Recovery Corner with Jamie Smolen, MD
Recognizing when a loved one is in trouble
With the holiday season upon us, we may be gathering with friends or family members. And during those gatherings, we may notice new or alarming behaviors related to their mental and physical health. While this time of year is often a time for celebrating, reflecting and enjoying life’s bounty, it can also a time for all of us to be aware and concerned if any of our loved ones are in trouble.
Several tragic and unbelievable events have happened across the country throughout the last year. Our awareness of our surroundings and the people around us should be at an all-time high. Some concerning changes to watch for include:
- Persistent sad, anxious or “empty” mood
- Feelings of hopelessness, pessimism
- Feelings of guilt, worthlessness, helplessness
- Insomnia, early-morning awakening or oversleeping
- Low appetite and weight loss or overeating and weight gain
- Thoughts of death or suicide
- Restlessness, irritability, violent outbursts
- Unusual or unexplained need for money; borrowing, stealing
- Changes in relationships, friends, hangouts or hobbies
- Deterioration in personal appearance or grooming habits
These changes could signal one or more mental illnesses, including addiction. Thanks to neuroscience and decades of substantiated research, we know that addiction is classified as a mental illness. We also know, from similar research, that there is a correlation between addiction and other mental illnesses. It is not uncommon for someone to be diagnosed with addiction in addition to another mental illness. This is called dual diagnosis or comorbidity.
The brain disease of addiction is complex. Addiction affects pleasure and reward circuits and pathways in the brain responsible for obsessive thoughts about alcohol and drug use. An addict’s brain can be temporarily or permanently altered by drug or alcohol use, and sometimes this alteration disrupts normal brain function. When the brain stops behaving normally, a person may suffer from other mental illnesses like depression, anxiety or schizophrenia.
Scientists have found that there is a high rate of comorbidity involving drug addiction, alcoholism and mental illness. When a person suffers from two or more mental illnesses, it may be difficult to pinpoint an accurate diagnosis, and the likelihood of getting better is hard to predict.
When someone is addicted to drugs or alcohol, his or her brain is exposed to stress and trauma, which can cause symptoms related to other mental illnesses, including depression or anxiety. However, the reverse also is true. Someone who suffers from the diseases of depression or anxiety might turn to drugs or alcohol to self-medicate, to get high or to simply run from symptoms of those diseases.
Research shows that people diagnosed with mood or anxiety disorders are about twice as likely to suffer from addiction compared to the general population. Likewise, those diagnosed with a drug use disorder are about twice as likely to suffer from a mood and anxiety disorder. It’s also worth noting that rates of addiction are higher in males. Men are also more likely to suffer from antisocial personality disorder. Women tend to have higher rates of mood and anxiety disorders, which also puts them at risk to abuse substances.
Proper treatment for a mood disorder can reduce the risk of developing subsequent drug and alcohol use. And a diagnosis and proper treatment of alcohol and drug use disorders may reduce the risk of developing mental illnesses.
Hopefully, family and friends will enjoy themselves this holiday season, but be aware. Be vigilant of those around you. And if you see anything that concerns you, talk to your loved ones and friends about how to address the issue. Most of us want only the best for our friends and family. If you suspect someone is dealing with a serious mental problem or with an addiction to drugs or alcohol, speak up. Speaking up is one of the most thoughtful and loving things you can do. Offer support and resources and urge them to seek appropriate care from a professional.
Jamie Smolen, M.D., is an associate professor in the department of psychiatry at the University of Florida College of Medicine. He practices psychiatry and addiction medicine at the UF Health Florida Recovery Center. Smolen is an evaluator for the Florida Professionals Resource Network, Intervention Project for Nurses and the Florida Department of Health. Smolen’s consulting expertise has also been sought by several Major League Baseball teams and the National Football League. He has fulfilled an important role in the successful treatment of many impaired health care providers and professional athletes.