What came first: the chicken or the egg?
Parents of teens with a dual diagnosis are frequently faced with a similar question. Are their child’s symptoms the result of a mental health disorder, or brought about by risky substance use?
At Eagle Overlook, we focus on the treatment over the cause. That’s how we became the top-rated treatment center in Georgia. Dual diagnosis treatment is an integrated approach to teen recovery that addresses your child’s fundamental needs.
In other words, we treat teenagers, not diagnoses.
Even so, it can be helpful to understand the basics of dual diagnosis in adolescents. We’ve created this guide to help explain what this complex diagnosis means. We’ll also discuss the best practices for residential treatment.
Whatever your teen is facing, we’re here to make the journey easier. Read on to learn everything there is to know about dual diagnosis treatment for teens.
What Is a Dual Diagnosis in Teens?
Between 60% and 75% of teenagers enter residential treatment with a dual diagnosis. That means they have received a diagnosis of a mental illness and a substance abuse disorder. Mental illness often contributes to the adolescent’s substance abuse problem.
Teenagers have very little agency in the world. Their development encourages them to separate from parents and caregivers to gain a sense of autonomy. When faced with mental health struggles, many teens seek ways to self-medicate rather than ask for help.
Sometimes teens aren’t aware that they need help, to begin with. Their bodies are changing, hormones are surging, and it can be challenging to determine what is “normal.” Risky teen behaviors such as drinking and drug use quickly turn into coping mechanisms and take their toll.
Alcohol is an easily accessible substance. It’s a mainstay at adolescent parties and gatherings. Alcohol is addictive mainly because it works.
Liquor encourages the body to produce dopamine. Dopamine travels to our reward centers, helping a depressed or anxious brain feel “normal” for a brief time.
The same is true for recreational drugs. These addictive substances can numb pain, create false euphoria, or counteract uncomfortable symptoms. Experimentation quickly leads to addiction as the drugs make it easier for the teen to function.
In some cases, substance use can also trigger the onset of a mental illness. Ultimately, it does not matter which diagnosis caused the other. Teens deserve holistic, comprehensive treatment that addresses both conditions.
Common Mental Health Disorders in a Dual Diagnosis
A dual diagnosis may involve any combination of mental health and substance abuse disorders. Mental health disorders might include personality, mood, or trauma-related conditions.
Many mental illnesses begin during adolescence. Hormones and development play a role in the onset of these conditions. These same changes can lead to poor impulse control, triggering experimentation and addiction.
The following mental health disorders are commonly diagnosed along with substance abuse disorders in teens:
- Major depression
- Post Traumatic Stress Disorder (PTSD)
- Bipolar Disorder
- Generalized anxiety disorder
- Obsessive Compulsive Disorder (OCD)
- Attention Deficit Hyperactivity Disorder (ADHD)
- Borderline Personality Disorder (BPD)
- Cluster C Personality Disorders
- Paranoid Personality Disorder
- Conduct Disorder
- Oppositional Defiant Disorder
- Schizophrenia or Schizotypal Personality Disorder
A teen can carry a diagnosis of more than one mental health disorder and still be dual-diagnosed. Many of the above conditions are comorbid with other mental health conditions. For example, many teens with personality disorders also struggle with depression or anxiety.
Common Substance Abuse Disorders in a Dual Diagnosis
There are near-infinite combinations of mental health disorders and substance abuse disorders. Some teens with a dual diagnosis are not addicted to substances at all. Teenagers may use food, gambling, pornography, video games, or the internet to cope.
The difference between an interest and an addiction is the impact on the teen’s quality of life. If a teen is neglecting hygiene, school work, or friendships to engage in an activity, it may be an addiction. They may also experience withdrawal-like behavior if deprived.
Most adolescents in teen recovery centers have addictions to drugs or alcohol, however. Substances may include one or more of the following:
- Marijuana or cannabinoid synthetics
- Cocaine
- Stimulants (Ritalin, Adderall, etc.)
- Prescription painkillers (Vicodin, Oxy, etc.)
- Heroin
- Crystal Meth
- MDMA
- Hallucinogenic drugs (Mushrooms, LSD, etc.)
- Inhalants
- Alcohol
Teens with schizophrenia often become dependent on nicotine. Some research suggests that it may help ease symptoms of psychosis.
It is rare for teenagers to attend residential treatment for nicotine addiction. The exception is if they are also addicted to an additional substance.
Teenagers rarely have a lot of money or resources. They will become dependent on the drugs or alcohol they can access. Teenagers may turn to a variety of substances if they lack access.
Teen drug abuse is both a symptom and a diagnosis.
How To Receive a Dual Diagnosis
No two teens present with the same symptoms or needs. Thus, it can be difficult to pin down a dual diagnosis.
The process begins when a teen receives a thorough patient evaluation. This is often performed by a psychiatrist or psychologist. These mental health professionals should have experience with adolescent pathology.
A diagnosis begins with a conversation. The mental health professional will discuss the teen’s history of symptoms. They will work to untangle the underlying factors that have caused or exacerbated mental illness and substance use.
The process often takes time. The professional needs to consider psychosocial factors. These may include trauma, home life, and genetics.
Mental health professionals may also need to observe certain behaviors. Observation helps confirm mental health diagnoses with specific characteristics.
