disorders/index.html)) look different for different people. They can even be invisible to others. But even for high achievers, anxiety can get in the way of important goals. If anxiety is interfering with your daily life, you may have one of these diagnoses:

Everyone feels stressed from time to time. But if your anxiety interferes with the rest of your life, you might have one of these diagnoses. And while it’s normal to search for ways to manage these feelings, not all coping mechanisms are healthy.

The Connection Between Anxiety and Drug Addiction

Anxiety and addiction ((Smith, J. P., & Book, S. W. (2008). Anxiety and substance use disorders: A review. The Psychiatric Times, 25(10), 19–23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904966/)) are 2 of the most common diagnoses in the U.S. And they often occur together. Some people develop addiction in an attempt to self-medicate anxiety. Others feel anxiety about their addiction. Whichever comes first, one thing is clear: anxiety and addiction are a volatile combination. ((Nguyen, A., Mirbaba, M., Khaleghi, F., & Tsuang, J. (2017). Current treatment options for co-morbid anxiety and alcohol use disorders: A review. Journal of Addictive Behaviors and Therapy, 1(1), 0–0. https://www.primescholars.com/abstract/current-treatment-options-for-comorbid-anxiety-and-alcohol-use-disorders-a-review-106758.html))

What’s more, each of these conditions can make the other one worse. And that’s true even if a drug helps with your short-term symptoms. For example, benzodiazepines are commonly prescribed for anxiety. But some benzos, like Xanax, have a rebound effect. ((Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A review of alprazolam use, misuse, and withdrawal. Journal of Addiction Medicine, 12(1), 4–10. https://doi.org/10.1097/ADM.0000000000000350)) They’re hugely effective at relieving the symptoms of panic attacks. But, if you reduce your dosage, your anxiety might spike. This can easily lead to relapse.

The complex relationship between addiction and anxiety has an impact on treatment. ((Brady, K. T., Haynes, L. F., Hartwell, K. J., & Killeen, T. K. (2013). Substance use disorders and anxiety: A treatment challenge for social workers. Social Work in Public Health, 28(0), 407–423. https://doi.org/10.1080/19371918.2013.774675)) Specifically, it can be hard to treat underlying anxiety while you’re actively taking drugs. When you’re ready to heal from either of these conditions, you might benefit from treatment for co-occurring disorders.

Treating Both Addiction and Anxiety

There’s a silver lining here. Because these issues are so common, experts have sought out many effective therapies. In residential rehab, you might try one of these, or combine them as part of a comprehensive care plan.

Cognitive Behavioral Therapy

Data shows that cognitive behavioral therapy (CBT) can effectively treat anxiety and co-occurring addiction. ((Alamdarloo, G. H., Khorasani, S. M., Najafi, M., et al. (2019). The effect of cognitive-behavioral therapy on depression, anxiety, and stress levels in iranian males with addiction. SAGE Open, 9(1), 215824401882446. https://doi.org/10.1177/2158244018824466)) This type of talk therapy helps you recognize unhealthy thought patterns. When you understand the reason behind your own behaviors, you can learn to respond in a healthier way.

Your therapist will act as a guide, teaching you practical coping strategies. As you incorporate those skills into your daily life, you’ll learn to regulate your emotions. This healthy behavior can make it easier to work through anxiety without taking drugs.

Yoga

There’s more to yoga than physical exercise. It also teaches mindfulness, breathwork, and emotional endurance. It can even give you a sense of community. For these reasons and more, research shows that yoga reduces anxiety. ((Kuppili, P. P., Parmar, A., Gupta, A., & Balhara, Y. P. S. (2018). Role of yoga in management of substance-use disorders: A narrative review. Journal of Neurosciences in Rural Practice, 9(1), 117–122. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812135/))

This is part of why yoga is often used in addiction treatment. Specifically, this mind-body practice can reduce drug cravings, helping you kick-start recovery. And over time, it can help you reconnect with yourself in an even deeper way.

Biofeedback

Biofeedback uses sensors to track your physical responses ((Banerjee, S., & Argáez, C. (2017). Neurofeedback and biofeedback for mood and anxiety disorders: A review of clinical effectiveness and guidelines. Canadian Agency for Drugs and Technologies in Health. https://www.ncbi.nlm.nih.gov/books/NBK531603/)) to certain stimuli. For example, you might wear a heart rate monitor during a therapy session. Then, with a clinician’s help, you’ll review the data it collected. This helps patients understand their own reactions to stress.

This treatment gives you valuable information about how your body reacts to certain emotions. You can then use that data to change your physiological response using different relaxation techniques. The goal is to empower you to make different choices—ones that will support your long-term health. As a result, biofeedback reduces both anxiety and drug cravings. ((Khatami, M., Woody, G., O’Brien, C., & Mintz, J. (1982). Biofeedback treatment of narcotic addiction: A double-blind study. Drug and Alcohol Dependence, 9(2), 111–117. https://doi.org/10.1016/0376-8716(82)90056-4))

Moving Forward, on Your Own Terms

Often, anxiety is the fear of things you can’t control. Some of those things—like the weather—will always be out of reach. That’s okay. In recovery, you can learn to accept your emotions just as they are. And by doing that, you can take back control of the best parts of your life.

Browse a list of anxiety treatment centers to learn about their housing, treatment options, insurance, and more.

Reviewed by Rajnandini Rathod

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Exploring the Link Between ADHD and Addiction

Attention-deficit/hyperactivity disorder (ADHD) is a serious mental health issue. From the name, it’s easy to think this condition is a set of behavioral problems. But those are just the symptoms. In reality, ADHD comes from a neurochemical imbalance—and it’s remarkably similar to the brain chemistry of addiction.

If you’re considering treatment for ADHD and addiction, you can start by learning how they relate to each other.

The Brain Chemistry of Addiction and ADHD

People with ADHD have much a higher risk of addiction. ((Davis, Caroline, et al. “Attention-Deficit/Hyperactivity Disorder in Relation to Addictive Behaviors: A Moderated-Mediation Analysis of Personality-Risk Factors and Sex.” Frontiers in Psychiatry, vol. 6, Apr. 2015, p. 47. PubMed Central, https://doi.org/10.3389/fpsyt.2015.00047.)) This is true across age groups, affecting both adults and teens with ADHD. ((Schellekens, Arnt F. A., et al. “Often Overlooked and Ignored, but Do Not Underestimate Its Relevance: ADHD in Addiction – Addiction in ADHD.” European Addiction Research, vol. 26, no. 4–5, 2020, pp. 169–72. www.karger.com, https://doi.org/10.1159/000509267.)) Experts agree that the 2 conditions have “a shared biological background.” Specifically, both addiction and ADHD have an impact on dopamine, which is a neurotransmitter.

Dopamine relates to the brain’s reward system. ((Watson, Stephanie. “Dopamine: The Pathway to Pleasure.” Harvard Health, 20 July 2021, https://www.health.harvard.edu/mind-and-mood/dopamine-the-pathway-to-pleasure.)) This naturally occurring chemical is released when you do something pleasurable. The brain defines “pleasure” broadly: your dopamine might increase when you buy a new pair of shoes, get a job, or eat a cookie. And when an activity feels good, you’re more likely to do it again.

That can be very healthy. For example, you can get dopamine from exercise. ((“Five Surprising Ways Exercise Changes Your Brain.” Greater Good, https://greatergood.berkeley.edu/article/item/five_surprising_ways_exercise_changes_your_brain. Accessed 14 Dec. 2022.)) Your brain is quite literally wired to make you want to work out. But there’s a downside to dopamine. Plenty of activities—like substance use—feel good while doing serious damage to your health. And for people with ADHD, dopamine might already be hard to come by.

