MDD & Opiod Addiction: Co-Occurring Disorders and Drug Rehab

Those who struggle with mental health disorders and substance use disorders are diagnosed as having co-occurring disorders. People with co-occurring disorders have the best chance of achieving long-term sobriety when entering a dual-diagnosis treatment center. Dual diagnosis treatment centers treat but also have integrated mental health treatment. Combining treatments can help those who are dealing with depression, bipolar disorder, and other mental health illnesses.

Depression and Opioid Addiction

 Depression, also known as Major Depressive Disorder (MDD) or clinical depression, is treatable. MDD requires a medical diagnosis, although depression tests online are gaining popularity. Online depression tests can often be a starting point for those wanting to seek help for their mental health disorders, but any diagnosis should come directly from a licensed medical professional. Even if a test is coming from a reputable website, professional help should always be sought for a proper diagnosis.


Depression is typically marked by a persistent feeling of sadness or loss of interest, which is also a common feeling among those struggling with opioid addiction. MDD or clinical depression can lead to many behavioral and physical symptoms. Those suffering from the co-occurring disorders of substance use and MDD can often have trouble differentiating between the effects of the two. Is the depression causing the drug and alcohol abuse, or is the drug and alcohol abuse causing the depression? When someone is developing a substance use disorder, it often leads to depression.


Commonly abused drugs like synthetic opioids and opiates (prescription drugs and heroin, for example) have a bi-directional relationship. This relationship means that suffering from either depression or substance abuse disorder increases the risk of turning to opioids for comfort or becoming depressed from opioid use. The co-occurring disorders of depression and opioid abuse form a vicious cycle that can spiral out of control quickly if left untreated.

 If someone is already struggling with depression and becomes addicted to opioids, the depression can become worse. Research has estimated that 48% of people in the United States dependent on opioids will also experience depression.

 If you or a loved one are struggling with co-occurring disorders depression and opioid addiction, the addiction must be addressed first. Medical detox is often required to help soothe the unpleasant withdrawal symptoms of opioids. Withdrawal symptoms can include nausea, sweating, extreme anxiety, restless legs, sleep problems, and intense cravings. Trying to combat these symptoms without the assistance of medical detox is possible but difficult. Unfortunately, many people don’t get through the full withdrawal if they aren’t in a detox setting due to the intense cravings associated with opioid addiction.

Treating Depression and Opioid Addiction Simultaneously 

Finding a program that treats co-occurring disorders (addiction and mental health issues) at the same time can be hard, but there are dual diagnosis drug rehabs that cater to co-occurring disorders. Those suffering from both often need a higher, more intensive level of care, like a Partial Hospitalization Program (PHP). Our PHP Addiction Treatment Program includes behavioral therapies, group therapy, support groups, individual therapy, case management sessions, medical provider appointments, and 12-step meetings.

Group therapy during the PHP portion of our program allows those with co-occurring disorders to address problems in a group setting and get feedback from peers, which is always run by a counselor or therapist to help guide the conversation or activity. Those suffering from co-occurring disorders depression and opioid addiction isolate and withdraw themselves from society. Group therapy is often one of the first steps to opening up to others and reintegrating into a controlled environment. Twelve-step meetings at the PHP level of care help in this area as well. It helps to introduce clients back into society slowly. Going back into the “real world” takes time and can bring up fears and concerns with clients who aren’t used to day-to-day activities at this point in their lives. 

Case management in PHP helps clients learn accountability, set a schedule, and address any outstanding or ongoing legal problems. When dealing with depression alone, being accountable for daily responsibilities can be a monumental task. When entering sobriety, those skills often have to be learned again. Our addiction treatment team helps clients to set goals that are achievable. Over time, case managers work with each client to establish and complete goals that are now achievable at different stages in their recovery.