Be aware that a mental health diagnosis is not a static thing, particularly in growing teens. Some conditions are very similar or may vary based on the effects of substances.
Mental health professionals will use this initial diagnosis as a guideline for treatment. The label or diagnosis may shift or change over time.
The Fundamentals of Treatment
Treatment for a dual diagnosis must involve an integrated approach. That means the treatment program should address the needs of the whole child. They will receive psychiatric, medical, social, and emotional support.
Teens rely on substances because they lack other coping skills. Treatment seeks to help teens identify their emotional needs. The goal is to provide a toolbox they can access when it would be easier to reach for drugs or alcohol.
Teens will have time to heal, but recovery focuses on moving forward and embracing new skills.
The key is well-researched, evidence-based treatment modalities. The ideal methods focus on a teenager’s unique developmental needs. Dignity is the minimum requirement, with education at the forefront of all recovery activities.
A great program must be innovative to meet each teenager where they are. Effective programs provide a range of opportunities to process trauma and practice new skills. Quality treatment programs incorporate recreation and the arts to achieve results.
The goal of treatment is resilience. Professionals understand that a teen cannot achieve that state alone. A great addiction counselor will accompany them on the journey.
Therapy at Eagle Overlook
We employ two types of traditional therapy for teens at Eagle Overlook. These include Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT). These modalities work in concert to address a teen’s fundamental needs.
Dialectical Behavior Therapy
Dialectical behavior therapy is all about arming teens with tools to use when faced with social or emotional conflict. We use DBT to teach actionable skills. These methods help teenagers make better choices when faced with scenarios in which they’d typically turn to alcohol or drugs.
There are four tenants of DBT. They include mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness.
Teens learn to remain present and come to tolerate their difficult emotions. They begin to access strategies and improve their communication skills.
Rather than constantly employing a fight or flight response, teens learn to stop and think. They begin to name and address their feelings. This evidence-based therapeutic approach teaches skills useful long after they leave treatment.
Acceptance and Commitment Therapy
Acceptance and Commitment Therapy is another evidence-based treatment modality. It encourages teens to become active participants in their own lives and recoveries.
Sometimes teens turn to substances because they don’t know what else to do. ACT essentially teaches other productive next steps. This treatment helps teens embrace the bigger picture and imagine the future with hope.
The key to this treatment is learning when to sit with difficult emotions and when to act. Teens learn to observe their behavior with less judgment. When they do make an active choice, it is kinder and less impulsive.
Experiential Programming at Eagle Overlook
Teens have had fewer life experiences than adults. They are young, and their feelings are difficult and new. Experiential treatments challenge teens by expanding their world and transforming their extant worldviews.
At Eagle Overlook, we employ outdoor behavioral healthcare. We bring residents into the wilderness to learn about nature, themselves, and one another. Teens learn about their capabilities, engage in team building, and try new skills in a meaningful context.
We’re also proponents of equine-assisted psychotherapy. Horses are natural mirrors. They help teens understand how their behavior impacts others.
Likewise, we offer horticultural therapy. This helps our teens gain confidence in new, observable skills.
The natural world has a healing effect on individuals of all ages. When teens engage with plants and animals as part of treatment, they have more time to process, reflect, and actively practice new learning.
Education as Treatment
Understanding is one key to enlightenment. If teens don’t understand their diagnosis, they can’t overcome their challenges. That’s why Eagle Overlook offers psychoeducational sessions as part of every treatment plan.
An experienced, knowledgeable mental health professional runs each session. Teens learn to understand the complexities of their diagnosis and what to expect from treatment. We begin discussing aftercare early so residents can look ahead to their next steps.
Treating the Whole Teen
Treating substance abuse disorders means treating more than mental health. At Eagle Overlook, we’re proud to staff qualified medical professionals to assist in holistic treatment.
A medical director and registered nurse will always be on-site. Staff is available 24/7 to support teens who may face physical challenges during treatment.
We offer on-site lab testing and medication management to help residents maintain abstinence. With that said, Eagle Overlook is not a sterile medical environment. It is warm, comfortable, and community-driven, so teens feel right at home.
The best way to address the needs of the whole individual is through a personalized daily schedule. No two residents have the same needs, thus no two patients have the same routine. Every teenager receives a customized treatment plan.
Likewise, the length of stay is different for each resident. Teens have structured time to complete schoolwork, and tutors are available when necessary. Their academics never suffer while they pursue treatment.
There is also plenty of time for safe and appropriate recreation. We believe activities that promote sobriety are essential to recovery. Our teens look forward to movie nights, pizza parties, ping pong tournaments, and various art activities.
Families are also an integral part of the program. Treatment is always in context. We invite parents and caregivers to join us for their teen’s recovery journey.
Teen Dual Diagnosis Treatment at Eagle Overlook
Dual diagnosis treatment for teens is complex and multifaceted. Your child deserves holistic, developmentally appropriate care. Choose a program that addresses your child as an individual and teaches them the skills they need to lead an independent, resilient, substance-free life.
The journey begins at Eagle Overlook Recovery in stunning Dahlonega, Georgia. We’ll provide integrated, personalized treatment on 54 wooded acres in the Appalachian mountains. Contact us today to begin the process and help your teen overcome their dual diagnosis.