Substance Use and Mental Health:
What’s the Connection?

Discover how Continuum Outpatient Center offers personalized care for individuals facing substance use and mental health challenges at the same time.

Written and medically reviewed by the clinical team at Continuum Outpatient Center, including licensed therapists, addiction specialists, and medical professionals.

The Complex Relationship Between Substance Use and Mental Health

Substance use and mental health disorders are often deeply intertwined, and this connection can manifest in multiple ways.

Research consistently shows that individuals with mental health conditions are at higher risk of developing substance use problems. According to estimates, more than 25% of adults who suffer from serious mental illness also misuse drugs.¹

Conversely, those with substance use disorders (SUD) are more likely to experience mental health challenges. Research suggests that around 37% of people with alcohol addiction and 53% of those with drug addiction suffer from at least one serious mental health condition.²

How Substance Use Can Exacerbate Mental Health Conditions

Substance use can aggravate pre-existing mental health disorders by interfering with the brain’s regular functioning.

For instance:

Anxiety

Substances like alcohol, stimulants, or cannabis can amplify anxiety symptoms. In a study, 17.7% of those with an SUD were also diagnosed with an anxiety disorder.³

Initially, the substance may induce a feeling of relaxation or euphoria. However, as the effects fade, a “rebound” anxiety often follows, which can lead to a cycle of self-medication. The fear of experiencing withdrawal or anxiety can push individuals further into dependence on the substance.

Depression

Alcohol and drug use can alter serotonin and dopamine levels in the brain, which are critical for regulating mood. Chronic substance use may deplete these neurotransmitters.

This can lead to persistent feelings of:

Sadness
Loss of interest
Emotional numbness

These effects can lead to a vicious cycle where depression is both a cause and consequence of ongoing substance use. Research indicates that 25% of individuals with major depressive disorder also struggle with substance addiction.⁴

Post-Traumatic Stress Disorder (PTSD)

Many individuals with PTSD may use substances to cope with intrusive memories. However, while substances like alcohol or opiates may provide temporary relief, they ultimately increase the intensity of PTSD symptoms over time.

How Untreated Mental Health Issues Can Lead to Self-Medication

Mental health conditions can often drive individuals to self-medicate with substances in an attempt to alleviate symptoms.

This behavior is especially common when people feel that their mental health struggles are:

Misunderstood
Stigmatized
Dismissed

For example, individuals with anxiety disorder may find that alcohol helps them relax in social situations, leading to regular use. However, alcohol impairs cognitive function, exacerbates anxiety in the long term, and can create a dependency on the substance to cope.

Challenges in Dual Diagnosis Treatment

Dual diagnosis refers to the condition in which an individual is diagnosed with both a mental health disorder and an SUD at the same time. Below are some common challenges that hinder effective care during combined treatment of substance use and mental health.

Misdiagnosis or Delayed Diagnosis

In many cases, individuals with a dual diagnosis seek treatment for just one disorder—either mental health or substance use. Consequently, the other condition may not be diagnosed right away.

For example, anxiety or depression may be misattributed to the effects of substance use rather than being recognized as pre-existing mental health conditions that require treatment.

On the flip side, the psychiatric symptoms of a person’s mental illness may be mistakenly diagnosed as a reaction to substance withdrawal. This diagnostic ambiguity can delay proper treatment and increase the risk of worsening symptoms.

Complicated Treatment Plans

The complex interplay between substance use and mental health makes treatment plans more intricate.

For instance, medications prescribed for mental health conditions like antidepressants or antianxiety medications might interact negatively with substances or lead to side effects that complicate recovery.

This is why treatment plans require careful coordination among various healthcare providers in dual-diagnosis treatment.

Stigma and Shame Surrounding Dual Diagnosis

Individuals with both substance use and mental health disorders often experience social stigma that can prevent them from:

Seeking help
Adhering to treatment
Disclosing their struggles

This can perpetuate feelings of isolation and guilt. Addressing this challenge involves creating a compassionate environment where individuals feel safe to discuss their conditions without fear of discrimination.

