MENTAL HEALTH, DUAL DIAGNOSIS OF SUBSTANCE ABUSE AND DEPRESSION
Name: Patrick K. Kimuyu
Substance abuse and co-occurring disorders are seemingly becoming an enormous challenge to health care systems. Substance abuse has become popular, especially among the young people even though its prevalence appears to be a cross-sectional health issue with drug addiction occurring across all ages and gender. On the other hand, mental illnesses are increasing at an alarming rate among the global population; thus, unprecedented burden to healthcare systems and professionals. Ordinarily, the occurrence of a mental health issue such as depression and a substance abuse problem is what is commonly referred to as dual diagnosis or a co-occurring disorder. From a nursing perspective, dual diagnosis does not appear to be a simple task because it deals with handling two problems concurrently: the mental health problem and the substance abuse issue. Saisan, Segal and Smith (2013) remark, “Dealing with substance abuse, alcoholism, or drug addiction is never easy, and it’s even more difficult when you’re also struggling with mental health problems, but there are treatments that can help” (par. 1). Therefore, a nurse requires extensive understanding on dual diagnosis, so as to provide efficient support and proper treatment to the patient. Moreover, overcoming dual diagnosis requires the nurse to guide the patient in developing efficient self-help strategies for recovery.
Understanding the nature of dual diagnosis involves a comprehensive evaluation of the symptoms of the mental health problem and substance abuse. For instance, in a case where the mental health disorder is depression interacting with substance abuse problem such as alcohol or drug addiction, the two issues requires a comprehensive evaluation prior to the adoption of the appropriate treatment option.
Depression is one of the most common mental health disorders among the global population. It manifests itself through an array of symptoms; thus, different individuals portray different depression symptoms, making it difficult to determine whether an individual is depressed or not. However, there are some common symptoms of depression which can help a nurse to identify the mental health disorder. Ordinarily, depression is determined through the use of a combination of five or more symptoms including loss of pleasure or sadness. Some of the most common symptoms of depression are constant exhaustion, loss of appetite, change of sleep patterns, anger and anxiety. Other significant symptoms of depression include guilt-feeling, pessimism, unable to concentrate in decision making, isolation from other people and suicidal feelings. In most cases, aches in various body parts and pains accompany other depression symptoms (DBSA, n.d).
On the other hand, substance abuse behavior can be identified through the use of different symptoms. Ideally, an array of symptoms is used to rule out drug addiction among the affected individuals. For instance, drug abuse among teenagers is manifested by problems at school such as the reduction of academic performance, physical health issues such as exhaustion and lack of energy, and an abrupt change in social behavior. In some cases, neglected appearance among teenagers and changes in their money spending tendencies serve as some of the principal indicators of substance abuse (Mayo Clinic, 2013).
It is believed that the co-occurring disorders interact synergistically to produce the overall effect observed in co-morbidity patients. In some cases, the presence of untreated mental health issue enhances the severity of the substance abuse problem. However, the advancement of the substance abuse problems causes an increase in the impact of the mental health disorder; thus, causing unprecedented complication. For instance, drug or alcohol abuse has been found to increase mental health disorders, especially with regard to depression.
However, it is worth to understand the basis of the co-occurring disorders and their relationship among individuals. As such, a nurse has to understand which of the co-occurring disorders appears first or which of the two problems influence the onset of the other. Clinical research indicates that, most people with mental health problems tend to be addicted to drugs. However, it is worth noting that, neither substance abuse nor depression or anxiety influence the cause of each other, even though, these two problems are linked. In most cases, symptoms of depression are often self-medicated using drugs or alcohol because they seem to relieve individuals of depression. However, the mental health problem may become worse, owing to the side effects of substance abuse. In such circumstances, the mental health disorder can be viewed to as the cause of substance abuse (Saisan, Segal & Smith, 2013).
On the other hand, the risk of mental health disorders has been found to be increased by substance abuse. Ordinarily, interplay of different factors such as genetic, social and environmental factors is believed to be the cause of mental health disorders, but substance abuse enhances the strength of the underlying risk factors to establish the mental health disorder (Fleming & Hanson, 2013). In such a case, substance abuse can be viewed to as the cause of the mental health problem because the other underlying risk factors are not manifested during the onset of the mental health problem.
Moreover, the symptoms of most mental health problems, including depression are believed to be worsened by substance abuse. For instance, alcohol or drug abuse among individuals with mental health problems triggers new symptoms or increase the severity of the existing symptoms. In regard to medication, alcohol or drug abuse influences the impact of medication with anti-depressants, mood stabilizers and anti-anxiety pills. In general, substance abuse reduces the efficacy of medication administered to address mental health disorders such as depression (Saisan, Segal & Smith, 2013). Therefore, substance abuse interferes with the management of mental health problems, leading to unprecedented complications among the affected individuals.
In regard to the treatment of dual diagnosis, management of dual diagnosis aims at treating the symptoms of the co-occurring disorders. For instance, treatment for individuals with substance abuse problem and depression focuses on relieving the symptoms of depression through medical approaches while mitigating the substance abuse issue. Therefore, treatment of mental health illnesses and drug addiction should be addressed all together for the realization of remarkable recovery (Fleming & Hanson, 2013). Despite the complexity of the treatment of dual diagnosis, efficient therapeutic approaches help to eliminate the problems; thus, helping the affected individuals to reclaim their lives.
In general, treatment of dual diagnosis involves different approaches, especially with regard to the mental health problem and substance abuse involved. Currently, health care professionals are addressing the issue of co-occurring disorders from what is commonly referred to as effective integrated treatment. Ideally, patients with co-occurring disorders require an elaborate treatment approach to address the problems involved. This is so because; addressing a single issue does not help the patient to recover from the afflictions caused by the co-occurring disorders. Research indicates, “If both are recognized, the individual may bounce back and forth between services for mental illness and those for substance abuse, or they may be refused treatment by each of them. Fragmented and uncoordinated services create a service gap for persons with co-occurring disorders” (Drake, 2003 par. 4). Therefore, effective integrated treatment is the most reliable approach in helping patients with co-occurring disorders to realize absolute recovery. Drake (2003) remarks, “Providing appropriate, integrated services for these consumers will not only allow for their recovery and improved overall health, but can ameliorate the effects their disorders have on their family, friends and society at large” (par. 4).