Mood disorder and substance abuse have a close relationship. According to the National Institute on Drug Abuse (2008), over 30 percent of those with mood disorder in the United States also have substance abuse disorder. As a therapist, it is never easy to identify and distinguish between those abusing substances as a self-medication towards mood disorder from those who suffer from the disorder as a result of drug abuse.
According to the Nation Health Research, self-medication is common among most of the substance abusers (Harris et al. 2005). Theoretically, those who use substance abuse such as marijuana and alcohol to balance their mood disorder believe that it is only through doing so that they will manage to conduct their daily activities. From this theoretical perspective, a conclusion can be drawn that those who abuse substance as a self-medication strategy towards mood disorder will be tempted to use a higher amount of the substance. Those who suffer from mood disorder as a result of substance abuse, on the other hand, have a long history of the abuse. Either they started using the substance at their early stages and hence have developed the disorder from the practice.
Stop first or treat first? Which one comes first?
Treating a patient suffering from the mood disorder that is at the same time abusing substances is sometimes a challenging experience (Quello, 2005). Some of the therapists will prefer that the patient first stops using the substance to get medicated, while others will address the medication issue while the patient is still using the substance. Khantzian (1997) warns that it is an injustice to wait for a mood disorder patient stop substance abuse before treating them. The bottom line of this argument is that some of the mood disorder patients find themselves in such a situation because they abused an addictive substance such as cocaine. It is not very easy to quit using addictive substances such as cocaine even when the patient understands the underlying threats of abusing the substance. According to me, I will have to put to use some of the strategies to help the patient stop using the substance before commencing on the treating procedures.
The National Institute on Drug Abuse concludes that the best practice to ensure that a mood disorder patient who abuses substances is assisted is through ensuring that the person in question is placed on a medication while at the same time going through a withdrawal process. Patients who make an abrupt stop from abusing substances will always suffer a chronic disorder called discontinuation syndrome which can be as deadly as a mood disorder. To ensure that the patient is safe from discontinuation disorder, Quello (2005) advises that therapists must not wait for the patient to stop using the substance but instead assist them through. It can be concluded that as a therapist, I will go for the second choice which demands that I address other issues firsts to get the substance abuse stop rather than waiting for the patient to stop the use of the substance abuse.
References
Harris, K. M., & Edlund, M. J. (2005). Self‐medication of mental health problems: New evidence from a national survey. Health services research,40(1), 117-134.
Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: a reconsideration and recent applications. Harvard review of psychiatry, 4(5), 231-244.
National Institute on Drug Abuse, & United States of America. (2008). Comorbidity: Addiction and Other Mental Illnesses.
Quello, S. B., Brady, K. T., & Sonne, S. C. (2005). Mood disorders and substance use disorder: a complex comorbidity. Science & Practice Perspectives, 3(1), 13.
