When navigating the complex journey of addiction recovery, understanding how your body responds to stress can be a crucial factor in maintaining long-term sobriety. One of the most important stress-related chemicals in your body is cortisol, often called the “stress hormone.” At Healthy Life Recovery, we recognize that managing stress and understanding its biological components—including cortisol—plays a vital role in successful recovery from substance use disorders.
This comprehensive guide will help you understand what cortisol is, how it affects your body and mind, its complex relationship with addiction, and most importantly, how elevated cortisol levels can increase relapse risk and what you can do about it.
What Is Cortisol?
Cortisol is a steroid hormone produced by the adrenal glands, which sit on top of your kidneys. Often referred to as the body’s primary stress hormone, cortisol plays several essential roles in maintaining your health and helping you respond to challenging situations. According to the National Center for Biotechnology Information, cortisol is the main glucocorticoid released from the zona fasciculata layer of the adrenal cortex and affects nearly every organ and tissue in the body.
Normal Functions of Cortisol
When functioning properly, cortisol acts as your body’s built-in alarm system and regulatory mechanism. This essential hormone helps maintain balance in multiple bodily systems throughout the day. The Cleveland Clinic notes that cortisol affects nearly every organ system in your body and helps regulate several key functions.
Cortisol regulates blood sugar levels by helping maintain steady glucose levels for sustained energy, while also controlling inflammation by reducing immune system responses that could become harmful if left unchecked. The hormone manages blood pressure and helps maintain proper cardiovascular function, and it influences metabolism by affecting how your body processes fats, proteins, and carbohydrates for optimal energy use.
Perhaps most notably, cortisol supports your fight-or-flight response by providing the energy and alertness needed during stressful situations. It also works closely with your circadian rhythm to regulate sleep-wake cycles, promoting alertness during the day and allowing for proper rest preparation in the evening.
The Cortisol Cycle
Understanding your body’s natural cortisol rhythm is crucial for recognizing when this system becomes disrupted by stress, trauma, or substance use.
In healthy individuals, cortisol levels follow a predictable daily pattern that supports optimal functioning. Cortisol levels peak shortly after waking in the morning, providing the energy boost needed to start the day with alertness and motivation. Throughout the afternoon, these levels gradually decrease, allowing for sustained but manageable energy as the day progresses.
By evening, cortisol reaches its lowest point, which allows for natural relaxation and proper sleep preparation. During the night, levels remain low to promote restorative rest that helps the body and mind recover from the day’s activities. However, chronic stress, trauma, and substance use can severely disrupt this natural rhythm, leading to significant health and recovery challenges that can persist long after achieving sobriety. Research from the National Institute of Mental Health shows how chronic stress can be linked to both physical and mental ailments through cortisol dysregulation.
Activities and Behaviors That Trigger Cortisol Release
Recognizing the various factors that can elevate your cortisol levels is essential for developing effective stress management strategies in recovery. These triggers can be physical, emotional, environmental, or lifestyle-related, and understanding them helps you identify potential risks before they become overwhelming.
Understanding what causes cortisol levels to rise can help you identify potential stressors in your recovery journey. Cortisol release can be triggered by various factors that range from obvious physical stressors to subtle environmental influences that may not immediately seem problematic.
Physical Stressors
Your body responds to physical challenges by releasing cortisol as part of its protective mechanisms, though prolonged exposure to these stressors can become problematic.
Intense exercise, while beneficial in moderation, can elevate cortisol levels when taken to extremes or when your body hasn’t had adequate time to recover between sessions. Illness or injury triggers cortisol release as part of your body’s natural healing response, helping mobilize resources for recovery but potentially creating additional stress if prolonged.
Sleep deprivation disrupts your body’s natural cortisol regulation, leading to higher baseline levels and reduced ability to manage daily stressors effectively. Exposure to extreme temperatures, whether very hot or cold environments, can trigger your body’s stress response as it works to maintain optimal internal temperature. Similarly, hunger or malnutrition from skipping meals or inadequate nutrition can stress your body’s systems and trigger cortisol release as your body tries to maintain stable blood sugar levels.
Psychological and Emotional Stressors
The mind-body connection means that emotional and psychological challenges can have profound effects on your cortisol levels, often creating a cycle where stress leads to elevated hormones, which in turn makes it harder to cope with future stressors.
