Addictions, whether it’s substance abuse or behavioural, frequently manifest with psychiatric conditions like depression, anxiety or mood disorders. They have traditionally been treated separately.
The dual diagnosis units at Akeso psychiatric hospitals provide integrated treatment programmes taking into account that addiction and psychiatric conditions are often strongly interrelated.
“People suffering from stress, anxiety or symptoms of depression may self-medicate with drugs or alcohol.
“In the short-term, this may help 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 another addictive disorder, begin to display changes in their behaviour, neglect their responsibilities and are unable to function in their daily lives.”
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, making them unmanageable.
“It is a chicken and egg scenario, irrespective of which came first. Both the addiction and the mental illness contribute to a destructive cycle. We find that a holistic treatment approach, addressing 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 addictions and co-morbid psychiatric conditions. The team includes psychologists, psychiatrists, occupational therapists, an addiction counsellor, a general practitioner and a social worker, if required.
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.
“There are also a range of other addictive disorders that can have devastating consequences if not addressed. Our programme also assists those with gambling, sex or pornography addiction and we’re also increasingly seeing patients addicted to online gaming.”
It is also possible to develop an addiction to legal medication, such as codeine, which is in over-the-counter painkillers, sleeping pills, or benzodiazepines, which are prescription tranquillisers.
Deiner suggests seeking help if you notice any of the following:
- Your life becomes unmanageable. Work and relationships are negatively affected.
- Preoccupation with addictive substance or behaviour.
- Feeling anxious or stressed about not having access to the addictive drug or activity.
- Justifying “need” for addictive substance or behaviour.
- Failing to cut down use of the substance or the behaviour