bipolar and alcohol

While the association between a mood disorder and co-occurring alcoholism is well established, the most prevalent dual diagnosis is the one involving bipolar disorder and alcohol. Although the science behind this particular comorbidity isn’t yet clear, what is known is that alcohol abuse compounds the severity of the bipolar disorder and complicates treatment.

Bipolar disorder is a complex mental health condition that features extreme mood swings that vacillate between depressive and manic states, with some intermittent normal periods between these. There are four types of bipolar disorder, with bipolar I being the most serious. Individuals who suffer with bipolar disorder may gravitate toward alcohol use in an effort to soften the effects of the mental health disorder.

Gaining a better understanding of the relationship between bipolar and alcohol abuse allows us to improve the response time for getting someone much needed treatment for either or both of these conditions. Fortunately, both bipolar disorder and alcohol use disorder can be effectively managed through medication and psychotherapy.

What is Bipolar Disorder?

Mental illness can result in deep disturbances to all aspects of daily life, and bipolar disorder is particularly difficult to endure. Bipolar disorder, formerly referred to as manic-depression, features extreme mood swings. The characteristic shifts in mood and energy levels make it hard to complete basic tasks that others can so easily accomplish. According to the National Institute of Mental Health, bipolar disorder afflicts about 2.8% of the adult population in the U.S. Among those diagnosed with bipolar disorder, 82% are classified as severe.

The 4 types of bipolar disorder include:

Bipolar I Disorder. Bipolar I is the most common and most severe form of bipolar disorder, characterized by manic episodes that last for at least seven days or with manic symptoms so severe that acute stabilization in a hospital setting is often necessary.

Bipolar II Disorder. Bipolar II is defined by a pattern of manic and depressive episodes, but not to the same severity of Bipolar I.

Cyclothymic Disorder. Cyclothymic Disorder, or cyclothymia, is features repeated periods of manic symptoms and depressive symptoms lasting at least two years, however the symptoms do not reach the diagnostic criteria for manic or depressive episodes.

Unspecified Bipolar Disorders. This category includes those who experience bipolar disorder symptoms that do not fit into the above categories.

Symptoms of bipolar vary depending on the type of the disorder, but may include:

Depressive symptoms

  • Low mood that persists
  • Loss of interest in everyday life activities
  • Fatigue
  • Sleep problems
  • Inability to concentrate or make decisions
  • Feelings of guilt or worthlessness
  • Restlessness or slowed behaviors
  • Weight loss or gain that is unintended
  • Thoughts of suicide

Manic symptoms

  • Racing thoughts
  • Rapid speech, very talkative
  • Euphoric, hyperactive behavior
  • Increased activity and energy
  • Reduced sleep
  • Easily distracted, difficulty finishing tasks
  • Engages in high risk behavior
  • Poor decision-making

The Effects of Bipolar Disorder

Bipolar disorder can be dangerous to one’s physical health as well. Often the individual with bipolar will fixate on their own death, even obsessing about suicide. Also, many who struggle with bipolar disorder will engage in self-harming behaviors, such as the practice of “cutting” or other forms of self-mutilation, as an outlet for feelings of frustration and self-loathing.

Relationships are hard hit by bipolar disorder. People battling bipolar disorder often isolate themselves, withdrawing socially because they feel misunderstood. The isolating behaviors only worsen interpersonal relationships and can negatively impact employment stability.

Substance abuse is common among those with bipolar disorder, particularly alcohol abuse, further complicating the symptoms and exacerbating high-risk behaviors. Other comorbidities may include anxiety disorder, psychosis, eating disorders, and ADHD.

The Link Between Bipolar and Alcohol Use Disorder

The connection between bipolar disorder and alcohol use disorder has been the subject of research. It has been found that 46.2% of individuals with bipolar I disorder also have a comorbid alcohol use disorder, although it has yet to be discovered exactly why there is such a high prevalence of this dual diagnosis. Some of the possible causes for these comorbid disorders are posed in an article, “Bipolar Disorder and Alcoholism,” [Sonne and Brady]:

  • That bipolar disorder may be a risk factor for substance use
  • That symptoms of bipolar may emerge during alcohol withdrawals
  • That individuals with bipolar may use alcohol to mitigate mania
  • That bipolar disorder and alcoholism affect neurotransmitters the same way
  • That there is a genetic component with family history of both disorders

Unfortunately, alcohol abuse only enhances the symptoms of bipolar disorder. Although someone suffering from the relentless mood swings attempts to find relief in alcohol use, this strategy only worsens the disease and can lead to alcohol dependence or addiction.

The Warning Signs of Alcohol Use Disorder

The telltale signs and symptoms of alcohol use disorder (AUD) include behavioral, physical, and psychological elements. The DSM-5 established a list of criteria that helps to diagnose the severity of an alcohol problem. The more symptoms that are present, the higher the severity of the AUD. Mild AUD is indicated when 2-3 criteria are present, moderate AUD when 4-5 criteria are met, and severe AUD is diagnosed when 6 or more criteria are met.

The diagnostic criteria include:

  • Higher levels of alcohol consumption or drinking over a longer period of time than was intended
  • Persistent unsuccessful attempts to cut down or control alcohol use
  • Significant time spent obtaining, drinking, and recovering from the effects of alcohol.
  • Alcohol cravings
  • Recurrent alcohol use leading to failure to fulfill major role obligations at work, school, or home
  • Recurrent use of alcohol, despite having mounting interpersonal problems caused or worsened by alcohol
  • Giving up or missing important social, occupational, or recreational activities due to alcohol use
  • Recurrent alcohol use in high risk situations
  • Increased tolerance markedly increases levels of alcohol consumption to get desired effect
  • Withdrawal symptoms when alcohol is withheld

Dual Diagnosis Treatment for Bipolar and Alcoholism

According to statistics provided by the National Alliance on Mental Illness, approximately 9.2 million Americans struggle with a dual diagnosis, such as bipolar and alcohol addiction. When layering alcoholism over an existing mental health disorder, the individual’s condition becomes more serious. The resulting co-occurring disorders leaves individuals with mounting negative life consequences and deteriorating mental and physical health.

It is essential to seek help for comorbid disorders at a residential recovery program that specializes in treating a dual diagnosis. These programs are staffed appropriately with the psychiatric expertise necessary to prescribe medication, design a customized treatment plan for co-occurring disorders, and to effectively manage the unique mental health challenges that may emerge in the treatment setting.

It is essential that someone with both bipolar disorder and an AUD obtain treatment for both disorders simultaneously. Treatment will be multi-pronged, including medication, psychotherapy, holistic elements, and recovery support. These treatment elements include:

Detox and withdrawal.  Initially the individual must first eliminate the chemical toxins from the body through an alcohol detoxification process. This typically takes 5-7 days and is best undergone in an inpatient medically supervised detox program that is trained to identify dangerous withdrawal symptoms.

Medication: Mood stabilizing medications, such as antipsychotics and antidepressants, are the most commonly prescribed drugs for treating bipolar disorder. The specific type of bipolar disorder will dictate the medications. Lithium is the predominant medication prescribed for controlling bipolar disorder, in addition to anticonvulsants and SSRIs. Some may benefit from medication-assisted treatment for the alcoholism. Naltrexone is a non-narcotic drug that can help individuals maintain sobriety by reducing the cravings that lead to relapse.

