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 Posted: Thu Jul 22, 2010 5:03 am
Concurrent Disorders
Submitted by: Julie Green, M.ED. Mental Health and Addictions Prevention Services. Vancouver Island Health Authority, South Island.
[Nikolita note: Normally I have the experts' text all in bolded font, but because this section is *all* dialogue between them, I have bolded only their names to make it easier to read. Also, see the bottom of this post for the bolded definitions mentioned throughout the dialogue.]
Kara: Have you ever heard about concurrent disorders before?
Justin: Concurrent... what?
Zach: Yes, I heard about them a few months ago from my doctor when I went to see him because I couldn't sleep and had basically no energy. All I wanted to do was stay in bed because I didn't see a point to getting up. My doctor asked me a bunch of questions, like about my appetite, my motivation and my moods. It was tough for me to talk about, but when he diagnosed me with depression, even I had to admit it made sense. Concurrent Disorder is just a really medical way of explaining what happens when you are using drugs or drinking heavily AND have depression, anxiety, or some other kind of concern.
Justin: Why do they use the term concurrent disorder?
Zach: My doctor knows that I recently quit using crystal meth. He is not sure if my sleeping problems, lack of energy constant worrying and depression are symptoms of withdrawal from crystal meth, or signs of another issue that may be surfacing, like depression or anxiety. My doctor says the symptoms of withdrawal look very similar to the conset of a psychological issue, making it difficult to decide what behaviour is related to what cause - especially when they show-up together.
Kara: Oh... now I get it. When you explain it that way it makes more sense.
Justin: I never knew it took the body that long to withdraw from a drug like crystal meth!
Kara: That's the first time I have thought that "not being able to sleep" could be a sign of something else, like depression. There are a number of people I know who have difficulty getting to sleep at night and are feeling tired all the time. Does this mean they are withdrawal symptoms from their alcohol and other drug use, or a sign of a mental health issue?
Zach: It's hard to tell. You can never really know unless you go see a counsellor or doctor. For example, my new doctor told me because I have a family background of addictions, and my mom was hooked on sleeping pills for a long time, I am more at-risk of developing a mental health issue. That surprised me. I knew because of my family background I was at-risk of becoming addicted to alcohol or other drugs, but I did not think that this also meant I was at risk of mental health concerns.
Justin: I don't get it. What makes your doctor think you are at-risk of developing a mental health problem because your mom was addicted to sleeping pills?
Zach: My doctor knows that 90% of the time the addiction problems show up first. See, many people who experience something like depression, anxiety or delusions will try to cope with it by using drugs, because sometimes the effects of drug use help to hide some of the unplesant symptoms. For example, my doctor suspects that my mother started to use sleeping pills to help her escape the terrible insomnia she was experiencing, not knowing at the time that her sleeplessness was related to her undiagnosed anxiety and depression.
Justin: Isn't your mom concerned about being diagnosed with clinical depression?
Zach: Actually, my mother is relieved. My mother is happy to finally know what the real problem is. She has never really felt very energetic or happy since she was a teenager. It concerned her when she noticed me starting to feel the same why. This is why she insisted I see the doctor.
Kara: What do you think about being labelled as someone experiencing depression?
Zach: Well, first of all, my doctor has reassured me that I am normal and okay. Most people will be depressed at some time in their lives as a normal reaction to high levels of stress, disappointments, or withdrawal from alcohol or other drugs. My doctor told me a recent survey showed 40% of youth have felt really depressed. Drugs and alcohol are one of many ways to deal with depression, which explains why so many people experiencing a problem with drugs also happen to be depressed. Up to 50% of people who are suffering from depression are also abusing drugs or alcohol!
Kara: What are the signs of clinical depression?
