Mental health problems and substance abuse are closely linked conditions that therapists and other health professionals regularly face. When mental disorders and substance abuse co-occur in an individual, the person is said to have a dual diagnosis or co-morbidity. According to the Centre for Addiction and Mental Health, people with a mental illness are twice as likely to have a substance use disorder as the general population. At least 20% of people with a mental illness have a co-occurring substance use disorder.

Dual diagnosis treatment requires an integrated plan that addresses both conditions as related disorders. The Canadian Centre for Addictions offers mental health and addiction treatment using a client-centred approach that gives you or a loved one the best chance at recovery.

Mental Health and Addiction Treatment in Toronto, Ontario

Mental health problems and substance abuse are closely linked conditions that therapists and other health professionals regularly face. When mental disorders and substance abuse co-occur in an individual, the person is said to have a dual diagnosis or co-morbidity. According to the Centre for Addiction and Mental Health, people with a mental illness are twice as likely to have a substance use disorder as the general population. At least 20% of people with a mental illness have a co-occurring substance use disorder.

Dual diagnosis treatment requires an integrated plan that addresses both conditions as related disorders. The Canadian Centre for Addictions offers mental health and addiction treatment using a client-centred approach that gives you or a loved one the best chance at recovery. 

What is the Relationship between Mental Health and Addiction?

Mental health and addiction are complexly intertwined and may be difficult for an untrained person to distinguish. In a dual diagnosis, both conditions present different symptoms that can affect functionality. They also affect each other, meaning if one is left untreated, the other tends to get worse. The symptoms of a dual diagnosis differ among individuals, with factors like genetics, brain responses, and environmental triggers exacerbating symptoms of mental health disorders or substance addiction. 

Individuals with mental health disorders tend to self-medicate with alcohol or drugs. While these substances may ease existing symptoms at first, they can trigger adverse effects leading to worse symptoms in the long term. Mental illnesses are caused by a plethora of factors, and it’s unlikely that substance abuse is the sole cause of any mental illness. However, individuals at risk of mental health problems will increase their chances of developing a mental illness if they abuse drugs or alcohol. 

Mental health problems and substance use disorders will usually not improve unless treated. It can often feel like the individual is facing an impossible situation due to overlapping symptoms that often amplify each other. However, with the right combination of treatment and support, one can recover from a dual diagnosis and get their life back on track. CCFA’s mental health and addiction treatment centre offers a holistic client-centred perspective that combines mental health support and traditional rehab programs for treating co-occurring disorders.

How CCFA Tackles Mental Health and Addiction

At CCFA’s mental health and addiction rehab centres, we understand that addiction is only a symptom. It is a person’s temporary solution to an already existing problem. Behaviours of addiction are used to self-medicate, numb, and escape from underlying issues, emotions, and feelings. We work to help identify these underlying issues specific to each individual that enters our program. 

In a rigorous two-year study at CCFAy, employing a reliable measure of depression and anxiety, and employing both descriptive and inferential statistics, psychologist Jonathan Siegel identified that at the beginning of treatment, 75% of all residents admitted into CCFA’s inpatient addiction treatment program reported issues of compromised mental health. While there may be various reasons for this, problems with drugs and alcohol are associated with various mental health issues.

CCFA’s program is designed to focus on the identification of the underlying issues that led to addiction.

We do this with the following:

Rehabilitation and Wellness Inventory

As part of the ongoing evidence based research at CCFA and a commitment to ongoing improvement in treatment, CCFA administers a 50 item inventory to residents before and after treatment. The inventory is a reliable and valid instrument and takes, on average, about 10 minutes to complete. The Rehabilitation and Wellness Inventory (RWI) is administered at the beginning and end of treatment. The data is analyzed by Psychologist Jonathan Siegel, and it focuses on the following subscales and data categories:

Biopsychosocial Assessment 

A Biopsychosocial Assessment is administered at the beginning of CCFA’s program. This type of assessment is based on the theory that health and illness result from a combination of biological, psychological, and social factors. Our biopsychosocial assessment involved asking the client questions covering their biology, psychology, and social factors. 

Biological factors include genetics, physiology, chemistry, and neurology, and questions may cover the following:

• Family medical history
• Pre-existing medical conditions
• Current use of prescription drugs or supplements

Psychological factors include the client’s personality, thoughts, emotions, and behaviour and questions may cover the following:

• Mood changes
• History of suicidal thoughts or behaviour
• Family history of psychiatric illness
• Strengths and weaknesses

Social factors include environmental or interpersonal conditions affecting the client’s thoughts, emotions, and behaviour. Social questions may cover the following:

• Family situation and relationships with family members
• Presence of an emotional support structure
• Job satisfaction and financial stability
• Presence of stressors in the client’s life

Onsite Registered Psychotherapist 

CCFA’s onsite psychotherapist will provide one-on-one direct counselling with a special focus on working on underlying the mental issues that the individual may be experiencing. These one-on-one psychotherapy sessions are in addition to the one-on-one sessions that the individual will receive from their Primary Addictions Counsellor.