 Individual therapy sessions during PHP are crucial in treating co-occurring disorders depression and substance addiction. Talk therapy is one of the best ways to address depression, and the private setting allows for a level of confidentiality that isn’t offered in group therapy. Individual therapy sessions can help clients treat the underlying factors of what is driving their opioid addiction. Individual therapy is essential for clients with co-occurring disorders. Individual therapy sessions can help clients identify symptoms caused by their mental illness like clinical depression, and what is caused by their addiction.

 Medical provider appointments are imperative to ensure that if medication is required, clients are on the proper medication and dosage. A large problem in the field of mental health disorders is medication compliance. Medication compliance plays a vital role when treating co-occurring disorders in a PHP setting. Medications can reduce the symptoms of psychiatric disorders and allow clients to focus on therapy, 12-step meetings, and their day-to-day activities that are setting them up for long-term sobriety. Having access to a medical provider allows for any changes to be made that are adversely affecting a client, which can lead to better medication compliance. Not being compliant with medication when struggling with addiction and mental health illnesses can be narrowed down to a few causes:


  • Medication-related side effects.
  • Adverse reactions between medication or concerns of being over medicated.
  • Returning to substance use. Once someone relapses on substances, they often stop taking their medication or are concerned about reactions between substances and the medications.
  • Feeling better, which can lead clients to believe they no longer need medication.
  • Lack of support about being on medication.


 Everyone at GateHouse Treatment, from clinical staff to case managers, is supportive of any path that a client must take to achieve sobriety and to live a happy and fulfilled life. Our comprehensive treatment approach is blended with a robust clinical approach to set everyone up for success. We offer individualized treatment plans that best suit what clients need, especially with co-occurring disorders.

Intensive Outpatient Treatment for Co-Occurring Disorders

After PHP treatment has been completed, the next step is an intensive outpatient program (IOP). While in GateHouse’s IOP treatment program, clients are still offered group and individual therapy, case management and medical provider appointments. The structure of their days is different. In our IOP, we have a strong focus on medication management to help those in taking the next steps in their lives. Medication compliance and management is essential at this stage of IOP for those with co-occurring disorders.

The stress of getting a job, getting deeper into their 12-step work and dealing with life can cause emotional distress in those who are newly sober. Case management also plays a significant role at this point in treatment to assist clients in reaching their next goals and moving further in their recovery.

GateHouse Treatment also offers an Addiction Treatment Family Program that allows the families of clients to receive help in dealing with the ripples of addiction and how it has affected their lives. Our Family Program will allow those with co-occurring disorders to discuss with their families where they are at now with both their mental health and sobriety. Our Family Program allows for the bedrock of relationships to be set and can begin to clear the air in a healthy and safe environment. The Family Program also allows for clients to set the tone for maintaining their mental health alongside sobriety. At the same time, this program allows family members to set boundaries surrounding both their mental health needs and substance use disorder.

The Next Steps of Treating Co-Occurring Disorders like Depression and Opioid Addiction 

Recovery is possible from both co-occurring disorders like depression, obsessive-compulsive disorder and opioid addiction. At GateHouse Treatment, we provide the tools and push clients to achieve long-term sobriety. Drug rehab is only a part of our clients’ lives, and after they leave, that is where their recovery truly begins and flourishes. Alumni programs help those who have left our dual diagnosis treatment center stay connected. Our alumni program is in place to prevent relapse while providing past clients and their families with the resources they need to stay on track.

After leaving our facility, ongoing concerns may need to be addressed, especially regarding medication needs for treating depression, sober living, or medication assisted treatment (MAT)  needs. The care for our clients doesn’t stop when they leave our treatment center. 

Coming to GateHouse for Co-Occurring Disorder Treatment

If you or a loved one are struggling with co-occurring disorders like clinical depression and opioid addiction, contact us today at 855-448-3588. We have an admissions team ready to speak to you at any time and answer any questions. At GateHouse Treatment, we understand co-occurring disorders like clinical depression and opioid addiction. You can heal. We can help.

GateHouse Treatment Editorial Staff

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