I started dual diagnosis therapy because my anxiety and substance use keep feeding into each other, but I’m still unsure where I fit. Some sessions feel focused on addiction, while other times it’s mostly about my mood and panic. I get why both matter, but I sometimes leave feeling like I’m not fully being treated for either one.
Part of me worries I’m exaggerating the substance problem, and another part worries I’m minimizing it because I’m more comfortable talking about anxiety. It’s awkward trying to explain that I’m not looking for an excuse, but I also don’t think I can deal with one issue while ignoring the other.
I’m trying to give the therapy a fair chance instead of deciding after every uncomfortable session that it isn’t working. Has anyone else felt caught between the mental health and addiction sides of treatment?
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Vanessa, that fear of exaggerating one problem while minimizing the other sounds really understandable. Anxiety can make it hard to speak openly about substance use, especially when you’re worried about being judged or misunderstood.
It may help to tell your therapist exactly what you said here: that you sometimes leave feeling neither issue was fully addressed. A good dual diagnosis plan should make room for both, even if the focus shifts from session to session. Giving it time while still speaking up about what isn’t working seems like a fair balance.
Vanessa, the part about being more comfortable talking about anxiety really hit home. It’s easier to discuss panic than the choices or habits that come with using, especially when I’m worried the therapist will only see me through that one issue.
I’ve found it helps to write down what I want covered before the session, even just a few points about mood, panic, cravings, and what happened between appointments. Then I can say if one area is taking over. You shouldn’t have to prove which problem is “real” for both to get attention.
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@Krista_Dawson, writing things down before the session makes sense. I’ve gone in intending to mention substance use, then spent the whole appointment explaining the panic and left without saying what I meant to.
One time I brought a short list and started with the topic I was most tempted to avoid. It made the conversation uncomfortable, but at least it got on the table.