As a strong rain fell one night last week outside his Oxnard home, Bryan Herrill did something he hadn't done in years of battling addiction and depression.

He pulled his electric guitar out of storage, hooked up the amplifiers and played until 2 in the morning, starting with Neil Young's folk rock and ending with Social Distortion's punk anthem "Story of My Life."

"I got callouses working on my fingers again," he said before a counseling session the next day.

Herrill, 51, has shown the kind of progress therapists are looking for in people struggling with the double whammy of serious substance abuse and serious mental illness. The combination is both difficult to live with and common: National research shows 60 percent to 70 percent of people with severe mental illness have a substance abuse problem.

These individuals often turn to drugs to handle emotions spawned by some type of trauma in their pasts, but the drugs can worsen psychological symptoms, leading to more drug use and then more mental illness.

Nor is it clear whether the mental issues would have surfaced without the drugs. Many began abusing substances from ages 10 to 13, affecting brain development.

Methods shown to work

Now counselors say a nationally lauded program in Ventura County is beginning to make a difference for people caught in the cycle.

Called Integrated Dual Diagnosis Treatment, the program won recognition this year for how well it incorporated what are called "best practices" — methods shown to work.

It was one of four cited for exemplary work in dual-diagnosis programs by the federal Substance Abuse and Mental Health Services Administration, which handed out the science and service awards for the first time this year.

Psychologist Linda Gertson, who oversees the program in the Ventura County Behavioral Health Department, says efforts to treat the two types of disorders separately simply don't work. This one uses a team of specialists trained in both fields to counsel people in one setting, not shift them from expert to expert and from site to site.

Participants are assessed with an eye toward their experience with both types of disorders, including how the two interact, Gertson said.

The system also uses a type of intervention called "motivational enhancement therapy."

The idea is to connect with the clients' own reasons for wanting to change rather than trying to shame them into quitting, she said.

"You go where the client is in terms of assisting them with finding internal sources of motivation to get out of the vicious cycle," she said. "Years ago under the Synanon model, the idea was to shame the client to give up substances of abuse. Research has shown that model is a terrible failure."

'Escalating cycle'

More than 150 people have been treated in the program since 2005. It now operates at outpatient clinics in Oxnard and Thousand Oaks but is scheduled to expand to other areas of the county with the aid of almost $700,000 in state funding, officials said.

The interplay of substance abuse and mental illness is often complicated by violence in the clients' lives. About 80 percent have survived child abuse, domestic violence or some other traumatic experience. They turn to drugs to deal with the emotional fallout, but that can backfire, Gertson said.

"If you have severe physical or sexual abuse as a child, the stress hormones secreted by the body affect the same areas of the brain involved in substance abuse," she said. "They turn to substances, but the drugs exacerbate the anxiety and depression, so you have this vicious kind of escalating cycle."

The knowledge that he had both psychological and drug problems came late to Herrill.

He had been drinking and using drugs heavily for 35 years, running the gamut from alcohol and marijuana to LSD, cocaine, methamphetamine and heroin, but said the depression did not strike until the last six or seven years.

Life got worse

He was a high-functioning addict for decades, working as an electrical sign contractor and paying child support regularly for his daughter, he said. But the toll of job injuries, failed relationships and drugs started mounting.

Life got dramatically worse in February 2006, he said, when a couple of acquaintances entered his room in a single-room residency hotel and beat him in a home-invasion robbery. That spawned post-traumatic stress syndrome, leaving him with claustrophobia in a roomful of people, paranoia late at night and anxiety over loud noises, he said.

He started living in his truck, got into three accidents and was "drinking like a fish" and using "as much heroin as I could get my hands on," he said. After totaling his truck, he rented a van to drive to a handyman's job in Santa Barbara. On the way, he was stopped, and a patrolman found heroin and a loaded handgun he was carrying for protection in the vehicle, he said.

He had entered treatment before, but with no job, a felony conviction and no vehicle, he recommitted himself to getting sober.

Giving him hope

Herrill felt he was running out of places to hide after repeatedly entering detoxification programs and relapsing. Then a year ago, he turned to the county's dual-diagnosis program, where he was advised to enter Joshua House, a residential treatment program in Santa Paula.

Released from there in September, he began to work in earnest with Keith McCourtney, a therapist in the dual-diagnosis program. Herrill says he's now two months sober. He meets individually with McCourtney once a week, takes medication for depression, attends a group counseling session and is heavily involved in Alcoholics Anonymous.

Herrill, who is physically disabled from job injuries, said it's too early in his recovery to set new goals. But he is trying to clean out the negative things in his life and recapture some of the joy he once found in old passions like music.

He said the program's emphasis on both mental illness and drug addiction in the same setting is giving him hope.

"This is the first time I feel comfortable in my own skin in the last six or seven years."