Zach: It's normal to feel bummed once in awhile, but when you feel really crappy and it won't pass after a couple of weeks, it becomes really hard to get through the day, let alone go to school, have fun with friends and talk to your parents; anything that requires energy becomes a real challenge. For me, I just wanted to stay in bed all day, and sometimes for no apparent reason I'd feel like crying. I knew it wasn't just an average bad mood when I realized I had stopped getting enjoyment out of anything.
Justin: What are you doing to help with your depression?
Zach: My doctor has prescribed an anti-depressant for the short-term to stabilize me emotionally, since I was feeling so depressed I was becoming suicidal.
Kara: You didn't tell us about that before.
Zach: I know. Feeling suicidal is not easy to talk about.
Justin: I'm glad you told us. Are the anti-depressants helping you to feel better?
Zach: Taking anti-depressants has been an important firrst step for my healing. I know taking medication is not necessarily right for everyone, but it is for me right now. I hope that one day I am able to feel ok and manage stress without them. Medication is one part of my holistic recovery plan. I see a counsellor once a week to talk things out and work on how I cope with stress. It really helps me to understand that I can get through this. I am also drinking lots of water, eating healthy, exercising, learning relaxation techniques, and have reduced my school work load.
Kara: Do your teachers know you have a concurrent disorder? How are they responding?
Zach: Yes, my tecahers know I have a concurrent disorder. My doctor has given me some information about concurrent disorders to share with them, about stimulants and mental health. This has helped my teachers to understand that when someone has been using alcohol and other drugs, it may be difficult to determine what has caused the depression a person is experiencing. The teachers understand stimulants like crystal meeth cause the release of hormones called dopamine and serotonin in the brain and, over time, the body loses its ability to release them, which makes people feel depressed. They now realize symptoms of depression can last from 6 months to 2 years, depending on how long a person has used the drugs, and how much stress is in his or her life.
Justin: Is there a different type of treatment for depression depending on the cause?
Zach: No, treatment for depression is the same whether it is caused by withdrawal symptoms related to alcohol or other drug use or a mental health issue.
Justin: I guess when you're going through withdrawal it's tough to tell whether the symptoms you're experiencing are because of the drugs or because of the depression. How do you know?
Zach: You don't know until you see your doctor. But you can still try and be on the lookout for some of the symptoms we've been talking about, especially if you come from a family with mental health or addiction concerns.
My doctor told me teens who come from families who have schizophrenia should realize that there is no "safe dosage" of using drugs, especially drugs like marijuana, because even a small dose may cause the onset of this illness. Some people this of it as an allergic type of response to the marijuana. My doctor says anyone with a family history of mental illness such as schizophrenia, depression or anxiety is advised to avoid using marijuana.
Kara: Wow. I didn't know that using marijuana could be such a risk for my mental health. I only thought harder drugs like crystal meth or LSD were risky to use. I've heard those drugs can cause short-term or long-term "substance-induced psychosis," which may look similar to schizophrenia.
Justin: I wonder how many people out there using drugs know about concurrent disorders?
Kara: I bet not that many. It's hard enough to be honest about drug use, let alone things like depression and anxiety. It seems like we need to have conversations like this more often, with more people.
~
Definitions
- Concurrent Disorders: when substance abuse occurs alongside a psychological or mental health disorder, such as anxiety, depression, or psychosis.
- Depression: an emotional state characterized by feelings of hopelessness, inadequacy and sadness that persist for longer than 2 weeks.
- Anxiety: a state of feeling uneasy, apprehensive or worried about what might happen, often to an excessive and irrational degree.
- Delusion: a false, persistent belief that is not confirmed by fact or reality.
- Insomnia: a chronic inability to sleep.
- Anti-depressant: prescription medication used to treat depression by effecting neurotransmitters in the brain.
- Dopamine: thought to be the main chemical messenger in the reward centres of the brain, which promotes the experience of pleasure; dopamine production in the brain is increased by various drugs.
- Serotonin: a neurotransmitter that can be produced naturally by the brain, or synthetically through drugs, that regulates mood and produces feelings of well-being.
