There’s a kind of cruel efficiency in the way the human brain adapts. Once a person is in pain, their thoughts drag like a rusted chain, and something – alcohol, pills, a needle, a prescription – makes it all feel less immediate. The brain, ever the opportunist, takes note. It rewires. It reinforces. Before long, you’re not dealing with just one problem (the sadness, the paranoia, the panic) but two. And the two begin feeding off each other. Together, they blur the lines between cause and effect, symptom and self. This is dual diagnosis. It’s a term that represents a snarl of interlocking gears – mental illness and substance use disorder, tangled together, each complicating the treatment of the other. Yet, understanding dual diagnosis and its impact on recovery is crucial. Because untangling these gears, while unmistakably difficult, isn’t impossible as some might imagine it to be.
What is dual diagnosis?
Simply think of a person trying to fix a leaky roof in the middle of a hurricane. That’s what treating mental illness looks like when substance use is involved. The effort is there. The tools are there. But an external force, relentless and unpredictable, keeps trying to undo all the work you’ve put in.
According to the National Alliance on Mental Illness (NAMI), dual diagnosis – also called co-occurring disorders – happens when someone experiences both a mental illness and a substance use disorder at the same time. It’s common, much more common than you’d think. Anxiety paired with alcohol dependency. Depression – with opioid use. Bipolar disorder coexisting with stimulants. The brain, brilliant but messy, doesn’t always compartmentalize.
And the treatment? Well, that’s where things get a little complicated. You can’t just fix one problem and hope the other will politely fade into the background. They’re not independent variables. They’re, in a sense, a single system – knotted together.
Understanding dual diagnosis and its impact on recovery
The treatment of dual diagnosis isn’t linear. It doesn’t follow a neat, step-by-step flowchart. Recovery equals unraveling old patterns, replacing them with something sturdier, and doing so while the brain is still trying to drag itself back to what it knows – chemical relief, however temporary.
Challenges of dual diagnosis treatment
Mental illness alone is a labyrinth. Addiction alone is a fire. Together, they are a burning maze. One of the biggest obstacles? Medications and substances don’t always play well together.
Some medications can be rendered useless by heavy alcohol use, and some can lead to symptom worsening. For example, drinking alcohol at the same time as taking antipsychotics is like letting two rival factions fight it out in your bloodstream, and that’s why you shouldn't mix them. And then there’s the issue of diagnosis itself. Substance use can mimic mental illness. Withdrawal can create symptoms that look like depression or psychosis. A person’s real baseline – who they really are without chemicals in their system – might not emerge for weeks, even months.
Treatment has to account for all of this, which means it has to be slow and careful and address both conditions at the same time.
Common pairs of co-occurring disorders
There’s a predictability to the way mental illness and substance use disorders pair up. Some combinations are particularly common, like recurring characters in a grim novel:
Depression and alcohol use disorder
Alcohol is a depressant, but, of course, it won’t tell you that upfront. It lures you in with a moment of relief, deepening the sadness it promised to numb.
Anxiety disorders and benzodiazepine dependency
The cycle here is vicious. Benzos quiet the anxiety, but dependence creeps in fast. And when withdrawal hits, the anxiety comes back stronger, meaner.
PTSD and opioid addiction
Trauma rewires the brain. It makes it hyper-alert, restless, exhausted. Opioids, with their warm, numbing effect, feel like the best solution out there – until you’ve developed a dependence and created a whole new problem.
Bipolar disorder and stimulant abuse
Mania already speeds up the brain. Stimulants pour gasoline on that fire. The crash, when it comes, is brutal.
These combinations – and many others – create a kind of push-pull effect in the brain. The substances seem to balance things out until they don’t. And by the time they stop working, they’re not optional anymore.
Treatment of dual diagnosis
The treatment of dual diagnosis – while its main objectives remain quitting substances and stabilizing mental health – is largely about rebuilding an entire way of thinking. It requires a kind of unlearning.
For one, traditional addiction treatment models don’t always work. The old school, just-stop-using approach doesn’t account for the fact that the substances were often a form of self-medication. Take them away, and the original problem comes rushing back.
