Dual-Diagnosis Treatment

At Nexus, we recognize that drug and alcohol addiction as well as substance use disorders are commonly associated with underlying or untreated mental health disorders.

Anxiety disorders, depression, bipolar disorder, trauma, ADHD, and other psychiatric disorders frequently coincide with an individual’s substance abuse. These co-occurring disorders may have developed as a result of drug and alcohol use or may have been a factor in why an individual began using in the first place. Regardless of when the disorder manifests, it’s crucial that they be addressed during substance abuse treatment in order to give clients the best chance at long-term recovery. Otherwise, clients risk returning to their communities without tools to deal with any underlying mental health disorders and may find themselves turning to opiates, alcohol, or other drugs as a way to self-medicate.

Dual-Diagnosis Treatment at Nexus Recovery

Since drug and alcohol addiction is a chronic brain disease, individuals are more likely to see long-term success if they participate in a treatment program designed by medical and mental health professionals.

What Types of Therapies Do You Offer?

Some of the modalities used in our dual-diagnosis clinical program include:

    At Nexus, we have a team of physicians and therapists who perform a thorough assessment of new clients in order to determine if any underlying mental health disorders are present. If there is any co-occurring disorder, we coordinate with the appropriate professionals to ensure it is treated with the same level of care and expertise as an individual’s addiction.

    Offering Truly Individualized Care

    At Nexus Recovery, treatment for every client will be customized to meet his or her individual needs. By tailoring treatment to the individual, we give our clients the best chance of success as they transition back into their families and communities.

    In addition to the initial assessment, we coordinate care to ensure clients continue to be monitored by mental health professionals throughout their stay. If a mental health disorder becomes apparent once an individual has time away from drugs or alcohol, our treatment team is able to address it immediately.

    Alumni & Family Testimonials

    “As a parent, therapist and doctoral candidate in Mind-Body Medicine, who has been on the path with my son for over a decade and through many treatment facilities, I can wholeheartedly recommend Nexus. The main reason that Nexus stands out in my experience is that they offer treatment from the heart. They treat families and individuals seeking treatment holistically, considering mind, body, and spirit. Johnnie M. is one of the most loving and non-judgemental individuals I have met working in this field. He is all love and no BS and the people he touches sense it. This kind of perspective and respect for the journey turned out to be the best kind of medicine. I will add that the women who lead the required family portion of the therapeutic treatment are true professionals who skillfully guided my son and me to new levels of vulnerability, trust, and honesty. We are now enjoying the warmest, most stress-free, and unguardedly loving relationship we have had in many years. He is thriving, no longer a slave to his addiction, and I too am a changed and more liberated woman, living without daily fear for my son’s life. I am grateful beyond measure.”

    Common Co-occurring Mental Health Disorders We Treat

    While any mental health disorder can coexist with an addiction, some are more commonly observed than others.

    Identifying the presence of a co-occurring disorder is not always easy as many symptoms of mental health disorders overlap with signs of addiction. In many cases, it is not uncommon to find that underlying mental health conditions are not identified until a person enters treatment for an addiction. The presence of a mental health disorder could be an underlying influence in the development of an addiction, or it may be the result of prolonged substance abuse. Regardless of which presents itself first, co-occurring disorders require specialized treatment in order to adequately address them.


    Depression is one of the most common mental health disorders affecting people in the United States. Depression is characterized by persistent, long-lasting feelings of sadness, guilt, worthlessness, and other negative thoughts and feelings. This results in people losing interest in things they once enjoyed, experiencing significant changes in sleep and eating patterns, and it can take a toll on relationships. In some cases, symptoms of depression can be so overwhelming that a person is incapable of completing tasks and adhering to responsibilities that they have in everyday life.

    Substances may be misused in an attempt to self-medicate for symptoms of depression. While this may provide temporary relief, it often exacerbates symptoms of depression and can worsen a person’s overall mental health. Quitting use of substances can also lead to a worsening of symptoms, leaving many people trapped in a cycle of chasing temporary relief while simultaneously putting their physical and mental health at risk.