Work-related pressures such as tight deadlines, workplace conflicts, or job insecurity can create chronic stress that keeps cortisol levels consistently elevated throughout the day. Relationship difficulties, including arguments with family members, romantic breakups, or ongoing tensions with friends, trigger both immediate cortisol spikes and longer-term elevation when conflicts remain unresolved. Learning how to support a loved one in recovery can help reduce relationship stress for everyone involved.
Financial concerns about money problems, unexpected expenses, or general economic uncertainty can create persistent worry that maintains elevated cortisol levels. Major life changes, even positive ones like moving to a new home, starting a new job, or significant life transitions, require adaptation that can stress your system. Trauma reminders, whether from past experiences of abuse, accidents, or other traumatic events, can trigger immediate and intense cortisol responses that may persist long after the trigger is removed. Understanding the connection between trauma disorders and addiction is crucial for comprehensive recovery.
Social anxiety about potential judgment from others or fear of social rejection can create anticipatory stress that elevates cortisol before, during, and after social interactions. Perfectionism and setting unrealistic expectations for yourself creates chronic stress as you constantly feel like you’re falling short of impossible standards. Understanding the relationship between anxiety and addiction can help address both issues simultaneously.
Lifestyle Factors
Daily habits and lifestyle choices can significantly impact your cortisol levels, often in ways that may not be immediately obvious but can accumulate over time to create chronic stress.
Excessive caffeine consumption, particularly from multiple cups of coffee, energy drinks, or other stimulants throughout the day, can directly stimulate cortisol production and interfere with your body’s natural rhythm. Alcohol and drug use disrupt the delicate balance of your stress response system, often creating a cycle where substances initially seem to provide relief but ultimately lead to more severe cortisol dysregulation.
Poor dietary choices, including high sugar intake, processed foods, and irregular eating patterns, can create blood sugar instability that triggers cortisol release as your body tries to maintain equilibrium. Social isolation and lack of meaningful connections with others can create chronic stress, as humans are naturally social beings who require community for optimal mental health.
Information overload from constant news consumption, social media use, or trying to stay on top of every current event can overwhelm your nervous system and maintain elevated stress levels. Similarly, multitasking and trying to manage too many responsibilities simultaneously can create a sense of being constantly “on” that prevents your cortisol levels from returning to baseline.
Environmental Stressors
Your physical environment plays a crucial role in determining your stress levels, and certain environmental factors can create chronic cortisol elevation that affects your recovery and overall well-being.
Noise pollution from constant exposure to loud or disruptive sounds, whether from traffic, construction, or neighbors, can keep your nervous system in a state of heightened alertness. Overcrowded living or working conditions can create a sense of lack of personal space and privacy that triggers stress responses.
Toxic relationships with manipulative, critical, or emotionally harmful individuals can create chronic stress that affects every aspect of your life. Chaotic or unpredictable living environments where you never know what to expect can prevent your body from feeling safe enough to allow cortisol levels to normalize.
The Complex Relationship Between Cortisol and Substance Use
The relationship between cortisol and addiction is bidirectional and complex. Understanding this connection is crucial for anyone in recovery or seeking to understand addiction better.
How Substance Use Affects Cortisol
The relationship between different substances and cortisol is complex and varies significantly depending on the type of substance, frequency of use, and individual factors. Understanding these patterns can help explain why early recovery is often so challenging and why comprehensive treatment is necessary.
Different substances impact cortisol levels in various ways, often creating complex patterns of elevation and suppression that can persist long after the substance has left your system.
Alcohol initially may appear to lower cortisol temporarily, creating a false sense of relaxation that can be misleading about its true effects on your stress system. However, chronic alcohol use leads to consistently elevated cortisol levels and severely disrupted circadian rhythms that can take months to normalize. During alcohol withdrawal, the body experiences dramatic spikes in cortisol that contribute significantly to the anxiety, insomnia, and physical discomfort that make early sobriety so challenging. Understanding whether you need alcohol detox is crucial for safe recovery.
Stimulants like cocaine, methamphetamine, and prescription medications such as Adderall cause immediate and significant cortisol elevation during use, often reaching levels that would normally only occur during extreme stress. The crash period following stimulant use leads to severe cortisol dysregulation and extreme fatigue as your adrenal system struggles to recover. Long-term stimulant use often results in chronic stress response activation and what’s commonly called adrenal fatigue, where your body’s ability to produce appropriate cortisol levels becomes impaired. Understanding commonly abused stimulants can help identify when professional help is needed.