The Biology of ADHD

If you have ADHD, it may take extra effort to concentrate, sit still, or complete important tasks. This often interferes with relationships, schoolwork and career. In severe cases, people with ADHD can qualify for disability benefits. ((Is ADHD A Disability? https://www.disability-benefits-help.org/disabling-conditions/adhd-and-social-security-disability. Accessed 14 Dec. 2022.)) But it also comes with some advantages. Like any other type of neurodivergence, this condition changes the way you see the world. And your unique insight can be a strength.

Biologically, people with ADHD can’t regulate dopamine levels. ((Blum, Kenneth, et al. “Attention-Deficit-Hyperactivity Disorder and Reward Deficiency Syndrome.” Neuropsychiatric Disease and Treatment, vol. 4, no. 5, Oct. 2008, pp. 893–918. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626918/.)) This condition affects at least one of the genes responsible for that process. And that, experts say, “makes it difficult for neurons to respond to dopamine.”

In other words, even if you have healthy dopamine levels, it may not feel that way. So things that “should” be pleasurable might not always feel as good as you want them to.

If nothing feels good enough, it makes sense to go looking for new types of stimulation. This may explain the link between ADHD and risk-taking. ((Shoham, Rachel, et al. “ADHD-Associated Risk Taking Is Linked to Exaggerated Views of the Benefits of Positive Outcomes.” Scientific Reports, vol. 6, no. 1, Oct. 2016, p. 34833. www.nature.com, https://doi.org/10.1038/srep34833.))

Drug use falls neatly into this category.

Dopamine and Addiction

Over time, addiction makes the brain less sensitive to dopamine. ((The Neurobiology of Substance Use, Misuse, and Addiction | Surgeon General’s Report on Alcohol, Drugs, and Health. https://addiction.surgeongeneral.gov/executive-summary/report/neurobiology-substance-use-misuse-and-addiction. Accessed 14 Dec. 2022.)) At first, your brain starts associating drugs with a sense of reward. The act of taking drugs triggers a release of dopamine, whether or not the drug itself does.

As you get used to this repeated flood of dopamine, you’ll feel less satisfaction from taking drugs. This effectively increases your tolerance to the drug, so you need to take more of it to achieve the same result. At the same time, you start feeling less pleasure from other activities. So even if you no longer enjoy the sensation of being high, you might still feel driven to take drugs.

These behaviors quickly become a vicious cycle. Psychiatrist and dopamine expert Dr. Anna Lembke explains that for people in this state, joy is often out of reach. “Now, our drug of choice doesn’t even get us high,” she says. “It just makes us feel normal.” ((Hu, Elise, and Audrey Nguyen. “Too Much Pleasure Can Lead to Addiction. How to Break the Cycle and Find Balance.” NPR, 4 Apr. 2022. NPR, https://www.npr.org/2022/03/31/1090009509/addiction-how-to-break-the-cycle-and-find-balance.))

But if you have ADHD, addiction recovery might not be enough to break the cycle. You might stop taking drugs, but still feel unsatisfied with your life. In order to heal from these co-occurring disorders, it’s important to find treatment for both of them.

Treatment for ADHD and Addiction

ADHD is often diagnosed in children ((Braaten, Ellen. “5 Things Parents and Teachers Need to Know about ADHD.” Harvard Health, 27 Oct. 2017, https://www.health.harvard.edu/blog/5-things-parents-and-teachers-need-to-know-about-adhd-2017102712643. and teens, and some people grow out of their symptoms. But that’s not true for everyone. And recent data shows that you can develop ADHD as an adult, ((“‘Late-Onset’ ADHD May Emerge in Young Adults.” Psychiatric Times, https://www.psychiatrictimes.com/view/late-onset-adhd-may-emerge-young-adults. Accessed 14 Dec. 2022.)) even if you showed no signs of it in childhood.

Because of these complexities, you might need different types of treatment in different stages of recovery. And after you complete rehab, you may benefit from ongoing care for addiction, ADHD, or both. Certain therapies are especially helpful for people with these diagnoses.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a popular treatment for many mental health conditions. And a wealth of data supports CBT as a therapy for ADHD and addiction. ((Zulauf, Courtney A., et al. “The Complicated Relationship Between Attention Deficit/Hyperactivity Disorder and Substance Use Disorders.” Current Psychiatry Reports, vol. 16, no. 3, Mar. 2014, p. 436. PubMed Central, https://doi.org/10.1007/s11920-013-0436-6.)) This framework focuses more on practical skills than it does on emotional processing. Your therapist will teach you coping strategies for dealing with difficult thoughts, urges, social situations, and more. In between sessions, you’ll try them out in your daily life.

Integrated Cognitive Behavioral Therapy

As the name implies, integrated cognitive behavioral therapy (ICBT) integrates components of CBT ((Capone, Christy, et al. “Integrated Cognitive Behavioral Therapy (ICBT) For PTSD and Substance Use in Iraq and Afghanistan Veterans: A Feasibility Study.” Journal of Traumatic Stress Disorders & Treatment, vol. 3, no. 4, 2014, p. 1000134. PubMed Central, https://doi.org/10.4172/2324-8947.1000134.)) and other treatment methods. Patients learn about their condition, practice mindfulness, and learn flexible thinking skills. You’ll use a workbook, and your therapist will give you homework assignments to complete between sessions. This format empowers clients to develop practical skills and put them to use in real-life situations.

ICBT is a highly effective treatment for co-occurring ADHD and addiction. ((van Emmerik-van Oortmerssen, Katelijne, et al. “Integrated Cognitive Behavioral Therapy for ADHD in Adult Substance Use Disorder Patients: Results of a Randomized Clinical Trial.” Drug and Alcohol Dependence, vol. 197, Apr. 2019, pp. 28–36. PubMed, https://doi.org/10.1016/j.drugalcdep.2018.12.023.)) One study even found it to be more effective than other forms of CBT. ICBT can also treat post-traumatic stress disorder (PTSD). ((McGovern, Mark. Integrated Cognitive Behavioral Therapy for Co-Occurring PTSD and Substance Use Disorders. Clinical trial registration, NCT01457404, clinicaltrials.gov, 23 Oct. 2015. clinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT01457404.)) However, like most types of talk therapy, ICBT focuses on mental, emotional, and behavioral issues. Since ADHD is also a neurochemical issue, many people need medical treatment as well.

Medication for ADHD

Prescribing medication to treat co-occurring ADHD and addiction ((Mariani, John J., and Frances R. Levin. “Treatment Strategies for Co-Occurring ADHD and Substance Use Disorders.” The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, vol. 16, no. Suppl 1, 2007, pp. 45–56. PubMed Central, https://doi.org/10.1080/10550490601082783.)) is a controversial issue. If a patient has ADHD without addiction, prescription stimulants are the standard treatment. But stimulants are highly addictive. Because of this, experts disagree about the best course of action.

This controversy even affects people with ADHD who have no history of drug abuse. Some sources caution against treating ADHD with stimulants ((Chardée A. Galán, M. S., and PhD Kathryn L. Humphreys. “ADHD and Substance Use: Current Evidence and Treatment Considerations.” Psychiatric Times, vol. 34, no. 8, Aug. 2017. www.psychiatrictimes.com, https://www.psychiatrictimes.com/view/adhd-and-substance-use-current-evidence-and-treatment-considerations.)) because of the risk of future addiction. Others say prescribed stimulants protect against addiction, ((APA PsycNet. https://psycnet.apa.org/record/2013-43688-006. Accessed 14 Dec. 2022.)) because they empower patients to manage symptoms in a healthy way.

During addiction recovery, taking medication of any kind can be complicated. Tell your doctor about your history before you start a new prescription. Together, you can make a plan to keep yourself safe. For example, they might only prescribe you a few pills at a time, and ask you to come back into their office before you can get more.

Whatever treatments you pursue, it’s essential for you to get an official diagnosis first. That can be surprisingly difficult, especially for people of certain demographics.