Psychotherapy: Thoughts can influence behaviors, and negative thoughts can lead to self-destructive behaviors. Cognitive behavioral therapy (CBT) is the most commonly used form of psychotherapy for treating bipolar disorder. CBT therapists will guide the individual to identify thought distortions or triggers that lead to the disruptive behaviors, and help them change these destructive thought patterns. CBT is also effective for individuals in addiction recovery, providing them with essential coping skills.

Interpersonal and social rhythm therapy.  IPSRT provide life skills that helps the patient learn how to better predict and manage the bipolar episodes. This therapy focuses on the importance of maintaining a consistent daily routine, in addition to improving interpersonal relations and stress management.

Holistic: Experiential and holistic therapies can aid in regulating bipolar symptoms and promote overall wellness. These activities might include massage therapy, yoga, deep-breathing techniques, mindfulness meditation, art therapy, guided imagery, and aromatherapy.

Lifestyle: Because establishing a healthy routine is essential in managing bipolar disorder, residential programs will counsel patients on nutrition and exercise. Improving sleep quality, getting regular exercise, eating a nutritious diet, and managing stress are all intrinsic to achieving emotional stability and reducing the probability of a relapse.

Recovery support groups.  Success in recovery does not end with completion of a dual diagnosis program. Aftercare is an important aspect of recovery and should be included in the comprehensive dual diagnosis treatment planning. Aftercare includes regular participation in a recovery community, such as a 12-step or non 12-step program, ongoing outpatient group and individual counseling, and possibly transitional housing for a few months in sober living.

Elevation Behavioral Health Provides Dual Diagnosis Treatment

Elevation Behavioral Health is an upscale private residential mental health program in Los Angeles. Elevation is committed to providing leading dual diagnosis treatment for individuals who struggle with both bipolar disorder and alcohol use disorder. Our expert staff ensures that each individual in our care receives compassionate and respectful care, along with the most up to date evidence-based treatment measures. Our beautiful, serene setting provides a soothing and supportive environment for healing and new beginnings. For more information, please reach out to the Elevation team at (888) 561-0868.

Bipolar Disorder and Addiction

Bipolar disorder is a serious mood disorder that’s characterized by alternating episodes of extremely high and very low moods. According to the Depression and Bipolar Support Alliance, bipolar disorder affects around 5.7 million adult Americans each year, and it’s the sixth leading cause of disability in the world.1

Bipolar disorder is the sixth leading cause of disability in the world.

Bipolar disorder commonly co-occurs with substance use disorders. Results of the U.S. National Comorbidity Survey found that 71 percent of people with bipolar disorder reported at least one lifetime substance use disorder.2 Alcohol dependence was reported by 61 percent of respondents, and 40.7 percent reported drug dependence.

How Substance Abuse Affects Bipolar Disorder

According to an article published in the journal Science & Practice Perspectives, people with bipolar disorder who abuse alcohol had an earlier onset of symptoms, more frequent hospitalizations and more mental illnesses.3

Those who suffer from bipolar disorder and a co-occurring substance use disorder are also the highest risk group for suicide. This is largely due to the combination of risk-taking behaviors and major depressive episodes that characterize bipolar disorder and the loss of inhibition and a deepening of despair that often characterize intoxication.

If you or someone you love suffers from co-occurring bipolar disorder and a substance use disorder, then the sooner treatment begins, the better the outcome is likely to be. Each disorder worsens the other, and left unchecked, co-occurring disorders can lead to devastating disability.

That said, even severe cases of co-occurring bipolar disorder and addiction can be successfully treated, as long as an individual remains committed to treatment and fully engaged in the treatment plan.

Even severe cases of co-occurring bipolar disorder and addiction can be successfully treated as long as an individual remains committed to treatment and fully engaged in the treatment plan.

Signs and Symptoms of Bipolar Disorder

Bipolar disorder is characterized by four types of mood episodes. These are mania, hypomania, depression and mixed episodes. Each type of episode can last for weeks or months, especially when left untreated, and each has its own set of signs and symptoms. Signs of bipolar episodes are those that others may notice, while symptoms are those that an individual with bipolar will feel.

Mania

Signs and symptoms of a manic episode include:

  • Feelings of grandiosity and self-importance
  • Talking rapidly
  • Alternating moments of incredible elation and intense pessimism
  • A reduction in hours of sleep per night
  • Engaging in risk-taking behaviors
  • Impaired judgment
  • Irrational thoughts and behaviors
  • Hallucinations

Hypomania

Psychotic symptoms are absent during periods of hypomania, which has symptoms that are similar to but far less intense than those of the manic phase. During hypomania, a person will likely:

  • Be capable of managing day-to-day activities
  • Feel happier, more energetic or more irritable than usual
  • Need less sleep
  • Feel capable of taking on more responsibility at work or school
  • Be more likely than usual to engage in high-risk behaviors, including substance abuse
  • Feel like the bipolar disorder is under control

Depression

The depressive phase of bipolar disorder is marked by severe lows and includes signs and symptoms such as:

  • Feelings of hopelessness, helplessness and sadness
  • A loss of interest in activities you once enjoyed
  • Fatigue and sleepiness
  • Appetite changes or changes in weight
  • Feelings of guilt and self-hatred
  • Thoughts of death or suicide

Mixed Episodes

Bipolar symptoms aren’t always cut and dry. A mixed episode is a combination of symptoms for mania and depression.

Five types of bipolar disorder are commonly diagnosed:

  • Bipolar I Disorder is the most severe form of the disorder and is characterized by one or more mixed or manic episodes and one or more major depressive episodes.
  • Bipolar II Disorder is characterized by lower highs than bipolar I disorder. Bipolar II is diagnosed after one or more major depressive episodes and at least one hypomania episode.
  • Bipolar Not Otherwise Specified doesn’t follow a pattern. For example, you may have very rapid swings between manic and depressive episodes, or you may experience recurring hypomanic episodes without any depressive episodes.
  • Cyclothymia is a mild form of bipolar disorder that’s characterized by alternating hypomanic episodes and milder episodes of depression. These alternating episodes must last for at least two years to be diagnosed as cyclothymia.
  • Bipolar with Rapid Cycling is characterized by having four or more depressive, manic or hypomanic episodes in a 12-month period. Rapid cycling can occur with any of the types of bipolar.

Substance Use Disorders: Addiction and Dependence

Addiction is characterized by continuing to use a psychoactive substance even though it’s causing problems in your life. Addiction affects the structures and functions of the brain and is widely considered to be a diagnosable, treatable and preventable brain disease. If you’re addicted to drugs or alcohol, a number of psychological and physiological mechanisms are likely at work, including learned, reinforced behaviors and changes in the way the chemicals in your brain function.