- Schizophrenia: a mental illness characterized by various symptoms such as delusions, hallucinations, disorganized speech or behaviour, or paranoia.
- Substance-induced Psychosis: hallucinations or delusions that occur during withdrawal or acute intoxication; usually it is very brief, but early recognition is very important.
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Posted: Thu Jul 22, 2010 10:52 pm
Behavioural Checklist - Signs and Symptoms of Alcohol and Other Drug Use and/or Mental Health Issues
The behavioural checklist assists in the early identification of the signs and symptoms of substance use problems and/or mental health issues. The signs and symptoms of both have been included in this behavioural checklist, as there is an overlap of similarity between them. Research has shown that people with a family background of mental illness and/or problematic alcohol or other drug use are more vulnerable to developing similar problems. If you are concerned about this, or have any questions and would like more information, please contact your local Addictions or Mental Health Community Services.
* = May be signs and symptoms of BOTH alcohol or other drug use and/or mental health issues.
(Please check all behaviours that apply)
Classroom Conduct
Changes in usual class behaviour:*
- Avoids participating in class.
- Slow in thought process and decision-making, and responding to questions.
- Has memory and concentration problems.
- Asks for more assistance than normal.
- May ask for advice without a specific problem.
- Late for class.
- Skipping classes.
Difficulty maintaining normal, focused conversation:*
- Loses train of thought easily.
- Has difficulty expressing thoughts or feelings.
- May change subjects inappropriately.
Quarrelsome and suspicious:*
- Argumentative.
- Irritable.
- Verbally abusive.
- Sudden temper outburst.
- Defiance.
- Defensive.
- Breaking rules.
- Violent.
- Extreme negativity.
- Frequently requiring discipline.
- Vandalism.
Changes in personality:*
- Silliness, outbursts of laughter or giddiness (more than usual).
- Irritability.
- Paranoia.
- Nervousness or hyperactivity.
- Mood swings.
- Erratic behaviour.
- Anxiety or agitation.
- Depression.
Changes in general appearance:*
- Decline in personal hygiene.
- Differences in body posture or movement (slower or faster).
- Frequent trips to nurse, health room or bathroom.
- Or may be frequently sick.
Lack of motivation:*
- Sleeping in class.
- Daydreaming.
- Time disorientation.
Withdrawing from relationships:*
- Isolation.
- Avoids eye contact.
Changes in friends:*
- New friends.
- Secretive regarding friends.
- Sudden unexplained popularity.
Compulsive overachieving:*
- Preoccupied with academic or other success.
- Perfectionism.
- Difficulty accepting mistakes.
- Obsessive.
Academic Performance
- Requesting more help.*
- Decline in quality of work.*
- Incomplete work or work not handed in.
- Drop in grade or failing.*
Other Behaviours
- Borrowing money.
- Stealing.
- Suspected involvement in the sex trade.
Physical signs and symptoms of intoxication:*
- Smell of marijuana or alcohol on or "around" person.
- Red, glassy eyes; burns around the mouth.
- Sores on body.
- Picking at skin.
- Droopy eyelids.
- Acts slightly sedated.
- Slurred speech (different than usual).
- Staggering.
- Obsessive and repetitive behaviours.
- Hallucinations.
- Sudden weight loss.
- Depression.
Preoccupation with alcohol or other drugs:
- Brags and talks freely about alcohol or other drug use.
- Associates with known users.
Possession of alcohol and other drug paraphenalia:
- Pipes.
- Eye drops.
- Rolling papers.
- Needles.
- Burnt spoons or knives.
- Lighters.
- Roach clips.
- Foil.
- Small bottles.
- Bags.
- Selling, delivering alcohol and drugs.
- Fear of authority, contact with parents or other authority figures.*
Statistics and Facts
- About 18% of children and youth in some surveyed regions of Canada have a mental health problem.
- 50% of individuals with schizophrenia have a substance use problem.