Getting an Accurate Diagnosis

Because of the overlapping symptoms of ADHD and addiction, ((Chardée A. Galán, M. S., and PhD Kathryn L. Humphreys. “ADHD and Substance Use: Current Evidence and Treatment Considerations.” Psychiatric Times, vol. 34, no. 8, Aug. 2017. www.psychiatrictimes.com, https://www.psychiatrictimes.com/view/adhd-and-substance-use-current-evidence-and-treatment-considerations.)) doctors can’t always distinguish between them. This means that if you already have an ADHD diagnosis, you might need to start addiction treatment before you can get one. Most rehabs start their program with thorough assessments, so it’s relatively easy to get assessed for ADHD while you’re in residential treatment. Some doctors even recommend screening everyone in addiction treatment for ADHD. ((Matthys, Frieda, et al. “[Summary of the practice guideline for the diagnosis and treatment of ADHD in adolescents and adults with addictions].” Nederlands tijdschrift voor geneeskunde, vol. 157, no. 24, Jan. 2013, p. A6025.))

In some populations, though, ADHD is harder to diagnose. There are several possible reasons for this. Many clinicians have a preconceived image of what ADHD patients look like. This makes it easy to miss the symptoms when they present in a different way. It can also be hard to differentiate between ADHD and other mental health issues.

ADHD in Teens

For children and teens with ADHD, ((“Severity of ADHD in Children Increases Risk of Drug Use in Adolescence, Says Longitudinal Study.” Https://Www.Apa.Org, https://www.apa.org/news/press/releases/2003/08/adhd-drugs. Accessed 14 Dec. 2022.)) early diagnosis is key. That’s because children with more severe ADHD symptoms are at a greater risk of developing addiction later on. However, ADHD symptoms may not appear before puberty. ((Ostojic, Dragana, and Carlin J. Miller. “Association Between Pubertal Onset and Symptoms of ADHD in Female University Students.” Journal of Attention Disorders, vol. 20, no. 9, Sept. 2016, pp. 782–91. DOI.org (Crossref), https://doi.org/10.1177/1087054714535249.)) And because even healthy teenagers go through behavioral changes, that timing can make it difficult for parents to notice a problem. While this can be an issue for teens of any gender, it’s most common among young women.

Women With ADHD

Data suggests that up to 75% of women with ADHD may be undiagnosed. ((Walters, Anne. “Girls with ADHD: Underdiagnosed and Untreated.” The Brown University Child and Adolescent Behavior Letter, vol. 34, no. 11, Nov. 2018, pp. 8–8. DOI.org (Crossref), https://doi.org/10.1002/cbl.30337.)) That might be because women with ADHD often show different symptoms ((Quinn, Patricia O., and Manisha Madhoo. “A Review of Attention-Deficit/Hyperactivity Disorder in Women and Girls: Uncovering This Hidden Diagnosis.” The Primary Care Companion for CNS Disorders, vol. 16, no. 3, 2014. www.ncbi.nlm.nih.gov, https://doi.org/10.4088/PCC.13r01596.)) than clinicians expect.

For example, one study found that women were more likely to be inattentive than hyperactive. Inattention primarily affects the person feeling it. Your inability to focus on your book won’t distract a stranger at a bus stop. But hyperactivity, which is common in men with ADHD, can be disruptive in a group setting. Both clinicians and patients’ loved ones commonly miss “internalizing” symptoms like inattentiveness. Instead, women with ADHD are often misdiagnosed with bipolar disorder, anxiety, or depression.

Differentiating Between ADHD and Anxiety

ADHD and anxiety ((Pliszka, Steven R. “ADHD and Anxiety: Clinical Implications.” Journal of Attention Disorders, vol. 23, no. 3, Feb. 2019, pp. 203–05. DOI.org (Crossref), https://doi.org/10.1177/1087054718817365.)) often go hand in hand. While ADHD is not an anxiety disorder, ((ADHD and Anxiety: What’s the Connection? 15 May 2017, https://www.medicalnewstoday.com/articles/315303.
)) they can present with similar symptoms. For instance, either condition might get in the way of finishing your homework. In people with ADHD, that’s probably because you just can’t focus. On the other hand, people with anxiety might be able to focus, but afraid of getting it wrong.

ADHD can also cause anxiety. That’s because its symptoms make it harder to achieve your goals. Some people get anxious about the impact ADHD has on their lives. Without proper treatment, it’s all too easy to get stuck in this loop.

If you have both of these conditions, it’s important to get the right diagnosis before taking medication. Otherwise, you’ll risk making your symptoms worse. ADHD patients commonly take stimulants, which can increase anxiety. ((Stimulants – Alcohol and Drug Foundation. https://adf.org.au/drug-facts/stimulants/. Accessed 14 Dec. 2022.)) Stimulants may still be a good fit for some people with anxiety disorders—it all depends on your specific health history. You can work closely with your doctor to design a care plan that meets your needs.

ADHD May Be a Risk Factor for Depression

There’s less of an overlap between the symptoms of ADHD and depression, but they have a strong correlation. People with ADHD often develop depression ((Riglin, Lucy, et al. “ADHD and Depression: Investigating a Causal Explanation.” Psychological Medicine, vol. 51, no. 11, Aug. 2021, pp. 1890–97. Cambridge University Press, https://doi.org/10.1017/S0033291720000665.)) later in life, even if they grow out of childhood ADHD symptoms.

There may be a genetic link between these conditions. And people with ADHD and depression often have other mental health issues, like addiction or trauma. Recovering from these co-occurring disorders is complex. You may require specialized care, and ongoing treatment even after rehab.

Post-traumatic Stress Disorder

Everyone experiences trauma differently. Something that feels like just a bad day to you might be deeply traumatizing for someone else. And your personal history can make you more or less likely to develop post-traumatic stress disorder (PTSD).

ADHD increases your risk of developing PTSD ((Biederman, Joseph, et al. “Is ADHD a Risk for Posttraumatic Stress Disorder (PTSD)? Results from a Large Longitudinal Study of Referred Children with and without ADHD.” The World Journal of Biological Psychiatry, vol. 15, no. 1, Jan. 2014, pp. 49–55. DOI.org (Crossref), https://doi.org/10.3109/15622975.2012.756585.
)) in response to trauma. That’s especially true for people with both ADHD and alcohol addiction. ((Luderer, Mathias, et al. “ADHD Is Associated with a Higher Risk for Traumatic Events, Self-Reported PTSD, and a Higher Severity of PTSD Symptoms in Alcohol-Dependent Patients.” European Addiction Research, vol. 26, no. 4–5, 2020, pp. 245–53. www.karger.com, https://doi.org/10.1159/000508918.)) And data shows that people with ADHD experience a higher number of traumatic events, whether or not they develop PTSD.

If you have trauma symptoms, you might benefit from trauma-informed care (TIC). TIC is a general approach to treatment, not a specific type of therapy. This means you can get trauma-informed care for ADHD, addiction, PTSD, and any other concerns you’re seeking help for.

Many Roads to Recovery

Everyone’s recovery is unique, and that’s doubly true for people with co-occurring disorders. Your provider will help you design a care plan that accounts for your various goals.

The act of healing can empower you to understand the depth of your emotional experience. That’s how it happened for Peach Perkins.

Peach is in recovery from ADHD, alcohol and drug addiction, ((ADHD and Substance Abuse: ADHD Aha! Podcast. https://www.understood.org/en/podcasts/adhd-aha/adhd-and-substance-abuse-peachs-story. Accessed 14 Dec. 2022.)) as they explained on the podcast ADHD Aha! But it took them almost a year of sobriety to understand how those conditions worked together. At first, they thought addiction was “the thing preventing me from doing a good job at work. Now I can really go all in. And I was still at work, just my eyes were crossed and I still couldn’t do what I needed to do. That wasn’t what was in my way.” After that realization, they were able to get an official ADHD diagnosis. With the right diagnosis, they finally got the treatment they needed—and you can too.

