Double Trouble: A Dual Diagnosis

What is the relationship between drug abuse and mental illness?

Many chronic drug abusers–the individuals we commonly regard as addicts–often simultaneously suffer from a serious mental disorder. Drug treatment and medical professionals call this condition a co-occurring disorder or a dual diagnosis.

What is chronic drug abuse?

Chronic drug abuse is the habitual abuse of licit or illicit drugs to the extent that the abuse substantially injures a person’s health or substantially interferes with his or her social or economic functioning. Furthermore, any person who has lost the power of self-control over the use of drugs is considered a chronic drug abuser.

What are some serious mental disorders associated with chronic drug abuse?

Chronic drug abuse may occur in conjunction with any mental illness identified in the American Psychiatric Association (DSM-IV). Some common serious mental disorders associated with chronic drug abuse include schizophrenia, bipolar disorder, manic depression, attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, panic disorder, and antisocial personality disorder. Many of these disorders carry with them an increased risk of drug abuse.

Disorders With Increased Risk of Drug Abuse

  • Antisocial personality disorder 15.5%
  • Manic episode 14.5%
  • Schizophrenia 10.1%
  • Panic disorder 04. 3%
  • Major depressive episode 04.1%
  • Obsessive-compulsive disorder 03.4%
  • Phobias 02.1%

 Source: National Institute of Mental Health.

How prevalent are co-occurring disorders?

Co-occurring disorders are very common. In 2002 an estimated 4.0 million adults met the criteria for both serious mental illness and substance dependence or abuse in the past year.

Which occurs first–chronic drug abuse or serious mental illness?

It depends. In some cases, people suffering from serious mental disorders (often undiagnosed ones) take drugs to alleviate their symptoms–a practice known as self-medicating. According to the American Psychiatric Association, individuals with schizophrenia sometimes use substances such as marijuana to mitigate the disorder’s negative symptoms (depression, apathy, and social withdrawal), to combat auditory hallucinations and paranoid delusions, or to lessen the adverse effects of their medication, which can include depression and restlessness.

In other cases mental disorders are caused by drug abuse. For example, MDMA or Ecstasy, produces long-term deficits in serotonin function in the brain, leading to mental disorders such as depression and anxiety. Chronic drug abuse by adolescents during formative years is a particular concern because it can interfere with normal socialization and cognitive development and thus frequently contributes to the development of mental disorders.

Finally, chronic substance abuse and serious mental disorders may exist completely independently of one another.

Can people with co-occurring disorders be treated effectively?

Yes, chronic drug abusers who also suffer from mental illness can be treated. Researchers currently are investigating the most effective way to treat drug abusers with mental illness, and especially whether or not treating both conditions simultaneously leads to better recovery. Currently, the two conditions often are treated separately or without regard to each other. As a result, many individuals with co-occurring disorders are sent back and forth between substance abuse and mental health treatment settings.

Source: http://www.justice.gov/ndic/pubs7/7343/index.htm

For more info on the Dual Diagnosis see: http://bipolar.about.com/cs/dualdiag/a/0008_dual_diag.htm

Let the Church Be the Church

Brennan Manning

“Any church that will not accept that it consists of sinful men and women, and exists for them, implicitly rejects the gospel of grace. As Hans Kung wrote, “it deserves neither God’s mercy nor men’s trust”.

The church must constantly be aware that its faith is weak, its knowledge dim, its profession of faith halting, that there is not a single sin or failing which it has not in one way or another been guilty of.

And though it is true that the church must always disassociate itself from sin, it can never have any excuse for keeping any sinners at a distance. If the church remains self-righteously aloof from failures, irreligious and immoral people, it cannot enter justified into God’s kingdom. But if it is constantly aware of its guilt and sin, it can live in joyous awareness of forgiveness. The promise has been given to it that anyone who humbles himself will be exalted.”

Brennan Manning

Lithium: Help for the Afflicted

 

Lithium (brand names Eskalith, Lithobid, Lithonate, and Lithotabs) is the most widely used and studied medication for treating bipolar disorder. Lithium helps reduce the severity and frequency of mania. It may also help relieve bipolar depression. Studies show that lithium can significantly reduce suicide risk. Lithium also helps prevent future manic episodes. As a result, it ma y be prescribed for long periods of time (even between episodes) as maintenance therapy.

Lithium acts on a person’s central nervous system (brain and spinal cord). Doctors don’t know exactly how lithium works to stabilize a person’s mood. However, it helps people with bipolar disorder have more control over their emotions and reduce the extremes in behavior. It usually takes one to two weeks for lithium to begin working.