- 60% of individuals with a diagnosis of depression have a substance use problem.
- 43% of those with a substance use disorder meet the criteria for another mental disorder.
- "Within poplations of concurrently disordered youth, in 90% of cases the mental health problem precedes the substance use problem."
- "The median age for the development of early mental health problems is 11 years old."
[The above 2 quotes taken from the Children's Commission 1999 report.]
- Early recognition, diagnosis and treatment of early psychosis can lead to significantly improved recovery.
- Delays in starting effective interventions for psychosis may diminish the chances of complete recovery, and/or slow the recovery process.
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Posted: Fri Jul 23, 2010 12:13 am
Community Resources for Youth Substance Abuse (Central/Southern BC)
Disclaimer: The following list of community resources for youth substance abuse for central/southern BC is intended to serve as a guide. The omission of an agency, program, or counselling service from this guide does not imply any disapproval, just as inclusion of an agency, program or counselling service in no way implies endorsement by Drugs and Addiction Magazine Ltd.
For changes or additions, please e-mail info@dafacts.com.
Armstrong - Spallumcheen Boys & Girls Club
PO Box 332
3459 Pleasant Valley Road
Armstrong, BC
V0E - 1B0
Phone: (250) 546-3465
Armstrong - Spallumcheen Youth Centre
3385 Pleasant Valley Road
Armstrong, BC
V0E - 1B0
Phone: (250) 546-1852, or call the club at (250) 546-3465 for info.
Mental Health & Addictions c/o Interior Health Authority
PO Box 488
700 Ash-Cache Creek Highway
Ashcroft, BC
V0K - 1A0
Phone: (250) 453-1940
Barriere Diagnostic Treatment Centre c/o Yellowhead Community Services
PO Box 659
4537 Barriere Town Road
Barriere, BC
V0E - 1E0
Phone: (250) 672-9731
Bonaparte Indian [Native] Band - Alcohol & Drug Progam
PO Box 669t
Cache Creek, BC
V0K - 1H0
Phone: (250) 457-9624
Freedom Quest Regional Youth Services Head Office
1005 - 2nd Street
Castlegar, BC
V1N - 4T2
Phone: (250) 304-2676
Toll-free: 1-877-304-2676
Chase Health Centre
825 Thompson Avenue
Chase, BC
V0E - 1M0
Phone: (250) 679-3312
Yellowhead Community Services
PO Box 1082, RR 1
Clearwater, BC
V0E - 1N0
Phone: (250) 674-2600 MCF
PARTY Program Cranbrook Health Council
13 - 24 Avenue N.
Cranbrook, BC
V1C - 3H9
Phone: (250) 417-6220
Easy Kootenay Addiction Services
202 - 1617 Baker St.
Cranbrook, BC
V1C - 1B4
Phone: (250) 489-4344
Summitt Community Services Society
#100, 125 - 10 Avenue S.
Cranbrook, BC
V1C - 2N1
Phone: (250) 489-3114
Interior Health Alcohol & Drug Counselling
138 - 10th Avenue N., Bag 3000
Creston, BC
V0B - 1G0
Phone: (250) 428-3553
Enderby Community Health Centre
707 - 3rd Avenue
Enderby, BC
V0E - 1V0
Phone: (250) 838-0738
East Kootenay Addiction Services
PO Box 2049
802B - 2nd Ave
Fernie, BC
V0B - 1M0
Phone: (250) 423-4423
Golden Family Centre
PO Box 415
Golden, BC
V0A - 1H0
Phone: (250) 344-2000
Boundary Mental Health & Addiction Services
PO Box 34
7474 - 3rd St.