Find Balance in Treatment for ADHD and Addiction

ADHD is often, but not always, a life-long condition. Recovery usually doesn’t mean getting rid of your symptoms entirely. Instead, you’ll learn to manage them in a healthier way. And those coping skills can make it easier to heal from co-occurring diagnoses like addiction.

Learn more about rehab programs for ADHD, including their locations, pricing, insurance coverage, and more.

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Does Trauma Cause Addiction?

Addiction rarely begins on its own. Something often triggers the need to use substances to self-medicate, cope, or forget painful events, even just briefly.

Uncovering and addressing the traumas behind your addiction is an important part of the recovery journey. And with rehab centers dedicated to treating trauma, you can work through this with the support and guidance of peers and professionals.

How Trauma Sets the Stage for Later Challenges

You may have experienced developmental trauma while growing up, or a traumatic event in the more recent past. In either case, addiction often arises as a way to cope with its effects—whether we realize it or not.

Childhood Trauma

Early traumas tend to show up in our present lives in a number of ways. Behavioral health professionals call these “adverse childhood experiences,” or ACEs, and they’re closely tied to all kinds of issues we may grapple with as adults. ACEs can involve abuse, neglect, and other forms of family dysfunction.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “ACEs are strongly related to development and prevalence of a wide range of health problems, including substance abuse, throughout the lifespan.” That’s because exposure to high stress at a young age affects brain development. “Disruption in early development of the nervous system may impede a child’s ability to cope with negative or disruptive emotions,” says SAMHSA. “Over time, and often during adolescence, the child adopts coping mechanisms, such as substance use.”

Recognizing this in yourself for the first time can be overwhelming. But ACEs are extremely common. In a massive, long-term study by the CDC, “28% of…participants reported physical abuse and 21% reported sexual abuse,” and many had parents who divorced or struggled with mental illness or addiction.

Trauma isn’t okay, but it is common, even among those who appear to have had a “perfect” childhood.

Adult PTSD

Sometimes, symptoms of this develop into an ongoing condition: post-traumatic stress disorder, or PTSD. It’s surprisingly common for adults to experience symptoms from childhood trauma they don’t remember. It’s also possible for an experience as an adult to trigger a PTSD episode based on framework laid by traumatic experiences as a child.

Even though we may not be consciously aware of their origins, we might still see the effects of these traumas later in life. And they dramatically increase our likelihood of developing addiction and other mental health issues. Studies show that adult survivors of childhood trauma are more likely to engage in high-risk and self-harming behaviors, including substance abuse.

Using Substances to Manage Trauma Symptoms

The effects of trauma can be extremely hard to live with, no matter how old you are. Thoughts and feelings associated with trauma are invasive, repetitive, and can be terrifying and exhausting. Veteran mental advocate expert Dr. Harry McCleary explains, “Avoidance is a core symptom of PTSD. The last thing that anyone that has experienced a trauma wants to do is experience something similar.” One of the most common ways to do this is to use substances.

Substances are easily available, and the relief they provide is immediate.

The problem with this is that it works until it doesn’t. As soon as the effects wear off, the trauma comes back—and often even more so, due to a rebound effect. Regularly using substances to cope can quickly lead to dependence and addiction, which only creates more problems. And as long as you’re using substances to avoid your feelings, you’re not developing the coping skills necessary to manage them.

Addiction can also put you in high-risk situations—whether it’s getting more drugs in an unsafe way, or making uninhibited decisions—that lead to further traumas. As McCleary says, “Now you have multiple problems: a substance issue, and a PTSD issue, and one is feeding on another.”

The good news is that both addiction and trauma are highly responsive to treatment.

Why Treatment Should be Trauma-Informed

Trauma-informed care is “an approach in the human service field that assumes that an individual is more likely than not to have a history of trauma.” In practice, this can look like the following:

  • creating a trauma-informed culture
  • training all staff on trauma
  • screening all incoming patients for trauma
  • evaluating practices to make sure they’re not potentially retraumatizing

Trauma-informed therapists work with a knowledge of trauma and the cultural and socioeconomic factors that contribute to it. These treatment settings reduce the chance that patients will feel triggered, unsafe, or uncomfortable as they work through their trauma.

Learn more about this approach in our article on finding a trauma-informed rehab.

Learning to Manage Triggers

In rehab, you may spend some time learning how to identify and manage triggers. Substance abuse has a strong connection to PTSD symptoms, which makes managing them important. With the support of trained professionals, you can learn new ways of responding to stress within the safe environment that residential care provides.

Addressing Co-Occurring Disorders

Trauma and addiction very often go hand in hand. If you have PTSD or another diagnosis along with addiction, it’s a good idea to find a program that specifically treats co-occurring disorders. As Dr. McCleary says, “Substance use and PTSD are such close friends that we’ve developed multiple treatments to treat both at the same time. There are treatment facilities that treat both at the same time. Because that’s how prevalent this is.”

Plenty of qualified professionals specialize in treating people in exactly your position.

All you have to do is reach out to them to take the first step towards healing.

Finding Rehab for Trauma and Addiction

Trauma isn’t fair, but it is a fundamental part of the human experience. And if you’re struggling with its effects, you’re certainly not the only one.

You are normal.

There’s nothing wrong with you.

And you have endless opportunities to heal.

Looking into rehabs that specialize in treating trauma can be a great place to start that healing journey. Visit our directory to learn more about your options and reach out to treatment centers directly.

Reviewed by Rajnandini Rathod

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Treatment–And Hope–for People With Co-Occurring Disorders

Addiction doesn’t happen in a vacuum. For some people, drug abuse is related to another mental health diagnosis. If you have a co-occurring disorder, you may need specialized care during rehab.

Pre-existing mental health conditions can make addiction more likely. And, some addictions can also cause emotional problems. If either of these applies to you, it’s important to find highly specialized care. Even if a rehab treats both your conditions separately, they may not be qualified to help you heal from both at once.

Because of this, it’s very important for you to find a rehab facility that specializes in treating co-occurring disorders.

Do You Have an Underlying Mental Health Condition?

You may have more than one condition and not even know it. Many people turn to drug use to self-medicate their underlying mental health issues. And what’s more, the symptoms of drug abuse can mimic those of other conditions. This can make it hard to diagnose and treat substance abuse co-occurring mental illness. ((Myrick, H., Cluver, J., Swavely, S., & Peters, H. (2004). Diagnosis and treatment of co-occurring affective disorders and substance use disorders. The Psychiatric Clinics of North America, 27(4), 649–659. https://doi.org/10.1016/j.psc.2004.06.003)) Fortunately, once you have the right diagnosis, both addiction and mental health issues are highly treatable.

Experts estimate that about 50% of people with an addiction have a co-occurring disorder. ((Substance use and co-occurring mental disorders. (n.d.). National Institute of Mental Health (NIMH). Retrieved from https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health)) If you think you might be 1 of those 50%, there are some signs to watch out for. According to the team at White Manor River, some common signs of dual diagnosis include the following:

  • withdrawing from relationships
  • sudden behavioral changes, including erratic or risky behavior, and changes to sleep and appetite
  • feelings of confusion, hopelessness, despair
  • anxiety that is only relieved by ritualistic behavior
  • trouble at work
  • mood swings and emotional dysregulation
  • coping with any of the above symptoms by taking drugs

If you notice these signs, you should get a formal assessment from an addiction or mental health expert. They’ll be able to guide you toward the right type of treatment.

How Mental Health Affects Addiction—And Vice Versa

Many people with mental health issues take drugs to self-medicate. While that can make you feel better in the short-term, it only makes your condition worse over time. This creates a vicious cycle. You might take drugs to control symptoms, and then feel worse, leading right back to drug use. Without professional support, it can be very hard to break free of this pattern.

