Stress and trauma rarely show up alone. By the time someone reaches treatment, the trauma has usually picked up company: anxiety, sleep that won’t come, racing thoughts, and often a substance that started as a way to turn the volume down. This is the story of one woman who came to Destination Hope in that exact tangle, and of the clinical work that helped her find her footing. Details have been kept general to protect her privacy.
The pattern she arrived with is common, and the research backs that up. The National Institute on Drug Abuse notes that people with substance use disorders report markedly higher rates of lifetime trauma than the general population, and that trauma and post-traumatic stress frequently travel alongside substance use. That’s why we treat the mental health condition as the primary diagnosis here, with co-occurring substance use addressed at the same time rather than waiting in line behind it.
How She Arrived
The client came to Destination Hope in her mid-20s. She had been working in customer service in the southern United States. By her own account, the main driver of her decline was the combination of stress and trauma that had built up over time. She had a history of daily marijuana use and arrived with little insight into how it was feeding her current state, which is its own clinical hurdle to clear.
Other factors had stacked up behind that. She had stopped taking her medication as prescribed. Her impulse control and judgment had eroded. Tension at home and friction in her relationships were constant. She was struggling to hold down work and, at times, to function day to day. Anxiety ran underneath all of it. None of these problems sat in isolation. Each one made the others worse, which is exactly why a 72-hour stabilization or a standard outpatient check-in rarely breaks the cycle.
The Treatment Program
Working with clinicians every day, she started by taking honest stock of her own mood, energy, sleep, and the racing thoughts she’d been living with. The medical team built a medication regimen aimed at stabilizing her mood so the rest of the work could hold. In the nursing-led medication group, she learned something that had been invisible to her: how alcohol and drug use can blunt or interfere with the psychiatric medication meant to help her. That single insight reframed her daily marijuana use as a clinical problem instead of a habit she could keep on the side.
From there the work widened. In a group called “Living Mentally Well,” she began to understand her own diagnosis and to practice healthier judgment. Accountability groups helped her name the impulsive behaviors that had been creating chaos in her life and tie cause to effect. Repeating the ordinary structure of daily living, the chores, the personal care, the small tasks, gave her back a sense of function that crisis had taken away.
As she gained clarity, the deeper work began in individual sessions. She processed a strained relationship with a family member and started to let go of the anger and resentment she’d been carrying. That family member came in for therapy with her, which opened a path toward forgiveness on both sides. Our approach treats the family as part of the picture, not a footnote, so hers was connected to Al-Anon and the National Alliance on Mental Illness to learn about mental health and recovery on their own terms.
Why Trauma and Substance Use Are Treated Together
When a substance use disorder sits on top of trauma or another mental health condition, treating them separately tends to leave the door open for relapse on both sides. The Substance Abuse and Mental Health Services Administration, in its guidance on trauma-informed care, describes integrated treatment that addresses trauma and substance use at the same time as the more effective path. NIDA reaches the same conclusion: co-occurring conditions usually do better when they’re treated together rather than one after the other.
That’s the model behind her care. Our trauma resolution therapy works the root of the pain while the psychiatric and substance use pieces are handled in the same plan, under one clinical team, through dual diagnosis treatment. The substance use never got treated as the headline, and the trauma never got treated as a side note.
Treatment Outcomes
As her recovery progressed, she learned new ways to cope with the depression and anxiety that had been running her life. One of her first homework assignments was to keep an anxiety thought record, logging three episodes of high anxiety and the circumstances around each. Tracking it that way helped her see her own triggers and where the spikes were coming from. In mindfulness group she picked up relaxation skills like guided imagery, meditation, and diaphragmatic breathing, then practiced folding them into ordinary days.
After weeks of a stabilized medication regimen, individual therapy, and group work, she was ready for the next phase: planning her aftercare. With her case manager she connected to vocational services and built skills toward steady employment. To anchor a support network, she was introduced to the National Alliance on Mental Illness and given a full list of meetings near where she’d be living. She stepped down into intensive outpatient treatment while living with her supportive family, carrying the work forward instead of leaving it behind at discharge.
If This Sounds Like Someone You Love
If you’ve watched someone go through the cycle in this story, the stalled medication, the substance use, the relationships fraying, the days that stop working, you already know how exhausting it is to wait for the next crisis. There’s another way through it. Destination Hope provides psychiatrist-led residential care that treats trauma and co-occurring substance use together, with on-site detox and a full continuum of step-down care. Call our admissions team at (954) 302-4269 to talk through what help could look like.
Crisis and Emergency Resources
If you or someone you know is in a substance use or mental health crisis, help is available now. Contact the SAMHSA National Helpline at 1-800-662-HELP (4357) for free, confidential treatment referrals 24/7. Reach the 988 Suicide and Crisis Lifeline by calling or texting 988. The Crisis Text Line is available by texting HOME to 741741. For emergencies, call 911.
