Untreated Mood Disorders and Addiction


Untreated Mood Disorders & Addiction

There is a strong and proven correlation between addicts, alcoholics and untreated mood disorders.  These disorders are have traditionally been referred to in clinical treatment environments as Axis I & II diagnosis or dual diagnosis, very generally meaning substance use disorder plus a mood disorder.  Here are some of the more common forms of mood disorders and the terms used to describe them…

Clinical or Major Depression, to be distinguished from feeling down or sad, to the extent that biochemistry may be altered, there is no situational precedent and impairment in cognition may be significant enough to affect daily functioning to include degradation of daily routines such as eating, sleeping, grooming, exercise or work habits.  Hospitalization may be necessary if an individual feels compelled towards self-harm.  A variety of proven treatment options that may be used in combination with one another may include: medications, transcranial magnetic stimulation (TMS), exercise, diet, establishment of routines, proper sleep hygiene, electroconvulsive therapy, and cognitive-behavioral therapy.

Mania is a disorder that may present in grandiose gestures, risky behaviors, unrealistic goals or optimism despite situational realities, hyperactivity, promiscuity, pressured speech or a need to continue talking, euphoria, sometimes to the extent of breaks from reality such as hearing things or paranoia.  Again, as with depression, hospitalization may be indicated if the individual becomes agitated to the point they pose a threat to themselves or others. The use of mood disorder stabilizing medications such as Lithium, Depakote, Tegretol, Lamictal, etc. are generally indicated in treatment.

Once more commonly called Manic-Depression, Bipolar Disorder requires a proper diagnosis must usually include either separate distinct episodes of both mania and depression or evidence of what is known as mixed episodes in which a person may experience both at the same time. This might include agitation, restlessness, or hostility combined with suicidal ideation, lack of motivation, confusion, sleeplessness and resultant exhaustion.  From a medication standpoint, bipolar disorder is often treated with mood disorder stabilizers combined with antidepressant medications.  In the case of mixed episodes, which are more difficult to treat, the newer generation of atypical antipsychotic medications are added in to help control what is known as bipolar depression.  Antidepressant medications alone are contraindicated for individuals with bipolar disorder as they are thought to induce manic episodes or symptomology.

Often presenting as low-grade, chronic depression, Dysthymia usually does not require hospitalization or intervention. Individuals with dysthymic mood disorder tend to have a persistently low mood, as if grieving at all times, regardless of positive environmental stimuli.  Routine functioning is moderate to minimally impaired and it usually manifests itself in motivational, sleep hygiene, and empathic issues.  Flat affect or emotional blunting may also be present. This form of depression is considered most common.

A disorder that tends to manifest by presenting changes or alterations in routines and behaviors directly related to seasonal changes is called Seasonal Affective Disorder or SAD.  Depression, once again, is a prominent feature here as an individual with SAD may fall into a slump of sorts only during particular times of the year. The correlation, or cause and effect, can be directly observed throughout one’s personal history in regards to particular seasons. Shorter-term treatments may be indicated in these cases, such as therapy and/or short-term application of antidepressant medication, changes in diet, more exposure to sunlight. EMDR or light therapy for areas where sunlight is less prevalent during certain times of the year may be helpful, as well as more rigid adherence to routine.  Impact on mood can be mild to moderate sometimes, though rarely, it can be severe.

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