Transcript How Mental Illness and Addiction Influence Each Other

COMORBIDITY IN ADDICTION
AND OTHER MENTAL
ILLNESSES
The Chiromo Lane Medical Centre
(CLMC) Approach
Definitions
Mental illness
- A wide range of mental health conditions – disorders- that
affect the mood, thinking and behavior (Mayo clinic).
Co-morbidity
- Two or more disorders occurring in the same person (NIDA).
Addiction
- A primary chronic disease of brain-reward, motivation,
memory and related circuitry (ASAM).
Drug Abuse and
Mental Illness:
A “Complex Dance”
Complexities
 Mental illnesses are often compounded by drug
and alcohol abuse, making it a challenge to get
the right diagnosis, treatment and management
for both.
 Mental illnesses can increase the risk for
alcoholism or drug abuse
 Alcohol and drug abuse can exacerbate
underlying mental illnesses.
Drug Abuse and Mental Illness:
Underlying Causes
There are also other factors that could
explain the frequent simultaneous
occurrence of addiction and mental
illness, including:
Underlying Causes cont…
 Genetics
Certain studies have found genetic
variations that are associated with mental
illness.
 Chemical deficiency.
Neuro-chemical deficiencies have been
linked to mental illnesses
Some of these deficiencies are found in
dopamine, serotonin, norepinephrine
Underlying Causes cont….
 Environment
Some environments were found to be
more stressful leading to mental
breakdowns. These increase risk of
alcohol and drug abuse
Drug Abuse and Mental
Illness:
Co-morbidities
Co-morbidities
 Depression
In some cases, individuals may start to abuse a
substance to handle the symptoms of depression.
Bipolar Disorder
Those with bipolar disorder may attempt to smooth out
mood swings with alcohol.
Co-morbidities cont’d
 Anxiety Disorders
e.g. social anxiety persons may use alcohol and other drugs to get
the courage to socialize.
Generalized Anxiety Disorder people use substances to alleviate
the worrying.
 Trauma and Stressor – related Disorders
e.g. People with Adjustment Disorder, Acute Stress Disorder and
Post-Traumatic Stress Disorder may use substances to cope
with the flashbacks of the trauma event.
.
Comorbidities cont’d
 Schizophrenia
Marijuana is commonly used by people with schizophrenia
disorders to cope with the symptoms.
Cigarette smoking is prevalent among people with
schizophrenia.
 Attention Deficit Hyperactive Disorder (ADHD)
Persons with ADHD are likely to use substances impulsively
and use cannabis to manage concentration.
Drug Abuse
and Mental
Illness:
Treating Two
Sets of
Symptoms
It is very important, but often difficult, to
distinguish primary mental disorders
from drug induced symptoms.
It is recommended that one is
substance-free for a short period in
order to tease apart the various
symptoms.
Dual Management
Treatment needs to focus on both conditions at
the same time, once the right diagnosis has
been made.
CLMC – Retreat Relationship
 Multidisciplinary approach – Psychiatrists,
psychologists, psychiatric nurses, counselors,
social workers, pharmacists..
Recommendations
• Research on local Kenyan co-morbidity rates informed by a
specialized treatment facility
• Increase appreciation for dual treatment
• Enable formulation of effective policies that ensure best
clinical practice
• Spearheading incorporation of context-based interventions to
improve mental health in private and public institutions
Thank You