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April 17, 2017

Recovery for More Than One Diagnosis is Possible - Linda Lewaniak

treatment for eating disorders and substance useChange is hard. We are creatures of habit. When we get stuck in our patterns, it can be very hard to change. This is especially true when it comes to treating mental health problems.
 
Eating disorders are debilitating. If you have an eating disorder and another co-occurring issue (substance use disorder, anxiety disorder or mood disorder), you not only tend to have more severe symptoms, you can also be more resistant to treatment. This can make it more difficult to achieve full recovery.
 
No matter how many diagnoses you have, recovery is always possible.
 
If you want to achieve recovery, you must have hope. And you must be willing to do the work.
 
Treating co-occurring issues
 
Many individuals are living with co-occurring issues: an eating disorder may be coupled with anxiety, depression, a substance use disorder or a serious medical problem. As mental health professionals, it is our duty to consider all parts of the puzzle. As we work to help our patients identify a target behavior to work on in the present moment — we must also reflect on how a patient’s other behaviors play a role.
 
We want to help all our patients achieve their goals, identify their values and live a value-driven life filled with purpose. This is why we are proud to work in an Integrated Services model. We believe that Integrated Services is the best way to help our patients achieve full recovery.

Achieving full recovery
 
Our patients in eating disorder treatment face a number of co-occurring issues, often including substance use disorders or other compulsive habits. Some of the more common habits we see in our patients include:
 
  • Drinking alcohol
  • Stimulant abuse
  • Marijuana use
  • Binge eating
  • Compulsive sexual behaviors
 
When people dealing with the above issues go into treatment at a typical facility, they may have to flip flop between programs. First, they go to an eating disorder treatment program to get help for an eating disorder. Then, they may develop a problem with alcohol. They enter a substance use program. As alcohol use is being dealt with, the eating disorder or another mental health issue could re-appear.
 
This is why we integrate treatment for all conditions — treating substance use and other mental health and medical issues at the same time.
 
Accepting that there is a problem
 
When it comes to substance use, our philosophy is that you will not get better if you continue to use. Substance use affects recovery. In treatment, we encourage patients to abstain from any problem behaviors as we focus on the following areas:
 
1. Education — We want to raise awareness and educate patients on the basics of substance use and other compulsive behaviors. We explain the short-term and long-term harmful effects of these behaviors. We educate on the Disease Model of Addiction to help patients understand the origins and mechanics of their use.


2. Identifying the problem — We work closely with our patients to help them identify the target issues that they want to work on. One of the biggest obstacles for patients is that they know that they can stop — they just don’t want to. This often requires educating them about how their substance use is affecting their recovery otherwise — affecting the efficacy of psychotropic medications, contributing to their eating disordered behaviors, etc.
 
3. Working towards recovery — Another focus of treatment is that we help our patients find effective tools to help them learn to recognize and manage their emotions, triggers, thoughts and behaviors. We help them find a personalized, individualized path to help them achieve full recovery. And we address all issues concurrently in treatment. We also help them understand the importance of community and having a sober support system.
 
Dealing with ambivalence and feeling stuck
 
In a variety of treatment settings, as patients make progress in therapy and step down to different levels of care (moving from residential to a partial hospitalization program or intensive outpatient therapy, for example), some patients will start drinking or using again.
 
If all the issues the patient is dealing with (eating disorder, substance use) have not been addressed, a patient may start to use and think, “Well, I didn’t use for the past two months and I’m feeling so good that I am going to use now.” Over time, this same patient may wonder, “I dealt with one problem, but now I have another problem — and I’m using again — will my problems ever go away?”
 
This is why it’s so critical to treat the whole person in an Integrated Services model. This model addresses all parts of the puzzle, and patients benefit from working with a multi-disciplinary team.
 
At Insight Behavioral Health Center, our patients may meet with any of the following on a regular basis, depending on their individual needs:
 
  • Eating disorder specialist
  • Mood and anxiety specialist
  • Substance use disorder specialist
  • Psychiatrist
  • Medical doctor
  • Dietitian
  • Exercise physiologist
 
With such a diverse team of experts, we can successfully address many co-occurring issues at once. This diverse method of care is embedded in all levels of treatment at our program so that all of our patients can benefit.
 
If you are concerned about your own health or the health of someone else, please know that help is available. If you are in treatment or having a relapse, please don’t give up on recovery. You have the ability to keep trying. So please don’t stop!
 
Let us know how we can help.
 
Linda Lewaniak LCSW, CAADC is the Program Director of Integration at Insight Behavioral Health Centers, Illinois. A Licensed Clinical Social Worker (LCSW) and Certified Advanced Addictions and other Drug Counselor (CAADC), Lewaniak has more than 25 years of experience in the treatment of chemical dependency and comorbid mental illnesses.
 
April is Alcohol Awareness Month. This national event helps to raise awareness and reduce the stigma associated with alcoholism, causes, treatment and recovery. The National Council on Alcoholism and Drug Dependence, Inc. (NCADD) is the founder and sponsor of NCADD Alcohol Awareness Month.
 
 
 
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