Your doctor will want to take regular blood tests during your treatment because lithium can affect kidney function. Lithium works best if the amount of the drug in your body is kept at a constant level. Your doctor will also probably suggest you drink eight to 12 glasses of water or fluid a day during treatment and use a normal amount of salt in your food. Both salt and fluid can affect the levels of lithium in your blood, so it’s important to consume a steady amount every day.

The dose of lithium varies among individuals and as phases of their illness change. Although bipolar disorder is often treated with more than one drug, some people can control their condition with lithium alone.

Lithium Side Effects About 75% of people who take lithium for bipolar disorder have some side effects, although they may be minor. They may become less troublesome after a few weeks as your body adjusts to the drug. Sometimes side effects of lithium can be relieved by tweaking the dose. However, never change your dose or drug schedule on your own. Do not change the brand of lithium without checking with your doctor or pharmacist first. If you are having any problems, talk to your doctor about your options.

Common side effects of lithium can include:

  • Hand tremor (If tremors are bothersome, an additional medication can help.)
  • Increased thirst
  • Increased urination
  • Diarrhea
  • Vomiting
  • Weight gain
  • Impaired memory
  • Poor concentration
  • Drowsiness
  • Muscle weakness
  • Hair loss
  • Acne
  • Decreased thyroid function (which can be treated with thyroid hormone)

Notify your doctor if you experience persistent symptoms from lithium or if you develop diarrhea, vomiting, fever, unsteady walking, fainting, confusion, slurred speech, or rapid heart rate. Tell your doctor about history of cancer, heart disease, kidney disease, epilepsy, and allergies. Make sure your doctor knows about all other drugs you are taking. Avoid products that contain sodium, such as certain antacids. While taking lithium, use caution when driving or using machinery and limit alcoholic beverages.

If you miss a dose of lithium, take it as soon as you remember it — unless the next scheduled dose is within two hours (or six hours for slow-release forms). If so, skip the missed dose and resume your usual dosing schedule. Do not “double up” the dose to catch up. There are a few serious risks to consider. Lithium may weaken bones in children. The drug has also been linked to birth defects and is not recommended for pregnant women, especially during the first three months. Breastfeeding isn’t recommended if you are taking lithium. Also, in a few people, long-term lithium treatment can interfere with kidney function.

A word of encouragement.  I’ve been taking 12oo mg of Lithium twice a day for over three years now, with just minor side effects.  (Mostly a bad hand tremor.)  Taking Lithium has stabilized me and protected me from my more bizarre behavior.

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Reviewed by the doctors at The Cleveland Clinic Department of Psychiatry and Psychology.

http://www.webmd.com/bipolar-disorder/bipolar-disorder-lithium

Four Truths from God

I want to share four truths that I heard in church last Sunday. They are four truths that our youth minister heard a Christian speaker share at a conference earlier last week. But these four truths weren’t new with that speaker either. Their source is God and they are told to us in His Word.

For broken believers — those struggling with mental illness or substance abuse — these truths can be particularly difficult to fully grasp and internalize. We hear them and obtain a head knowledge of them, but to truly understand these truths they must make their way to our hearts. My prayer is that you who read this will allow God to settle these truths not only in your mind but in your heart as well.

  1. You are loved.

    But because of his great love for us, God, who is rich in mercy, made us alive with Christ even when we were dead in transgressions. Ephesians 2:4-5a (NIV).

  2. You matter.

    “For I know the plans I have for you,” declares the LORD, “plans to prosper you and not to harm you, plans to give you hope and a future.” Jeremiah 29:11 (NIV).

  3. You are chosen.

    But you are a chosen people, a royal priesthood, a holy nation, a people belonging to God, that you may declare the praises of him who called you out of darkness into his wonderful light. 1 Peter 2:9 (NIV).

  4. You are not alone.

And I will ask the Father, and he will give you another Counselor to be with you forever—the Spirit of truth. The world cannot accept him, because it neither sees him nor knows him. But you know him, for he lives with you and will be in you. I will not leave you as orphans; I will come to you. John 14:16-18 (NIV).

So the next time you think no one loves you because you haven’t done anything to earn the love of others, refute that lie with the truth that God loves you. The next time you think you are too insignificant to matter to anyone, refute that lie with the truth that God has a plan for your life that is perfectly suited to how He made you. The next time you are feeling lost and alone, remember that you have been chosen by God to belong to Him and that He has sent His Holy Spirit to dwell in you so that you will never be alone.

 

Bryan’s Note: Please dear one, check out Linda’s home site at http://lindakruschke.wordpress.com/