Signs and symptoms of addiction include:4

  • Using drugs or alcohol despite negative consequences to your health, relationships, finances or legal status
  • A loss of control over the frequency of using drugs or alcohol, the duration of use and the amount consumed
  • A loss of interest in hobbies and activities you once enjoyed
  • Increasingly neglecting your responsibilities at home, work or school
  • Taking serious risks as a result of drug-seeking or drug-taking behaviors
  • Hiding the extent of your drug use from family and friends
  • Problems in your relationships with family, friends or coworkers
  • Neglecting personal hygiene

Dependence is characterized by changes in brain function that reach a tipping point at which the brain now needs a psychoactive substance in order to function “properly.” When the substance is withheld from the body, withdrawal symptoms set in as your brain’s way of telling you it can’t operate normally without the substance of abuse present. Withdrawal symptoms are the main indication that physical dependence has occurred.

Why Bipolar Disorder Commonly Co-Occurs with a Substance Use Disorder

A number of theories attempt to explain the high prevalence of bipolar disorder co-occurring with a substance use disorder.3

Self-Medication

One theory proposes that having a mood disorder increases the risk of developing a substance use disorder, and vice versa. The effects of a mood disorder often lead to self-medication with drugs or alcohol. Substance use may seem to reduce symptoms initially, but almost always worsens a mental disorder.

Someone with bipolar disorder may try to suppress feelings of rage or anger with an opiate like oxycodone; someone else may try to lift a depressed mood with cocaine or another stimulant. In many cases, chronic substance abuse causes mild symptoms of mental illness to worsen to a clinically significant level, due to changes in already-abnormal neurotransmitter activity. As such, it can be difficult to determine which occurred first: the substance abuse or the bipolar disorder.

It can be difficult to determine which occurred first: the substance abuse or the bipolar disorder.

Kindling

Kindling occurs when repeated disruptions sensitize brain cells and lead to symptoms that become more frequent and severe over time. Some substances, like alcohol and cocaine, sensitize neurons, and this makes them more easily disrupted. This may help explain the progression of a substance use disorder from chronic abuse to addiction, and it may explain why mood disorders often progress as well, with symptoms worsening over time and increasingly shorter periods of remission occurring between episodes.

Genetics

Both substance use disorders and mood disorders have genetic risk factors, and some genetic influences may increase the risk of developing both bipolar disorder and an addiction. This may occur in three ways:

  • The genetic variable makes an individual vulnerable to a mood disorder, which that person may then self-medicate, leading to addiction.
  • The genetic variable causes the brain to respond to drug exposure in a way that leads to chronic abuse, which then causes changes that lead to or uncover the mood disorder.
  • The genetic variable causes the brain to develop in a way that makes it vulnerable to both addiction and bipolar through mechanisms like sensitized neurons and kindling.

Diagnosing Co-Occurring Bipolar and Addiction: Integrated Screening and Assessment

The Substance Abuse and Mental Health Services Administration has developed a best-practices protocol for the integrated screening and assessment of co-occurring disorders.5 Individuals who seek treatment for a mental health issue will be screened for a substance use disorder as a matter of course, and those who seek treatment for a substance use disorder will be screened for mental illness. The screening process serves to answer the question of whether a co-occurring disorder may be present.

If the screening is positive, a detailed and thorough assessment will take place, and if the presence of a co-occurring disorder is established, this assessment will serve as the basis for an individualized treatment plan.

According to the Substance Abuse and Mental Health Services Administration’s 10 Guiding Principles of Recovery, there is no single way to treat addiction, because nobody responds to the same treatments in the same way. Every individual has a unique combination of issues, needs and preferences when it comes to treatment, and these must be addressed through a unique, personalized treatment plan.6

Every individual has a unique combination of issues, needs and preferences when it comes to treatment, and these must be addressed through a unique, personalized treatment plan.

Why Integrated Treatment is Essential for Co-Occurring Disorders

If you suffer from co-occurring bipolar and substance use disorders, choosing a dual diagnosis treatment program is crucial for improving your chances of long-term recovery from each disorder.

Treating only the bipolar disorder won’t address the issues underlying the substance use disorder, which will typically continue to worsen the bipolar symptoms. Conversely, treating only the substance use disorder won’t help curb the self-medicating and risk-taking behaviors that are associated with bipolar disorder, which will likely contribute to relapse very quickly.

Integrated treatment for co-occurring disorders is a meaningful collaboration among the treatment teams for both disorders, each of which is treated in the context of the other. An enormous body of research shows that specialized, dual diagnosis treatment for co-occurring disorders has a far better outcome than stand-alone treatments for a substance use disorder and other mental illness.

Integrated treatment for co-occurring disorders is a meaningful collaboration among the treatment teams for both disorders.

It is important to find an evidence-based integrated treatment program if you have a co-occurring disorder.7 This type of treatment involves treatment specialists who are trained to treat both substance use disorders and serious mental illnesses. These specialists:

  • Strive to meet all of the various unique needs of people with co-occurring disorders
  • Use treatment interventions that are appropriate for an individual’s particular stage of recovery
  • Administer treatment therapies in group, individual and family settings
  • Involve the individual in the development of a treatment plan
  • Integrate medication services with other treatment protocol

Using a combination of behavioral therapies and medication is the most effective way to treat a co-occurring disorder. A holistic approach to treatment is essential and should include both traditional and complementary treatment therapies that address issues of the body, mind and spirit.

Medications Used for Treating Bipolar Disorder

Bipolar disorder can be successfully managed with a variety of medications, depending on the symptoms.8

  • Mood stabilizers help control manic and hypomanic episodes and include drugs like lithium and lamotrigine.
  • Antipsychotics like risperidone and aripiprazole help control symptoms that other medications have been unable to affect.
  • Antidepressants effectively treat depression, but since these medications can trigger a manic episode, they’re usually taken with a mood stabilizer or antipsychotic. Common antidepressants include fluoxetine and citalopram.
  • Combination medications are those which contain both an antidepressant and a mood stabilizer.
  • Anti-anxiety medications in the benzodiazepine family may be prescribed for short-term use to reduce anxiety and improve sleep.

Treatment Therapies for Co-Occurring Bipolar Disorder and Addiction

Psychotherapy, or talk therapy, helps individuals learn to change their way of thinking and behaving. Research shows that psychotherapy is highly effective for treating both bipolar disorder and substance use disorders.

Group Therapy

Peer groups are valuable sources for developing coping skills and strategies. Sharing similar experiences provides a strong sense of belonging to people who may otherwise feel disenfranchised. Group members hold each other accountable and help one another evaluate their thoughts and behaviors. The opportunity to help others itself can also help bring about meaningful change.

Family Therapy

Family therapy is essential for restoring function to the household and improving communication among family members. Both bipolar and addiction take a major toll on the functioning of the family system, and fostering a healthy home environment goes a long way toward preventing relapse.

