Mental Health and Substance Use: Q & A Featuring Compass Psychiatrist and Addiction Specialist Deepali Gershan, MD

Gain valuable insights from Dr. Deepali Gershan, Compass Psychiatrist and Addiction Specialist, as she shares her expertise on the nuanced topic of mental health and substance use. In this blog, we delve into the complexities of this important subject, exploring its significance and receiving valuable perspectives from an experienced professional. One of our goals for this blog is to educate our community about the relationship between substance use and mental health and how family members, clinicians, psychiatrists, and other community supports can work together as a team to support our loved ones and patients. This Q&A is for anyone interested in learning more about this topic or looking for ways they can help those struggling with substance use and mental health in their own circles.

Dr. Deepali Gershan is the Medical Director of Over 18 Programs at Compass Health Center in Northbrook. She provides clinical care for young adults and adults in the PHP/IOP programs. She has been committed to expanding access to substance use treatment for individuals receiving mental health treatment at Compass since she began working at the company over seven years ago. Dr. Gershan has worked with staff clinicians over the years to expand group-based substance programming, increase access to medication-assisted treatment for substance use, and helped launch a Virtual Dual Diagnosis program during the peak of the covid-19 pandemic.

Q: What comes first: Substance use or mental health problems?

Deepali Gershan, MD: We know that for some people, mental health problems can lead to substance use meaning the use of alcohol, illicit drugs, misuse of prescription drugs, or over-the-counter medications. We also know that substance use can cause or exacerbate certain mental health disorders, particularly anxiety, depression, schizophrenia, and bipolar disorder though certainly the effects of substances are not limited to these mental health disorders. Both mental health and substance use disorders share certain underlying causes, particularly early life exposure to trauma or stress and genetic vulnerabilities.¹

Roughly half of the people with a substance use disorder will have a mental health disorder at some point in their life and vice versa. According to the recent SAMHSA 2021 National Survey on Drug Use and Health, approximately 9 million adults in the United States have a co-occurring disorder, meaning both a mental health disorder and a substance use disorder.²

Q: How do you know if you have a dual diagnosis?

Deepali Gershan, MD: Having a Dual Diagnosis, also known as a Co-Occurring Disorder, means having both a diagnosed mental health disorder and a substance use disorder. If you have a diagnosed mental health disorder, use substances, and have noticed at least two of the following symptoms over the past 12 months, you should notify your healthcare provider.

Increase in tolerance (needing more of a substance to achieve the same effect or a diminished effect with the same amount of use)
Withdrawal symptoms
Risky or hazardous use (using your substance in an unsafe environment or continuing to use substances despite worsening physical or psychological problems)
Social or interpersonal problems with substance use (impairment in work, school, home responsibilities)
Continued substance use despite physical or psychological problems caused or exacerbated by substance use
Neglecting major role responsibilities (work, school, home) because of substance use
Important activities are given up or reduced because of substance use
Repeated attempts or unsuccessful attempts to reduce, quit or control substance use
Impaired control over your substance use (consuming larger amounts or over a longer period of time than intended)
Spending excessive time obtaining substances or recovering from the effects of use
Cravings³

Q: How can one identify the right treatment path for them?

Deepali Gershan, MD: If you are experiencing physical withdrawal symptoms, it is important to urgently seek medical attention to assess and prevent potentially serious or life-threatening withdrawal. If you are not experiencing any acute concerns, schedule a time to speak with your mental health provider, therapist, psychiatrist/NP/PA, primary care physician, or any medical provider with whom you have a trusted relationship. Be honest about your symptoms so you can be referred to the appropriate level of care to treat your physical health needs, including withdrawal and mental health concerns. Treatment for mental health and substance use disorders is often a journey, so be patient with your progress and engage with your healthy supports, including friends, family members, and loved ones. National Drug and Alcohol Facts Week (2)

Mental Health & Substance Use Treatment Options

It's important to have regular conversations about mental health and substance use with friends and loved ones. While one may lead to the other, it is best for an individual experiencing symptoms of either to seek help from a trusted medical provider to ensure they receive appropriate treatment. It is also paramount that if a person is experiencing difficult physical withdrawal symptoms, they seek medical attention immediately.

At Compass Health Center, we provide safe, successful, and tailored treatment options while navigating this complex journey. With our diverse treatment teams having specialized areas of expertise, individuals can feel empowered to find their story of healing. We invite everyone to learn more about our Mental Health and Substance Use treatment options at Compass Health Center.