    Much like depression, anxiety is an incredibly common mental health disorder. There are a wide variety of anxiety disorders that can affect people including specific phobias, panic disorders, obsessive-compulsive disorder (OCD), and generalized anxiety disorders. While these may be triggered by different factors, they all can dramatically interfere with a person’s ability to meet the responsibilities of everyday life.

    Addiction often develops as a person will attempt to self-medicate for symptoms of anxiety. Substances may provide a person with a temporary calm, but these feelings are often short-lived. Tolerance can develop quickly, leading a person to need greater amounts to achieve the same effects. Increased tolerance often leads to the development of an addiction as a person becomes dependent on substances to feel “normal”. Unfortunately, withdrawal from substances can create symptoms that worsen anxiety and may lead to heightened states of panic or hyper-anxiety.

    PTSD or Trauma

    Exposure to traumatic experiences can lead to the development of post-traumatic stress disorder (PTSD). Traumatic events can vary, but many fall under categories of witnessing/experiencing violence, accidents, natural or human-caused disasters, sexual trauma, combat/war, and other forms of violence. While most people will experience at least one traumatic event in their lives, not everyone develops PTSD as a result. It is often characterized by persistent feelings of fear, recurring nightmares, trouble sleeping, feelings of detachment, becoming easily startled, and experiencing invasive thoughts/feelings.

    PTSD is treatable with a variety of therapies, but it is not uncommon to find that many people will attempt to self-medicate for symptoms using drugs or alcohol. Symptoms of PTSD often persist because they have not been fully resolved. Substances may be used in an attempt to silence symptoms or escape reality, but over time, this can make symptoms of PTSD more severe.

    Bipolar Disorder

    Bipolar disorder, also known as manic-depressive disorder, is characterized by sudden, dramatic shifts in energy levels, behavior, and mood. These shifts are more dramatic than the typical shifts people experience on a daily basis and they often interfere with a person’s ability to manage everyday responsibilities. It also often takes a toll on a person’s ability to maintain relationships with others.

    Drugs and alcohol may be used to offset the sudden, intense shifts people experience, but studies suggest that substance abuse can also trigger these swings. Chemical imbalances in the brain can play a role in the development of bipolar disorder and the introduction of illicit substances can further affect these imbalances, leading to more frequent, severe shifts in mood and energy.

    Eating Disorders

    Eating disorders are characterized by disturbances to a person’s eating patterns and behaviors. There are several types of eating disorders, including but not limited to, anorexia nervosa, bulimia nervosa, and binge eating disorder. Obsession with food, body weight, and shape may indicate the presence of an eating disorder.

    Substance abuse may develop as a means of addressing a person’s hyper-focus on weight and intake. Drugs and alcohol are often used due to perceived positive side effects including their ability to suppress appetite, affect weight loss, or increase energy levels. Because many people who struggle with eating disorders often have nutritional deficiencies and other physical health issues, the use of substances can put a person at increased risk for numerous life-threatening health problems.

     In addition, when someone gets sober, eating disorders may be triggered as a different way of coping with uncomfortable feelings or emotions.

    Schizoaffective Disorder

    Schizoaffective disorder is a mental health disorder whose symptoms often cause it to be misdiagnosed as bipolar disorder or schizophrenia. Schizoaffective disorder is relatively rare compared to other mental health conditions and because of this, it is less well-studied. There are two major forms of the disorder that are categorized as bipolar and depressive. Symptoms can vary from person to person and are dependent on what type of schizoaffective disorder is present, but some of the most common symptoms include hallucinations, delusions, disorganized thinking, depression, and manic behaviors.

    Schizoaffective disorder can cause a person to have major manic and depressive episodes with dramatic, intense mood swings that may occur simultaneously with symptoms such as delusions or hallucinations. Drugs and alcohol may be used as a method of coping with symptoms, but often worsen the condition. Because schizoaffective disorder is not incredibly common, substance abuse may allow it to go undetected and untreated for a long period of time.

    Why Choose a Dual-Diagnosis Treatment Center?

    In the realm of addiction treatment, dual-diagnosis has become increasingly popular because of its necessity.

    Dual-diagnosis treatment focuses on treating both the addiction and any diagnosed or undiagnosed mental health disorders simultaneously. Studies show that 6 out of 10 people in addiction treatment also struggle with a co-occurring mental health disorder. In some cases, the mental health disorder propelled the addiction, while in others, it developed as a result. Regardless of which came first, it is important to treat both equally to reduce the risk of relapse and improve the recovery experience.