Family therapy is essential for restoring function to the household and improving communication among family members.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy helps you learn to identify and evaluate self-destructive thoughts, beliefs and attitudes and replace them with healthier ways of thinking and behaving. It also helps you cope with symptoms and recognize the signs that point to a mood shift. Research shows that cognitive-behavioral therapy is highly effective for treating those with bipolar disorder.9

Dialectical Behavior Therapy

A 2013 study found dialectical behavior therapy to be a promising treatment for bipolar disorder, according to an article published in Psychiatric Times.10 Originally developed to treat people with suicidal thoughts and actions, dialectical behavior therapy involves teaching participants four sets of essential behavior skills:

Mindfulness – the practice of being aware and present in the moment

Distress tolerance – how to tolerate, rather than eliminate, painful situations

Interpersonal effectiveness – how to say no to people and ask for what you want in a way that promotes healthy relationships and a high level of self-respect

Emotional regulation – how to control your emotions and change those you want to change

Interpersonal Therapy

Bipolar disorder and addiction both have a strong influence on your interactions with others. Interpersonal therapy addresses your various relationships and explores how your interactions with others affect your disorders and vice versa.

Social Rhythm Therapy

Keeping a routine and getting adequate sleep are both crucial for recovering from co-occurring disorders. The body’s circadian rhythms are deeply affected by bipolar disorder. Resetting and stabilizing your biological clock for better sleep, daily functioning and overall mental health can make a big difference in your recovery.

Challenges in Recovery from Bipolar Disorder and Addiction

Recovery from a substance use disorder can be particularly challenging if you have bipolar disorder. The nature of manic and depressive episodes, such as the prevalence of risk-taking behaviors during a manic episode and the feelings of hopelessness that characterize a depressive episode, can lead to disengagement with your treatment plan. This can quickly lead to a relapse.

Although research shows that people with bipolar disorder recover more slowly when alcohol abuse or addiction co-occurs, with the right dual diagnosis program and a high level of engagement in treatment, many people can and do recover from bipolar disorder and addiction.

With the right dual diagnosis program and a high level of engagement in treatment, many people can and do recover from bipolar disorder and addiction.

Choosing a Recovery Program

If you have bipolar and a substance use disorder and you’re ready to get the help you need to recover from both disorders, choosing a residential dual diagnosis treatment program is essential for the best possible outcome. Residential treatment programs enable you to focus solely on recovery, and they offer an enormous amount of support during treatment. Components in choosing a treatment program include:

  • State accreditation. Make sure the facility is accredited by the state it’s in.
  • Licensing. Ensure the mental health professionals and addiction specialists are fully licensed and well trained.
  • Research-based treatment protocol. Find out whether the program uses a research-based, best-practices treatment protocol and adheres to the National Institute on Drug Abuse’s Principles of Effective Treatment.11
  • Statistics. Ask about the program’s outcome statistics. Treatment programs should have readily available statistics concerning their success rates, and they should be forthcoming with that information.
  • Personal preferences. Make sure the program and the facility are a good match for your personal preferences. For example, if you’re vegetarian, are meatless options available for meals?
  • Are the residential facilities clean and comfortable? Does the facility feel like a hospital or a home?
  • A holistic approach. High-quality treatment programs will offer a number of holistic, research-based complementary therapies like yoga, art therapy, acupuncture or nature therapy.
  • Insurance. Does the facility accept your insurance? Keep in mind that under the Mental Health Parity and Addiction Equity Act of 2008, insurance companies must offer the same level of benefits for mental health and addiction recovery services that they do for standard medical treatments.12

Recovering from a co-occurring disorder isn’t easy, but the hard work pays off in a dramatically higher quality of life and sense of self-efficacy and well-being. Hope is the foundation of recovery, which is a process of change that occurs from the inside out and leads to better health and wellness and a self-directed life.13 As long as you have hope for a better future in which you’re able to strive to reach your full potential, there’s always a high potential for long-term recovery.

Sources:

  1. Bipolar Disorder Statistics. (n.d.). Retrieved from http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_bipolar_disorder
  2. Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005, June). Prevalence, Severity, and Comorbidity of Twelve-Month DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617-627. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847357/
  3. Quello, S. B., Brady, K. T., & Sonne, S. C. (2005, December). Mood Disorders and Substance Use Disorder: A Complex Comorbidity. Science & Practice Perspectives, (3)1, 13-21. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851027/
  4. About Addiction: Signs and Symptoms. (2015, July 25). Retrieved from https://ncadd.org/about-addiction/signs-and-symptoms/signs-and-symptoms
  5. Substance Abuse Treatment for Persons with Co-Occurring Disorders. (2005). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64196/
  6. SAMHSA’s Working Definition of Recovery: 10 Guiding Principles of Recovery. (2012). Retrieved from https://store.samhsa.gov/shin/content/PEP12-RECDEF/PEP12-RECDEF.pdf
  7. Integrated Treatment for Co-Occurring Disorders. (2009). Retrieved from http://store.samhsa.gov/shin/content//SMA08-4367/Brochure-ITC.pdf
  8. Bipolar Disorder: Treatment & Drugs. (2015, February 10). Retrieved from http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/basics/treatment/con-20027544
  9. Psychotherapies. (n.d.). Retrieved from http://www.nimh.nih.gov/health/topics/psychotherapies/index.shtml
  10. Duerr, H. A. (March, 2013). DBT Holds Promise for Patients With Bipolar Disorder. Retrieved from http://www.psychiatrictimes.com/bipolar-disorder/dbt-holds-promise-patients-bipolar-disorder
  11. Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). (2012, December). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
  12. Implementation of the Mental Health Parity and Addiction Equity Act. (2016, March 18). Retrieved from http://www.samhsa.gov/health-financing/implementation-mental-health-parity-addiction-equity-act
  13. Recovery and Recovery Support. (2015, October 5) Retrieved from http://www.samhsa.gov/recovery
depression and alcohol

There are many reasons why individuals suffer from alcoholism, and genetics, environmental factors and mental health issues are just a few explanations. Co-occurring disorders occur when an individual suffers from both a mental health issue and an addiction such as depression and alcohol. Though they are completely treatable, co-occurring disorders are especially delicate and require integrated clinical therapy to achieve lasting results. >/p>

Depression Statistics

Nearly a third of individuals who suffer from major depressive disorder also suffer from alcoholism. Though it can be hard to determine with certainty, in many cases the depression is present before the addiction takes place.

These numbers are compounded by the fact that 10 percent of Americans experience depression, yet more than 80 percent of those who deal with depression go undiagnosed and untreated. In the absence of professional treatment, it’s not uncommon for those suffering in silence to deepen their relationship with alcohol.

Negative Feedback Loops

Whether alcoholism is caused by depression or vice versa varies on a case-by-case scenario, but what remains the same is the impact that the two have on one another. For an individual struggling with alcoholism and depression, the negative feedback loop is self-perpetuating.

A person drinks in an attempt to feel better, only to find that the relief is merely temporary, if at all. This may lead to further attempts to self-medicate by drinking larger amounts with more frequency. Through this process, depression compounds these factors, leading the individual to quickly descend into addiction.

Social Consequences

The seemingly endless cycle of addiction has residual social repercussions as well. Many times people find themselves not caring about anything outside of their addiction. They may be unwilling to speak with others, show up at work or do anything that might interfere with their drinking routine. The inability to listen to reason, combined with disconnection from the world around them, produces a potent fertilizer in which depression, anxiety and addiction can grow.

