Research is showing, more and more, that mood disorders (depression and bipolar disorder, also called manic depression) and other physical illnesses affect one another. Treating mood disorders can help people manage other illnesses and improve their general health.
Data from a recent DBSA Consensus Conference supported the finding that people with depression have a higher risk of developing heart disease. One reason for this may be that a lack of serotonin in the bloodstream may cause blood platelets to stick together more frequently and cause more blockages in the arteries.
Depression is also prevalent among people with HIV who have a two-fold greater risk of developing a mood disorder than the general population. Ten to fifteen percent of people with diabetes experience one or more major depressive episodes and the risk of developing some cancers is 10-25% higher in people with depression than in people without a mood disorder.
Depression also substantially increases the risk of developing conditions such as osteoporosis, obesity or chronic pain.
In Time Magazine, Michael D. Lemonick concluded that, “The idea that treating depression might lessen the severity of other diseases…makes basic biochemical sense. Everyday experience makes it clear that brain chemistry governs more than just the emotions.”
Depression and bipolar disorder can worsen other illnesses or other illnesses can trigger episodes of mania or depression. Treating both illnesses is important and informing your health care professionals about all your illnesses is equally important.
Talk about your physical health with your psychiatrist or therapist and talk with your primary care doctor about your mental health.
When asked how you are doing, let your doctor know the facts beyond “Fine.” Discuss the possibility of one illness worsening the other, and ask your doctor what steps you can take to prevent this.
Be sure the medications you are taking do not:
Contribute to your mood disorder or make your moods less stable.
Have side effects that look like symptoms of mood disorders (confusion, aches, weight or sleep changes).
Interact with one another, which can change their effectiveness.
Always read the medication interaction information your doctor or pharmacist gives you.
You can always find out more about your medication and its interactions online at:
www.nlm.nih.gov/medlineplus/druginformation.html
DBSA's Finding Peace of Mind: Treatment Strategies for Depression and Bipolar Disorder.
Offer your family doctor, heart specialist or other physician materials about mood disorders from DBSA to help them start discussions with you and other patients. Encourage your doctors to ask all of their patients whether they have symptoms of depression.
It is important to tell your doctor about all of the symptoms you are experiencing and all other illnesses for which you are receiving treatment.
Make a commitment to stick with treatment of both illnesses and find ways to work more healthy activities into your life. Allow yourself time to heal, find support and don’t give up hope.
Dual Diagnosis and Recovery
What is dual diagnosis?
Dual diagnosis is the term used when a person has a mood disorder such as depression or bipolar disorder (also known as manic depression) and a problem with alcohol or drugs. A person who has a dual diagnosis has two separate illnesses, and each illness needs its own treatment plan.
There is help and hope.
Mood disorders and alcohol/drug problems are both treatable illnesses. They are not moral weaknesses or character flaws. They can affect anyone, regardless of age, ethnicity or economic background. Studies have shown that more than half of the people who have depression or bipolar disorder also use alcohol and/or drugs.
What is self-medication?
Sometimes people may use alcohol or drugs to help cover up or mask symptoms of a mood disorder. For example, if a person’s mind is racing because of mania, a drink of alcohol may slow it down. If a person has intense sadness or hopelessness because of depression, a drug may help him or her feel happy or hopeful for a period of time. This “self-medication” may appear to help, but it actually makes things worse. After the temporary effects of the alcohol or drugs wear off, a person’s symptoms are often worse than ever. Self-medication can cause a person’s mood disorder to stay undiagnosed for a long time.
What are the symptoms of mood disorders?
Knowing the symptoms of mood disorders can help you decide to seek help. You can’t diagnose yourself. Only a health care professional can diagnose and treat a mood disorder. When a person’s mood switches between depression and mania, it is called bipolar disorder (also known as manic depression).
Symptoms of Depression
When a person has five or more of the following symptoms, including feelings of sadness or loss of interest or pleasure, or if these symptoms interfere with a person’s life, s/he may have major (clinical) depression and should see a health care professional.
Feeling sad, crying a lot
Major changes in appetite and sleep patterns
Irritability, anger
Worry, anxiety
Pessimism, indifference, feeling like nothing will ever go right
Loss of energy, constant exhaustion
Unexplained aches and pains
Feelings of guilt, worthlessness and/or hopelessness
Not able to concentrate or make decisions
Not able to enjoy things once enjoyed, not wanting to socialize
Recurring thoughts of death or suicide
If you or someone you know has thoughts of death or suicide, contact a medical professional, clergy member, loved one, friend or crisis line such as 1-800-273-8255 (TALK) immediately, or go to your nearest hospital emergency room.
