Conquering Co-Occurring Disorders

By The Fix staff 08/28/17

“If we only treat the symptom, the underlying issues remain and it is more likely relapse will occur.”

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We’re living at a time when the understanding of addiction and protocols for treating substance abuse is changing more quickly than ever. That is especially true when it comes to co-occurring disorders of mental illness and substance misuse.

“The standard of care has changed quite a bit recently and that change has been based on science,” says Charlene Lenkart, ACMHC, a therapist at Maple Mountain Recovery, a trauma-informed treatment center in Mapleton, Utah.

Nearly 8 million Americans live with both mental illness and a substance use disorder, and in order to treat co-occurring disorders these individuals need a specialized treatment facility with clinicians who understand how to treat both illnesses at the same time.

“It is more effective to treat both at same time because they are related to each other,” says Lenkart. When a person comes to Maple Mountain with co-occurring disorders, the staff first works to stabilize them physically. Then the client and clinicians begin working two treatment plans concurrently, one to stabilize the mental illness and one to address the maladaptive coping strategy of abusing substances.”

Professionals used to believe in treating one illness first, but now it is understood that mental illness and addiction are so intertwined that they must be treated together.

“Oftentimes addiction is a symptom,” Lenkart says. “If we only treat the symptom, the underlying issues remain and it is more likely relapse will occur.”

People often begin misusing substances to help alleviate the symptoms of their mental illness.

“The easiest and quickest way to deal with something like depression, anxiety and trauma is by using a substance,” Lenkart explains. Using drugs is a quick and effective — albeit temporary — way to alleviate the pain of mental illness, so the use is reinforced and can quickly spiral out of control.

“If I do it once and it works really well to get my needs met, I’m going to probably do it again,” Lenkart says. “Our brain’s entire objective is to keep us alive. We will do anything to avoid pain, seek pleasure and survive.”

For people with mental illness who have not had access to proper treatment, substance use becomes a means of survival.

“If you only treat the substance use and not the mental health, it’s like putting a bandaid on when someone has cancer,” Lenkart says. “It’s just treating the outward symptoms, not what’s really wrong with the person.”

Untreated mental illness and substance misuse both can lead people to feel shame, guilt and worthlessness, which contribute to depression and anxiety.

“These are real painful emotions that are difficult to pinpoint and treat,” Lenkart says.

In order to do so clients must delve into their feelings around their mental illness, as well as issues in their past.

“We might go deeper into past trauma to find where the feelings are coming from. And we have to address self worth on the mental health side.”

Cognitive-behavioral therapy is especially beneficial for treating both mental illness and addiction, but many treatments cross over both illnesses, Lenkart says.

“Oftentimes we can can treat both with one evidence-based treatment,” she said.

As patients begin to do the tough internal work they often are able to apply what they’ve learned to their other illness.

“People will start to make connections on the side of the addiction, about their thoughts and feeling, that they can then relate directly to their mental health issues,” Lenkart says. “When they learn to manage their thoughts and feelings, they can translate that to the same symptoms that come with the other disorder.”

While treating co-occurring disorders, it is important to take into account the addictive potential of certain drugs when developing a medication plan. At Maple Mountain, clinicians work with clients and their doctors to develop a treatment plan that aligns with their values.

“We try to empower them to make the decision,” Lenkart says. “We allow them to do the research about the medications and their disorder to make an informed decision.”

Maple Mountain Recovery is a trauma-informed addiction treatment center in Mapleton, Utah. Learn more about their program at and follow them on Facebook.

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