Dual Diagnosis Treatment

Quitting cold turkey can not only be ineffective, it can be dangerous. Receiving help from certified professionals through a medically supervised detox program will greatly increase chances of recovery and decrease the dangers that come along with detoxing.

Trained specialists look at the root of the addiction and mental health issue and treat them both from the very start—healing both mind and body. Peoplecan learn new ways to cope with their mental health issues and begin to discover the potential that they may have thought was gone forever.

Types of Therapy

Many dual-diagnosis treatment facilities go beyond conventional individual and group therapy, giving individuals the chance to get to know themselves again through activities like art, yoga, exercise and music. When administered effectively and adhered to, therapy can help resolve co-occurring disorders and give people suffering from addiction the tools they need to overcome obstacles in a healthy and positive way.

Anyone who is suffering from alcoholism or who may be developing a drinking problem shouldn’t wait to treat these issues. The more time that passes, the more difficult it will be to break the negative feedback loop.

Role of Environment in Addiction

Drug and alcohol addiction impacts 23.5 million Americans each year. The sad truth is, though, that only around 11.2 percent of those people seek professional treatment. There are numerous factors that can contribute to addiction—trauma, mental illness, peer pressure—but out of all of the possible causes, there is one that affects every single person: environment.

Environment and the Brain’s Reward System

A person’s social interactions with others and their personal circumstances impact the risk of developing an addiction. When someone lives in an environment that does not challenge their mind or that makes them feel bad due to rocky relationships with loved ones, they are not stimulating the reward system in their brain. That lack of stimulation means that they are more likely to abuse drugs or alcohol in an effort to improve the way that they feel.

Poor social stimulation includes:

  • Poor relationships with family
  • A boring job situation
  • Poor interactions with co-workers
  • A lack of friends
  • Lack of respect at work or at home
  • Conflict in any relationship

Trauma or Abuse

Almost 50 percent of women and 60 percent of men experience traumatic situations at least once in their lifetime. That’s more than half of the country’s population. How do so many people cope with these stressful and painful memories? Many of them drink or do drugs. The reality is, though, that using only makes things worse. It might mask the pain for a moment, but it doesn’t resolve it. Instead, the symptoms compound into ugly globules of depression, anger and self-hatred. Soon they’ll have no choice but to feed their addiction, even though substance abuse is no longer covering up the pain.

Peer and Family Influences

A person’s quality of life, peer interactions and family influences greatly impact the way that they view the world—including their decisions regarding drugs or alcohol . If they work in a job that encourages alcohol consumption, then they are subconsciously influenced by the behavior of their peers and co-workers. Or if a loved one takes a prescription medication and leaves it in a location that they can access easily, they might be tempted by its presence and know where to turn if a conflict arises.

These influences make it almost impossible to stop using once a person becomes addicted. It’s time for them to take back control, and the first step is separating from anyone who pressures them into using or who uses around them.

Finding the Help They Need

It’s no secret that addiction is harmful to a person’s life, their relationships and their health. In order to find the help they need, it is important to look past what their peers are doing and look into themselves. They should make their own decisions. Many times those decisions include entering into a new, encouraging environment and surrounding themselves with others who will support them and help guide them back to sobriety.

Each person’s situation is unique. Their story is their own. Finding a treatment facility that fits a person perfectly can be a challenge, but it is vital to their success. A high-quality program will look into past traumas and living environments in order to pinpoint the root cause of their addiction. From there, they will finally be able to heal and grow into the person they want to be.

is addiction a disease or a choice

Is addiction a disease or a choice? That question has fueled countless debates over the years. Though there is solid evidence supporting both sides, the scientific and biological proof that drives the concept of addiction as a disease is paramount.

What causes a person to first pick up a bottle or take a few pills may be a choice, but the deeper issue of addiction is anything but. Like other diseases, addiction is the product of a series of environmental, psychological and biological factors baked together into a dangerous concoction.

What is the Disease Theory?

The disease theory of addiction essentially looks at addiction as a medical illness that can’t be controlled without ongoing treatment. Addiction has been classified as a physical disease due to the cycles of cravings and withdrawal symptoms it produces. It changes the way the brain functions, leading people to do things against their expressed will. This is where choice ends and chronic illness begins.

Addiction and the Brain

Drugs tap into the brain’s communication system and physically change the way the brain processes information. This causes the brain’s reward system to be flooded with feel-good chemicals, sending the user into a state of euphoria. The overstimulated reward system of the brain reinforces the behavior of drug use, leading to the desire to use again.

These pathological changes in the brain result in overpowering urges to use. Even if a person expresses a sincere desire to quit using, they’re drawn to take whatever steps are necessary to obtain their drug of choice. The disease completely overwhelms them—their thoughts, feelings and actions—until the only thing they’re able to focus on is using, as though their life depends on it.

Addiction and Survival Instincts

The survival instinct drives people to seek out resources that will trigger the brain’s reward sensors, i.e., when people eat, they feel full and satisfied. As time passes and behaviors are positively and consistently rewarded, a body begins to make the connection between the act and the feeling of pleasure it produces. Eventually, people start to crave the behavior more and more until it becomes an automated routine.

Addictive drugs evoke patterns of behavior similar to those prompted by natural rewards. As the user falls deeper into addiction, though, that single behavior starts to take precedence over all other instincts, including eating, sleeping, working or even caring for children. Addiction becomes their dominant survival instinct, which is one reason giving it up is so challenging. Their body yearns for it and feels the need to fulfill its instinctual goal.

Treating Addiction as a Disease

It is no secret that treatment can help people quit using, avoid relapse and successfully recover, but finding a treatment center that focuses on treating addiction as a disease may be the most effective option. It focuses on mental health as a whole, digging into a person’s past and exposing events that may have triggered them to start using in the first place . This allows people to heal from the inside out, removing the baggage that has held them down for so long.

Types of treatments used to heal mind and body include:

  • Individual therapy
  • Meditation
  • Art therapy
  • Yoga
  • Group therapy
add and alcohol

When we hear the term attention deficiency disorder (ADD) the first thing that usually comes to mind is a hyperactive 6-year-old boy struggling to focus on his schoolwork. ADD has been on the radar since the 1980s when formal diagnosis and the introduction of using drugs to help manage it. ADD diagnoses continue to rise, increasing by 43% since 2010.

What is not well known is that adult ADD is fairly commonplace. In fact, according to an article published by Cambridge University Press, about 50%-75% of children with ADD will carry the disorder into adulthood. As an adult struggles with the effects of this mental health condition, certain comorbidities can develop. In fact, there is a strong link between adult ADD and alcohol addiction. This dual diagnosis can be found among adults with undiagnosed and untreated ADD, where the individual is using the alcohol as a form of self-medication to help them relax.

For those with both ADD and alcohol addiction, a more challenging treatment picture results. Dual diagnosis treatment requires a specialized approach to assisting recovery, where both psychiatric expertise and addiction treatment team up to address both co-occurring disorders at the same time. With this customized protocol, individuals struggling with ADD and alcohol addiction can indeed overcome the challenges posed by the coexisting disorders and enjoy a productive and fulfilling life.

