Tag Archives: co-occuring

Take Four

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Yes. It may be two in the morning and she may be up right now. But she simply can’t sleep. She tried and succeeded for a couple of hours only to arise completely awake. She had taken more melatonin and yawned a couple times, but still no luck. She has tried watching a bit of television, having a snack and painting for a while… Nothing. Her thoughts are racing, her eyes are shifting and she cant stop rocking. What does all this mean? I’ve been taking my meds, eating, working out and sleeping for long hours. I haven’t done anything to promote this, Im done with that childish fantasy of mania as I expressed before. She did have coffee earlier but she couldn’t imagine that the caffeine from then would have lasted this long. That must have been over twelve hours ago. None of this made any sense. She reviewed her day. It was productive. Up until she took her PM meds ,which made her feel groggily and irritated, she had had a very good day. No pressures of her addiction from outside sources, just a light and easy day spent walking around town and lounging in the coffee shop. Nothing to offset any sort of manic state! She took a drag from one of her moms cigarettes. There was nothing to do now but wait for some sort of signal from her brain that told her it was time to sleep.

The time to sleep would never come. Instead she would paint until the sun would shine, then she would step outside and take a brisk walk around her favourite place in her hometown.
There was a park located two blocks from her house where a black paved path directed her to a wooden bridge over a quite creek. She would place herself directly in front the creek as it encircled a lonely island. Today was unlike any other day she had visited this place. Today there were countless geese. Maybe thirty, maybe less, maybe more. It really didn’t matter. She glares up at the sky and sees a blanket of grey clouds floating quickly to reveal a clear blue hue. She smiles. Today is going to be a great day.

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So far it had been a good day. After looking up the closing times to all the local coffee shops she came to the conclusion that she had to settle with Starbucks. Still not having bought anything she sits on the bare side of the room staring at her reflection on the crayon-streaked window. Only this time she doesn’t care how they got there. Instead of the usual dabbling of her mind, she is at ease. She feels drowsy having just taken her medication and slightly restless; wanting-to-roll-around-on-the-floor kind of feeling. Her eye lids dripped down her cheeks trailing the dark circles that had formed. Her eyes were dilated and her head was spinning. She wanted to take a moment to gather her thoughts. All she could think was this is crap. It’s all a load of crap. There’s no reason to be writing now, there is nothing to write about! But of course there is something to write about. But she simply was not excited about anything that happened today, even though quite a lot of exciting things did happen.
Her giddy humour brought her dancing through the Target store with one of her friends from NA. She remembers walking through the toy section and seeing a jesting display of miniature houses– she couldn’t help but touch it. The moment she did, BAM! The entire case lit up in an array of colours from pink to blue. She jumped up and laughed so loud that another man in the aisle couldn’t help but join her. OH MY GOD, it spins! She blurted out as she began to fiddle with the contraption that made each house go around to reveal the masterpiece in all of its angles. Her friend pulled her away, speaking softly to calm down. She breathed deep. The rest of the adventure was spent pointing out different items; unique or not, they all enthused her.
She then spent several hours visiting her dad, putting a smile on her face and admitting to her current state. But I feel fine. But that’s just the problem isn’t it? A normal person wouldn’t feel so fine after no sleep.

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Drug Addiction and Disorders

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In a dual diagnosis, both the mental health issue and the drug or alcohol addiction have their own unique symptoms that may get in the way of your ability to function, handle life’s difficulties, and relate to others. To make the situation more complicated, the co-occurring disorders also affect each other and interact. When a mental health problem goes untreated, the substance abuse problem usually gets worse as well. And when alcohol or drug abuse increases, mental health problems usually increase too.

Brain Disorders

What comes first: Substance abuse or the mental health problem?

Addiction is common in people with mental health problems. But although substance abuse and mental health disorders like depression and anxiety are closely linked, one does not directly cause the other.