So, treatment has to be tailored. Integrated. This means addressing both mental health and addiction at the same time, in the same setting, with professionals who understand how the two interact. Group therapy, cognitive-behavioral therapy (CBT), medication-assisted treatment (MAT) – each piece has to be carefully placed.
And then, of course, there’s the matter of support. Recovery is easier when you’re not doing it alone. Community – whether in the form of therapy groups, sober friends, or understanding, empathetic family members – can make all the difference between relapse and stability.
Conclusion
Understanding dual diagnosis and its impact on recovery means accepting the fact that healing is rarely a straight path. It’s a series of recalibrations, setbacks, and adjustments. It’s learning to sit with discomfort instead of trying to numb it in the quickest way possible. Lastly, it’s recognizing that addiction and mental illness are intertwined, feeding into each other like a closed loop, like a snake eating its tail. Recovery, then, is about breaking that loop. It’s about rewiring the brain, not just away from substance use, but toward something else – stability, connection, clarity.
While it isn’t easy, it’s highly possible. Because our brains, for all their flaws, are remarkably adaptable. Even after years of damage, they can learn to function in new ways. They can heal. And for anyone struggling with dual diagnosis, that is the most important thing to remember: healing is a process. And it’s one worth fighting for.
The intricate dance between trauma and addiction is more than just a coincidental pairing; it's
an intense interplay many experts have passionately studied and discussed. As we delve into
the connection between trauma and addiction, we'll uncover layers of complexities, revealing
insights that may be the key to unlocking inner peace for many. This article promises to
illuminate the profound relationship between these two facets of the human experience, offering
a deeper understanding for those interested in the subject.
The Basics: What is Trauma?
In our journey to explore the interconnection between trauma and addiction, it's vital first to
understand trauma's essence. Often seen as a cornerstone in many emotional struggles,
trauma is a vast territory with profound implications.
Defining Trauma
At its core, trauma refers to unexpected and deeply distressing experiences that leave lasting marks on one's emotional well-being. These aren't mere events. They're experiences that linger, often profoundly altering the psyche.
Types of Trauma
● Physical Trauma: Typically involves bodily harm or injury. It can be due to accidents,
violence, or any event causing physical harm.
● Emotional Trauma: Stemming from intense negative experiences, like bullying,
betrayal, or loss, that affect the emotional psyche.
● Psychological Trauma: Often results from long-term abuse, neglect, or exposure to
distressing events, deeply affecting mental health.
Impact of Trauma on Daily Life
Trauma doesn’t just reside in the past; it projects into one’s daily existence. It can manifest in
myriad ways - from disrupted sleep patterns and anxiety spikes to difficulties forming or
maintaining relationships. Every traumatic event, regardless of its nature, possesses the power
to ripple through various facets of daily life.
Understanding Addiction: More than Just Dependency
As we transition from trauma, grappling with another challenging facet: addiction is pivotal. It's
easy to reduce addiction to mere dependency, but such an oversimplification misses the profound depths of this experience. To genuinely understand its interplay with trauma, we must
first delve into the intricacies of addiction.
Defining Addiction
At its essence, addiction is the compulsive need for a substance or behavior, pursued
regardless of the harm it might cause. It's not just a craving; it's a relentless pull that often
overrides logic and self-awareness.
Differentiating Types of Addictions
● Physical Addiction: This involves the body's dependence on a substance, where its
absence can lead to withdrawal symptoms. It's the body crying out for its "fix."
● Psychological Addiction: While there might not be physical symptoms, the mind
becomes fixated on the substance or behavior, seeing it as a means of coping or finding
pleasure.
Common Substances and Behaviors People Get Addicted To
From alcohol, nicotine, and opioids to behaviors like gambling, eating, or even internet usage,
the spectrum of addiction is vast. They all have in common their potential to be used as tools for
numbing pain, often stemming from unresolved trauma. As we'll soon discover, healing trauma often necessitates confronting these addictive behaviors head-on, recognizing them not as isolated issues but interwoven with traumatic experiences.