About ADD

In the U.S. ADD affects about 8 million adults, or 4% of the adult population. In adults, the hyperactivity that is so prevalent in childhood ADHD may not be the problems. Instead the disorder can lead to a series of symptoms that can disrupt daily functioning. Effects of adult ADD can range from declining job performance due to an inability to stay on task until completion, to disruptions in relationships, to impulsive behaviors.

While many adults with ADD may have also had the issue as kids, some have learned to compensate for the traits of ADD and never received treatment. Coping with ADD as an adult can include relying on making daily to-do lists to stay on task and to not forget important commitments, using reminders on the phone so meetings or appointments are not missed, to accessing apps that help with task management. For example, there are dictation apps that can help the adult with ADD to remember important information or to organize tasks.

The cause of ADD is still a mystery, although there are certain factors that may be involved. These include:

  • Genetics. Sometimes ADD will run in families. ADD is a risk if there is a family history of other mental health disorders as well, such as depression or anxiety disorder.
  • Toxin exposure. There is some evidence that points to the possibility that lead exposure, such as in pain or old pipes, during childhood may be a risk factor for ADD. Also, exposure to pesticides or PCBs may play a role. It is thought that these toxins may interfere with brain development.
  • Being born prematurely, or the mother had a difficult pregnancy.
  • If the mother drank alcohol, used drugs, or smoked during pregnancy
  • Developmental impairment with the central nervous system

Symptoms of ADD in Adults

Many of the adults who grapple with the symptoms of ADD in daily life are not even aware that they have this mental health disorder. They may feel overwhelmed in trying to manage the many demands in daily life, and wonder why they seem to be so ill-equipped compared to their peers. These individuals don’t know that they have a brain disorder that is basically scrambling their thoughts and interrupting concentration and cognitive functioning. All adults with ADD also had it as a child, although in many cases it was never clinically diagnosed. For this reason, some adults with ADD may assume it is a newly emerging problem.

Common symptoms of ADHD in adults:

  • Chronically late to work or for appointments. Being late to appointments, events, or meetings is a hallmark symptom of adult ADD.
  • Poor organizational skills. Individuals struggle to keep things in order, leading to increased stress and anxiety.
  • Trouble multitasking. Someone with ADD has difficulty focusing on or managing more than one task at a time. Given more tasks to juggle can lead to confusion and anxiety.
  • Mood swings. Mood swings, irritability, and temperamental behavior are common
  • Poor listening skills. Wandering thoughts and difficulty concentrating make paying attention difficult for the adult with ADD.
  • Chronic boredom. Job hopping due to boredom, jumping from relationship to relationship are typical in the need to seek constant gratification and excitement.
  • Forgetful. Someone with ADD may have a difficult time remembering data or information, which can make it difficult when training on the job, as it may come across as carelessness or lack of intelligence.
  • Difficulty controlling anger. Individuals with ADD can be prone to explosive angry outbursts, usually stemming from frustration.
  • Low tolerance for frustration. Become easily upset when something frustrates or annoys them.
  • Impulsive behaviors. This can manifest in a variety of ways, such as impulsive shopping habits, sexual impulsiveness, reckless driving, or any impulsive acts that have negative consequences. Difficulty delaying gratification.
  • Difficulty managing stress. The chaotic symptoms that accompany ADD can lead to stress overload, and the individual struggles to manage the stress.
  • Anxiety. Many with ADD experience anxiety as chronic worrying is common.
  • Depression. Depression is a common co-occurring mental health disorder with ADD, as the negative consequences
  • Disorganized. The person with ADD often feels overwhelmed with stimuli and then cannot stay focused enough to sort things out. This can cause difficulty completing tasks or projects at work, paying bills on time, or keeping up with family obligations.
  • Low motivation. The individual with ADD struggles between a desire to tackle multiple tasks at once and complete lack of motivation.
  • Trouble in relationships. Poor listening skills, trouble making or keep commitments, being bored with the relationship, and not attending to a relationship can lead to marital strife and relationship discord.
  • Substance abuse or addiction. Alcohol or drugs may be accessed as a means to improve sleep or relaxation, or they may be indicative of the impulsive nature of the person with ADD.

Adults with ADD may have trouble staying at a job for very long, resulting in job-hopping and lower income potential and career satisfaction. The inability to control impulsive behaviors can lead to alcohol abuse, accidents, unsafe sexual practices, and multiple marriages.

Co-occurring ADD and Alcohol Addiction 

A dual diagnosis exists when there is a mental health disorder, such as ADD, and a co-occurring substance use disorder. In many instances, the individual develops a substance use disorder in response to the mental health issue. They may begin to use alcohol as a means of reducing the effects of the ADD by its relaxant properties.

Unfortunately, some individuals may find their tolerance to alcohol increasing, leading to higher consumption of the substance in hopes of experiencing the initial calming effects. As consumption increases, the possibility for developing an alcohol use disorder increases as well.

Adults with ADD and alcohol addiction will find they have increased the suffering, as alcoholism has its own set of highly impairing features. The co-occurring disorders have the potential to cause serious disruption in daily functioning, and mounting consequences can result in the addition of an addition mental health disorder developing, such as depression or anxiety. For these reasons it is imperative that someone struggling with Add and alcohol addiction seek out the professional help that a dual diagnosis recovery program can provide.

Treatment for ADD and Alcohol Addiction Co-Occurring Disorders

Recovery will begin with a thorough evaluation of both the alcohol use disorder and the ADD, from which a customized treatment plan will emerge. Comprehensive dual diagnosis treatment involves combining several therapeutic elements that will address both disorders simultaneously. These include:

  • Medical detox. The first step in recovery is a medically supervised detox and withdrawal period. This will allow the individual to rid the body of the ethyl alcohol while under the close supervision of an expert detox team. Alcohol detox can be unpredictable, so for this reason detox and withdrawal should be monitored by a detox professional.
  • Cognitive behavioral therapy. CBT can help modify irrational thinking that is common with individuals with ADD. These irrational thoughts may include may include black-or-white thinking, catastrophic thinking, personalization, and an over-emphasis on negative thoughts. By making adjustments in the cognitive thought process, the negative behaviors are reduced. CBT can also help the individual respond differently to triggers that formerly resulted in alcohol misuse.
  • Group therapy. Small group settings led by a therapist can help encourage participants to share their experiences and personal stories, which can engender mutual peer support while in treatment.
  • Medication. Pharmacotherapy is typically part of the treatment plan for managing symptoms of ADD.  The medications for adults with ADD may include Adderall, Vivanse, Focalin, Dexedrine, Concerta or Ritalin. Non-stimulant medications include Intuniv, Kapvay, and Strattera.
  • Addiction education. Learning about the impact of alcohol on brain chemistry and structure can be a deterrent to relapse, and includes guiding the individual with relapse prevention strategies and new coping skills.
  • Holistic therapies. Learning effective methods to enhance relaxation can benefit both of these disorders. These activities might include deep breathing exercises, meditation, yoga, and massage therapy.

Individuals with a dual diagnosis of ADD and alcoholism can learn to manage these conditions and improve the quality of life through targeted treatment at a high quality residential dual diagnosis program.