  • Alcohol or drugs are often used to self-medicate the symptoms of depression or anxiety.Unfortunately, substance abuse causes side effects and in the long run worsens the very symptoms they initially numbed or relieved.
  • Alcohol and drug abuse can increase underlying risk for mental disorders. Mental disorders are caused by a complex interplay of genetics, the environment, and other outside factors. If you are at risk for a mental disorder, drug or alcohol abuse may push you over the edge.
  • Alcohol and drug abuse can make symptoms of a mental health problem worse. Substance abuse may sharply increase symptoms of mental illness or trigger new symptoms. Alcohol and drug abuse also interact with medications such as antidepressants, anti-anxiety pills, and mood stabilizers, making them less effective.

Recognizing co-occurring disorders or dual diagnosis

It can be difficult to diagnose a substance abuse problem and a co-occurring mental health disorder such as depression, anxiety, or bipolar disorder. It takes time to tease out what might be a mental disorder and what might be a drug or alcohol problem.

Complicating the issue is denial. Denial is common in substance abuse. It’s hard to admit how dependent you are on alcohol or drugs or how much they affect your life. Denial frequently occurs in mental disorders as well. The symptoms of depression or anxiety can be frightening, so you may ignore them and hope they go away. Or you may be ashamed or afraid of being viewed as weak if you admit the problem.

Admitting you have a dual diagnosis or co-occurring disorders

Just remember: substance abuse problems and mental health issues don’t get better when they’re ignored. In fact, they are likely to get much worse. You don’t have to feel this way. Admitting you have a problem is the first step towards conquering your demons and enjoying life again.

  • Consider family history. If people in your family have grappled with either a mental disorder such as depression or alcohol abuse or drug addiction, you have a higher risk of developing these problems yourself.
  • Consider your sensitivity to alcohol or drugs. Are you highly sensitive to the effects of alcohol or drugs? Have you noticed a relationship between your substance use and your mental health? For example, do you get depressed when you drink?
  • Look at symptoms when you’re sober. While some depression or anxiety is normal after you’ve stopped drinking or doing drugs, if the symptoms persist after you’ve achieved sobriety, you may be dealing with a mental health problem.
  • Review your treatment history. Have you been treated before for either your addiction or your mental health problem? Did the substance abuse treatment fail because of complications from your mental health issue or vice versa?

Signs and symptoms of alcohol abuse or substance abuse

If you’re wondering whether you have a substance abuse problem, the following questions may help. The more “yes” answers, the more likely your drinking or drug use is a problem.

  • Have you ever felt you should cut down on your drinking or drug use?
  • Have you tried to cut back, but couldn’t?
  • Do you ever lie about how much or how often you drink or use drugs?
  • Have your friends or family members expressed concern about your alcohol or drug use?
  • Do you ever felt bad, guilty, or ashamed about your drinking or drug use?
  • On more than one occasion, have you done or said something while drunk or high that you later regretted?
  • Have you ever blacked out from drinking or drug use?
  • Has your alcohol or drug use caused problems in your relationships?
  • Has you alcohol or drug use gotten you into trouble at work or with the law?

Signs and symptoms of common co-occurring disorders

The mental health problems that most commonly co-occur with substance abuse are depression, anxiety disorders, and bipolar disorder.

Common signs and symptoms of depression

  • Feelings of helplessness and hopelessness
  • Loss of interest in daily activities
  • Inability to experience pleasure
  • Appetite or weight changes
  • Sleep changes
  • Loss of energy
  • Strong feelings of worthlessness or guilt
  • Concentration problems
  • Anger, physical pain, and reckless behavior (especially in men)

Common signs and symptoms of mania in bipolar disorder

  • Feelings of euphoria or extreme irritability
  • Unrealistic, grandiose beliefs
  • Decreased need for sleep
  • Increased energy
  • Rapid speech and racing thoughts
  • Impaired judgment and impulsivity
  • Hyperactivity
  • Anger or rage

Common signs and symptoms of anxiety

  • Excessive tension and worry
  • Feeling restless or jumpy
  • Irritability or feeling “on edge”
  • Racing heart or shortness of breath
  • Nausea, trembling, or dizziness
  • Muscle tension, headaches
  • Trouble concentrating
  • Insomnia