Adolescents experiment with drugs or alcohol for many reasons. Perhaps they want to fit in with their peers or they feel rebellious. Maybe they’re curious about the substance and want to feel more “like an adult.” Or perhaps they’re struggling with life’s challenges, and they’re looking for an escape.

Teens with mental health problems are more at risk for developing a dependence on drugs or alcohol. Because the focus often lands on abusing alcohol, illegal drugs, or prescription drugs, these mental health issues often go undiscovered and untreated. When a person has both a mental illness and a substance use problem, they may have what is known as a dual diagnosis, or a co-occurring disorder, and need a dual diagnosis treatment program like Elk River Treatment Program for adolescents and teens.

What is Dual Diagnosis?

The term dual diagnosis can include a broad range of conditions. It could describe a teenager with depression who abuses prescription medication to cope. Or it could also be used to describe a person that has become dependent on cocaine or heroin in order to cope with the symptoms of schizophrenia or post-traumatic stress disorder (PTSD.) Regardless of the diagnoses, using drugs and alcohol only worsens the condition. A person may feel like they need drugs or alcohol to cope with the symptoms of their mental illness, but this only leads to short and long term effects on a person’s mood, brain, and behavior.

Dual Diagnosis Statistics

A dual diagnosis is more common than you might think. Approximately one-third of people with a mental illness will have a substance abuse problem. The National Institute on Drug Abuse estimates that 60 percent of people with a substance use disorder also have a mental illness. Males are particularly at risk, as are teens with other medical conditions. A person’s genetic makeup, experiencing a traumatic event, and neurological differences (i.e. low levels of neurotransmitters) are also considered to be contributing factors to a co-occurring disorder.

Though any mental illness that occurs alongside a substance use disorder qualifies as a dual diagnosis, the most common are:

• Depression
• Bipolar disorder
• Anxiety disorders
• Conduct disorders
• Post-traumatic stress disorder (PTSD)
• Attention deficit disorder (ADD)
• Eating disorders

Because a person can experience both the substance dependence and the mental illness simultaneously, the symptoms can vary. But generally, you can look for the following:

• Extreme changes in mood and behavior
• Avoiding friends and family
• Thoughts or plans for suicide
• Loss of control over substance use
• Feeling like they need drugs or alcohol to function

Some symptoms of mental illness can go undetected, so often the signs of substance use are the most obvious when a person has a co-occurring disorder. Here are some behavioral signs as well as symptoms of substance use that you might observe.

Behavioral Signs of Substance Use

• Lack of interest in activities they once enjoyed
• High focus on privacy
• Pressuring peers to use drugs or alcohol
• Riskier behaviors, including sex, reckless driving, etc.
• Legal or academic problems
• Using more drugs or alcohol to achieve the same effect
• Talking often about drugs or alcohol

Signs and Symptoms of Substance Use

• Changes in sleep
• Difficulty concentrating
• Lack of energy
• Changes in personality
• Changes in mood
• Lack of appetite or overeating
• Irritability or anxiety

Treating a dual diagnosis early is imperative for your child. Without treatment, a co-occurring disorder can make life incredibly difficult for your child and your family. Without the necessary integrated treatment, a person with a dual diagnosis may struggle with finding and maintaining employment, finishing school, getting along with family members, and securing financial stability. They are also at increased risk for homelessness, suicide, and medical complications that can shorten their lifespan.

Integrated Dual Diagnosis Treatment Program

In the past, many treatment programs often made the mistake of treating substance use or mental illness separately when a person had a dual diagnosis. Today, researchers and practitioners agreed that integrated dual diagnosis treatment similar to Elk River Treatment Program is the best approach for recovery.

Detoxification

The first step in treating a dual diagnosis is detoxification. If a teen has used drugs or alcohol recently and frequently, they may need to be medically monitored for up to a week for withdrawal symptoms to be treated. Inpatient detoxification is considered the best practice because it removes an individual from the environment where they may have access to drugs or alcohol. If your teen requires detox before entering treatment, ERTP's admission counselors may offer suggestions on an acute drug and alcohol center in your area.

Medications to help with Dual Diagnosis

A person with a dual diagnosis may be prescribed medication for both their substance use and their mental illness. Medication taken correctly with frequent consultations with a doctor or psychiatrist can treat or relieve many of the mental illness symptoms that led to substance use in the first place. Similarly, medication can help with withdrawal symptoms a person experiences when they stop using drugs or alcohol. It’s important that you coordinate care with all doctors involved in treatment, so they understand there is a dual diagnosis and that other physicians may be prescribing medication.

