Dual Diagnosis Treatment & Evaluation in Austin and Surrounding Areas
Living with dual diagnosis can feel like trying to fix the roof during a storm while the basement floods. When anxiety spikes, you use to take the edge off—then wake up with more anxiety and shame. When depression drags you under, you promise to cut back tomorrow—then tomorrow arrives heavy, and the cycle repeats. Your calendar fills with cancellations, relationships strain, and it starts to feel like you’ve got a secret second job: managing symptoms, urges, and damage control.
What most people miss: dual diagnosis isn’t a character flaw or a “willpower problem.” It’s two conditions that feed each other—symptoms drive use, and use drives symptoms—until it all blurs together. You shouldn’t have to explain yourself twice or choose which part “matters” today. I meet you exactly where you are, map the pattern without judgment, and help you take the next right step toward steadier days, clearer thinking, and real momentum. Reach out—I’ll help you untangle the loop and find relief that lasts.
Understanding Dual Diagnosis
Plain-English definition: Dual diagnosis refers to having both a mental health condition (like depression, anxiety, bipolar disorder, PTSD, ADHD) and a substance use disorder at the same time.
How it often appears in adults vs stereotypes:
Adults often don’t fit the stereotype of “addiction first, mental health second” — many turn to substances to cope with undiagnosed or untreated mental health symptoms.
Symptoms may not be obvious; someone can appear “functional” while still battling both conditions daily.
Common symptoms and examples:
Mood swings, irritability, or unexplained anxiety while using or in withdrawal
Substance use that worsens mental health symptoms
Difficulty maintaining relationships, work, or routines
Feeling “stuck” because progress in one area stalls when the other flares up
Why it’s often missed or misunderstood: Many providers treat only one issue at a time, which can make relapse or symptom return more likely. An integrated approach is essential.
My Diagnostic Process
Comprehensive intake — exploring your mental health history, substance use patterns, and how they interact
Evidence-based assessments — screening for co-occurring disorders using validated tools
Differential diagnosis — ensuring symptoms are attributed to the correct root cause (e.g., depression vs. substance-induced mood disorder)
Personalized plan — not just a label — creating a treatment strategy that addresses both conditions simultaneously
Treatment Tailored to You
Integrated therapy that addresses both mental health and substance use in the same sessions
Medication management for mental health stabilization and craving reduction when appropriate
Skills training for managing triggers, cravings, and emotional regulation
Relapse prevention planning with ongoing support and accountability
Lifestyle and support network building to reinforce long-term recovery
Personalization matters because no two dual diagnosis cases are the same — the right plan adapts with your progress.
Why My Practice is Different
Most online information about dual diagnosis is either too clinical or oversimplified. I believe in giving you a clear, practical understanding of what’s happening in your brain and body, along with specific tools you can start using right away. You’ll know your options, understand the “why” behind each recommendation, and never feel left in the dark.
Actionable Steps You Can Take Today — Dual Diagnosis (mental health + substance use)
1) Name both lanes—out loud
Say: “I’m managing two linked problems: [mental health] and [substance].” Naming both reduces shame and helps you plan for each.
2) Keep a 7-day Dual Log
Track 4 things, twice a day: mood (1–10), cravings (1–10), sleep hours, substance use (what/how much/when). Add columns for triggers, meds taken, and a one-line note (“argued with boss,” “skipped lunch”). Patterns jump out fast.
3) Find your “cross-triggers”
Split a page in two. Left: top 5 mental health triggers (e.g., panic, loneliness, insomnia). Right: top 5 substance triggers (e.g., payday, certain friends). Draw lines between overlaps. Those intersections are your high-risk zones—plan extra supports there.
4) HALT + SLEEP check (3x/day)
Ask: Hungry? Angry? Lonely? Tired? If “yes” to any, do one small fix (snack, text a safe person, 10-minute rest). Add SLEEP debt as a fifth red flag.
5) Build a 3-tier coping menu
60 seconds: long exhale, splash cold water, step outside
5 minutes: brisk walk, grounding (5-4-3-2-1), quick snack
15+ minutes: call someone, journal, meeting/class/workout
Post it where you’ll see it. Use it before, during, and after urges.
6) “If/Then” cards for top 3 triggers
If I can’t sleep by midnight, then I get out of bed, read on the couch, tea—no scrolling.
If I’m invited to drink, then I order a zero-proof first and text my check-in person.
If I feel shame after a slip, then I hydrate, eat, and do a 10-minute walk before any decisions.
7) Delay, Distract, Decide (10-minute rule)
When an urge hits: delay 10 minutes, do one item from your 5-minute list, then decide again. Most urges crest and fall if you don’t feed them.
8) Urge surfing (90 seconds)
Notice the urge like a wave: “rising… peaking… falling.” Keep breathing longer on the exhale. Don’t argue with the thought—ride it.
9) Play the tape forward
Write two short scripts you can read when cravings hit:
Path A: “If I use, the next 12 hours look like…”
Path B: “If I ride this out, the next 12 hours look like…”
Choose based on the ending you want.
10) Environmental reset (make the hard thing harder)
Clear paraphernalia, unfollow triggering accounts, move alcohol out of the house, delete dealer numbers, install app/site blocks, keep recovery resources on your phone’s home screen.
11) Medication safety basics
Keep a single prescriber + single pharmacy. Use a weekly pill organizer and alarms. Never change doses or stop psychiatric meds on your own. Avoid mixing with alcohol or non-prescribed sedatives—interactions can be dangerous.