    There is no standard path in which a dual diagnosis is identified, but they often exist and go undiagnosed for long periods of time. Mental health conditions can be confused for symptoms of the addiction, leading a person to not receive adequate treatment for both conditions. It can be difficult to identify the presence of a co-occurring disorder because symptoms can appear to be related to the addiction itself. Rather than focusing solely on treating the symptoms of addiction, treating the whole person by exploring a person’s history and experiences can help uncover the catalysts. In many cases, addiction develops as a means of self-medication for an existing condition or as a way to escape painful experiences. An initial assessment, therapy, and intensive care can help identify the need for dual-diagnosis care and provide comprehensive treatment when needed.

    The Difference with Dual-Diagnosis Care

    Dual-diagnosis care encourages a holistic approach to recovery. Rather than strictly utilizing traditional therapy options, dual-diagnosis may employ new forms of treatment, experiential therapy, and other individualized approaches to provide therapeutic benefits in nontraditional settings.

    This allows therapists to observe clients in environments in which they let down their guard, respond naturally, and explore the world around them. It can provide useful insights into a client’s needs and help propel treatment in the right direction.

    The treatments mentioned above used in dual-diagnosis are further explained below.

    • Cognitive Behavioral Therapy (CBT): CBT focuses on changing clients’ unproductive, negative thoughts through developing healthy coping mechanisms and focusing on problem-solving so that clients are empowered to change their circumstances.
    • Motivational Enhancement Therapy (MET): MET helps clients accept the need for help in treatment by resolving ambivalence and encouraging self-motivating statements early in sessions.
    • Multidimensional Family Therapy (MDFT): This form of treatment is family-centered and primarily used to help adolescents cope with the problems that have developed as a result of substance abuse.
    • Psychodynamic Therapy: This treatment is often used in patients who have depression, who have lost a sense of meaning in their lives, and in cases where a person has difficulty forming meaningful relationships with others.
    • Dialectical Behavioral Therapy (DBT): DBT focuses on helping clients who suffer with borderline personality disorders and other mood disorders. It works by helping clients manage painful emotions and learn how to decrease conflict in their lives.
    • Gestalt Therapy: Gestalt therapy focuses on personal responsibility and exploring what is happening in the present in order to work on developing solutions.
    • Eye Movement Desensitization and Reprocessing (EMDR): EMDR is used to help those who have experienced trauma. When asked to recall traumatic incidents, it diverts the client’s attention to reduce distress and makes the experience less emotionally upsetting to explore.
    • Rational Emotive Behavior Therapy (REBT): REBT helps clients change irrational beliefs, resolve emotional or behavioral problems, and ultimately feel more fulfilled.
    • Art Therapy: Art therapy allows clients to express themselves through a medium that requires no words. It can be a powerful way to relieve stress and express oneself in a healthy way.
    • Surf Therapy: Surf therapy challenges clients to take on a physical activity they may have no experience with. In the water, they respond naturally to stimuli, allowing therapists to observe behaviors and provide real-world context to coping mechanisms for stressful situations.
    • Music Therapy: Creating, writing, or playing music provides a valuable outlet in treatment and can help a person cope with stressors in a healthy way.
    • Yoga: Yoga encourages inward focus, inviting clients to clear their minds, focus on their breathing, and engage their bodies and minds simultaneously.
    • Meditation and Mindfulness: Meditation and mindfulness encourages self-awareness and self-reflection. The ability to clear one’s mind from the noise of daily life can provide inner peace and focus that is valuable in recovery


    What is Dual-Diagnosis?

    Dual-diagnosis treatment is a relatively new approach to an age-old problem. In addiction treatment, many people struggle with symptoms of mental health disorders for a variety of reasons. 

    Some of these may be a side effect of using specific substances, others may be symptoms of withdrawal, and there may even be some that have existed since before the addiction developed. Regardless of the timeline in which these presented, the existence of mental health conditions and addiction were often treated separately. Unfortunately, these two separate issues often overlap and exacerbate symptoms of one another. Leaving one untreated while addressing the other almost never works well. Instead, dual-diagnosis treatment ensures the underlying reasons for substance abuse are addressed and mental health is treated simultaneously with addiction.