The Risk of Relapse and Setbacks

Relapse is more frequent among individuals with both substance use and mental health disorders. In a study, patients with dual diagnosis had a relapse rate of 39.8%. In contrast, those who did not have a co-occurring mental health disorder had a relapse rate of 26.4%.⁵

The risk of relapse is heightened when mental health symptoms are not well managed or when individuals are not given the tools to cope with life’s challenges in healthy ways.

Cognitive Impairments

Many individuals with dual diagnosis experience cognitive impairments that affect their ability to:

Process information
Make decisions
Adhere to treatment plans

This cognitive decline can make it more difficult for individuals to engage in therapeutic work.

Building and Maintaining Motivation

Individuals with both substance use and mental health disorders may struggle with feelings of:

Hopelessness
Low energy
Apathy

This is particularly true when dealing with the compounded challenges of managing both conditions at once. The feeling that recovery is an insurmountable task can result in a lack of commitment to long-term goals.

The Role of Motivation in Substance Use and Mental Health Treatment

Building motivation requires a strengths-based approach that recognizes the challenges of dual diagnosis.

It is important to help individuals regain their sense of self-efficacy by:

Encouraging small victories
Providing consistent support
Focusing on gradual progress

Trauma and Its Role in Co-occurring Disorders

Individuals with dual diagnosis often have a history of trauma that contributes to their conditions. A study found that 94% of individuals with a dual diagnosis had experienced at least one traumatic event in their lifetime.⁶

Untreated trauma can undermine recovery efforts and make healing more difficult. This is why trauma-informed care is essential for individuals with dual diagnosis.

Comprehensive Dual Diagnosis Treatment at Continuum

At Continuum Outpatient Center, dual diagnosis treatment goes beyond simply addressing two separate conditions. We believe that effective recovery must be comprehensive. This is why we focus on the whole person and the complex interplay between substance use and mental health disorders.

Here’s how we help individuals and their loved ones heal—mind, body, and spirit:

Integrated Care: Treating Substance Use and Mental Health Together

Integrated care at Continuum involves a team-based approach where professionals from both substance use and mental health disciplines collaborate to create a comprehensive treatment plan.

Our San Antonio recovery team includes:

Addiction specialists
Therapists
Psychiatrists
Medical providers

These experts work together to ensure that substance use and mental health are addressed in a way that supports the individual’s overall well-being. The goal of this integrated approach is to provide the tools and support needed to foster lasting recovery.

Customized Treatment Plans: Personalizing the Path to Recovery

At Continuum., we understand that no two individuals are alike. Every person has their own journey—their own history, needs, and goals.

Here, treatment reflects that. We customize treatment plans based on the unique needs, preferences, and goals of each person.

This personalization begins with a comprehensive assessment in which our team conducts in-depth evaluations to understand the:

Individual’s medical history
Mental health background
Substance use patterns
Family dynamics
Life circumstances

This thorough assessment provides the information necessary to design a treatment plan that is not only appropriate for the person’s current needs but also adaptable as their recovery progresses.

Ongoing Adjustments

As individuals progress through substance use and mental health treatment, we continuously reassess their needs and adjust the treatment plan accordingly. This ensures that care remains relevant and effective, adapting to changes in the person’s recovery journey.

Family Involvement: Strengthening Support Systems

Recovery from dual diagnosis is not only about the individual; it’s also about the support system surrounding them.

At Continuum Outpatient Center., we recognize that involving family members in substance use and mental health treatment can:

Provide crucial emotional support
Foster understanding
Strengthen the foundation for lasting change

Family Therapy Sessions for Substance Use and Mental Health Treatment

We offer family therapy sessions as part of our integrated treatment approach. These sessions provide a safe space for family members to:

Express concerns
Share their feelings
Heal from unresolved challenges
Learn how to support their loved one in a way that encourages recovery

Often, unhealthy communication, enabling behaviors, or past trauma can complicate recovery. Through therapy, families can learn how to set healthy boundaries and communicate effectively.

