Depression And Substance Abuse

Substance abuse disorders (including alcohol and prescription drugs) frequently co-exist with depression. Substance abuse must be discontinued in order to clarify the diagnosis and maximize the effectiveness of psychiatric interventions. Additional treatment is necessary if the depression remains after the substance use and withdrawal effects have ended.

Individuals or family members with concerns about the co-occurence of depression with another illness or chemical dependency, should discuss these issues with the physician.

Many factors can contribute to depression. Some people become depressed for a combination of reasons. For others, a single factor appears to trigger depression. Some become depressed for no apparent reason. Regardless of the cause, depression needs to be diagnosed and rated.

Check any symptoms experienced for more than 2 weeks. If four or more of the symptoms for depression or mania have been checked, physical and psychological evaluation by a physician and/or mental health specialist should be sought.

Symptoms of Depression:

• A persistent sad, anxious or "empty" mood
• Loss of interest or pleasure in ordinary activities, including sex
• Decreased energy, fatigue, feeling "slowed down"
• Sleep problems (insomnia, oversleeping, early-morning waking)
• Eating problems (loss of appetite or weight, weight gain)
• Difficulty concentrating, remembering, or making decisions
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Thoughts of death or suicide; a suicide attempt
• Irritability
• Excessive crying
• Recurring aches and pains that don't respond to treatment

It is estimated that up to 80% of peolple with chemical dependency or addiction also have a co-occurring mental health problem such as anxiety or depression.

By BILL URELL

Definition Of Addiction

How many legitimate definitions of addiction are there? There are hundreds-literally hundreds.

Which one is the best? Actually, there are several good ones. Read on.

Morse & Flavin's (RM Morse,DK Flavin JAMA, 1992 Am Med Assoc) definition of addiction represents the one traditionally utilized by treatment centers and substance abuse counselors. It is very good and touches all of the bases. Published in The Journal of the American Medical Association, Vol. 68, No.8, Morse & Flavin defined addiction thusly (paraphrased for simplicity):

• Addiction is a primary, progressive, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over use of the substance, preoccupation with the substance, use of the substance despite adverse consequences, and distortions in thinking.

Diagnostic and Statistical Manual of Mental Disorders (1994)

The DSM IV (1994) relies on symptoms for its definition. The DSM says that addiction, or dependence, is present in an individual who demonstrates any combination of three or more of the following symptoms (paraphrased for simplicity), occurring at any time in the same 12-month period:

• Preoccupation with use of the chemical between periods of use.
• Using more of the chemical than had been anticipated.
• The development of tolerance to the chemical in question.
• A characteristic withdrawal syndrome from the chemical.
• Use of the chemical to avoid or control withdrawal symptoms.
• Repeated efforts to cut back or stop the drug use.
• Intoxication at inappropriate times (such as at work), or when withdrawal interferes with daily functioning (such as when hangover makes person too sick to go to work).
• A reduction in social, occupational or recreational activities in favor of further substance use.
• Continued substance use in spite of the individual having suffered social, emotional, or physical problems related to drug use.

By BILL URELL