Treating Co-occurring Disorders While in Sober Living

Anyone can benefit from living inside a sober living community. Here, people have a network of sober companions they can lean on during the dark days, and they have a safe place to sleep at night that’s free of the temptations that might lead to the use and misuse of drugs. But there may be some people who really need to spend time within a sober living community. These people may have mental illnesses in addition to an addiction, and the advanced help they get in a sober living home could allow them to recover in a way they’d never quite achieve if they’d returned to their homes instead of accepting extra help.

Defining Co-Occurring Disorders

co-occurring disorders and sober livingIt’s not uncommon for people with mental illnesses to develop addictions. For example, according to the Office of Applied Studies, about 4 million of the 17.5 million adult Americans who have a mental illness also abuse alcohol or drugs. In some cases, the addiction seems to awaken hidden receptors for mental illness, allowing latent dysfunction to spring into life in a dramatic way. In other cases, the underlying mental illness seems to make the development of an addiction just a little more likely. For example, according to research funded by the National Institute on Drug Abuse, people with both schizophrenia and substance abuse tend to have an increased sensitivity to feel-good brain chemicals in the portions of the brain that produce psychosis, and they have a lack of sensitivity to feel-good chemicals in the portions of the brain that deal with reward. The science is complicated, but it suggests that people with these two conditions may have enhanced psychosis due to their drug use, and they may find they need high levels of drugs in order to find them rewarding. It’s a vicious circle in which people use high levels of drugs, feel psychotic and then need high levels of drugs again.

People with co-occurring disorders may be at a great risk of relapse due to these types of chemical alterations. They may feel depressed, for example, and know that drugs can provide a temporary sensation of relief. In time, they may feel as though drugs are the only route to happiness, and the damage those drugs have caused makes feeling happy or normal without drugs almost impossible. People like this may always have a hidden urge to relapse to use, unless their mental illness is addressed. The dysfunction works as a trigger that can lead right back to poor decisions.

Therapy Challenges

therapy challengesPeople who have co-occurring disorders tend to benefit from the same types of therapy as people who have only addictions and no mental illnesses. This makes sense, as both groups of people need to learn to:

  • Understand their triggers for addiction
  • Manage their responses to triggers
  • Find new outlets for their time
  • Make a long-term commitment to sobriety

Even so, people with co-occurring disorders may take a therapeutic path that’s a little different than the path followed by other addicted people. For example, the Substance Abuse and Mental Health Administration (SAMHSA) reports that people with post-traumatic stress disorder often need therapy that lasts for a long time, and that therapy might move quite slowly. Clients with this disorder may find trusting others to be incredibly difficult, and they may not be able to discuss their emotions in-depth in the early days of therapy. Where their counterparts might be able to zip through therapy for addiction and move right home again, these people might need to stay connected with therapy for longer periods of time, and they may go quite slowly through that therapy.

woman looking at papersSimilarly, some people who have co-occurring disorders haven’t ever been asked to deal with a mental health issue in the past. For example, in a study in the American Journal of Drug and Alcohol Abuse, researchers found that about half of people diagnosed with a mental illness in an addiction program had never received any mental health treatment in the past. The discovery of a mental illness can be shocking, and some people resist the idea of getting any kind of help at all. In their addiction treatment programs, they may be willing to discuss their substance use and abuse, but they may balk at any therapy for their mental illnesses. It’s only when the veil of drugs and alcohol has been lifted that these people see the dangers inherent in leaving a mental illness in place, and only then may they be willing to get help for that issue.

The Role of Sober Living

role of sober livingPeople with these sorts of complex issues may leave their addiction programs long before they’ve addressed all of the concerns that feed into the addiction. If they moved back into their old communities, they’d be likely to fall right back into the arms of their addictions, as they haven’t yet dealt with all the triggers that prompted the original issue. A sober living community may help, as these facilities don’t allow the use of any addictive substances whatsoever. A relapse is more difficult to accomplish in this setting, as drugs are simply harder to come by.

A sober home also has rules and regulations that can increase a person’s compliance with therapy. For example, most homes require residents to attend all their counseling sessions for addiction or mental illness, and some facilities even require residents to provide proof of their attendance. Skipping a session could mean losing privileges in the home, and in some cases, it might even lead to expulsion. This could be the prompt that keeps people coming back to therapy, even when they think they’re doing well and don’t need the help. The rules just spur them to take action.

communitySober homes can also be a life raft for people with very serious addiction concerns. According to SAMHSA, people with co-occurring disorders tend to struggle with life outside of the treatment facility. They may not have steady jobs, and they may live in depressed neighborhoods. They may also have a weak support network at home, and they may not feel as though they have someone to rely upon if things go wrong. Turning a person loose into a situation like this could also lead to a relapse, as people might just be under intense pressure that they can’t handle. A sober home can help, as the environment is safe and secure. A network of peers is available around the clock, and those peers can ensure that the person stays on track with the recovery plan. Additionally, the day-to-day structure of a home like this can help people learn how to manage their lives when treatment ends and they’re on their own in the community once more. The foundation of help they get here can reverberate throughout their lives.

Common Therapy Types

People with co-occurring disorders may benefit from almost any kind of therapy; however, a study in the Nordic Journal of Psychiatry suggests that these types are commonly provided:

  • Cognitive Behavioral Therapy
  • Motivational Interviewing
  • Family therapy
  • Education

Some of this therapy is provided in individual sessions with a counselor. People who have borderline personality disorders, for example, don’t tend to relate to other people or find them trustworthy, so they really need to participate in solo work. When they have a close relationship with a counselor, that connection can allow for a more robust healing process. There are some people, however, who benefit from group work, so they can learn from other people who have the same kind of mental illness.

The amount of time spent in therapy can also vary dramatically. Those new to the recovery process might spend a portion of each day in treatment, for example, while those who are farther along in the recovery process may only go to treatment sessions once or twice per week. Similarly, some people need to take medications for their mental illnesses, and they may need to visit their doctors regularly in order to ensure that the dosage of those medications is appropriate. Others may not need any medication at all in order to keep the illness under control. Much depends on the mental illness at hand and the preferences of the person in treatment. All of those treatment plans should be shared with the leaders of the sober living home, however, so the person can be encouraged to follow those plans to the letter.

Getting Started

Some people find out about sober living homes through their addiction treatment teams, and they’re transitioned into the homes just as soon as their addiction has stabilized and they’re ready to move forward with life. Other people find sober homes through the recommendation of friends and family members. Still others seek out information on the Internet, looking for the perfect place to support their growth and healing. No matter what method you choose, you might still have questions about how sober homes work, and how they might fit into your long-term plans for recovery. If so, we hope you’ll call us. We can provide you with a significant amount of information about how our homes are structured, and we might even help to smooth your enrollment process. Please call us to find out more.