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Dual Diagnosis Treatment in Los Angeles: When Addiction and Mental Health Need to Be Treated Together
For roughly half the people who walk through our doors at Altus Rehab, the substance use disorder isn't the only thing going on. There's a depression that started before the drinking. An anxiety disorder that the cocaine was masking. A trauma history that fentanyl quieted, until it didn't. When addiction and a mental health condition appear together, clinicians call it a co-occurring disorder, or dual diagnosis — and treating one without the other almost never holds.
What "dual diagnosis" actually means
A dual diagnosis is the simultaneous presence of a substance use disorder (SUD) and another psychiatric condition — most often depression, anxiety, bipolar disorder, PTSD, or ADHD. The DSM-5 doesn't treat them as one diagnosis; it treats them as two distinct illnesses that interact. NIDA estimates that about 50% of people with a serious mental illness will also experience a substance use disorder at some point, and the relationship runs in both directions: substances can trigger latent psychiatric conditions, and untreated psychiatric conditions are one of the strongest risk factors for substance misuse.
Why integrated treatment matters
For decades, addiction treatment and mental health care lived in separate buildings. Patients were told to "get clean first, then deal with the depression" — or vice versa. The outcomes were poor. Modern integrated treatment addresses both conditions in parallel, with one clinical team, one treatment plan, and one set of medications coordinated across both diagnoses. SAMHSA and the American Society of Addiction Medicine (ASAM) both consider integrated dual-diagnosis care the standard of evidence-based practice.
What integrated care looks like at Altus Rehab
Our DHCS-licensed dual-diagnosis program (license #191196AP) at our two private estates in Encino is built around three things: a careful psychiatric assessment on day one, medication-assisted treatment where it's clinically appropriate, and a small caseload (only 12 beds across both properties) so trauma-focused therapy can happen safely alongside detox and stabilization. Most major PPO insurance plans are accepted, and our medical team is led by Dr. Giles.
Common conditions we treat alongside addiction
Anxiety, major depression, bipolar disorder, post-traumatic stress disorder, ADHD, and treatment-resistant depression are the most frequent psychiatric diagnoses we see paired with substance use. Each requires a different combination of medication, talk therapy, and structured environment...