What’s more, long-term drug use can change your brain chemistry. ((Abuse, N. I. on D. (2020, August 20). Commonly used drugs charts. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/commonly-used-drugs-charts)) No matter why your addiction started, you can develop mental health issues because of this behavior. Substance abuse can interfere with every part of your life, including your relationships, career, and physical health. Co-occurring disorders can make those effects even worse. They also make it harder to seek treatment.

Recovering from your co-occurring disorder ((Chance, K. (2020, September 9). Kara anne. Faces & Voices of Recovery. https://facesandvoicesofrecovery.org/story/kara/)) might be complex, but it’s not impossible. Kara Anne’s story is proof of that. “Major depressive disorder became my dark cloud reality around 6th grade,” she says. “To an outside observer, my life seemed more than fine; if only they were right.”

In college, Kara Anne found alcohol. “Drinking at the pubs became my established norm,” she says. She spent the next several years going in and out rehab, caught in a cycle of recovery and relapse. Finally, “recognizing that treatment of each disease separately was not showing success,” she tried dual diagnosis treatment.

With the right kind of support, Kara Anne found relief. “Finally, I have found freedom, peace, gratitude, acceptance, purpose, introspection, and self-awareness. My recovery is my new beginning.”

There are countless stories like Kara Anne’s. And there are plenty of different treatments to help you write your own recovery story.

Starting Recovery From a Dual Diagnosis

People with co-occurring disorders usually need specialized care. It’s also possible to have more than just 2 diagnoses. The more conditions you have, the more complex your treatment will need to be. And your treatment plan may change over time, especially if you undergo medical detox. This is because your emotional state will likely change after you stabilize your brain chemistry.

Remember that you’re a whole person, and so much more than your symptoms. Treatment for co-occurring disorders honors not only the complexity of your diagnoses, but the complexity of your needs for long-term recovery.

Talk Therapy

Almost any rehab experience includes 1:1 talk therapy. In these private sessions, you’ll build a close relationship with your provider. They’ll help you understand your emotions, work through triggers, and set goals for recovery. Over time, you can also process the feelings that come up during other types of therapy.

This treatment is often the cornerstone of residential treatment. Your therapist may even design your overarching plan of care.

Behavioral Therapies

Behavioral therapies can be used to treat co-occurring addiction and mental health disorders. ((Substance use and co-occurring mental disorders. (n.d.). National Institute of Mental Health (NIMH). Retrieved from https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health)) Once in rehab, a team of specialists will evaluate you, and help you determine the best form of treatment. The list below is an example of some psychotherapies that are commonly used to treat people with a dual diagnosis. However, the experts at your rehab center will ultimately help you choose the most effective therapies for your unique needs.

  • Dialectical behavior therapy (DBT): Participants learn mindfulness strategies to help them regulate difficult emotions. You’ll also practice tolerating triggers, and building healthy relationships.
  • Contingency management (CM): Patients get rewards for healthy behaviors, like testing negative for drug use.
  • Cognitive behavioral therapy (CBT): This form of talk therapy helps you work through negative beliefs, thoughts, and behaviors.
  • Assertive community treatment (ACT): This program offers personalized mental health services to people in their own homes or communities.
  • Family therapy: Involving the entire family can be beneficial for recovery. Family members learn how to best support the person with an addiction. They also work through their own issues, learning how to build stronger relationships.

Medications That Can Treat Dual Diagnoses

In some cases, people with co-occurring disorders benefit from medication. ((Murthy, P., Mahadevan, J., & Chand, P. K. (2019). Treatment of substance use disorders with co-occurring severe mental health disorders. Current Opinion in Psychiatry, 32(4), 293–299. https://doi.org/10.1097/YCO.0000000000000510)) For example, research suggests that the antipsychotic drug clozapine works best to treat patients with addiction and schizophrenia. In addition, lithium and quetiapine have been helpful for some patients with bipolar disorder and addiction. If you’re curious about medication, start by talking to your mental health team about what options are safe for you. Every person has unique brain chemistry. Just because the meds listed here can be helpful, it doesn’t mean they’re right for everyone.

Many other medications are effective for various co-occurring disorders. It’s just a matter of finding what works best for you. You may even continue taking them after you complete rehab. If you have a history of addiction, though, ongoing medications have some risk. To guard against relapse, you should stay in close contact with your prescriber whenever you’re taking meds.

Social Support from Your Network

Your community can make a huge difference throughout recovery. Your loved ones can inspire you, motivate you, and help you live a happy and fulfilling life–that’s also a sober one.

Relationships With Friends & Family

Social support is an important part of treatment for dual diagnoses. ((Horsfall, J., Cleary, M., Hunt, G.E., & Walter, G. (2009). Psychosocial treatments for people with co-occurring severe mental illnesses and substance use disorders (dual diagnosis): a review of empirical evidence. Harv Red Psychiatry, 17(1), 24-34. https://sites.bu.edu/sswhrsaseminar/files/2013/09/Psychosocial-Treatments-for-People-with-Co-occurring-Severe-Mental-Illnesses-and-Substance-Use-Disorders-Dual-Diagnosis-A-Review-of-Empirical-Evidence.pdf)) As Don Lavender, the program director at Camino Recovery says, “If you don’t have family involvement, you run the risk of clients returning to an environment where they don’t have support or understanding.” If you’re no longer in touch with your family of origin, most rehabs also offer support for chosen family members.

In addition to family therapy, social support can have a huge impact on your healing journey. You may be able to repair long-term relationships by practicing the interpersonal skills you learn in rehab. And if that’s not possible, you can always build a new support network.
Support Groups for Co-Occurring Disorders
Self-help groups can provide invaluable support for people with co-occurring disorders.. For example, Dual Diagnosis Anonymous (D.D.A.) is a 12-Step group specifically for people with multiple conditions, including addiction and mental health concerns. You can attend their frequent online meetings from anywhere in the world. Membership is free.

Recovery is not a cure, but rather, a new way of life. As you build healthy habits, it can be inspiring to surround yourself with people who share your experience. Groups like D.D.A. can help you transform into a new version of yourself—a version that’s happy, healthy, and drug-free.

Recover in a Sober Living Home

Sober living homes, or therapeutic communities (TCs), are a great fit for some people. You may be able to attend rehab in this type of environment, or join 1 for longer-term residential support. Sober living helps reinforce positive behaviors, like attending therapy and refraining from substance use ((Substance use and co-occurring mental disorders. (n.d.). National Institute of Mental Health (NIMH). Retrieved from https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health)). The people you meet there can become mentors, friends, and even chosen family.

Research suggests that therapeutic communities are beneficial for people with a multiple conditions ((Abuse, N. I. on D. (–). How do therapeutic communities treat populations with special needs? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/therapeutic-communities/how-do-therapeutic-communities-treat-populations-special-needs)). A meta analysis reviewed 4 different studies on TCs, and found that people with co-occurring disorders had better outcomes after living in these communities than from standard care alone.

Choosing the Right Rehab

Before starting treatment, look for a rehab center that specializes in your specific diagnoses. For example, a rehab facility that treats bipolar disorder may or may not be qualified to treat post-traumatic stress disorder (PTSD). The following questions can help you choose the best facility for your particular needs. Don’t be afraid to discuss them at length with the admissions team.

  • How do you evaluate clients for dual diagnoses?
  • If I complete detox at your facility, will I be reevaluated for co-occurring disorders before beginning inpatient treatment?
  • Which specific mental health concerns do you treat most often?
  • Which mental health diagnoses does your staff specialize in treating?
  • What experiences does your team have in treating my specific diagnoses?
  • What types of therapy do you offer for various co-occurring disorders?
  • Do you create individualized treatment plans for each client? If so, how involved is the client in co-designing their treatment plan?
  • For clients with dual diagnoses, how do you integrate different types of therapy to address each person’s unique needs?
  • Do you prescribe psychiatric medication for clients with dual diagnoses?
  • How do you manage medications for clients detoxing from substance misuse?
  • How do you help clients with co-occurring disorders plan for ongoing mental health care after residential rehab?