Building Connections Beyond Substance Use and Mental Health Treatment

At Continuum, we believe that recovery is a lifelong journey that extends beyond the treatment center. Our integrated treatment approach includes building connections to community-based resources, such as:

12-step programs
Peer support groups
Local mental health services

These resources provide individuals with opportunities to connect with others who are facing similar challenges. This can help reduce feelings of isolation and foster a sense of belonging.

Overview of Our Tailored Programs for Addressing Dual Diagnosis

Continuum Outpatient Center offers three primary levels of care for dual diagnosis, including:

Partial Hospitalization Program (PHP)

For individuals facing significant challenges with both substance use and mental health disorders, the PHP offers an intensive treatment environment that provides structured, full-day care.

This 4-week program is often recommended for those who require more support than traditional outpatient care can provide, but who do not need 24-hour inpatient treatment.

Key features of our PHP include:

Structured Daily Schedule

Our PHP provides a highly structured environment that helps individuals stay focused on their recovery.

The day typically includes a combination of:

Individual therapy
Group therapy
Psychoeducation

Comprehensive Support

In addition to therapy, clients in PHP benefit from:

Medical monitoring
Psychiatric support
Medication management

This integrated approach ensures that all aspects of the dual diagnosis are addressed.

Focus on Stabilization and Recovery

Our PHP is specifically designed to help individuals stabilize from the acute effects of substance use while simultaneously working to manage mental health conditions. The goal is to prepare individuals for a smoother transition into less intensive levels of care.

Intensive Outpatient Programs (IOP)

Our IOP is designed for individuals who are ready to step down from more intensive programs like PHP but still need consistent, structured support.

Key aspects of our IOP include:

Therapeutic Support

Similar to PHP, IOP offers individual therapy, group therapy, and family therapy. However, the focus is on helping individuals maintain their recovery in less controlled environments.

Group therapy offers a vital space for clients to:

Connect with peers
Share experiences
Gain insight into their struggles with substance use and mental health

Skill Development

Our IOP helps individuals build essential life skills for managing both substance use and mental health recovery.

These skills include:

Communication techniques
Emotional regulation
Stress management
Building healthy relationships

We also guide patients in recognizing triggers and managing cravings in real-world situations.

Flexibility

IOP provides individuals with the ability to attend treatment around their personal schedules. This makes it an ideal option for those who need ongoing care but cannot commit to the time requirements of inpatient or PHP care.

The ability to balance treatment with life responsibilities helps individuals maintain stability while continuing their recovery journey.

For even more accessible treatment opportunities, we also offer a virtual IOP—empowering individuals and their loved ones to begin healing from the comfort and security of their own home.

Drug Rehab Aftercare

Recovery is lifelong. It doesn’t magically stop when treatment is concluded. Instead, it’s a perpetual process that requires continued support and connection.

At Continuum, drug rehab aftercare is designed to provide ongoing support and guidance as individuals transition from formal treatment back into their everyday lives.

We facilitate weekly alumni meetings to offer continued support to individuals who have completed PHP or IOP programs.

Drug Rehab Aftercare Meetings

These meetings provide an opportunity for individuals to:

Maintain connections with others in recovery
Share experiences
Receive guidance as they navigate the challenges of everyday life

This continued engagement is essential for individuals to maintain sobriety and mental wellness over the long term.

Therapeutic Interventions Utilized for Recovery

Below are some of the most common therapies we utilize to treat substance use and mental health:

Cognitive Behavioral Therapy (CBT)

CBT is based on the understanding that thoughts, feelings, and behaviors are interconnected. Negative thought patterns can lead to unhealthy behaviors, such as substance use, which then worsen emotional and psychological states.