Symptoms of Mania
When a person has three or more of the following symptoms, including an unusually excited, irritable or energized mood for a week or more, or if these symptoms interfere with a person’s life, s/he may be having a manic episode and should see a health care professional.
Increased physical and mental activity and energy
Extreme optimism and self-confidence
Grandiose thoughts, increased sense of self-importance
Irritability
Aggressive behavior
Decreased need for sleep without feeling tired
Racing speech, racing thoughts
Impulsiveness, poor judgment
Reckless behavior such as spending sprees, major business decisions, careless driving and sexual promiscuity
In severe cases, delusions (thinking things that aren’t true) and hallucinations (seeing or hearing things that don’t exist)
Why is it important to treat both the mood disorder and the alcohol/drug use? When neither illness is treated, one illness can make the other worse. When only one illness is treated, treatment is less likely to be effective. When both illnesses are treated, the chances for a full and lasting recovery are greatly improved, and it is easier to return to a full and productive life.
Why is it important to stay clean and sober when getting treatment?
Mixing alcohol or drugs with medication can have serious and dangerous effects. Many medications, including over-the-counter medications, interact with alcohol or drugs in harmful ways. It is also unlikely that you will benefit from talk therapy if you are under the influence.
What should I expect from treatment?
You may need to go to more than one doctor and attend more than one support group. All of your treatment providers should be aware that you have a dual diagnosis. Treatment for your mood disorder may include counseling or psychotherapy, medication and DBSA support groups where you can share your experience living with depression or bipolar disorder. Treatment for your alcohol and/or drug use may include some type of recovery group.
If you are drinking or using every day, you and your doctor may decide that you need to check into a hospital or treatment center so you can be treated for physical withdrawal symptoms. After treating the withdrawal, you will need to treat the addiction. This may include a residential or outpatient alcohol/drug treatment center, a 12-step group or another group that focuses on living without substances. In these groups, you will learn how others stopped drinking or using, how to cope with cravings and urges to drink or use, and how to live comfortably without the use of alcohol or drugs.
Talk therapy (psychotherapy) can help you learn to cope with symptoms of depression and/or mania, and change the patterns of thinking that may be making them worse. Therapy can also help you look at your drinking/using habits and work on staying clean and sober. You may get therapy from a psychiatrist, a psychologist, a social worker, a therapist, a counselor, a nurse or another health professional.
Medication to help with symptoms of depression and mania may be prescribed by a physician or psychiatrist. You and your doctor will work together to find the right medication(s) for you. Different people have different responses to medication, and many people need to try several before they find the best one(s). Though it may not be easy, be patient when starting new medications and wait for them to work. Don’t lose hope. Some can take four to eight weeks before you feel their full effects.
Keep your own records of treatment—how you feel each day, what medications and dosages you take and how they affect you, and any alcohol or drug use. DBSA’s Personal Calendar can be very helpful with this.
Medications that affect the brain may also affect other systems of the body, and cause side effects such as dry mouth, constipation, sleepiness, blurred vision, weight gain, weight loss, dizziness or sexual problems. You might feel the side effects before you feel the helpful effects of your medication. Many times, these side effects will go away in a few weeks. If they don’t go away immediately, don’t be discouraged. There are ways to reduce or get rid of them.
Change the time you take your medication to help with sleepiness or sleeplessness.
Take it with food to help with nausea.
Your doctor may change your dosage or prescribe another medication.
Tell your doctor about any side effects you are having. You and your doctor should work together to make decisions about medication.
Never stop taking your medication or change your dosage without talking to your doctor first.
Am I still clean and sober if I take medication?
Absolutely. Taking medication as prescribed by a doctor is not the same as using alcohol or street drugs to feel better. Medications affect the same brain chemicals that alcohol and street drugs do. But medication balances the levels of these chemicals instead of making them rise and fall. Medications help keep your brain chemicals, and your moods, more predictable and stable. They can help you to be yourself.
Best Wishes and Lot’s of Love,
Arthur Buchanan
Out of Darkness & Into the Light
209 Ellis Ave. Suite 1313
Bellevue, Ohio44811
567-217-1133 (Home)
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