Elevation Behavioral Health Offers Residential Mental Health Treatment in Los Angeles

Elevation Behavioral Health provides comprehensive dual diagnosis treatment for individuals struggling with ADD and a co-occurring substance use disorder. Our luxury accommodations and stunning setting help to provide comfort and healing while engaging in the comprehensive treatment program. For more information about the program, please contact Elevation Behavioral Health today at (888) 561-0868.

 

alcohol withdrawal and blood pressure

Alcohol dependency creeps in stealthily, like a thief in the night. What might have begun as an evening relaxation ritual slowly encroached into your daily life. As tolerance to the effects of the alcohol increased, higher consumption seemed to follow. Over time, what started out as a panacea for stress or emotional issues became its own serious problem.

When facing the prospect of getting treatment for an alcohol use disorder, the thought of going through the detox and withdrawal stage may seem daunting. This initial hurdle, one that is essential to recovery, may be so dreaded that it becomes a serious barrier to treatment. In this event it is important to take the long view, to envision detox as just a short-lived challenge to overcome in order to enjoy a life free from the grip of alcohol.

Alcohol detox and withdrawal, however, does come with some risks. Although alcohol withdrawal symptoms can vary significantly from one individual to another, ranging from mild to severe, because of the unpredictable nature of these symptoms it is always advisable to obtain a medically monitored detox. Alcohol withdrawal and blood pressure elevation, or any one of several other serious symptoms, can evolve quickly into a medical emergency.

About Alcohol Use Disorder

Alcoholism is a chronic relapsing disease that impacts brain chemistry and the central nervous system. Once the body has become accustomed to the daily consumption of alcohol it will react when alcohol is withheld, initiating withdrawal symptoms that send you right back to the alcohol for relief. The symptoms of alcohol addiction or chemical dependence include:

  • Unable to stop drinking once started, never feeling sated
  • Being able to drink increasing levels of alcohol
  • Blacking out, having no memory of actions, whereabouts, or conversations
  • Lying about your level of drinking
  • Hiding alcohol from family members
  • Neglecting responsibilities at home or work
  • Relationship problems caused by excessive drinking
  • Attempting to stop drinking but cannot
  • Withdrawal symptoms emerge when attempting to stop

Alcohol use disorder has the potential to cause a slew of significant disruptions and negative consequences in one’s life. These might include:

  • Loss of employment
  • Damage to professional reputation
  • Legal problems, such as getting a DUI
  • Interpersonal problems, divorce
  • Social withdrawal and isolation
  • Financial problems
  • A co-occurring mental health disorder may develop

There are many reasons to take that first step toward sobriety. When facing down the detox and withdrawal phase of recovery, it is best to view it as a necessary first step to a new, healthy, and productive life.

The Importance of a Medically Monitored Detox

When someone with an alcohol use disorder decides to get sober there are some important things to consider. First, it is generally considered a bad idea to attempt to detox without a trained detox team supervising the process. The spectrum of withdrawal symptoms during alcohol detox is wide, from minor tremors and insomnia to the delirium tremens (DTs). Because of the potential for a serious medical emergency occurring during detox and withdrawal, it is usually recommended that the individual have a medically monitored detox.  This type of detox will provide the appropriate medical attention should alcohol withdrawal and blood pressure increases team up to cause a serious medical condition.

A medical detox provides the safest route to sobriety, where trained detox medical providers monitor the detox and withdrawal phase of early recovery. While supervising the process, the detox professional will utilize various medical and holistic interventions to help alleviate the painful withdrawal symptoms. Without this support, the difficulty experienced during detox can derail recovery right at the outset. The detox support team will provide medications, such as benzodiazepines, to assist with anxiety and insomnia, which can also help with alcohol withdrawal and blood pressure spikes, as these drugs are sedatives. In addition, they will access over-the-counter medications to help with fever and chills, nausea and vomiting, diarrhea, and other symptoms. The psychological support provided by a medical detox team is critical to helping the individual get through the challenging detox process and then safely transition to active treatment.

What to Expect During Alcohol Detox and Withdrawal

Upon entering the residential program a thorough intake interview will be conducted.  Health status, addiction history, and mental health history will be assessed in an effort for the provider to anticipate any potential risks during the detox process. The severity of symptoms is determined by various factors identified during the initial evaluation. These factors include:

  • The age of the individual
  • The general health status, if there are any medical conditions present
  • The length of history of the alcohol use disorder
  • The usual amount of alcohol consumed on a daily basis
  • The existence of another substance use disorder
  • The existence of a co-occurring mental health disorder

When an individual abruptly discontinues alcohol intake they will begin to experience withdrawal symptoms within 6-8 hours. Withdrawal symptoms are in response to the brain and central nervous system having made adjustments over time in response to the alcohol. Brain hyper-excitability ensues when the alcohol is withheld, leading to a range of highly uncomfortable symptoms.

Alcohol detox typically occurs in three stages. The first stage begins within 8 hours after the last alcoholic beverage and lasts about 24 hours. During this first stage, withdrawal symptoms include sweating, nausea, vomiting, hand tremors, irritability, and sleep difficulties. The second stage occurs on days 2-4 and involves the most intense symptoms, such as increased heart rate, elevated blood pressure and body temperature, mental confusion, mood swings, alcohol cravings, anxiety, and depression. The final stage, starting at day 4 and lasting 3-5 days, is the phase when symptoms begin to subside.

Alcohol withdrawal symptoms may include:

  • Shaky hands
  • Irritability
  • Nausea
  • Vomiting
  • Sweating
  • Headache
  • Agitation
  • Insomnia
  • Anxiety
  • Confusion
  • Hallucinations
  • Disorientation
  • Seizures

In some cases, unpredictable withdrawals symptoms can suddenly emerge on days 3-4, called the delirium tremens (DTs). For this reason, having medical personnel available who can manage the DTs is essential during the first 3 or 4 days of detox.

What Are the Delirium Tremens (DTs)?

In a small percentage of individuals, or 3%-5%, a medical emergency called the DTs can present a serious medical condition. The DTs might catch the individual completely off guard, which is why the development is so dangerous. In 5%-15% the DTs can lead to death. Alcohol withdrawal and blood pressure that rises dangerously, in addition to these symptoms, requires immediate medical intervention:

  • Grand mal seizures or convulsions
  • Delirium
  • Hallucinations
  • Hypertension
  • Very high fever
  • Cardiac arrhythmias
  • Hyperthermia

Getting help with DTs may mean a hospital stay to help stabilize the individual and improve the outcome. Treatment will involve benzodiazepines and/or barbiturates or phenobarbital, often using IV infusion for quick relief until symptoms stabilized and begin to subside. Dosing is determined by the specific withdrawal signs observed, such as delirium, and will incrementally be reduced over a period of several days once the severe symptoms have stabilized.

How is Alcohol Use Disorder Treated?

Alcohol addiction treatment immediately follows detox and withdrawal, and may involve an extended recovery program. The residential treatment setting provides the highest level of care, with 24-hour support and monitoring and a full schedule of daily treatment elements designed to help the individual overcome the alcohol addiction.