In the context of dual diagnosis, CBT focuses on:

Identifying and Challenging Negative Thoughts

Individuals learn to recognize negative thoughts that may contribute to both substance use and mental health challenges.

These include thoughts like:

“I’m not good enough”
“I can’t handle stress without using substances”
“Nothing will ever get better”

Once these thoughts are identified, they are challenged and replaced with healthier, more balanced perspectives.

Behavioral Activation

CBT encourages individuals to engage in positive activities that break the cycle of destructive behavior. This is especially beneficial for those struggling with depression, as it helps counteract the feelings of helplessness and inactivity that often accompany the condition.

Developing Effective Coping Strategies

Individuals in CBT learn practical tools for managing:

Stress
Cravings
Negative emotions

These coping strategies provide individuals with the skills to manage life’s challenges without relapsing into substance use.

Dialectical Behavioral Therapy (DBT)

DBT helps individuals manage the intense emotional swings that often contribute to both substance use and mental health challenges.

The therapy is structured around four main modules, including:

Mindfulness

Mindfulness is the practice of staying fully engaged in the current moment without judgment. By practicing mindfulness, individuals learn to become more aware of their:

Emotions
Thoughts
Physical sensations

This awareness allows individuals to respond to emotions with more intentionality and less reactivity.

Distress Tolerance

DBT teaches individuals how to manage crises without giving in to impulsive reactions. These skills are vital for those struggling with PTSD, anxiety, or depression, where high levels of distress can lead to substance misuse as a form of self-medication.

Emotion Regulation

For individuals with a dual diagnosis, emotional dysregulation can lead to self-destructive behaviors. DBT equips individuals with strategies to identify, label, and manage intense emotions in healthier ways. This can decrease the need to turn to substances for relief.

Interpersonal Effectiveness

Many individuals with dual diagnoses struggle with relationships. DBT teaches skills for improving communication, setting boundaries, and maintaining supportive relationships.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR focuses on the processing of traumatic memories through a structured approach. This therapy uses bilateral stimulation to help individuals reprocess traumatic memories and reduce their emotional charge.

This allows individuals to confront past traumas and integrate these memories into their narrative without the overwhelming emotional pain that may have led to substance use as a coping mechanism.

Integration of Holistic Methods

At Continuum Outpatient Center, the following holistic approaches complement traditional therapeutic modalities during dual diagnosis treatment:

Mindfulness Practices

Mindfulness involves cultivating an awareness of the present moment without judgment. It is particularly effective in:

Reducing stress
Managing anxiety
Enhancing emotional regulation

Mindfulness helps individuals stay grounded and present by utilizing techniques such as deep breathing, meditation, and mindful movement.

Yoga

Yoga promotes physical and mental well-being through a combination of:

Breathwork
Physical postures
Meditation

It helps individuals release tension, reduce stress, and increase body awareness. Yoga also promotes emotional balance, which is especially important for individuals with dual diagnoses who may struggle with emotional dysregulation.

Art Therapy

Art therapy allows individuals to express emotions that may be difficult to articulate verbally. Through creative activities, individuals can explore and release painful emotions, such as:

Trauma
Shame
Anger

Art therapy encourages emotional healing while fostering a sense of accomplishment and self-worth.

Start Your Dual Diagnosis Recovery Journey Today

If you or a loved one are struggling with both substance use and mental health challenges, it’s time to seek integrated care that can truly make a difference.

Our knowledgeable and compassionate Continuum team offers personalized treatment that addresses both conditions in tandem, empowering you to take meaningful steps toward recovery.

Take the First Step Toward a Balanced Life

Reach out today to learn how we can support your healing process with a tailored approach that brings together therapy, support, and lasting transformation.

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Questions About Treatment?

Reach out to our knowledgeable and compassionate Continuum Outpatient Center team for the guidance and support you need for sustainable recovery. We’re here to help you build a foundation for long-term happiness, wellness, and healing.

Substance Use and Mental Health: What’s the Connection?