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Interplay Between Addiction & Mental Health

Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC, Executive Director,

CEs are available:

~Objectives: Define co-occurring disorders  Identify the impact of addiction on the individual  Identify the impact of mood disorders on the individual  Identify the impact of chronic illness or pain on the individual  Explore the interplay between the three  Why I Care/How It Impacts Recovery  Co-Occurring Disorders are the EXPECTATION, not the EXCEPTION.  A person who is sober but depressed is at risk for addiction relapse  A person who is using is actively in an addiction (even a behavioral one) is altering the balance of neurotransmitters.
~Define Co-Occurring Disorders  Mental Health, Addiction, Physical Health problems and their interaction  Must be treated concurrently
~Think About It  When you are stressed out how does it impact your  Mood  Patience  Ability to concentrate/productivity  Problem solving/creativity  Sleep  Energy levels  Appetite  Headaches  Muscle Aches
~Think About It  People with addictions are:  Trying to get some relief from emotional or physical distress  Inadvertently worsening the problem by altering the neurochemicals
~Mental Illness Effects  Emotionally  Depression or anxiety  Cognitively  Difficulty concentrating  Perception of hopelessness and helplessness (Victim mentality)  Physically  Sleep disturbances  Eating Disturbances  Restlessness/agitation  Achiness  Fatigue
~Mental Illness Impact  Socially  Withdrawal/Difficulty dealing with people  Low self-confidence  Lack of energy or desire to interact  Relationship deterioration  Environmentally (The outside reflects the inside)  Disorganization  Lack of energy or desire to care for anything
~Mental Illness Addictive Behaviors  Emotionally  Addiction numbs or medicates depression or anxiety  Cognitively  Addiction reinforces hopelessness and helplessness (Victim mentality/stinking thinking)  Physically  Addiction helps people relax to get to sleep OR keeps them up instead of sleeping  Food is often used as a secondary self-soothing/addictive behavior OR people get so caught up in their addiction they forget to eat
~Mental Illness  Addictive Behaviors  Physically  Addiction helps soothe restlessness/agitation, but detoxing can intensify it  Achiness can be relieved or numbed by addictions, but (especially in the case of opiates) may cause the body to stop making or using endogenous opioids.  Addiction to stimulants may be used to self-medicate fatigue, but causes rebound exhaustion.
~Mental Illness¬† Addictive Behaviors¬† Socially¬† Addictions may be used to ‚Äúloosen up‚ÄĚ or make it easier to interact with others¬† The addiction may provide an alternate peer group that is tolerant¬† Environmentally (The outside reflects the inside)¬† In active addiction, there is little concern for the environment UNLESS the person is trying to hide the addiction in which case, they may become more attentive to cleanliness and organization.
~Addiction Effect (Benefits?)  Emotionally  Numbing  Relaxation  Euphoria  Cognitively  Stinking thinking  Physically  Energy  Improved Sleep  Relaxation  Socially  A new peer group  Environmentally
~Addiction Mental Illness¬† Emotionally¬† Addiction causes neurotransmitter imbalances¬† As depression and anxiety worsen, the need for the addiction/numbing increases. Life starts to revolve around using¬† The brief benefits lead to a continued need for the addiction to feel ‚Äúnormal‚Ä̬† Mentally/Cognitively¬† Addiction leads to lying, manipulation, and exacerbates cognitive distortions (stinking thinking)¬† Physically¬† Addiction usually disrupts circadian rhythms through too much or too little sleep¬† Addiction can alter hunger/satiation cues¬† Addiction can cause health problems leading to chronic pain¬† Socially¬† Addiction becomes the person‚Äôs best friend¬† Begin spending time only with using peers or alone¬† Loss of healthy relationships They don‚Äôt get it They want to take away the addiction¬† Environmentally (Inside | Outside)¬† Addiction takes precedence over environmental cleanliness or safety¬† feelings of depression¬† Addiction can cause a person to become obsessively neat to hide the fact that they are addicted
~Chronic Pain  Emotionally  Frustration  Depression  Anxiety  Cognitively  Difficulty concentrating  Negative perceptions  Physically  Sleep disturbances  Fatigue  Pain  Socially  Don’t feel like going out to do things with friends  Friends get tired of hearing about the pain  Friends may feel taken advantage of  Environmentally  Disarray  May stay in bed or on the sofa all the time
~ Chronic Pain  Addiction & Mental Illness  Emotionally  Opiate medications often intensify depression  Negative feelings can be numbed with addiction  Cognitively  Chronic pain creates a an environment for the victim mentality/stinking thinking common in addiction and mental illness  Physically  Sleep disturbances and fatigue leading to irritability, depression and self medication  Pain medications can actually intensify pain.  Socially  Addiction helps people not care that they don’t have healthy relationships  Environmentally  A depressing environment may intensify feelings of hopelessness which can be self-medicated with addiction  An obsessive need for order, but being in too much pain to clean can intensify anxiety which can be numbed with addiction
~Addiction, mental health and physical illnesses all impact  Mood  Eating  Sleeping  Pain  Motivation  Relationships  Addiction may temporarily address the issue, but it also intensifies all of the above problems when the person is not actively using. Summary
~ Summary  Comprehensive treatment of the whole person is vital  Example: Lack of pleasure  Address the neurochemical imbalances  Find alternative coping strategies besides the addiction  Identify cognitive issues that may be maintaining the negative mood  Identify any physical issues (chronic pain, hormone imbalances) that are contributing  Effects  Improved motivation  Improved ability to focus  Improved mood