Relapse Prevention Strategies: Tips for Managing Sobriety with Co-Occurring Disorders

Substance use disorder is a chronic illness. And like other chronic illnesses, relapse is always a possibility, especially without an ongoing treatment plan that includes targeted relapse prevention strategies.

As many as 40-60% of individuals with substance use disorder will relapse at least once. The risk of relapse is particularly high for those who suffer from co-occurring disorders – i.e., substance use disorder alongside another mental health condition.

The presence of co-occurring disorders can complicate recovery, but it doesn’t mean that long-term sobriety isn’t achievable. Instead, those with co-occurring disorders require a relapse prevention plan that addresses the unique challenges of a dual mental health diagnosis. We’ll be exploring this topic in more detail below, including how to develop an effective plan for preventing relapse with co-occurring disorders.

Co-Occurring Disorders in Substance Use Treatment

There are 9.2 million Americans struggling with co-occurring disorders. So, it’s no surprise that many individuals in substance use recovery also present with symptoms from another mental illness. The most common co-occurring conditions seen in substance use treatment include depression, anxiety and mood disorders, bipolar disorder, and post-traumatic stress disorder (PTSD).

These and other co-occurring disorders add another layer of complexity to substance use disorder and treatment. That’s because drugs and alcohol may be used in an attempt to manage the symptoms of another mental illness. Meanwhile, those symptoms may be worsened by substance use, leading to a more severe and more difficult-to-treat disorder.

An effective approach to relapse prevention therapy for those with co-occurring disorders acknowledges the ways that various disorders interact with each other. It also identifies the relapse triggers that exist outside of a co-occurring mental illness – and within it.

Understanding Addiction Relapse Triggers

Relapse happens for all sorts of reasons. But while the causes of relapse are varied, they can almost always be traced back to one or more specific triggers, be it a change in environment or a change in mental health and wellness. This is true for both people with co-occurring disorders and those without, though the former group will have unique mental health factors that must be addressed in recovery.

Types of triggers that can lead to relapse include:

• Environmental triggers – Stressful situations, social pressures, and access to substances.

• Emotional triggers – Depression and anxiety, trauma and PTSD, low self-esteem, loneliness.

• Behavioral triggers – Return to old habits and routines, avoidance of treatment, negative social influences.

• Mental triggers – Untreated mental health symptoms or a change in mental health treatment needs.

Triggers vary from person to person, and what leads to relapse for one individual may be easily managed in another. The goal of relapse prevention therapy is to figure out each patient’s potential triggers and put a plan into place for what to do if and when they become a problem.

Monitoring the Signs and Symptoms of Relapse

The first sign of a potential relapse isn’t always the use of the substance itself. Nor is increased substance use the only sign that a treatment plan is failing.

For individuals with co-occurring disorders and their loved ones, it’s important to be aware of all the signs and symptoms of relapse, any of which could signify the need for professional support. This includes:

• Physical signs – Changes in sleep patterns, physical health deterioration, changes in appetite.

• Emotional and psychological signs – Mood swings, increased sadness and anxiety, increased anger and irritability.

• Behavioral signs – Withdrawal from social activities, increased substance use, avoidance of coping mechanisms.

People with dual diagnoses may notice an increase in symptoms of their mental health disorder before thoughts of relapse occur. This further highlights the need for efficient management of both conditions since struggles with one could inevitably lead to struggles with the other.

Developing a Relapse Prevention Plan

Although the specifics of relapse prevention look different for everybody, there is a set blueprint that can be followed when creating a plan of action.

Step One: Establish Support Systems

A strong support system is integral to relapse prevention and can help ensure that individuals stay engaged with their treatment plans.

There are three types of support systems relevant to this process: therapeutic support, family and peer support, and community support. Each group plays a key role in motivating recovery and holding individuals accountable. This includes watching out for signs of relapse, as well as symptoms of general mental health distress.

Step Two: Build Coping Strategies

Just as essential as recognizing relapse triggers is knowing how to respond if they happen.

As part of substance use treatment, individuals are encouraged to identify positive coping mechanisms and stress management techniques that can be put to use in the real world. Relapse prevention strategies should also include day-to-day lifestyle practices that support mental and emotional well-being.

In the case of co-occurring disorders, these strategies must focus on both substance use and co-existing mental conditions. Prioritizing one over the other will leave some big gaps in relapse prevention, regardless of the overall effort put forth.

Step Three: Create a Relapse Response Plan

Relapse can happen to anyone. It’s what happens next that determines who returns to the path to recovery and who falls back into unhealthy patterns.

A thorough response plan includes an overview of relapse warning signs and direct steps to take when one or more of these signs appear. This should include professional support via a counselor or treatment program so that treatment plans can be modified as needed.

Get Relapse Prevention Support

Relapse is common for those with co-occurring disorders, but it’s not a given. The right strategies can make all the difference in preventing relapse and responding to it at its earliest stages. Beyond that, they can foster an environment of self-care and vigilance that is necessary for maintaining long-term sobriety.

Substance use programs at Retreat are focused on treating the whole person, including any co-occurring disorders. We also recognize the role that a family history of co-occurring disorders can play, with treatment plans that take into account all aspects of an individual’s life in and out of our facilities.

Please contact us to learn more about relapse prevention and how Retreat can help you put a plan for recovery into place.