Opioids including heroin and prescription painkillers initially suppress cortisol production, which can create a false sense of calm and relief from stress. However, as tolerance develops, the body experiences rebound effects with elevated cortisol levels that drive continued use. During opioid withdrawal, severe cortisol spikes contribute to the intense physical and emotional symptoms that make this process so difficult without medical support. Learning about opioid withdrawal timeline can help prepare for the recovery process.
Cannabis effects on cortisol can vary significantly between individuals and usage patterns. Acute use may temporarily lower cortisol in some users, which partly explains its appeal for stress relief. However, chronic cannabis use can lead to a blunted cortisol response that makes it difficult to manage stress naturally without the substance. When heavy cannabis users stop using, they may experience temporary increases in cortisol and anxiety as their natural stress response system recalibrates.
How Elevated Cortisol Contributes to Addiction Risk
When cortisol levels remain elevated for extended periods, they create biological and psychological conditions that significantly increase vulnerability to substance use. This happens through several interconnected mechanisms that affect both brain function and emotional regulation.
High cortisol levels can increase vulnerability to substance use through several mechanisms that create a perfect storm for addiction development. Chronic stress impairs the prefrontal cortex, the brain region responsible for executive functions like decision-making and impulse control, making it much harder to resist the immediate gratification that substances seem to offer.
Stress hormones can trigger powerful cravings by activating the brain’s reward system and making substances seem like an essential solution to emotional pain. Elevated cortisol also creates significant emotional dysregulation, making it much more difficult to manage feelings effectively without external help. The sleep disruption caused by chronic stress increases relapse risk and reduces your natural coping abilities, creating a cycle where you feel increasingly unable to handle life’s challenges.
Additionally, weakened immune system function from chronic stress makes individuals more susceptible to illness and depression, which can further increase the appeal of substances for relief. Memory and learning problems associated with high cortisol can interfere with your ability to form new, healthy habits and remember the negative consequences of substance use, making it easier to convince yourself that “just this once” won’t hurt.
Cortisol and Relapse Risk: The Critical Connection
One of the most important aspects of understanding cortisol in recovery is recognizing how elevated stress hormone levels can significantly increase the risk of relapse. Research consistently shows that individuals with higher cortisol levels face greater challenges in maintaining sobriety.
How Cortisol Increases Relapse Risk
Research consistently demonstrates that individuals with higher cortisol levels face significantly greater challenges in maintaining sobriety, making stress management a critical component of any successful recovery program.
Understanding the specific ways that cortisol increases relapse risk can help you recognize warning signs and take proactive steps to protect your recovery.
When cortisol levels spike, your brain’s reward system becomes hyperactive, making cravings for substances more intense and difficult to resist through willpower alone. This biological response can override rational decision-making processes, causing you to act on impulses that you would normally be able to control. These stress-induced cravings often feel different from other types of cravings because they’re driven by your body’s fundamental survival mechanisms.
Elevated cortisol significantly impairs the prefrontal cortex, which is the brain region responsible for executive function, planning, and impulse control. This impairment makes it much harder to access and use the healthy coping strategies you’ve learned in treatment when faced with triggers or stressful situations. You might find yourself knowing exactly what you should do but feeling unable to follow through.
High cortisol levels are strongly associated with increased anxiety, depression, and irritability, creating emotional states that can make substances seem like an appealing way to find relief. These emotional vulnerability periods can last for hours or even days, creating extended windows of increased relapse risk.
Cortisol dysregulation interferes significantly with restorative sleep, which is crucial for brain healing and emotional regulation in recovery. Poor sleep quality makes individuals much more vulnerable to relapse by reducing stress tolerance and impairing judgment. Finally, chronic elevation of cortisol can cause persistent headaches, muscle tension, digestive issues, and other physical symptoms that may trigger the desire to self-medicate, especially if these symptoms remind you of how substances used to provide relief.
High-Risk Periods for Cortisol-Related Relapse
Being aware of when you’re most vulnerable to cortisol spikes can help you prepare additional support and coping strategies during these challenging times.
Certain periods and situations present particularly elevated risk for cortisol spikes and subsequent relapse vulnerability. Early recovery, particularly the first 90 days, represents a critical window when your brain is still healing and your natural stress response system is recalibrating. During this period, even normal daily stressors can trigger disproportionate cortisol responses. Understanding coping strategies in early sobriety is essential for managing this vulnerable period.
