About two thirds of people with psychiatric disorders develop problematic drug or alcohol use. And most people with addictions either started with a mental health issue or else will develop one during their use. It’s not so surprising: There are genes in common, and both emerge together in the ‘right’ environments. This makes diagnosis and treatment a lot harder.

Fortunately, that’s exactly what we do well. Dr. Green wrote an article on some of this read here but some principles include:

  • Treat both conditions at the same time
  • Use medications good for both conditions and don’t exacerbate the other
  • Understand and educate how instability of one will trigger the other
  • Treat in phases, as things will look different in a few weeks
  • Be pragmatic; teach the basics of self-care and governance
  • Go gently and cautiously into affect
  • Work with an extended network