No matter how many diagnoses you have, healing is possible. Remember to be patient and kind to yourself during your recovery journey. This road may not be easy, but it’ll certainly be worth it.

Dual diagnoses are highly treatable. Visit our directory of co-occurring disorder rehabs to search by price, insurance, specializations, treatments offered, and more and connect with a treatment center today.

Reviewed by Rajnandini Rathod

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How Long Is Rehab for Drug and Alcohol Addiction?

The short answer is: it depends on your recovery goals. If you’re going through withdrawal, for instance, you may need short-term medical care. And after detox, most people go on to attend a 30-day rehab program. But many patients need more time in treatment—and that’s okay. As you compare different rehab programs, it’s important to think about how long your program will last. 

What Determines How Long Rehab Lasts?

Several factors affect how long you’ll spend in rehab. Your care team will evaluate your needs based on a number of criteria. 

How Severe Is Your Addiction?

Everyone’s experience of addiction is a little different. That includes the frequency and intensity of your drug use and your timeline for starting recovery. You could enter rehab with serious health issues due to years of untreated alcohol addiction. Or you might start treatment for meth addiction after taking it only a few times, already aware that you need help. Patients with more severe physical and mental health symptoms typically need more time in residential rehab. 

Do You Have Co-Occurring Disorders?

If you’re healing from co-occurring disorders, you may benefit from a longer stay. This gives your brain chemistry time to adjust—first to life without drug use, and then to any medications your care team prescribes. You may also need extra time to find the right types of treatment.

Are You Healing From Trauma?

Addiction and trauma often go hand in hand. Either one of these experiences can lead to the other. If you’re healing from both, your recovery journey might not be a linear experience. Some clients take a long time to unearth traumatic memories, and need expert care throughout that process. You could also find that after a short stay in rehab, returning home is the best way to continue your recovery. 

What Type of Treatment Do You Need?

There are many different ways to heal from drug addiction. In more traditional rehabs, you might start with detox and then go on to residential care. But some providers take a different approach. For example, ibogaine therapy is an alternative treatment that lasts just a few days. After you complete this type of therapy, you can return home, join an outpatient program, or go to residential rehab.

Other centers don’t adhere to a set timeline at all. In a rehab with individualized care, a team of experts will design a treatment plan just for you. Sometimes this means the length of the program itself can change to meet your needs. 

How Do You Respond to Treatment?

When you’re just starting recovery, you can only plan so far in advance. Your needs will almost certainly change over time. Along the way, you and your care team might decide you need more or less time in rehab than you originally planned. It’s important to remain flexible throughout your recovery journey. By taking adequate time to heal, you can set yourself up for long-term success.

The Length of Stay in Addiction Rehab

Although you can’t predict every aspect of your recovery, it’s still a good idea to think ahead. Talk to your doctor, therapist, or a rehab’s admissions team before you choose an addiction treatment program. They can recommend an initial length of stay, even if that changes in the future.

Short-Term Medical Detox

Medical detox can keep you safe during withdrawal. Depending on your health history, you may or may not need inpatient care at this stage. However, medical treatment is essential for people detoxing from alcohol, benzodiazepines, or opioids. Quitting these substances has serious physical side effects. In some cases, withdrawal can even be fatal.1 

Most detox programs last 1-2 weeks. During that time, your care team will keep you as comfortable as possible. You might see a doctor, nurses, psychiatrist, talk therapist, or other specialists. Some programs also offer complementary treatments like massage therapy.

Inpatient detox is just one step in your healing journey. Many programs require patients to plan for longer-term care before they start withdrawal. Then when you finish detox, you’ll go directly to rehab. 

30-Day Rehab Programs

For most patients, this is an average rehab stay. A 30-day program gives you plenty of time to get used to your new environment and focus on the hard work of recovery. But because it’s only a month, you won’t need to make long-term arrangements before you leave home. 

This time frame works well for people who need brief but specialized care so they can plug back into their lives. It’s an especially good fit for clients with a strong support network. You can turn inward while you start treatment, and reconnect with loved ones in the next stage of recovery.

A 30-day program can also help you keep your recovery private. High-profile clients might have a hard time explaining a long time out of the spotlight. 

60-Day Rehab Programs

If you have a more complex diagnosis, you might benefit from a longer stay in rehab. These programs can work well for people with multiple addictions. They can also help you recommit to recovery after relapse. 

Patients with co-occurring disorders may also need more time in treatment. It takes up to 6 weeks for most psychiatric medications to take full effect.2 If you start new meds when you arrive in rehab, it’s a good idea to stay until you know they’re working well. Otherwise, you might need to adjust your dosage as soon as you get home. Of course, this timeline depends on finding the right prescription shortly after arriving at rehab. Treatment sometimes takes more trial and error than that. 

90-Day Rehab Programs

These programs are a good fit for people who need highly specialized care. You’ll have time to find the right medications, try several different types of therapy, and get to know yourself again. In some rehabs, you can also spend this time building community with your peers. 

If you want to start treatment by attending a 90-day program, you’ll probably need to make certain arrangements in advance. For example, you might need to take time off work or hire a house sitter. And if you’re hoping to pay for treatment with insurance, check to see if it will cover this type of care. 

6-Month, 1-Year, and 2-Year Rehab Programs

An extended stay in rehab does more than kick-start your recovery. It offers you a whole new foundation. You’ll have time to reinvent yourself in a completely different context, without the pressure of the life you’re used to. 

When you attend a long-term program, you can expect things back home to change while you’re away. You may lose touch with certain people, or return to find they’ve changed as much as you have. That can be overwhelming—but it can also aid in your recovery. If you want to reenvision your life from a brand new perspective, this type of rehab can help you get started. 

Sober Living Environments

Sober living centers serve a different purpose than short-term treatment facilities. While these programs offer some structure, they rarely include clinical care. You may or may not attend therapy, or even have access to on-site staff. But you’ll still need to follow certain rules.

Most sober living environments require residents to pass regular drug tests. You’ll probably also join in mandatory activities, like support group meetings or shared meals. Residents can usually leave the house alone, but you might have to adhere to a curfew. 

With these structures in place, sober living centers encourage you to take control of your own life. You’ll probably get a job or go to school outside the house. You may need to pay rent or maintain a certain GPA to stay in the program. Some of these environments will limit the time you can live there, but others allow you to stay on indefinitely. 

Trust the Process

Healing is unpredictable. You might be able to choose how long you spend in rehab—but you can’t decide how long it will take to heal. Some clients need to extend their stay, and some return to treatment more than once. By staying present with yourself and your changing needs, you can make the best possible choices about your recovery. 

Search our list of rehabs to find detox programs, sober living environments, and everything in between.

Frequently Asked Questions About Length of Stay in Drug and Alcohol Rehab

What factors determine how long rehab lasts?

The duration of rehab depends on several factors, including the severity of addiction, underlying trauma, and the presence of co-occurring disorders. People with more severe physical and mental health symptoms typically require longer stays in residential rehab.

What are the different types of rehab programs and their durations?

Rehab programs vary in length based on individual needs. Short-term medical detox typically lasts 1-2 weeks, while 30-day residential programs are common for those who need brief but intensive care. Complex diagnoses or co-occurring disorders may require longer stays of 60-90 days. Extended rehab programs of 6 months, 1 year, or 2 years offer a more comprehensive foundation for recovery. Sober living environments provide structure to support your transition back to daily life.

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Finding the Right Treatment for Co-Occurring Disorders

You are more than your diagnosis. That’s true no matter what, whether you have a substance use disorder or cancer. And the goal of rehab isn’t just to treat your illness; it’s to help you heal every aspect of yourself. For some clients, that means finding a treatment program that specializes in co-occurring disorders.