Anniversary dates including birthdays, holidays, or dates associated with trauma or loss can trigger powerful emotional and physiological responses that elevate cortisol for days or weeks. Managing seasonal depression in sobriety during challenging times of year is particularly important for maintaining recovery. Major life transitions such as job changes, relationship endings, moves, or other significant life changes require substantial adaptation that can overwhelm your stress management systems.
Financial crises including unexpected expenses, job loss, or income reduction create persistent worry that can maintain elevated cortisol levels for extended periods. Health problems, whether personal illness or family medical issues, trigger both immediate stress responses and longer-term anxiety about the future.
Legal troubles including court dates, legal proceedings, or interactions with law enforcement can create intense stress that persists long after the immediate situation is resolved. Relationship conflicts, particularly arguments with family members, friends, or romantic partners, can trigger both immediate cortisol spikes and ongoing elevation if conflicts remain unresolved.
Managing Cortisol Levels in Recovery
Successfully managing cortisol levels requires a comprehensive approach that addresses both the immediate symptoms of elevated stress hormones and the underlying factors that contribute to chronic stress. At Healthy Life Recovery, we incorporate evidence-based stress management techniques into all of our treatment programs because we understand that sustainable recovery requires addressing the biological, psychological, and social factors that influence stress response.
The good news is that there are many effective strategies for managing cortisol levels and reducing relapse risk. These approaches range from simple daily practices you can implement immediately to more comprehensive treatment interventions that address underlying trauma and mental health conditions.
Evidence-Based Stress Management Techniques
Research has identified several highly effective approaches for managing cortisol levels, many of which can be learned and practiced as part of your daily routine in recovery.
Mindfulness and meditation practices have been extensively studied and consistently show significant benefits for cortisol regulation. Mindfulness-based stress reduction (MBSR) has been proven to lower cortisol levels and improve emotional regulation, providing tools you can use anywhere and anytime you notice stress building. Deep breathing exercises offer simple techniques that can be used anywhere to activate your body’s relaxation response and counteract the fight-or-flight activation that drives cortisol release.
Body scan meditation helps you identify and release physical tension that often accompanies stress, while walking meditation combines the benefits of movement with mindfulness practice. These approaches work by activating your parasympathetic nervous system, which directly counteracts the stress response that elevates cortisol.
Physical activity and exercise provide some of the most effective natural methods for managing cortisol levels. Our Active Recovery Tracks include activities specifically chosen for their stress-reducing benefits and their ability to provide healthy outlets for stress energy. Yoga combines physical movement, breathing techniques, and meditation to create a comprehensive stress management practice that can significantly lower cortisol levels while building strength and flexibility.
Surfing and other water activities provide natural stress relief through connection with nature and the meditative aspects of being in water, while also providing excellent physical exercise. Our surfing for recovery program combines the therapeutic benefits of ocean activities with structured recovery support. Mixed Martial Arts (MMA) offers a structured physical outlet for stress and builds confidence through skill development and physical conditioning. Learn more about MMA for recovery and how martial arts can support stress management. Regular cardiovascular exercise of any type helps regulate cortisol production and improves overall mood through the release of natural endorphins. Understanding the benefits of exercise in addiction recovery can motivate you to incorporate physical activity into your daily routine. Our yoga for recovery program provides additional options for combining movement with stress management.
Proper nutrition plays a crucial role in stress hormone regulation and can significantly impact your cortisol levels throughout the day. Eating balanced meals at regular intervals helps prevent blood sugar spikes that can trigger cortisol release, while ensuring your body has the nutrients it needs to maintain stable energy levels.
Omega-3 fatty acids found in fish, walnuts, and flaxseeds help reduce inflammation and cortisol levels while supporting brain health and emotional regulation. Complex carbohydrates from whole grains, vegetables, and fruits support stable blood sugar and serotonin production, which helps counteract stress and promote feelings of well-being. Learning about nutrition and addiction recovery can help you develop an eating plan that supports stress management.
Limiting caffeine intake, especially in the afternoon and evening, can prevent artificial stimulation that interferes with your natural cortisol rhythm. Avoiding processed foods high in sugar and artificial ingredients helps prevent the blood sugar instability that can trigger stress responses and cortisol release.
