Addiction and mental health “strongly interrelated”

Patient outcomes tend to improve when treated in tandem

Tuesday, July 2 2019

Addiction, whether involving substance abuse or behavioural addictions, frequently manifest together with psychiatric conditions such as depression, anxiety or mood disorders. They have, however, traditionally been treated separately. The dual diagnosis units at Akeso psychiatric hospitals provide integrated treatment programmes that take into account that addiction and psychiatric conditions are often strongly interrelated.

“People suffering from stress, anxiety or symptoms of depression may try to ‘self-medicate’ with drugs or alcohol in an attempt to feel better. In the short-term this may help to mask the symptoms of a mental health condition but ultimately it fuels addiction and makes the condition worse,” says clinical psychologist, Janine Deiner, who practises at Akeso Alberton.

“The reverse is also observed, where people who have a drug or alcohol dependency, or other addictive disorder, begin to display changes in their behaviour, neglect their responsibilities and are unable to function in their daily lives,” adds Deiner.

Pic: Akeso Alberton general manager, Gathlyn Watkins (left), and clinical psychologist, Janine Deiner (right) who practises at Akeso Alberton. The psychiatric hospital has a dual diagnosis unit that provides integrated treatment programmes as addiction and psychiatric conditions are often strongly interrelated.

She explains that such changes are broadly characteristic of symptoms associated with certain mental health conditions, and often it is difficult to separate the effects of the addiction from those of underlying mental health issues. Also, drugs may exacerbate anxiety or mood disorders to the point where they become unmanageable.

“It is something of a ‘chicken and egg’ scenario, irrespective of which came first. Both the addiction and the mental illness contribute to a destructive cycle. We consequently find that a holistic treatment approach, which seeks to address both the addiction and the mental health problems in tandem, tends to offer better patient outcomes.”

The dual diagnosis unit at Akeso Alberton runs a 21-day in-patient programme for individuals with various types of addiction and co-morbid psychiatric conditions. The multi-disciplinary team includes psychologists, psychiatrists, occupational therapists, an addictions counsellor, a general practitioner and a social worker, where required, who work closely together to provide comprehensive treatment.

Deiner adds that many of the substances people become addicted to can interfere with the effects of prescribed psychiatric medications. Alcohol, for example, may counteract the benefits of antidepressant medication as it is a central nervous system depressant.

“While many people understand addiction to mean dependence on drugs or alcohol, there are also a wide range of other addictive disorders that can have devastating consequences if they are not addressed. Our programme also assists those grappling with gambling, sex or pornography addiction, and we are also increasingly seeing patients who are addicted to online gaming.”

It is also possible to develop an addiction to ‘legal’ medication, such as codeine, which is found in over-the-counter painkillers, sleeping pills, or benzodiazepines, which are prescription tranquilisers.

“While the individual may begin using these substances on the advice of a healthcare professional, it is all too common for the person to develop a tolerance for the medication, which means they need to take more and more to get the same effect. In time, they may find they cannot function normally without taking the medication.”

According to Deiner, people often have difficulty realising that they are in the grip of a potentially devastating addiction, and therefore delay seeking treatment. She suggests seeking help if you notice any of the following:

  • Your life becomes unmanageable. This can manifest in many different ways, but typically negatively affects work performance and social or family relationships.
  • A preoccupation with the addictive substance or behaviour, particularly if it consumes a considerable amount of your time and energy.
  • Feeling anxious or stressed about the prospect of not having access to the addictive drug or activity.
  • Justifying why you “need” to partake in the addictive substance or behaviour, for example “It’s been a stressful day, I need a joint to unwind”.
  • Failed attempts to cut down or control use of the substance or the behaviour.

“We are seeing improved outcomes in our dual diagnosis unit, when compared with traditional addiction rehabilitation programmes. It is essential, however, for the patient to realise that recovery from addiction is a lifelong process that requires long-term commitment,” she adds.

A medical doctor examines each person on admission, and a specialist psychiatrist supervises all medication. Patients benefit from one-on-one sessions with mental health professionals and experienced addiction counsellors, who have themselves been through addiction recovery, as well as from group therapy sessions.

“The programme aims to equip individuals with the necessary skills for sustained behavioural change to help break the cycle of addiction, as well as the treatment, therapy and support required to manage mental health conditions on an on-going basis.

“Social and family support is extremely important, especially once the person leaves our care and continues their recovery at home. We provide follow-up support, including family meetings that are hosted monthly, where the individual and their family members receive support and are equipped with skills to cope with the recovery process.”

Akeso Alberton hospital manager, Gathlyn Watkins, says the treatment provided in the dual diagnosis unit is helping many individuals and families to rebuild their lives.

“Addiction can seem like an insurmountable problem, and many people who turn to us for help have all but given up hope. Breaking addiction is not an easy journey, but it is possible with the right support. Thanks to our multi-disciplinary approach, the root causes of addiction can be effectively addressed and individuals can be empowered to regain control over their lives,” Watkins concluded.

Ends

Issued by:           MNA on behalf of Akeso Alberton
Contact:               Martina Nicholson, Graeme Swinney and Meggan Saville
Telephone:        (011) 469 3016
Email:                   martina@mnapr.co.za, graeme@mnapr.co.za or meggan@mnapr.co.za