One-on-One Sessions With a Primary Addictions Counsellor

A minimum of two one-on-one sessions a week with an individual’s personal Addictions Counsellor will concentrate on solution-focused strategies that will help the individual recognize the people, places and things that trigger the unhealthy coping mechanisms of addiction. These sessions will help cultivate and nurture new healthier coping mechanisms.

Discharge Planning

Residents will receive an individualized comprehensive support plan at the end of treatment that will connect people to continued mental health professionals and supports in their home community. 

The Different Types of Mental Health and Addiction Disorders

The most common types of mental health conditions that co-occur with substance addiction disorders include the following:

Depression

Depression is one of the most common mental illnesses and typically manifests an overwhelming feeling of sadness, hopelessness, or loss of interest in activities once enjoyed. Extreme cases of depression can increase the risk of self-harm and suicidal tendencies. A dual-diagnosis involving depression could include:

• Depression and alcohol addiction
• Depression and prescription drug addiction
• Depression and cocaine addiction

Anxiety Disorders

Anxiety disorders manifest in several ways, including panic attacks, social anxiety, and phobias. The symptoms of anxiety disorders may be physical or cognitive and include trembling, sweating, racing thoughts, rapid breathing, and sleeping difficulties. Common dual diagnosis cases involving anxiety disorders include:

• Anxiety disorder and alcohol addiction
• Anxiety disorder and opioid addiction
• Anxiety disorder and cannabis addiction

Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) is a condition where an individual who has experienced or witnessed a terrifying event has intense or disturbing thoughts related to the event. They may relive the events through flashbacks or nightmares and tend to avoid situations or people that remind them of the event. PTSD symptoms include negative thoughts, intrusive memories, numbness, disinterest, trouble concentrating, sleeping difficulties, and overwhelming fear, guilt, or shame. A dual diagnosis involving PTSD may include: 

• PTSD and opioid addiction
• PTSD and alcohol addiction
• PTSD and prescription drug addiction

Schizophrenia 

Schizophrenia is a mental illness that affects an individual’s perception of reality. A person with this condition may have problems with thinking, behaviour, and emotions. The symptoms of schizophrenia include delusions, hallucinations, disorganized thinking, social withdrawal, temper flares, and sleeping difficulties. A dual diagnosis involving schizophrenia may include:

• Schizophrenia and cannabis addiction
• Schizophrenia and opioid addiction
• Schizophrenia and prescription drug addiction

Bipolar Disorder

Bipolar disorder is a mental illness causing extreme shifts in a person’s mood and energy levels. A person with bipolar disorder will experience alternating highs and lows, with some period of stability between episodes. The symptoms of bipolar disorder may be manic or depressive, depending on the individual’s current mood cycle. A dual diagnosis involving bipolar disorder may include: 

• Bipolar disorder and prescription drug addiction
• Bipolar disorder and cannabis addiction
• Bipolar disorder and alcohol addiction

Attention-Deficit Hyperactivity Disorder (ADHD) 

Attention-Deficit Hyperactivity Disorder (ADHD) is a developmental condition that starts in childhood and often continues into adulthood. ADHD is marked by inattention and hyperactivity, leading to troubled relationships at work or school. Individuals with ADHD are prescribed stimulants for their symptoms and may easily abuse substances. A dual diagnosis involving ADHD may include:

• ADHD and prescription drug addiction
• ADHD and cocaine addiction

Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a mental condition that affects how a person feels about themselves and others. BPD leads to self-image issues, unstable relationships, difficulty managing emotions, and suicidal behaviour. 

A dual diagnosis involving BPD may include: 

• BPD and cannabis addiction
• BPD and prescription drug addiction

Eating Disorders

Eating disorders are characterized by abnormal eating behaviours and associated distressing thoughts and emotions. There are different types of eating disorders, such as anorexia, bulimia, and binge eating disorder. People with eating disorders may use drugs to suppress their appetite and form a habit of drug abuse. 

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (OCD) is characterized by unreasonable thoughts that lead to repetitive behaviours. There are several variations of the condition, and symptoms may include the following: 

• Fear of dirt or contamination
• Wanting things orderly and symmetrical 
• Unwanted thoughts
• Doubts such as wondering whether you’ve locked the door or turned off the gas

The involuntary behaviour associated with OCD can trigger depression and anxiety, leading to substance abuse. 

