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Affective or mood disorders constitute a group of mental health disorders that frequently affect the person’s affect or mood. These include Bipolar I and II, major depressive disorder, and cyclothymia. When these disorders occur in a person with a diagnosable substance use disorder, they are referred to as co-occurring disorders. Co-occurring disorders can sometimes be difficult to diagnose. Symptoms of a Substance Use Disorder can mask symptoms of mental illness, and symptoms of mental illness can be confused with symptoms of a Substance Use Disorder. People with mental health disorders sometimes do not address their substance use because they don’t believe it is relevant to their problems. The substance abuse counselor must thus be aware of the most frequently occurring mental health disorders. Likewise he or she must be aware of the pharmacokinetics and pharmacodynamics of the drugs commonly used to treat these disorders.
A relatively high percentage of patients with a substance use disorder will also present with a co-occurring anxiety disorder regardless of their drug of choice. Anxiety is the “fight or flight” response to danger. It allows a person to deal with something that is perceived as a threat. It is necessary for survival. But when anxiety is triggered unnecessarily, continues beyond the immediate threat, or causes a person to restrict his or her life, it may develop into a disorder. The most common anxiety disorders are generalized anxiety disorder, social phobia, specific phobia, obsessive-compulsive anxiety disorder, and post-traumatic stress disorder. The substance abuse counselor should be aware of the pharmacokinetics and pharmacodynamics of drugs utilized to treat these disorders since many of them, especially the short-acting benzodiazepines, have high tolerance and withdrawal liabilities.
Schizophrenia, also known as Psychotic Disorders or Thought Disorders, is a group of heterogeneous severe mental illnesses that are not only devastating to the patients but also carry a relatively poor prognosis. The rates of harmful substance use in this patient population are astronomical, as high as 75% in some cases. While medications utilized to treat these disorders possess no tolerance or withdrawal liability, they are fraught with side effects. Since many substance abuse counselors will deal with these patients, it is necessary for them to gain a rudimentary knowledge of the pharmacokinetics and pharmacodynamics utilized to treat these disorders.