Having a co-occurring disorder, or a dual diagnosis, just means that you’ve been diagnosed with more than one condition. In the context of rehab, the term is generally used for clients with multiple mental health concerns. For example, you may have a substance use disorder as well as anxiety, depression, PTSD, bipolar disorder, personality disorders, or schizophrenia. This is not an exhaustive list. Approximately 50% of people with substance use disorders have dual diagnoses.1

It’s technically true that anyone with more than one condition has a dual diagnosis. For example, a client might have both depression and diabetes. However, when a rehab facility offers a dual diagnosis treatment program, it’s safe to assume that they’re referring to conditions that relate to mental health. Substance use disorders and other mental health conditions generally have complex, multifaceted relationships. As such, people with multiple diagnoses can benefit from specialized forms of treatment.

Risk Factors for Co-Occurring Disorders

Substance use disorders are often related to certain mental health diagnoses.2 It’s important to remember that every person’s experience is unique, and these correlations aren’t necessarily causative. However, there are some well-documented risk factors that can make someone more likely to experience these co-occurring conditions.

Mental Health Concerns Can Make Substance Misuse More Likely

Mental health conditions, including substance use disorders, tend to run in families. Experts believe this is due to a combination of genetic and environmental factors. Studies have found that “as much as half of a person’s risk of becoming addicted to nicotine, alcohol, or other drugs depends on his or her genetic makeup.”3 However, life experiences also play a major role. Your diet, stress levels, physical activity, and any history of trauma can also contribute to substance misuse. According to experts, “that old saying ‘nature or nurture’ might be better phrased ‘nature and nurture’ because research shows that a person’s health is the result of dynamic interactions between genes and the environment.” Environmental conditions can also play a role in the development of mental illness.4

Research has clearly linked substance use disorders with mental health. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “People with mental illness are more likely to experience a substance use disorder5 than those not affected by a mental illness.” However, it’s not simply the case that mental health diagnoses can cause substance misuse. The reverse can also be true.

The Impact of Substance Use Disorders on Mental Health

Substance misuse changes brain chemistry. Active substance use has a short-term impact on a person’s mental and emotional state, but it doesn’t end there. Long-term drug use can also “lead to both short- and long-term changes in the brain,6 which can lead to mental health issues.” This can contribute to the development, or progression, of mental health conditions.

It’s not unusual for people to develop substance use disorders in response to mental or physical pain.7 And research has found that “people with a mental disorder, such as anxiety, depression, or post-traumatic stress disorder (PTSD), may use drugs or alcohol as a form of self-medication. However, although some drugs may temporarily help with some symptoms of mental disorders, they may make the symptoms worse over time. Additionally, brain changes in people with mental disorders may enhance the rewarding effects of substances, making it more likely they will continue to use the substance.”

This has a synergistic effect: emotional pain leads to substance misuse, which in turn increases emotional pain. As a result, many people find themselves caught in a cycle of unsustainable behavior, in which their attempts to self-soothe only amplify their distress.

Substance misuse, like many other mental health conditions, can become an all-consuming experience if it’s left untreated. Ultimately, it affects your mental health, your behavior, your relationships, and every other aspect of your life. In the midst of this crisis state, it can be difficult to even imagine life without these coping mechanisms. And this entire cycle is often accelerated for those with co-occurring disorders.

Breaking the Cycle

When you have a mental health diagnosis—whether or not it’s been officially diagnosed—it can be a struggle to find healthy coping mechanisms. Illicit substances can temporarily relieve the symptoms of mental illness, and unfortunately, they can also be more readily available than more appropriate prescription medications.

Many people find it difficult to admit that they have a problem, either with substance misuse or mental health in general. If you’re not ready to seek help, it’s unlikely that you’ll receive adequate medical care. However, you may be able to access illicit substances in a less formal way, without consulting a medical provider. Unfortunately, this accessibility is only possible due to a lack of expert oversight. Self-medicating can only get you so far.

Even with the best of intentions—for example, the conscious goal of self-medicating—substance misuse can impair your judgment. This makes it difficult to know whether your behavior has become problematic. “When an individual develops a mental illness, associated changes in brain activity may increase the vulnerability for problematic use of substances8 by enhancing their rewarding effects, reducing awareness of their negative effects, or alleviating the unpleasant symptoms of the mental disorder or the side effects of the medication used to treat it.”

futures recovery pool
You can receive professional help for co-occurring disorders at rehabs that offer these types of treatment programs, such as Futures Recovery Healthcare in Florida.

Substance Use Disorders and Trauma

Regardless of your reasons for substance misuse, unhealthy behaviors can cause further trauma. In fact, some clients report developing PTSD in response to their substance use. This can even be true for people who never experienced severe trauma before developing a substance use disorder.

Victoria Abadi, Addiction Therapist, writes, ” When a person is using a substance or behaviour addictively they often experience more trauma.9 This trauma may be caused by putting themselves in dangerous situations, behaving in a way that doesn’t reflect their moral compass, or feeling psychologically unstable due to the cocktail of chemicals and experiences.”

In addition, substance misuse often hurts relationships, including those with friends, family, and even work colleagues. If your relationships are damaged as a result of your behavior, you may experience the trauma of losing touch with a person you care about or rely on. This becomes a vicious cycle, and gives many people more reasons to continue engaging in unhealthy behavior.

As painful as this pattern can be, there is always hope for healing. Many people struggle with trauma as the cause or result of substance misuse. And many medical providers have experience in helping clients move forward. Alex Spritzer, Family Addiction and Psychiatric Nurse Practitioner at The Hope House Scottsdale, is one such therapist:

“I believe that at the heart of many addictions is a trauma base. From that trauma base, there’s other psychiatric symptoms present. That might include anxiety, insomnia, a racing mind, or mood swings–these are often psychiatric symptoms people look to abate when they’re using substances. In the dual diagnosis process, figuring out the reasons why people use [substances] is very important.”

The Hope House Scottsdale
The Hope House Scottsdale in Scottsdale, Arizona.

Finding the Right Type of Treatment for You

By their very nature, dual diagnoses are highly complex10 and unique to every client. And it can be difficult to “disentangle [their] overlapping symptoms.” For that reason, personalized treatment can be very helpful for people healing from multiple conditions.

Signs and Symptoms of Co-Occurring Disorders

Prior to rehab, many people aren’t even aware that they have co-occurring mental health conditions. It can be especially complicated to find out whether this applies to you, because the symptoms of some mental health concerns can be caused by “[physical] illness, medications, or substance abuse.”11 However, certain warning signs may indicate the presence of multiple mental health concerns.

The team at White River Manor notes that “those living with co-occurring disorders will find daily functioning difficult, if not impossible. While symptoms are often complex and can vary in severity, there are some common signs of dual diagnosis. According to their treatment team, these include

  • Social withdrawal: isolating from friends, family, and those who offer support
  • Sudden changes in behaviour (including engaging in risky or violent behaviours)
  • Changes in appetite and sleep patterns (including insomnia or excessive sleep)
  • Inability to concentrate and confused thinking
  • Intense or prolonged feelings of despair, hopelessness, and worthlessness
  • Anxiety issues that can only be relieved by certain behaviours or rituals
  • Difficulty staying in employment or meeting other responsibilities
  • Trouble maintaining relationships because of erratic behaviour or mood swings
  • Dramatic shifts in moods or energy levels and an inability to control emotions
  • Use of drugs and alcohol as coping mechanisms for any of the above, despite the dangers.”

If these symptoms describe your experience, you may want to consider a rehab program that specializes in co-occurring disorder treatment. Before choosing one facility over another, talk to the admissions team to learn more about what types of treatment they offer.