Quality sleep is absolutely essential for cortisol regulation, as your sleep-wake cycle is intimately connected to your stress hormone production. Maintaining a consistent sleep schedule by going to bed and waking up at the same time daily helps regulate your circadian rhythm and optimize cortisol patterns.
Creating a relaxing bedtime routine with activities that signal to your body it’s time to rest can significantly improve sleep quality and reduce nighttime cortisol levels. Limiting screen time and avoiding blue light exposure before bed helps maintain natural melatonin production, while ensuring your sleep environment is cool, dark, and quiet promotes deeper, more restorative rest.
Professional Treatment Approaches
While self-management techniques are essential, professional treatment often provides the most effective approach for addressing chronic cortisol elevation and its underlying causes, particularly when trauma, mental health conditions, or severe stress are involved.
Several evidence-based therapy approaches have been proven effective for managing cortisol and stress response systems. Cognitive Behavioral Therapy (CBT) helps identify and change stress-inducing thought patterns that can trigger cortisol release, teaching you to recognize and interrupt the cycle of negative thinking that maintains chronic stress. Our CBT services focus specifically on developing practical skills for managing stress and preventing relapse.
Dialectical Behavior Therapy (DBT) teaches essential distress tolerance and emotion regulation skills that directly impact your ability to manage stress without turning to substances. Our DBT programs provide comprehensive training in mindfulness, interpersonal effectiveness, and emotional regulation techniques that can significantly reduce cortisol levels and improve overall stress management.
EMDR Therapy addresses underlying trauma that may be contributing to chronic stress and elevated cortisol levels. Many individuals in recovery have experienced trauma that continues to trigger stress responses long after the original events. Our EMDR services help process traumatic memories so they no longer create ongoing stress activation.
Brainspotting Therapy offers another powerful approach for processing traumatic experiences that trigger stress responses. This innovative therapy helps identify and resolve trauma stored in the body and nervous system. Learn more about our Brainspotting services and how they can support stress management in recovery.
Healthy Life Recovery offers innovative approaches for managing stress and supporting recovery that go beyond traditional therapy methods. Our qEEG Brain Mapping technology identifies specific brain patterns related to stress and addiction, allowing us to create personalized treatment plans that target your individual neurological patterns. Learn more about our qEEG services and how brain mapping can guide your stress management strategy.
TMS Therapy provides a non-invasive treatment option that can help regulate mood and stress response by stimulating specific areas of the brain associated with emotional regulation. This FDA-approved treatment has shown significant success in treating depression and anxiety that often accompany elevated cortisol levels. Explore our TMS options to learn how this technology might support your recovery.
GeneSight Testing helps determine which medications may be most effective for managing co-occurring mental health conditions that contribute to chronic stress. By analyzing your genetic makeup, we can identify medications that are most likely to be effective and least likely to cause side effects. Learn about our genetic testing services and how personalized medication management can support your recovery.
Building a Comprehensive Stress Management Plan
Creating an effective plan for managing cortisol involves multiple strategies:
Daily Practices
- Morning mindfulness or meditation (5-10 minutes)
- Regular meal times with balanced nutrition
- Scheduled physical activity
- Evening relaxation routine
Weekly Commitments
- Therapy sessions or support group meetings
- Longer periods of physical activity or outdoor time
- Social connections with supportive individuals
- Planning and preparation for upcoming stressors
Monthly Assessments
- Review stress management strategies and their effectiveness
- Adjust techniques based on what’s working
- Identify new stressors or triggers
- Celebrate progress and achievements
The Role of Social Support in Cortisol Management
One of the most powerful tools for managing cortisol levels is having strong social support. Research shows that positive social connections can significantly reduce stress hormone production and improve recovery outcomes.
Building Recovery Community
At Healthy Life Recovery, we emphasize the importance of Recovery Community as one of our Four Pillars of lasting sobriety. This includes peer support groups where you can connect with others who understand the recovery journey, family involvement to heal relationships and build healthy boundaries, therapeutic relationships with counselors and therapists who provide professional support, and engaging in sober activities with like-minded individuals. Understanding the benefits of 12-step meetings can also provide additional community support.
Communication Skills for Stress Reduction
Developing effective communication skills can significantly reduce relationship-related stress and help prevent the interpersonal conflicts that often trigger cortisol spikes in recovery.
