Has there ever been a time in your life when you’ve said to yourself, “I can’t take this anxiety or depression anymore,” or, “I can’t deal with the thoughts and memories of what happened to me.”Unfortunately, some of those who suffer from depression, anxiety, trauma-related symptoms, ADHD, and other symptoms of mental illness “self-medicate” with chemically addictive substances to somehow relieve the pain of mental illness.
Those who experiment with addictive substances can develop a tolerance to the drug. When they try to stop, they experience symptoms of withdrawal, which often leads to more subtance abuse in an attempt to take away the increased depression, anxiety, psychosis, and possible symptoms of bipolar disorder.
According to the Co-occurring Disorders Workbook by Dennis C. Daley, Ph.D., there are relationships between substance use and mental illness. This can also increase the risk of an alcohol or other drug problem, which may lead to an increase in psychiatric symptoms.
For example, some people end up in a psychiatric emergency facility after the use of cocaine, methamphetamine, marijuana, or alcohol due to becoming severely depressed, manic, psychotic, or suicidal. Sometimes clients stop taking their prescribed medications and stop seeing their counselors and drug use may cause prescribed medications to become less affective or ineffective.
Substance-induced Psychotic Disorder
According to the DSM-5-TR, substance-induced psychotic disorder is caused by either excessive use or withdrawal of certain psychoactive substances such as cocaine, amphetamines, opioids, sedatives, hallucinogens, and alcohol. These symptoms are caused directly by exposure to the toxic substances and are not due to an underlying medical condition.
Symptoms of Alcohol Withdrawal
Alcohol withdrawal symptoms can include:
- Autonomic hyperactivity (e.g sweating or pulse rate greater than 100 bpm)
- Hand tremors
- Nausea or vomiting
- Transient visual, tactile, or auditory hallucinations or illusions
- Psychomotor agitation
- Generalized tonic-clonic seizures
Opioid Withdrawal Symptoms
Symptoms of opioid withdrawal can include:
- Dysphoric mood
- Nausea or vomiting
- Muscle aches
- Lacrimation or rhinorrhea
- Pupillary dilation, piloerection, or sweating
Cannabis withdrawal symptoms can include:
- Irritability, anger, or aggression
- Nervousness or anxiety
- Sleep difficulty
- Decrease appetite or weight loss
- Depressed mood
Following a withdrawal of stimulants, people may experience:
- Vivid, unpleasant dreams
- Insomnia or hypersomnia
- Increased appetite
- Psychomotor retardation or agitation
Chemical Dependency Assessment and Treatment
An assessment is used to determine your diagnosis and what type of treatment you need, such as therapy or medication. Treatment will help you reduce or eliminate your psychiatric symptoms, learn to manage your disorder, and learn how to deal with problems contributing to or resulting from your condition.
Chemical dependency treatment can also help you stop using alcohol or other drugs. The integrated approach means getting both of your disorders treated in the same program, and allows you to focus on both of your disorders by the same treatment team. According to research, the integrated approach is usually recommended.
Counseling provides you the opportunity to talk about your symptoms, problems, coping strategies (or lack thereof ), and steps you can take to help yourself. You can also disclose your inner thoughts and feelings to gain an understanding of yourself and what you can do to change.
What to Expect from Chemical Dependency Treatment
If you have a chronic illness, you may always experience some symptoms. All chronic illnesses require the ability to learn coping methods. You will want to ask your counselor for recommendations of how to manage chronic symptoms and issues to work on. Benefiting from treatment will take time, effort, and work — but it will be worthwhile.
Taking an Active Role
Taking an active role in your treatment will give you confidence and assurance that you are not alone in this. There is a team of professionals who care about you and want to take this journey with you to a better life. You will gain strength in knowing that you can take control of your life.
Don’t give up. Attending all your sessions and taking your medications as prescribed is the first step in devoting your life to getting the peace and happiness you deserve.
Taking an active part in developing your treatment plan will help you meet your goals. You will be able to physically see the progress you have made and what you have decided you need to further work on. Your treatment plan is like a map to your life’s fulfillment.
Setting Goals in Your Treatment Plan
Setting goals can show you what you can look toward by providing direction, and will help you focus on the time and energy it will take to reach your ultimate goal. Working toward reaching your self-identified goals will provide you with a sense of accomplishment and a sense of “this is what I want, and I can do this.”
This sense of accomplishment will assist you in feeling less depression and will lift your self-esteem. Dennis C. Daley, Ph.D. further concludes, “A goal refers to a process, a purpose, or some end that you wish to achieve. A goal can relate to learning valuable information, developing new skills, or changing something about yourself, your relationships, or your lifestyle.”