Grand Forks, BC
V0H - 1H0
Phone: (250) 442-0330
Freedom Quest Regional Youth Services
PO Box 2498
Grand Forks, BC
V0H - 1H0
Phone: (250) 442-2267
Hope Community Services
434 Wallace St.
Hope, BC
V0X - 1L0
Phone: (604) 869-2466
East Kootenay Addiction Services
PO Box 2289
122 - 7th Ave
Invermere, BC
V0A - 1K0
Phone: (250) 342-4242
Family Resource Centre of Invermere
PO Box 2289
Invermere, BC
V0A - 1K0
Phone: (250) 342-4242
Boys & Girls Club of Kamloops
PO Box 2101
Kamloops, BC
V2B - 7K6
Phone: (250) 554-5437
Community Counselling Connections
Suite 103, 1315 Summit Drive
Kamloops, BC
V2C - 5R9
Phone: (250) 374-3388
www.communitycounselling.ca
Interior Indian [Native] Friendship Society
125 Palm St.
Kamloops, BC
V2B - 8J7
Phone: (250) 376-1296
Phoenix Centre
922 - 3rd Avenue
Kamloops, BC
V2C - 6W5
Phone: (250) 374-4634
Freedom Quest Regional Youth Services
PO Box 546
Kaslo, BC
V0G - 1M0
Phone: (250) 353-7691
North Kootenay Lake Community Services Society
PO Box 546
336B Avenue
Kaslo, BC
V0G - 1M0
Phone: (250) 353-7691
Changes Program c/o ARC Programs Ltd.
#202, 532 Leon Avenue
Kelowna, BC
V1Y - 6J6
Phone: (250) 763-2977
Kelowna - Jaycees Downtown Youth Centre, Parents Together, Restorative Justice, Teen City Beat, Youth Employment Services, Reconnect, Outreach Mental Health, Emergency Placement Services
1633 Richter St.
Kelowna, BC
V1Y - 7N3
Phone: (250) 868-8541
E-mail: dyc@boysandgirlsclubs.ca
Parents Together - c/o Downtown Youth Centre
1434 Graham St.
Kelowna, BC
V1Y - 7N3
Phone: (250) 762-3989
Kelowna - Rutland Boys and Girls Club
355 Hartman Rd.
Kelowna, BC
V1X - 2M9
Phone: (250) 765-3345
Kelowna - The Clinic Outreach Health Services
539 Lawrence Avenue
Kelowna, BC
V1Y - 6L8
Phone: 868-2230
The Downtown Boys and Girls Club
PO Box 75
1434 Graham St.
Kelowna, BC
V1Y - 7N3
Phone: (250) 762-3914
Kelowna Alcohol & Drug Services
#207, 1815 Kirschner Rd.
Kelowna, BC
V1Y - 4N7
Phone: (250) 870-4681
Okanagan Boys and Girls Club
1633 Richter St.
Kelowna, BC
V1Y - 7N3
Phone: (250) 762-3914
Kelowna Outreach Health Services
539 Lawrence Ave.
Kelowna, BC
V1Y - 6L8
Phone: 868-2230
Ki-Low-Na Friendship Society
442 Leon Ave.
Kelowna, BC
V1Y - 6J3
Phone: (250) 763-4905
Iridian Centre (formerly Youth Detox)
c/o Okanagan Families Society
1829 Chandler St.
Kelowna, BC
V1Y - 3Z2
Phone: (250) 763-0456
Keremeos/Princeton Alcohol & Drug Services
700 - 3rd St.
Keremeos, BC
V0X - 1N0
Phone: (250) 499-3049
Lillooet Friendship Centre Society
PO Box 2170
Lillooet, BC
V0K - 1V0
Phone: (250) 256-4146
Lillooet (T'it'kit) Indian [Native] Band - Alcohol & Drug Abuse Program
PO Box 615
#10 Scotchman Road
Lillooet, BC
V0K - 1V0
Phone: 256-4118
Logan Lake Health Centre - Alcohol & Drug Counselling
Thompson Regional Health Board
PO Box 1089
5 Beryl St.
Logan Lake, BC
V0K - 1W0
Phone: (250) 523-9414
Lytton Drug & Alcohol Counselling Centre
Nlaka Pamux Nation Tribal Council
PO Box 430
1632 St. Georges Road, Hwy 12
Lytton, BC
V0K - 1Z0
Phone: (250) 455-2711
Lower Nicola Health Centre
181 Nawishaskin Lane
Merritt, BC
V1K - 1N2
Phone: (250) 378-4089
Freedom Quest Regional Youth Sevices
PO Box 100
Nakusp, BC
V0G - 1R0
Phone: (250) 265-3318
Freedom Quest Regional Youth Services
608B Lake St.