The Connection Between Trauma and Addiction": A Deeper Dive
Diving deeper into the confluence of trauma and addiction illuminates a landscape of
interdependence and complex causality. To truly appreciate the breadth of this relationship, we
must delve beneath the surface, identifying the intricate ways these two worlds collide and fuse.
Coping Mechanisms: Substance Use and Trauma
Trauma can leave emotional wounds that individuals might instinctively want to numb or
escape. Substance use often emerges as a makeshift solution, offering temporary relief from
haunting memories or overwhelming emotions. It's not so much about the high but about
seeking respite from the low.
Brain Chemistry: The Shared Alteration Pathway
Both trauma and addiction have profound impacts on the brain's reward systems. Traumatic
events can alter the brain's neurotransmitter systems, making one more susceptible to
substance misuse. In contrast, addictive substances can amplify trauma's effects on these
systems, creating a feedback loop of enhanced vulnerability.
Emotional Escapism: The Need to Numb
Beyond just the physical, there's an emotional dimension to consider. Trauma survivors might
turn to substances to dissociate from their traumatic memories. This "emotional escapism"
offers a temporary sanctuary, allowing individuals to distance themselves from distressing
feelings, even for a fleeting moment.
Mechanisms of Their Interplay
In this intricate web of trauma and addiction, the mechanisms that govern their interplay are as
profound as diverse. By dissecting these mechanisms, we can better appreciate how trauma
sets the stage for addiction and vice versa. It's a dance of causality, where each partner
influences the other's movements.
Avoidance Behavior: Dodging Traumatic Emotions
A primary mechanism that fosters addiction in trauma survivors is the urge to avoid trauma-
related emotions. For many, substances offer a sanctuary, a reprieve from the relentless weight
of traumatic memories. They serve as a shield, protecting the individual from confronting painful
emotions head-on.
Trauma-Induced Brain Changes: Setting the Stage for Addiction
The impact of trauma on the brain is profound. Areas like the amygdala (responsible for
emotional reactions) and the prefrontal cortex (associated with decision-making) change post-
trauma. This restructuring can increase vulnerability to addiction, as the brain's natural defenses
and judgment faculties become compromised. The substances or addictive behaviors often
exploit these weakened defenses, further deepening the connection.
The Vicious Cycle: Trauma Fuels Addiction and Vice Versa
A survivor might initially turn to substances to cope with trauma, but over time, the addictive
behavior can exacerbate trauma symptoms. For instance, substance abuse might lead to
traumatizing situations, or it might amplify feelings of guilt, shame, and self-loathing—thus
further entrenching the traumatic experience.
Breaking the Cycle: Healing and Recovery
Understanding the deep connection between trauma and addiction catalyzes breaking this
complex cycle. It brings us to the important question: How can healing and recovery occur
within this context? Focusing on treatments and approaches that tackle trauma and addiction
head-on is essential to pave the way for a more hopeful future.
Tailored Treatments: A Dual-Focus Approach
Effective treatments can't afford to look at trauma or addiction in isolation. Therapies must be
tailored to address both, thereby dismantling the underpinning cycle. For instance, Cognitive Behavioral Therapy (CBT) can be adapted to confront the underlying traumatic experiences
while equipping individuals with coping strategies for addiction.
Specialized Therapies: EMDR and Trauma Processing
Eye Movement Desensitization and Reprocessing (EMDR) is an innovative therapy designed to
help process and reframe traumatic memories. It doesn't just stop at the trauma; it creates
emotional stability, which can be pivotal in treating addiction.
Community and Support: The Role of Safe Spaces
The journey of recovery is rarely a solo endeavor. Peer support groups, community resources,
and family can play crucial roles. Regarding facilities, it's important to look for the right
Newburgh NY rehab that offers a conducive environment for trauma and addiction recovery.
Characteristics of the best facilities for addiction rehab in Newburgh, NY, often include
comprehensive dual-diagnosis treatment plans, experienced staff, and a strong emphasis on
community building.
