Conditions · Dual diagnosis
Depression and addiction.
Major depression alongside substance use is the most common dual-diagnosis pairing we see. Treated together, with depth — not as two separate checklists.
The depression underneath.
For most people we work with, the substance use was the visible problem and the depression was the actual one. The drinking, the using, the compulsive behaviors — they were ways of dampening a baseline state of bleakness, numbness, hopelessness, or self-loathing that had been there long before any of the substance use started.
Sometimes the depression is situational and grew over time. Sometimes it’s biological. Sometimes it’s tangled up with grief, trauma, or attachment ruptures that never got named. Usually it’s several of those at once.
You can’t white-knuckle your way out of it. You also can’t medicate your way out of it. The work is figuring out what the depression actually is, treating it directly, and building a life that doesn’t hand it constant fuel.
When outpatient is the right starting point.
- You’re depressed and your substance use is making it worse.
- You’ve been on antidepressants for years and the substance use is undoing their effect.
- You’re not in active acute suicidal crisis.
- You’re willing to engage with the underlying material, not just the symptoms.
If you’re actively suicidal or in immediate danger, please call 988 or go to the nearest emergency room. Outpatient is not the right starting point for acute crisis.
How we treat it
The substance use and the depression, together.
PHP and IOP at Glass House are dual-diagnosis programs by default. Process and individual therapy address the substance use and the depression as one picture. Medication coordination happens with prescribers we know. Experiential and creative work matter especially here — depression often makes it hard to access feeling through pure verbal therapy.
Done waiting for it to lift on its own?
One short message is enough. We’ll help you figure out next steps.