Alcohol recovery elements include:

  • Psychotherapy. Psychotherapy is the cornerstone of alcohol recovery, as it helps the individual examine underlying emotional issues or past traumas so these can be worked through. Cognitive behavioral therapy (CBT) provides a roadmap for making core changes in thought-behavior patterns that have kept a person trapped in addiction behaviors. The recovery skills learned in CBT help reframe disordered thinking into more positive, affirming thoughts.
  • Group sessions. Meeting with peers or family members to discuss topics related to recovery can help those in recovery learn how to communicate, and listen, more effectively.
  • Education. Learning about the impact of alcohol on brain chemistry and structure can be a deterrent to relapse, and includes guiding the individual with relapse prevention strategies and new coping skills.
  • Naltrexone. Naltrexone is a non-narcotic medication that can assist in reducing alcohol cravings and relapse for those who meet criteria for usage.
  • 12-step or similar programming. The meetings provide important peer support and the opportunity to share experiences, challenges, fears, and goals with others in recovery.
  • Adjunctive activities. Rounding out rehabilitation are several activities that augment the evidence-based therapies, including mindfulness training, yoga, massage, art therapy, acupuncture, recreational therapy, EMDR, equine therapy.

The Importance of Aftercare in Recovery

Consider addiction treatment and recovery as an ongoing continuum of care. The detox and withdrawal phase launches recovery, followed by therapy in a residential treatment program. But that is only the beginning of the therapeutic process. Aftercare, or continuing care, in addiction recovery involves ongoing interventions that can help to solidify and support recovery.

Through engagement in activities that reinforce sobriety, the chances of maintaining a sustained recovery are greatly improved. Individuals in early recovery are bound to encounter challenges to sobriety. These challenges may be emotionally overwhelming, possibly triggering a relapse. Aftercare options provide an added safety net where the individual will receive peer and professional support to help navigate these stressors as they occur. Aftercare efforts should include ongoing outpatient therapy, group therapy, and engagement in a recovery community.

Elevation Behavioral Health Provides Medical Detox for Alcohol Use Disorder

Elevation Behavioral Health is a Los Angeles-based residential recovery program that offers medical detox services and comprehensive addiction treatment for individuals with an alcohol use disorder. Our luxury accommodations and stunning setting help to provide comfort and healing while engaging in the comprehensive treatment program. For more information about the program, please contact Elevation Behavioral Health today at (888) 561-0868.

addiction and natural disasters

Substance Abuse Increases After Natural Disasters

Right now the news is saturated with heart wrenching stories about the victims of hurricane Harvey. It seems everywhere we turn there is more bad news about the damage done, people who will be displaced for years to come, and even fatalities. In addition to the aftermath of the hurricane in Houston, there are over 8,000 acres of wildfires currently burning in California caused by a severe heat wave.

Unfortunately, these tragic circumstances are often accompanied by something that is insidious and not quite as obvious as demolished houses: substance abuse. Psychology studies suggest that people abuse drugs and alcohol more often after natural disaster. While we cannot know the exact reasons for every case, it seems substances are often used to sooth psychological distress.

The Risk for People with Mental Health Disorders

Research shows that people who already have a mental health disorder are more likely to abuse substances after a natural disaster. One study assessed survivors for substance abuse after the Oklahoma City bombing. Researchers found that 6% of people without another mental health disorder used substances to cope. However, a staggering 13% – 40% of people with a mental health disorder abused substances as a coping mechanism.

If you or someone you know has been affected by the hurricane or fires and they have a mental health diagnosis, you might want to be extra cautious about substance use. It is important to offer people with these diagnoses mental health resources following tragic events. If we do not provide such support conditions can get worse as substance abuse rates rise.

Poverty and Proximity

Two of the biggest risk factors for substance abuse related complications are poverty and proximity to the natural disaster. One study published on www.nih.gov looked at how often people were hospitalized for substance abuse disorders following Hurricane Katrina. The study found that people were hospitalized more for substance abuse ofter the hurricane. However, they found that this increase was even more dramatic among certain people. Specifically, low-income individuals and people living closer to the flood zones had a dramatic increase in the number of hospitalizations following the storm

Here is what we can assume based on this research: people who have less money and face the most devastation are at a higher risk of substance abuse after natural disasters. So, what can we do in order to help? You can donate money that will help the victims, support first response organizations, and make recovery easy to find. This means trying to find places for recovery meetings following disasters or volunteering to lead phone meetings.

Mental health and disasters

Statistics About Substance Abuse Following Disasters

Numerous studies about different disaster all over the world show the same thing. When a disaster happens the rates of substance abuse and even addiction go up.

  • In New Orleans, hospitalizations for substance abuse increased 2.5% in the years following Hurricane Katrina
  • Following 9/11, alcohol consumption went up 24.6%, smoking went up 18%, and marijuana use went up 3% among New Yorkers
  • After the devastating earthquake in Haiti, the rate of substance addiction went up more than 4%

Sources:

Heads Up

The Global Journal of Mental Health

Why Substance Abuse Increases

It is impossible to say with certainty what causes substances abuse to rise after disasters. However, one good explanation is that people use drugs and alcohol in order to self soothe. Most of the studies mentioned above found that people had all kinds of psychological distress after disasters. In some cases this manifested as an increase in PTSD, depression, or anxiety. In others, people just reported feeling worse after these traumatic events.

Alcohol and other depressants effect the brain in such a way that it often has a down-regulating effect. In other words, these types of drugs feel calming for the mind and the body. To learn more about how some of these kinds of drugs effect your brain you can click here. People sometimes use these types of substances because it helps them relax or feel better. When you consider people often feel stressed and agitated after disasters, it makes sense why they would turn toward these substances for help.

Another reason that substance abuse might increase is that there are less available mental health services or places for social support. If you were in treatment for a mental health disorder and now you are unable to see your care provider or get your medication, it might make you feel like turning to substances. Likewise, if you went to church every week and now you are unable to you might start to feel isolated and alone. This lack of social support might be one big reason that substance abuse increases after natural disasters.

Healthy Ways to Cope with Stress

We know that a lot of this post has focused on what can go wrong after a natural disaster. However, there are ways to cope with psychological stress that are much healthier than drugs or alcohol. Of course, one of the big issues is that people are often torn from there homes and have few resources. So, it is important to remember the coping mechanisms that require little or no money and are relatively easy to do.

You can try meditating. Even just a few minutes of meditation might help boost your mood and calm you down. You don’t need any special equipment or even a phone. You can just sit on your bed for 2-5 minutes and focus on relaxing the different places of tension in your body. You can try other breathing exercises like taking in a deep inhale and making a “s” sound as you exhale very slowly. Elongating your exhale will engage the parasympathetic nervous system and help calm you down. You might also try striking up a conversation with a stranger, focusing on something that feels positive, or taking a short walk. All of these things have been shown to improve mood and functioning.

We know that it is hard to find healthy ways to cope when things get tough. There is arguably nothing more difficult to get through than the aftermath of a natural disaster. However, we hope that you are able to remain vigilant about the increased risk of substance abuse and hopefully find another way to get through the hard times.