Learning to communicate effectively can significantly reduce relationship-related stress through assertiveness training that helps you express needs and boundaries clearly and respectfully, conflict resolution skills for managing disagreements without escalating stress, active listening techniques for building stronger connections through improved communication, and healthy emotional expression that allows you to share feelings appropriately. These skills are often developed through therapy and support groups for families affected by addiction.
Warning Signs of Elevated Cortisol
Learning to recognize the early warning signs of elevated cortisol can help you take proactive steps to manage stress before it reaches crisis levels that might threaten your recovery.
Recognizing when your cortisol levels may be elevated can help you take action before reaching a crisis point. Common signs include physical symptoms, emotional and mental changes, and behavioral modifications that signal your stress response system is overactive.
Physical symptoms of elevated cortisol include persistent fatigue or feeling “wired but tired,” frequent headaches or muscle tension, digestive issues including stomach upset or changes in appetite, difficulty falling asleep or staying asleep, getting sick more frequently than usual, and weight gain particularly around the midsection.
Emotional and mental symptoms manifest as increased anxiety or feeling constantly “on edge,” irritability or short temper, difficulty concentrating or making decisions, memory problems, mood swings or emotional volatility, and feelings of overwhelm or hopelessness. These symptoms often overlap with signs of mental health disorders that may require professional attention.
Behavioral changes that indicate elevated cortisol include increased cravings for substances or addictive behaviors, neglecting self-care activities, isolating from friends and family, difficulty managing daily responsibilities, changes in eating patterns such as overeating or loss of appetite, and increased use of caffeine or other stimulants to cope with fatigue.
When to Seek Professional Help
Knowing when to reach out for professional support is crucial for maintaining your recovery and preventing cortisol-related complications that could threaten your sobriety.
If you’re experiencing persistent signs of elevated cortisol or finding it difficult to manage stress in recovery, it’s important to seek professional support. Consider reaching out for help if stress management techniques aren’t providing relief, you’re experiencing thoughts of relapse or return to substance use, physical symptoms are interfering with daily life, you’re having trouble sleeping for more than a few days, anxiety or depression symptoms are worsening, or you’re feeling overwhelmed by daily responsibilities.
Professional treatment options at Healthy Life Recovery include dual diagnosis treatment for co-occurring mental health conditions, intensive outpatient programs that allow you to maintain daily responsibilities while receiving support, and specialized therapies designed to address trauma and stress-related issues.
Take the Next Step in Your Recovery Journey
If you or a loved one is struggling with addiction and the stress that often accompanies it, don’t face it alone. Our team at Healthy Life Recovery is here to provide the comprehensive support you need to achieve lasting sobriety while learning to manage stress effectively.
Our holistic approach addresses not just the symptoms of addiction but the underlying factors—including stress and cortisol dysregulation—that contribute to substance use disorders. From medically supervised detox through outpatient programs and ongoing support, we’re with you every step of the way. Our executive detox program provides additional privacy and amenities for professionals seeking treatment.
Contact us today at (844) 252-8347 to learn how our evidence-based treatment programs can help you or your loved one build the stress management skills necessary for lasting recovery. Your journey to a healthier, more balanced life starts with a single phone call.
Medically Reviewed By:
Dr. Sanjai Thankachen
Dr. Sanjai Thankachen graduated from Adichunchanagiri Institute of Medicine in 2000. He completed his residency in psychiatry in 2008 at Creedmoor Psychiatric Center in New York. Dr. Thankachen is currently working with Pacific Neuropsychiatric Specialists in an outpatient practice, as well as working at multiple in-patient psychiatric and medical units bringing his patients the most advanced healthcare treatment in psychiatry. Dr. Thankachen sees patients with an array of disorders, including depression, bipolar illness, schizophrenia, anxiety, and dementia-related problems.
Edited for Clinical Accuracy By:
Sean Leonard, Psychiatric Nurse Practitioner
Sean Leonard is a board-certified psychiatric nurse practitioner. He received his master’s degree in adult geriatric primary care nurse practitioner from Walden University and a second postmaster specialty in psychiatry mental health nurse practitioner from Rocky Mountain University. Sean has experience working in various diverse settings, including an outpatient clinic, inpatient detox and rehab, psychiatric emergency, and dual diagnosis programs. His specialty areas include substance abuse, depression, anxiety, mood disorders, PTSD, ADHD, and OCD.