What are the Warning Signs of Mental Health and Addiction Disorders?

Mental health disorders and addiction frequently present similar symptoms, and it’s not always easy to tell whether an individual is dealing with either or both conditions. Some of the following signs in a loved one could point to a mental health or addiction disorder. 

• Sleep or appetite changes

If your loved one is not sleeping as well as possible or eating less than usual, they may be dealing with an addiction or mental health problem. You may also want to watch out for sudden overeating or oversleeping. 

• Mood swings

Dramatic fluctuations in mood and increased irritability can point to a mental illness or addiction disorder. They may also tend to withdraw from social functions and previously enjoyed activities.

• Thinking Problems

Mental health and addiction disorders can cause problems with thinking, feeling, and behaving. This includes problems with controlling one’s emotions, impulsivity, anger, resentment and comprised cognitive abilities, such as problems with the ability to sustain concentration, memory, problem solving, and logical reasoning. 

• Decreased functionality

Mental health and addiction disorders will cause a dramatic reduction in functionality at home, work, or school.

• Heightened sensitivity

You should consider the presence of a mental health and addiction disorder if your loved one is becoming overly sensitive to light, sound, touch, and other stimuli. 

• Nervousness and other unusual behaviour

Feeling nervous for no reason or behaving oddly or uncharacteristically can be a warning sign for mental health and addiction disorders. They may also have illogical thoughts, often marked by exaggerated beliefs about their abilities or circumstances. 

• Apathy or feeling disconnected

Losing interest in activities or feeling disconnected from oneself or surroundings can also point to mental health and addiction disorders. 

• Financial or legal troubles

If your loved one is having issues with money or the law on an increasingly frequent basis, they may be dealing with a mental health or addiction disorder.

Treatment Centre vs. Self Help

There are some individuals who chose to deal with issues of mental health and addiction without professional help. This is referred to as self-help. Self-help methods mean that rather than work with a psychiatrist or other professionals at an addiction and mental health treatment centre, you take measures on your own to improve the situation. It may also involve joining a group of people with similar issues who discuss their experiences and offer support and advice.

While many people can benefit from self-help programs, the reality is that most people dealing with mental health and addiction often require professional intervention. Trying to stop a substance addiction, for example, brings withdrawal symptoms that can be life-threatening. Professional help is usually required to navigate these unpleasant symptoms safely. The psychological impacts of mental health and addiction recovery can become more complicated than it needs to be without professional help. 

CCFA’s treatment centres for addiction and mental health issues provide a personalized treatment plan and resources that offer the best recovery chance. Getting sober is only the first step; experts often recommend a dual treatment approach that combines self-help with the professionalism of a treatment centre. Being part of a self-help group offers the individual the right environment to continue their recovery after they leave the treatment centre. 

Risks of Self-Medication

Self-medication is the practice of using available medications or other substances like alcohol to manage negative emotions. Individuals with mental health issues often self-medicate as an alternative to proper medical care. The cost of treatment, mental health stigmas, previously failed treatments, and the fear of side effects are some reasons people tend to self-medicate. 

However, self-medication carries severe health risks including:

• Worsened mental health condition or development of another condition

Self-medication can cause the progression of other conditions like bipolar disorder. Drug and alcohol use can also alter brain structure and function with time. These alterations can predispose an individual to other mental health conditions like psychotic or mood disorders. 

• Development of substance use disorder

Self-medication comes with the risk of dependence and addiction to the medication or substance of choice. Using drugs or alcohol indiscriminately can cause a person to need those substances to function. There is also the risk of overdose which can have severe or even fatal consequences. 

• Risk of drug interaction

Alcohol and drugs can interact with prescription medication such as painkillers, leading to adverse drug reactions, complications, and potential organ damage.

• Masking of severe diseases

Self-medicating with alcohol and drugs can seem to offer relief at first. However, this can mask the symptoms of more severe conditions and causes a delay in getting appropriate treatment. 

What to Expect After Treatment

Getting addiction and mental health treatment is a positive step that brings many benefits. However, mental health and addiction are chronic conditions that require continuous recovery work even after treatment. Relapse is a possibility with addiction, and mental health conditions can resurface. 

You may need to attend regular physical or online sessions with your therapist or join groups like Alcoholics Anonymous for support. Holistic therapies can help you manage stress and cope with triggers until you fully recover. You will have to avoid old friends or activities that encourage your condition and develop a routine conducive to recovery. 

Frequently Asked Questions