Once you have identified the goal you want to achieve, then you and your counselor will identify steps you choose to take to achieve your goal. Goals can be short-term, medium-term, or long-term. A short-term goal means your goal will be achieved within three months. A medium-term goal means you have decided it may take between three to six months to achieve. A long-term goal may take up to a year to achieve. For example: it may take up to six months to save enough money to rent an apartment. It may take practicing a skill everyday for three months to change negative thoughts that lead to depression.
Relapse Warning Signs to Watch For
Pay attention for the following warning signs, which may indicate an impending relapse:
- If you begin having racing thoughts and/or confusing thoughts
- If you begin experiencing paranoid thinking
- The thought enters your mind to harm yourself or someone else or commit suicide
- If you notice feeling sad or depressed
- If you begin to feel anxious, nervous, “on edge,” and/or fearful for no apparent reason
- If you are feeling guilty and shameful
- If you feel bored, restless, and/or empty inside
- If you feel lonely, angry, and exhausted for no apparent reason
Strategies to Cope with the Pressure to Get High
Are you being tempted to fall back into old, harmful habits? Here are some practical strategies to help you resist a chemical dependency relapse:
- Say No: Say straight out that you don’t want to use drugs or alcohol.
- Focus on Recovery: Tell the person you’re in recovery and don’t want to use.
- Medications: Tell the person you can’t use drugs or alcohol while you’re on medications.
- Leave the Situation: Get out of the situation as quickly as you can if you feel increased pressure to use.
- Use a Support Person: If there is an important event you can’t miss, take a support person with you.
Develop a Connection
Developing a connection means opening up and learning to trust the people caring for you. It includes sharing your problems, feelings, and struggles. Viewing this team of people as your partners. Being honest in reporting your relapses to them along with your progress so they can share your successes with you and help you through times when all is not going well.
If you choose, your family and loved ones can gain education and information from your treatment team as to how they can support you. There are several support group programs in the community, like NAMI, Alcoholics Anonymous, Narcotics Anonymous, and Dual Recovery Anonymous that can provide support and friendships, especially during difficult times when depression feels isolating. Faith-based counselors can also provide you with spiritual guidance.
Utilizing Spirituality in Your Life and Recovery
If you should decide you would like to learn about spirituality and how spirituality may assist you in your recovery or bring spirituality back into your life, you could discuss this subject in therapy with your counselor.
In my conversations with past clients, they disclosed that faith and/or religion has provided strength and guidance. Many have shared that they regained renewed meaning in their lives when they were at a point where they had no hope or self-love. Feelings of guilt and shame had destroyed their self-worth. Relying on God or a higher power has helped others receive peace and has gotten them through hard times.
Spirituality has provided others a sense of belonging and courage in “giving back to their community,” while at the same time feeling like they have caring support.
Learning about and gaining spirituality in your life can help you to accept that we all have shortcomings and have all made mistakes. You can learn to be kinder to yourself. We can learn and remind ourselves to show love, compassion, kindness, and forgiveness to others and ourselves. We can work on guilt and shame through prayer and know in our hearts we are cared about by God or our higher power. The courage you obtain will provide you the strength in working toward and maintaining recovery.
Strategies for Using a Support Network
Make a list of people you trust and feel comfortable asking for help, or organizations that have helped you in the past. Keep this list with you always.
- Look at recovery as a “we” program. Identify those in the program who will support your recovery. This could also include some of your friends and family members.
- Learn to be able to reach out to people. There are people out there who care about you and want to help, and they are not mind readers. When you feel uncomfortable in reaching out, this is the time when you really need help.
- Talk to your friends everyday, just to check in to avoid isolation.
Dennis C. Daley, Ph.D concludes: Many research studies show that treatment is effective for co-occurring disorders. You can experience positive effects of treatment even if all of your symptoms don’t go away, you still have problems in your life, or you relapse. Remember, progress is relative. Improvement, no matter how small, is a sign of progress. Quality of life often improves as a result of treatment.
Positive effects of treatment may include:
Stopping alcohol or drug use.
Remission or reduced severity of psychiatric symptoms.
Better mental, physical, and spiritual health.
Improved social, family, financial, and occupational functioning.
Better quality of life.
Counseling for Chemical Dependency
If you’re ready to break free from chemical dependency and corresponding effects of mental illness, Spokane Christian Counseling is here to help. Feel free to contact our office to schedule your first step toward healing and recovery. Support is just a phone call away!
Dennis C. Daley, Ph.D, Co-Occurring disorders Recovery Workbook, (Herald Publishing House/Independent Press, publication 2011).
Diagnostic and Statistical Manual of Mental Disorders (DSM-5) 5thed. (Washington, DC London England: American Psychiatric Publishing, APA, 2013), 547-583.
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