Conclusion
We unearth a complex, intertwined relationship in shedding light on the connection between
trauma and addiction. Understanding this nexus is invaluable for more effective interventions
and holistic healing. Trauma and addiction can be addressed with the right knowledge, tools,
and support, leading to a brighter, healthier future.
Unfortunately, being a survivor of trauma or abuse is exceedingly common. According to the National Sexual Violence Resource Center,one in four girls and one in six boys will be sexually abused before they turn 18 years old. Additionally, they also found that one in five women and one in 71 men will be raped at some point in their lives.
Being a survivor of abuse can be challenging, thankfully with some self-care in place you can begin your healing journey to a healthier you. That journey from feeling scared, afraid, angry and/or alone to a place of peace and acceptance can be an empowering one. Regardless of whether your trauma was recent or happened years ago, a daily self-care regimen will help you cope with the trauma that still affects you today.
1. Quality Sleep
An essential component of maintaining optimum physical, mental, and emotional health is ensuring you get adequate sleep each night. According to The Sleep Foundation, “while sleep issues after a traumatic experience can be distressing, they may also be an important opportunity for treating and healing from trauma. Research suggests that being able to sleep after a traumatic event can reduce intrusive trauma-related memories and make them less distressing.” Additionally, getting adequate sleep helps to improve memory, increase positive mood and decrease stress.
2. Meditate
Meditating for just five to ten minutes can have some really positive benefits including: boosting immune response, regulating stress levels, increasing focus and elevating mood. Headspace (the App) now has a program on Netflix that not only guides you through meditations but also explains why and how a particular exercise can help you. I’ve also always been a big fan of the App Insight Timer. I find guided meditations are often easier for people to start off with and you can then work your way into solely music, nature sounds or silent meditations. For anxious folx, guided meditation can help to give you a focus point so it is not so overwhelming in the beginning.
3. Exercise
Exercise is beneficial for just about everyone, but for trauma survivors it can also be a way to release pent-up emotions you have relating to what has happened to you. The type of exercise is not really as important, as engaging in a daily practice of release. If you like to dance, do some Zumba, if you are more of a yoga lover, go with that. For some, taking kickboxing or jiu-jitsu can help them feel more in control after an assault and better able to defend themselves. No matter what you choose remember that exercise should be an act of self-care, meaning it should be something you enjoy- not a punishment.
4. Positive Affirmations
For many survivors there is a good-deal of shame and guilt that comes with what has happened to them. For those reasons, it is all the more important to really focus on programing yourself with positive thoughts and beliefs. For example: “I am loved,” “I am worthy,” “I am valued,” “I am strong,” “I am enough.” I often tell client’s to pick an opposite thought to their negative self-talk, so if your inner “Karen” is saying: “I am disposable”, you say to yourself: “I am worthy and deserving of love, respect and affection”. There is a really amazing App that spams your phone, however often you set it, to give you positive affirmations called “I Am”. If its a struggle for you at first to come up with your own affirmations, I really recommend it.
This process of changing that inner voice takes time and truly is a practice so be gentle with yourself. You will have days where it works great and other days where you cannot seem to get “Karen” to stop talking. It’s okay, just take it one step, one moment at a time.
5. Support
Support is critical need for healing, surround yourself with people who build you up, cheer you on and pick you up when you are down. If you have a solid support system don’t be afraid to engage them, by calling a friend or family member, attending a support group and/or finding a therapist. If your support system is lacking, use a smartphone app or the Meetup website to find a local, like-minded group and make some new friends.
Often times survivors feel alone and like no one can or will understand how they feel, or that they will be judged for what happened to them. However, as said in the beginning abuse is more common than we would like to believe in this country. Sharing your struggles with people who understand and care about you and your well-being is an important aspect of your healing journey. If you are a sexual abuse survivor and need some words of advise from others who have been through it but are not ready to take that step of opening up just yet, I highly recommend Dear Sister by Lisa Factora-Borchers and Aishah Shahidah Simmons - a book of letters from survivors of sexual abuse to other survivors.
Are you a survivor of trauma or abuse? A licensed mental health professional can help you so you don’t have to go through this alone. Give our office a call today so we can set up a time to talk.
Keep Shining,