Addiction to Comorbidities – Dr. J Graces

Addiction to Comorbidities – Dr. J Graces

The high comorbidity between psychiatric conditions and substance abuse necessitates screening for substance use disorder in patients entering psychiatric treatment. Equally, those who present with substance use disorder should also be screened for other psychiatric disorders due to the relationship between the two. However, it is important to note that the renowned comorbidity between substance abuse and other psychiatric illnesses does not mean one leads to the other (National Institute on Drug Abuse, 2020). In this assignment, I will consider a hypothetical patient, Dennis, diagnosed with major depressive disorder and alcohol use disorder. Genetic, environmental, and neural underpinnings for the comorbid disorders are outlined below.

Genetic, Neural, and Environmental Underpinnings

Dennis’ family has a history of major depressive disorder, and this, therefore, genetically predisposes Dennis to major depressive disorder. His alcoholism nature that has led to the diagnosis of alcohol use disorder has a possible origin in genetic predisposition as well as environmental factors such as exposure to alcohol during his upbringing by his parents, who had alcohol use disorder.

In the case of major depressive disorder, there are neural underpinnings that emanate from the impaired regulation of hormones responsible for the normal functioning of the body. These hormones include serotonin, dopamine, and norepinephrine, which are responsible for regulating important functions of the body, such as sleep and wake patterns, mood regulation, addiction, and appetite. In this case, serotonin is responsible for sleep and wake patterns, and its alteration leads to depression. Similar to major depressive disorder, alcohol use disorder involves the alteration of the reward system controlled by dopamine. This alteration potentiates the urge to alcoholism despite being aware of the consequences of alcoholism (McHugh & Weiss, 2019).

When the two disorders occur, as in this case, the symptoms are more complicated and hence overburden the treatment. For example, alcoholism worsens depression symptoms and also interferes with the effectiveness of the therapeutic drugs. Untreated depression may also cause alcoholism. Furthermore, genetic vulnerabilities and environmental factors may lead to the development and maintenance of the disorders.

Treatment Approach

In this case, an integration of pharmacotherapy and other therapies during treatment is vital to address both depression and alcohol use disorder. This is because the treatment of one disorder and looking down on the other will lead to obvious relapse. In Dennis’ case, my suggested treatment approach would involve a regimen that includes depression management medications such as selective serotonin reuptake inhibitors, serotonin, and norepinephrine reuptake inhibitors, and also atypical antidepressants along with other therapies such as cognitive-behavioral therapy, motivational enhancement therapy, marital and family counseling as well as brief interventions. These will help address the negative thought patterns and develop coping skills. For the management of alcohol use disorder, there should be involvement of detoxification medications such as disulfiram, naltrexone, and acamprosate (Medline Plus, 2019).

Feedback

Mental illness disorders have been proven to have their comorbidity impacted by genetic, neural, and environmental factors. For instance, the environment plays a big role in susceptibility to substance use disorders due to the availability of the substance as well as learning from the environment. Secondly, during the treatment approaches, the two conditions should be managed concurrently to enhance the effectiveness of the approach. In the implementation of the treatment plan, the patient may experience withdrawal symptoms, but this can be overcome by linking them to support groups.

References

McHugh, R. K., & Weiss, R. D. (2019). Alcohol use disorder and depressive disorders. Alcohol Research: Current Reviews, 40(1). https://doi.org/10.35946/arcr.v40.1.01

Medline Plus. (2019). Alcohol use disorder (AUD) treatment. Medlineplus.gov; National Library of Medicine. https://medlineplus.gov/alcoholusedisorderaudtreatment.html

National Institute on Drug Abuse. (2020, April). Why is there comorbidity between substance use disorders and mental illnesses? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders/why-there-comorbidity-between-substance-use-disorders-mental-illnesses

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From NU-652-101 Psychiatric Mental Health Nurse Practitioner (PMHNP) II
Explain why patients entering treatment for a psychiatric/mental illness should be screened for substance use disorder and vice versa.

Addiction to Comorbidities – Dr. J Graces

Provide a clear example (hypothetical) of a substance use disorder and a specific mental health disorder. In your example, explain genetic, neural, and environmental underpinnings for the co-morbid disorder(s). Explain the integrated approach to treatment for this patient and why this is important. As usual, provide feedback to your peers.