12) Know withdrawal risks
If alcohol, benzodiazepines, or heavy opioids are involved, don’t stop suddenly without medical guidance—withdrawal can be medically serious. Prioritize a medically supported plan.
13) Two numbers ready
Save two contacts you can text “I’m having a moment” to—no explanations required. Make the text a shortcut on your phone.
14) The 3–3–3 stabilizers
3 meals (protein at breakfast)
3 movements (3 × 5 minutes spread through the day)
3 “lights” (morning daylight; dim lights 2 hours before bed; no screens last 30 minutes)
15) Sleep safety net (even when rough)
Fixed wake time, simple wind-down ritual, worry pad by the bed. If awake >20 minutes: get up, low-stimulation activity, return when sleepy.
16) Money guardrails
Carry limited cash, turn on bank alerts for spending spikes, pre-pay essentials on payday, keep rideshare/food apps off your phone during high-risk periods.
17) “Red/Yellow/Green” day rating (morning)
Green: normal bandwidth—do the plan.
Yellow: reduce demands, increase supports.
Red: bare minimum + safety first (sleep/food/meds) and zero high-risk exposure.
18) A 2-minute reset after any slip
Hydrate, eat something real, 10 slow breaths, text your check-in person: “I’m resetting now.” A slip becomes feedback, not a spiral.
19) Cravings kit (carry it)
Strong mint/gum, stress ball, grounding card, earbuds + calm playlist, a photo that matters to you, and your If/Then cards. Keep one at home, one in your bag.
20) Social map: 3 people, 3 places
List 3 safe people and 3 safe places (park, gym, library, meeting). When the urge hits, move your body to a safe place or voice to a safe person.
21) Boundaries scripts you can copy-paste
“I’m not drinking—I’m focusing on sleep and training.”
“I’m heading out early tonight.”
“Not my scene anymore, but have fun and let’s grab coffee this week.”
22) Replace the reward
Write 10 substance-free rewards you actually like (hot shower, good coffee spot, new playlist, short game, quick swim). Use one immediately after high-effort moments.
23) High-risk calendar
Circle dates/times that historically lead to use (paydays, anniversaries, travel, conflict spots). Pre-load extra supports and decide your exit plan for each.
24) Thought reframer (3 lines)
Trigger: “When I think ‘I always blow it’…”
Old story: “…my brain is catastrophizing.”
New stance: “I’m building reps. One decision at a time.”
25) “After-action” review (3 minutes)
What happened? What helped even 1%? What will I try first next time? Jot it in your Dual Log so the next plan is sharper.
26) Recovery capital builder (weekly)
Choose one pillar to strengthen: health, housing, work/school, relationships, purpose, fun. Add one small brick (email, appointment, class, chore, hobby time).
27) Food + mood basics
Don’t let protein + fiber be more than 4–5 waking hours apart. Bring a backup snack. Stable blood sugar = fewer urges.
28) Movement that regulates (not punishes)
Aim for 10 minutes after waking and 10 minutes mid-afternoon. Walk, cycle, stretch, or do a few sets at home. Use rhythm (music, metronome) to steady your nervous system.
29) Digital detox windows
Two 30-minute blocks daily with your phone in another room. Quiet brains crave fewer quick fixes.
30) Mini-plan for co-occurring symptoms
Anxiety spike: long exhale + grounding + walk
Low mood: sunlight + motion + tiny task
ADHD drift: two-tab rule + 10-minute focus sprint
Insomnia next day: protect wake time + gentle day
31) Coordinate care (simple, powerful)
Keep a one-page summary: diagnoses you’ve been given, meds/doses, allergies, past helpful strategies, emergency contacts. Share it with your prescriber/therapist so everyone rows the same direction.
32) Safe-use and overdose awareness (if relevant)
If opioids are in the picture, know where naloxone is and how to use it; don’t use alone. If alcohol/benzos are involved, avoid mixing and seek medical advice before any changes.
33) Values compass
Pick three words (e.g., steady, honest, present). When stuck, ask: “What would ‘steady’ do next?” Then do just that next step.
34) Hope ledger (daily)
End the day with two wins (no matter how small) and one lesson. Momentum compounds.
Start with 3–5 tools, place them where you’ll see them, and practice them before you need them. The goal isn’t perfection—it’s shortening the gap between urge and skill.
Dual Diagnosis Often Comes with Company
Dual diagnosis frequently overlaps with trauma, ADHD, borderline personality disorder, or chronic stress. Treating it effectively means addressing the full picture, not just one part.
Serving Austin and Beyond
I provide dual diagnosis treatment for clients in:
Austin, Barton Creek, Bastrop, Bee Cave, Bertram, Blanco, Briarcliff, Brushy Creek, Buda, Burnet, Cedar Park, Circle C, Creedmoor, Dripping Springs, Elgin, Florence, Georgetown, Granger, Great Hills, Hays, Hutto, Jarrell, Johnson City, Jonestown, Jollyville, Kyle, Lago Vista, Lakeway, Leander, Liberty Hill, Lockhart, Luling, Manor, Marble Falls, Martindale, Meadowlakes, Mountain City, Mustang Ridge, New Braunfels, Niederwald, Pflugerville, Point Venture, River Place, Rollingwood, Round Rock, San Marcos, Smithville, Steiner Ranch, Sunset Valley, Taylor, The Domain, The Hills, Thrall, Volente, Webberville, Weir, West Lake Hills, Wimberley, Woodcreek, Zilker, and throughout all of Texas!