Questions to Ask Your Provider About Co-Occurring Disorder Treatment

Because treatment of co-occurring disorders is so individualized, it’s important that you find a clinical team that can support you, specifically. Ideally, your clinical team will have experience treating not only substance use disorders, but every diagnosis that applies to you. For example, a rehab facility that specializes in treating clinical depression may or may not have the right resources for a client with ADHD. To find the right program, you may have to take an active role in advocating for yourself during the admissions process. Here are some questions you can ask the admissions team at a rehab center to see whether they can provide the support you need:

  • How do you evaluate clients for dual diagnoses?
  • If I complete detox at your facility, will I be reevaluated for co-occurring disorders before beginning inpatient treatment?
  • Which specific mental health concerns do you treat most often?
  • Which mental health diagnoses does your staff specialize in treating?
  • What experiences does your team have in treating my specific diagnoses?
  • What types of therapy do you offer for various co-occurring disorders?
  • Do you create individualized treatment plans for each client? If so, how involved is the client in co-designing their treatment plan?
  • For clients with dual diagnoses, how do you integrate different types of therapy to address each person’s unique needs?
  • Do you prescribe psychiatric medication for clients with dual diagnoses?
  • How do you manage medications for clients detoxing from substance misuse?
  • How do you help clients with co-occurring disorders plan for ongoing mental health care after residential rehab?

Diagnosing Co-Occurring Disorders

The first step in healing, as always, is to go through a thorough evaluation process to determine the best course of treatment. For people with multiple mental health concerns, this process can be complex.

Remember that there’s no one-size-fits-all solution for healing. Although you may consult with your medical team before you arrive at rehab, your treatment plan will likely change over time. This is especially true for people who undergo medical detox before starting a rehab program. Once you complete detox and stabilize your physical health, your emotional state may change significantly, making reevaluation necessary.

Even if it takes time to find your diagnosis (or diagnoses), it’s important that you stay focused on the present moment, and fully committed to the process of healing. Rehab can be challenging. It’s normal to get tired, or to feel daunted by the task at hand. However, your own dedication to personal growth is absolutely vital. Experts agree that “the patient’s acceptance of a problem and his or her willingness to engage in treatment are important predictors of clinical outcomes.”12

Effective Treatment for Co-Occurring Disorders

In the right rehab program, your commitment to healing will be met by a similar commitment from your treatment providers. Because dual diagnosis treatment requires a multifaceted approach, it’s important to work with a team that can address every aspect of your health.

Co-Occurring Disorders Benefit from Holistic Healing

At Futures Recovery Healthcare, for example, providers stay in close communication with each other about each patient’s progress:

“The integration of patient care — and many other supportive services — can greatly improve long-term patient outcomes. Integrated care is the process of coordinating the efforts of each member of a patient’s care team to enhance individual and systemic outcomes. All members of a patient’s care team collaborate on a regular basis to share information about a patient with the sole purpose of ensuring that health goals are being met, identifying any new conditions or needs, and adding therapies deemed important.”

In many cases, the symptoms of substance use disorders can be easy to identify. However, the symptoms of co-occurring conditions can be much more complex. This can make it harder to define what healing means for you. If you have bipolar disorder, for example, it’s unlikely that the condition will ever simply disappear. However, there’s always hope. During rehab, you can learn to manage your symptoms in a healthy and sustainable way.

Managing Chronic Conditions

Current research holds that many mental health conditions are, at least in part, caused by biological factors. For example, studies have found that bipolar disorder may be the result of a neurochemical imbalance.13 Other mental health conditions, such as PTSD, are influenced by life experiences and environmental conditions.14 There is still much research to be done about the etiology of these diagnoses.

Whatever the cause, many mental health concerns are chronic conditions.15 It’s possible to manage them using therapy and medication, but it’s counterproductive to assume that someday all your symptoms will simply disappear without ongoing medical treatment. If you’re feeling daunted by this idea, compare your diagnosis to a physical illness. It’s perfectly appropriate for a person with a heart condition to take prescribed medication every day. Ongoing mental health treatment is equally important, and in many cases, equally accessible.

People with any mental health diagnosis can benefit from learning healthy coping mechanisms. If you also have a substance use disorder, those same coping mechanisms can help you manage cravings and keep your physical health in order. During rehab, you’ll learn these skills. After residential treatment, you’ll start putting them into practice in more complex situations.

As you prepare for life after rehab, you’ll not only hone your coping skills; you’ll also start building a support network that can help keep you on track. Dr. Monika Kolodziej, Program Director at McLean Fernside, explains:

“We know that people must learn skills to help them operate in the world and deal with depression, deal with anxiety, as they are also staying away from substances. And we know from studies that groups are an important vehicle.”

You Are More Than Your Diagnosis

It’s extremely important to find a diagnosis that accurately describes your symptoms. Doing this empowers you to get the help you need, which may include talk therapy, prescription medications, support groups, and appropriate health insurance. However, you are not your illness. You are a whole person, with needs and goals and values that transcend any difficulties you may face.

As you pursue dual diagnosis treatment, remember that rehab is not the end goal of healing. Instead, it is the first chapter of a new story. By learning more about your own emotional experience, you’ll be able to move forward in a healthier and more joyful way.

If you have, or believe you may have, a dual diagnosis, learn more about rehab centers that treat co-occurring disorders here.

Frequently Asked Questions About Co-Occurring Disorder Treatment

What are co-occurring disorders?

Co-occurring disorders, also known as dual diagnoses, refer to the presence of multiple mental health conditions. In the context of rehab, it commonly refers to patients with substance use disorders and other mental health concerns such as anxiety, depression, PTSD, bipolar disorder, personality disorders, or schizophrenia.

What are the risk factors for co-occurring disorders?

Co-occurring disorders can be caused by a combination of genetic and environmental factors. Mental health conditions, including substance use disorders, tend to run in families. Life experiences, diet, stress levels, physical activity, and history of trauma can also contribute to substance abuse and the development of mental illness.

How can I manage my co-occurring disorder after completing residential rehab?

Managing a co-occurring disorder requires ongoing care and support. It’s important to continue therapy, take prescribed medications as directed, and develop healthy coping skills. Building a support network and participating in support groups can also help in maintaining recovery. Remember that co-occurring disorders are chronic conditions, but with the right treatment and self-care, you can lead a fulfilling life beyond rehab.
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What Are the Consequences of Co-Occurring Disorders?

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If you were diagnosed with cancer and you knew that there was a high chance of dying from it, you would probably seek treatment. Would you do the same for co-occurring disorders?

Perhaps you understand that a dual diagnosis describes a person who has both a mental disorder and a substance abuse problem. But maybe you’re wondering, “What exactly does that mean? How do co-occurring disorders affect my life?”

The consequences of co-occurring disorders should motivate you to get effective treatment.

Consequences of Co-Occurring Disorders

A number of negative consequences result from co-occurring disorders. They harm your physical and psychological health. They will do so increasingly because both disorders feed off each other as they propel one in a downward spiral of mental health problems and addiction. For example, by abusing substances, one is less likely to take the medications for his mental illness, while other side effects (like mood changes) add to the mental illness.

If untreated, you have a higher likelihood for

  • Medication noncompliance
  • Suicide
  • Relationship problems with family and friends
  • Financial problems
  • Employment problems
  • Violence
  • Legal problems, which may lead to jail or prison time
  • Living in neighborhoods where drug use is common
  • Unstable housing or homelessness
  • STIs

Hidden Symptom of Co-Occurring Disorders: “I’ve Tried Treatment Before, but It Doesn’t Work”

If you’ve been in and out of hospitals, counselors, and rehabs, it is possible that you do not have just one addiction or disorder. Many times doctors detect only one side of the problem and try to treat that disorder, which causes you to relapse due to the other, untreated disorder. It is possible that if you went to rehab or worked with a doctor, he or she only knew about one of your disorders.

To be able to treat you effectively, your counselors and doctors will need to recognize the existence of two disorders occurring at the same time. If you suspect that you are dually addicted or have a co-occurring disorder, speak with your sponsor, counselor, or physician today. Then look for treatment options that will treat both disorders simultaneously.

Find dual diagnosis treatment here.