Key Takeaways
- Approximately half of individuals with a substance use disorder also have a co-occurring mental health condition.
- Integrated treatment that addresses both conditions simultaneously produces significantly better outcomes than sequential treatment.
- San Diego County offers dual diagnosis services through county behavioral health, VA programs, and private treatment facilities.
- Common co-occurring conditions include depression, anxiety disorders, PTSD, bipolar disorder, and ADHD.
- Trust SoCal provides comprehensive dual diagnosis treatment with psychiatric care integrated into addiction programming.
Understanding Dual Diagnosis
Dual diagnosis, also called co-occurring disorders, describes the simultaneous presence of a substance use disorder and one or more mental health conditions. This is not a rare occurrence. National data indicates that roughly half of all individuals who experience a substance use disorder during their lifetime will also meet criteria for a mental health diagnosis, and vice versa. The relationship between these conditions is bidirectional, meaning each can cause, worsen, or maintain the other.
In San Diego County, the most common co-occurring conditions seen in treatment settings include major depressive disorder, generalized anxiety disorder, post-traumatic stress disorder, bipolar disorder, and attention-deficit/hyperactivity disorder. The county's large military and veteran population also contributes to high rates of trauma-related co-occurring presentations.
Historically, addiction treatment and mental health treatment were delivered in separate systems with little coordination. An individual might complete a residential addiction program only to relapse because an underlying anxiety disorder was never addressed. Or a person receiving psychiatric medication for depression might continue drinking because their substance use was viewed as a separate issue. Modern treatment recognizes these conditions as deeply intertwined and requiring simultaneous intervention.
Why Integrated Treatment Matters
Integrated treatment means that the same clinical team addresses both the substance use disorder and the mental health condition within a single treatment plan. This approach avoids the gaps, contradictions, and communication failures that occur when a client receives addiction services from one provider and psychiatric services from another.
Research from the Substance Abuse and Mental Health Services Administration and other federal agencies consistently shows that integrated treatment produces better outcomes across multiple measures including substance use reduction, psychiatric symptom improvement, treatment retention, housing stability, and overall quality of life. Individuals receiving integrated care are also less likely to require hospitalization or emergency services.
The key components of effective integrated treatment include a thorough psychiatric assessment at intake, medication management by a psychiatrist experienced in addiction medicine, therapy modalities that address both conditions such as cognitive behavioral therapy and dialectical behavior therapy, and a treatment plan that sets goals for both mental health and substance use recovery.
If you are currently taking psychiatric medication and considering addiction treatment, never stop your medication without medical guidance. A quality dual diagnosis program will work with your prescribing physician to ensure continuity of psychiatric care throughout treatment.
Common Co-Occurring Conditions
Depression and addiction frequently co-occur, with each condition exacerbating the other. Alcohol and other depressants can deepen depressive symptoms, while the shame and consequences of addiction fuel hopelessness. Effective dual diagnosis treatment addresses the neurochemical and psychological dimensions of both conditions simultaneously.
Anxiety disorders, including generalized anxiety, social anxiety, and panic disorder, often drive substance use as individuals self-medicate to manage overwhelming worry and physical tension. Treatment must provide alternative coping strategies before removing the substance that has been serving as the primary anxiety management tool.
PTSD and Trauma-Related Disorders
Post-traumatic stress disorder is one of the most common co-occurring conditions in San Diego, particularly among military veterans, first responders, and survivors of violence or abuse. Substance use often develops as a way to manage the hyperarousal, intrusive memories, and emotional numbing that characterize PTSD. Effective treatment must address the trauma directly through evidence-based modalities such as EMDR or Cognitive Processing Therapy while simultaneously treating the addiction.
Trust SoCal's clinical team includes therapists trained in trauma-focused treatments who understand the complex relationship between PTSD and substance use. Our integrated approach ensures that trauma processing occurs within the safety of a structured treatment environment, reducing the risk that trauma work will trigger relapse.
Bipolar Disorder and ADHD
Bipolar disorder and ADHD are also frequently seen alongside substance use disorders. The impulsivity and risk-taking associated with manic episodes and ADHD can increase vulnerability to substance experimentation and escalation. Accurate psychiatric diagnosis is essential because stimulant medications used to treat ADHD and mood stabilizers used for bipolar disorder require careful management in the context of an active or recent substance use disorder.
A comprehensive psychiatric evaluation at the beginning of treatment helps distinguish between symptoms that are substance-induced and those that represent an independent psychiatric condition. This distinction is critical for developing an appropriate medication strategy and treatment plan.
Dual Diagnosis Resources in San Diego County
San Diego County Behavioral Health Services operates programs specifically designed for individuals with co-occurring disorders. These county-funded services are available to Medi-Cal recipients and uninsured individuals through community-based providers. The county has also invested in training its contracted treatment providers to deliver integrated care, raising the standard of dual diagnosis treatment across the public system.
The VA San Diego Healthcare System offers co-occurring disorder treatment tracks for veterans, including specialized programming for PTSD with comorbid substance use disorders. These programs combine evidence-based trauma therapies with addiction treatment and medication management.
For individuals with private insurance, facilities like Trust SoCal provide the most comprehensive dual diagnosis care, with psychiatrists, psychologists, licensed therapists, and medical staff collaborating on individualized treatment plans. Our location in Fountain Valley, Orange County, is easily accessible from San Diego via the I-5 corridor, and our admissions team can be reached at (949) 280-8360.
Getting Started with Dual Diagnosis Treatment
The first step in addressing co-occurring disorders is a thorough assessment by a qualified clinical professional. This assessment should evaluate both substance use patterns and mental health symptoms, including a detailed history of when symptoms began, how they interact, and what treatments have been tried previously. Based on this assessment, the clinician can recommend the appropriate level of care and develop an integrated treatment plan.
If you suspect that you or a loved one has both a substance use disorder and a mental health condition, do not wait for one issue to improve before addressing the other. Integrated treatment addresses both simultaneously and produces the best outcomes. Trust SoCal's admissions team can conduct an initial assessment over the phone and guide you through the process of entering treatment. Call (949) 280-8360 today.
Bring a list of all current medications, past treatment history, and any psychiatric diagnoses to your assessment appointment. This information helps the treatment team develop an accurate picture of your needs from the start.
Courtney Rolle, CMHC
Clinical Mental Health Counselor