Nelson, BC
V1L - 4C8
Phone: (250) 352-3783
Boys & Girls Club - Oliver Office
9727 - 356th Ave.
Oliver, BC
V0H - 1T0
Phone: (250) 498-8844
Desert Sun Counselling Centre (Cross ref. Bateman House)
PO Box 1890
#2, 35041 - 99 St.
Oliver, BC
V0H - 1T0
Phone: 498-2538
Bateman House
Osoyoos, BC
Phone: (250) 495-2622
Phone: (250) 498-2538 (Oliver)
Bernie's Place
Boys & Girls Club
Families First Resource Society
1295 Manitoba St.
Penticton, BC
V2A - 4Z9
Phone: (250) 493-0512
Penticton Boys and Girls Club
245 Warren Avenue West
Penticton, BC
V2A - 7G8
Phone: (250) 487-7581
Breakaway Program for Youth
Pathways Addiction Resource Centre
#1, 996 Main St.
Penticton, BC
V2A - 5E4
Phone: (250) 492-0400 MCF
Revelstoke Drug & Alcohol Counselling Society
1200 Newlands Rd.
PO Box 5000
Revelstoke, BC
V0E - 2S0
Phone: (250) 814-2241
Salmo Community Resources Society
PO Box 39
Salmo, BC
V0G - 1Z0
Phone: (250) 357-2277
Interior Health Authority - Salmon Arm Health Unit
PO Box 627
851 - 16 St. NE
Salmon Arm, BC
V1E - 4N7
Phone: (250) 833-4100 MFC
Summerland Boys & Girls Club
PO Box 1111
9117 Prarie Valley Rd.
Summerland, BC
V0H - 1Z0
Phone: (250) 404-0440
Freedom Quest Regional Youth Services
#200, 1504 Cedar Ave.
Trail, BC
V1R - 4C6
Phone: (250) 364-0082
The Cammy LeFleur Street Clinic, North Okanagan Youth and Family Services Society
2900 - 32nd Ave.
Vernon, BC
V1T - 1Y7
Phone: (250) 545-3572
First Nation Friendship Alcohol & Drug Program
2902 - 29 Ave.
Vernon, BC
V1T - 1Y7
Phone: (250) 542-5311
Vernon Boys & Girls Club
3300 - 37th Ave.
Vernon, BC
V1T - 2Y5
Phone: (250) 542-3121
Vernon Mental Health & Addictions
1440 - 14th Ave.
Vernon, BC
V1B-2T1
Phone: (250) 549-5737
Westside Youth Centre
2466 Main St.
Westbank, BC
V4T - 1Z1
Phone: (250) 768-9139
Lake Country Boys & Girls Club
Winfield and Oyama Programs
3130 Berry Rd.
Winfield, BC
V4V - 1V2
Phone: (250) 766-5277
Addictive Drug Information Council
Vancouver, BC
Phone: (604) 264-2342
www.adicbc.com
RCMP Drug Awareness Services
Vancouver, BC
Phone: (604) 264-3029
www.rcmpda.com
Narcotics Anonymous
If you think you may have a problem with drugs, phone the Narcotics Anonymous helpline at 1-604-873-1018. We can help! Anyone may join us, regardless of age, race, sexual identity, religion, or lack of religion.
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Posted: Fri Jul 23, 2010 12:55 am
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