Psychotherapy or Counseling for Dual Diagnosis

While medication can be helpful, professionals agree that it works best in combination with psychotherapy or counseling. In order to gain understanding about all diagnoses, a person must be educated about their symptoms and learn coping strategies for dealing with them. While many types of therapy have proven effective, the most commonly used is Cognitive Behavioral Therapy (CBT), where an individual learns how patterns of thinking can influence mental health.

Residential Dual Diagnosis Treatment Centers

Some people may benefit from an inpatient or residential dual diagnosis treatment center, where their mental and physical health can be monitored 24 hours a day. Inpatient treatment often consists of individual and group psychotherapy and treatment planning tailored to the individual’s needs. An effective dual diagnosis treatment center is aware that a person with a dual diagnosis may have intrusive thoughts that effect functioning, a lack of motivation to change behaviors, and problems socializing with others. Treatment centers should also include:

• Counseling that addresses the relationship between substance use and mental illness
• A proper evaluation of mental health and substance use history
• Medication treatment to address symptoms of mental illness
• Educational programs for family members
• Follow-up programs that provide support after departure

When choosing a dual diagnosis treatment center, make sure that staff and the program are licensed and trained in treating all diagnoses. Behavioral healthcare professionals at Elk River Treatment Program (ERTP) offer effective treatment for young people with a dual diagnosis by using an integrated approach to treating both the mental illness and the substance use problem simultaneously.

Because many treatment centers may specialize in only substance use or a certain mental illness, finding the best care for a teen or child in dual diagnosis residential treatment may prove difficult. ERTP is staffed with a multidisciplinary Treatment Team that is led by a child and adolescent forensic psychiatrist. ERTP staff have also been educated and trained to work with teens with co-occurring disorders, and the program is licensed by the Alabama Department of Youth Services and accredited in Behavioral Health Care by The Joint Commission.

Elk River's Dual Diagnosis Treatment Program

According to Elk River's Program Director Zachary Turner, “Our experience is that teens respond well to group therapy and a positive peer culture. Teens can be extremely manipulative and are quick to pick up the mental health lingo. It’s much more difficult for them to manipulate an experienced Treatment Team, which is what we use in all treatments. And it’s almost impossible for them to manipulate their peers," Turner said.

Furthermore, Turner explained, the group therapy approach normalizes teens. "Before a teen is placed in a residential setting, he or she may have resisted individual counseling for a number of reasons. Some are led to believe that they are broke and that's why they need individual counseling. Through group settings, teens learn that they are not alone or broken. They see firsthand that there are many others, like them, that struggle with their thoughts and feelings,” Turner said.
Parents searching for answers often discover that treatment programs designed primarily to treat substance abuse are not recommended for individuals that have a diagnosed mental illness. Drug treatment centers generally rely on confrontation techniques and discourage the use of prescription medications. This conflict compounds the problems of individuals with mental illness.

A better approach, according to program officials at ERTP who are backed up by NAMI research, is to treat both disorders at the same time. Early studies show that when mental illness and substance abuse are treated together, suicide attempts and psychotic episodes decrease rapidly.

Since clients with a dual diagnosis do not fit the mold of most traditional 12-step programs, and adolescents, in general, do not respond well to the prospect of lifelong changes, the Treatment Team at ERTP incorporates “The Stages of Change” into a program of cognitive behavior modification, physician-directed medication management, healthy diet, physical activity including Yoga and other methods to lower stress levels. Clients learn to trace the pattern of negative behavior through an exercise called “The Courage Circle,” and they learn that life can be much fuller if they’re in tune with their feelings rather than distractions like cell phones and social networking.

What Can You Do Today?

Raising a child is challenging enough, so when you add substance use and mental health problems, it’s easy to feel overwhelmed. Rather them shaming or threatening your son or daughter, consider that drugs or alcohol may be the only way he or she knows how to cope with the intensity of a mental illness. You can help them reclaim control of their life by educating yourself more about dual diagnosis and the treatment programs available, including more long term dual diagnosis treatment centers. Never feel that you are alone, or that recovery isn’t possible for your child.

To get started, enlist qualified doctors and mental health professionals for a more thorough assessment. And remember, many people don’t discover they have a dual diagnosis until much later in life. By helping your son or daughter get the treatment they need early on, you can help them build a life where they have the strength, the tools, and the professional treatment they need to avoid drugs and alcohol and achieve any goal they set for themselves.