Anxiety, depression and addiction: treating both together

When mental health concerns and substance use or gambling happen together, clinicians sometimes call it a dual diagnosis, or co-occurring conditions. The Australian Institute of Health and Welfare (AIHW) reports that mental health conditions and alcohol and other drug use commonly occur together. If this is you, you are far from alone.

Why they so often turn up together

There is rarely a single cause, but a few patterns come up again and again:

• Coping with feelings. A drink to take the edge off anxiety, something to get through a low patch, a bet for a few hours of escape. It can work at first, which is part of why it sticks.
• The rebound. Many substances can worsen mood, sleep and anxiety as they wear off, which makes the next drink or dose feel more needed.
• Shared roots. Trauma, grief, chronic stress and burnout can feed both at once.

Over time it can become hard to tell which came first. The good news is that you don't need to untangle that before getting help.

Signs both may be in play

• You drink, use or gamble mostly to calm down, sleep or stop feeling low.
• Your mood or anxiety gets noticeably worse the day after.
• You have tried to stop, and the anxiety or sadness became too much.
• Counselling for your mood keeps stalling because the drinking or using carries on.
• Something painful happened, and the habit grew after it.

Why treating both at once matters

If only the drinking or using is treated, the anxiety or low mood that drove it can still be there on the first hard day back at home. If only the mental health side is treated, ongoing use can undo much of the progress. Working on both in one plan, with one team, means the pieces are seen together and nothing falls between two services.

At Sapphire this is the starting point. We look beyond the substance or behaviour to what drives it. Anxiety, depression, trauma, grief and burnout are worked on in the same plan as alcohol, drugs or gambling, by the same team.

What that looks like at Sapphire

• Talking therapies. One-on-one and group sessions with psychologists and counsellors, using approaches such as CBT, DBT, motivational interviewing, schema and family therapy, with trauma-informed care throughout.
• Care for the body. Yoga, mindfulness, EFT (a gentle tapping method), massage, the spa and equine sessions. Gentle ways to sleep better and practise calm, which matters when anxiety lives in the body.
• Structure. A steady, predictable day, regular meals from our chef and a small house of no more than six guests.
• Your own doctors stay involved. Your GP or psychiatrist stays your prescriber, and if you need a psychiatric review during your stay, we help arrange one.

You can read more about each option on our programs page.

A word about medication

If you take medication for anxiety, depression or another condition, please don't stop or change it on your own, even if you are stopping alcohol or drugs. Talk to your GP or psychiatrist first. Some medicines, including benzodiazepines, can cause dangerous withdrawal if stopped suddenly. Our guide to detox and rehab has more on why medical advice comes first.

Where to start

• Your GP is a good first stop. They can look at your mental and physical health together and refer you to a psychologist or psychiatrist.
• Beyond Blue offers free support for anxiety and depression on 1300 22 4636.
• Adis on 1800 177 833 can talk through alcohol and drug support in Queensland, 24/7.
• Our two-minute check can help you work out whether a stay at Sapphire is a sensible next step.

If things feel unsafe

Sapphire is a private residential program, not a crisis service. If you are having thoughts of suicide or self-harm, call Lifeline on 13 11 14 at any hour, or text 0477 131 114. If anyone is in immediate danger, call 000. When things are safer, we would be glad to talk.