    What Makes it Different?

    Prior to the introduction of dual-diagnosis treatment, mental health and addiction were treated sequentially which was often ineffective for long-term sobriety. Rather than distinguishing between mental health and addiction in terms of treatment options, dual-diagnosis addresses both simultaneously. Dual-diagnosis focuses on how mental health and addiction impact one another in order to improve outcomes. One in four people with a mental health condition also struggles with addiction. The two are often irrevocably linked, making it imperative to treat them together.

    Dual-diagnosis treatment provides individualized care designed to address a person’s unique needs in recovery. This should include:

    • A highly-trained treatment team that can address both mental health and addiction simultaneously
    • The potential use of medications to treat mental health disorders
    • A focus on building self-esteem and confidence to support a person through recovery
    • Treatment that spans beyond the individual by including family members and loved ones in the recovery process through group therapy, education, or individual counseling

    Signs & Symptoms of Dual-Diagnosis

    The signs and symptoms of a dual-diagnosis are similar to substance abuse disorders on their own. These may include:

    • Experiencing withdrawal symptoms after cutting back or quitting substance use
    • Feeling guilt or regret about behaviors
    • Lying and/or stealing to support addiction
    • Poor performance at work and/or in school
    • Cutting ties with friends or family in favor of a different, substance-abusing crowd
    • Using increasingly larger doses of substances
    • Inability to stop using
    • Believing delusions or hallucinations are real
    • Inability to maintain employment, manage finances, or keep healthy relationships
    • Experiencing dramatic mood swings and/or energy levels
    • Deliberately withdrawing from or cutting off relationships
    • Using substances to cope with stress

    Not everyone who displays these signs and symptoms has a co-occurring mental health disorder. The only way to accurately diagnose the need for dual-diagnosis is through the help of a professional. Evaluation specialists can examine a person’s psychological history and substance abuse patterns in order to determine whether or not dual-diagnosis treatment would be the most effective option.

        Understanding the Need for Dual-Diagnosis Treatment

        Mental health conditions can contribute to an altered sense of reality. This may make you inaccurately believe that dual-diagnosis treatment is not needed, which may in turn, cause you to neglect your own care.

        Mental health conditions can also make you believe you are not worthy of treatment and that drugs or alcohol are the only way you can cope.

        Depending on how severe the addiction is and how significantly mental health is impacting your ability to recover, there are multiple treatment options to consider. An initial assessment can help you determine what level of care is most effective for you. Those who struggle with severe signs of mental illness along with addiction often benefit the most from around-the-clock care from professionals, while those who are more mentally stable may not need such a hands-on approach.

        It is also important to note that medications are often used in treating dual-diagnosis. While there may be some reservations about using prescription medications, using these only as directed under the care of a doctor can have significant positive outcomes. It is important to assess the risks of using medications in treatment at an individual level. In many cases, medication greatly improves the recovery process as it alleviates symptoms of mental health often lead to relapse.


        Mental Health, Drug & Alcohol Abuse Stats

        It can be difficult to understand the sheer number of people impacted by mental health and substance abuse. Because addiction and mental health conditions are largely still stigmatized, it can be difficult to seek help or to know where to turn. To get a better understanding of the impact of dual-diagnosis, the Substance Abuse and Mental Health Services Administration (SAMHSA) regularly publishes data related to dual-diagnosis. Some of this data includes the following:


        • Approximately 17.5 million Americans over the age of 18 struggled with a mental health disorder within the past year, and about 4 million of those people also struggled with a co-occurring substance abuse disorder.
        • Rates of co-occurring mental health disorders becoming diagnosed for those in addiction recovery have steadily grown over the last few years.
        • More than 50 percent of those who struggle with co-occurring disorders did not receive treatment.
        • Statistics show that alcohol is the number one substance abused by those with co-occurring disorders. Roughly 41 percent of dual-diagnosis clients primarily abuse alcohol.
        • Rates of dual-diagnosis have increased steadily in recent years due to prescription painkillers.
        • Approximately 21 percent of dual-diagnosis clients use prescription painkillers.

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