- autumn rae florimbio
Autumn Rae Florimbio
Dr. Autumn Rae Florimbio received her doctoral degree in clinical psychology from the University of Tennessee, Knoxville. During her clinical studies, Dr. Florimbio was trained in the treatment of substance use disorders and completed a rotation in the substance use disorders clinic at the Ann Arbor VA Healthcare System. Prior to her doctoral training, she earned her master’s degree in psychology with a focus on substance use treatment. As a postdoctoral fellow at the University of Michigan, Dr. Florimbio conducts research focused on risk and protective factors related to the co-use of substances to inform intervention development. She is passionate about providing accurate information to reduce stigma around substance use and behavioral health.
Recent contributions of Autumn Rae Florimbio
Alcohol and Drug Addiction Withdrawal
Published on February 10, 2019 Updated on December 19, 2022Substance use disorder, or addiction, is a chronic disease characterized by the compulsive use of substances despite experiencing significant negative consequences.1The continued use of drugs or alcohol over time changes the brain’s functioning and reinforces substance using behavior.2 This can make it difficult for people to stop using substances, as when one stops taking substances or significantly reduces their intake, they may experience uncomfortable withdrawal symptoms.1,4 These withdrawal symptoms can make it difficult to quit using substances. Luckily, effective detox treatment exists to help you overcome withdrawal symptoms and begin working towards recovery. What is Withdrawal? Withdrawal is the physiological manifestations of dependence after a substance has been removed.16 In other words, the physical, affective, and cognitive symptoms that occur after chronic use of a substance that was present in the body is reduced or eliminated.1 Each type of substance has its own set of symptoms that characterize the withdrawal syndrome for that particular type of substance.1The symptoms that occur often cause distress and may include unpleasant and, in the case of certain substances, life-threatening physiological symptoms.1,4 [accordion title="Other Withdrawal Questions"] What is Post-Acute Withdrawal Syndrome (PAWS)? How Long Does Withdrawal Last? [/accordion] Alcohol Withdrawal Alcohol withdrawal is a manifestation of alcohol dependence and occurs when someone discontinues or significantly decreases their alcohol intake, especially after a period of prolonged heavy alcohol use.3 Symptoms of alcohol withdrawal may be mild, such as restlessness, stomach discomfort, or headache; or moderate, such as shakiness, insomnia, and increased sensitivity to light, sound, and touch. Severe symptoms of alcohol withdrawal are experienced by less than 10% of individuals and may include seizures and a constellation of symptoms known as delirium tremens.1,3 Severe symptoms of alcohol withdrawal can be life-threatening and require medical attention, so people at risk of experiencing severe alcohol withdrawal symptoms can benefit from medical detox services. Medical detox refers to interventions aimed at reducing harm and the adverse health consequences associated with severe withdrawal symptoms. It may include monitoring a person’s symptoms and overall health and administering medications.3, 4 If moderate to severe alcohol-related withdrawal symptoms are not treated, there is a possibility that seizures or delirium tremens, a form of severe alcohol withdrawal, will occur.5 The single best predictor that a person will experience severe withdrawal symptoms is if they have already experienced alcohol withdrawal seizures as a result of previous withdrawal.4 Symptoms of Alcohol Withdrawal Alcohol withdrawal symptoms can appear as soon as 6 hours after someone has had their last drink, and may include the following:1, 2, 4 Sweating. Increased heart rate. Shakiness or tremors of the hands. Sleep difficulties. Nausea or vomiting. Hallucinations (e.g., seeing, hearing, or feeling things that are not there). Restlessness. Anxiety. Seizures. Delirium tremens is a severe state of alcohol withdrawal with accompanying delirium (significant changes in cognition, awareness, and changes in consciousness) and is characterized by significant confusion and agitation, extremely high body temperature, tachycardia (or fast heart rate), and hallucinations (visual, tactile, or auditory).5 Benzodiazepine Withdrawal Benzodiazepines are a class of CNS depressants substances that are primarily prescribed to treat anxiety and insomnia.6 Benzodiazepines and other CNS depressants calm an overly excited central nervous system functioning, resulting in decreased alertness, slowed breathing, and decreased blood pressure.7 Long-term, regular use of benzodiazepines, even when used as directed by a doctor, may result in needing to take higher doses to feel the effects of the drug. Continued use can lead to dependence, which manifests as withdrawal symptoms.6 As with alcohol, which is also a CNS depressant, benzodiazepine dependence can result in dangerous, life-threatening withdrawal symptoms, including the potential for seizures, when a person stops using them or significantly reduces their dose.8 A person at risk of experiencing moderate to severe benzodiazepine withdrawal symptoms can benefit from medical detox.4 Symptoms of Benzodiazepine Withdrawal Benzodiazepine withdrawal symptoms vary based on typically depends on the type of benzodiazepine that they were taking.1 The length of time benzos were taken for and the dosages taken may also influence the severity of potential withdrawal symptoms.1 Withdrawal symptoms may appear within 6 to 8 hours following a reduction of benzodiazepines symptoms may not appear for approximately 1 week.1 Symptoms of benzodiazepine withdrawal may include the following:1, 8 Increased heart rate or palpitations. Sweating. Hand tremors. Nausea or vomiting. Anxiety. Hallucinations. Delusions. Seizures. Dizziness. Confusion or disorientation. Restlessness. Irritability or agitation. Heroin and Opioid Withdrawal Opioid medications are prescribed for moderate to severe pain relief.9 They are powerful medications for pain relief but can also induce feelings of euphoria at high doses. Heroin is an illicit opioid with similar properties and effects but currently has no medical use in the U.S Opioids can produce uncomfortable, although not usually life-threatening, withdrawal symptoms when someone with an opioid dependence ceases or stops using them.4, 9 All opioids produce similar signs and symptoms, but there can be a great deal of variance in the severity of the symptoms, the onset of the symptoms, and the duration of the symptoms depending on the opioids used.4 Additional factors that can influence opioid withdrawal symptoms involve the amount of time the substance was used, how much the substance was used, and the time between doses.4 Medical detox may be beneficial for those struggling with opioid withdrawal, largely due to the medications that may be prescribed to help manage withdrawal symptoms.4 Methadone and buprenorphine may be prescribed to reduce physical withdrawal symptoms.10 Symptoms of Opioid Withdrawal Opioid withdrawal can vary depending on the type of opioid substance consumed, the dosages consumed, how long the opioids were being used, and how long the intervals between dosages. General timelines can also vary greatly between substances. For example, symptoms of heroin withdrawal typically begin 6 to 12 hours after last use, whereas withdrawal symptoms for some prescription opioids do not appear until 2 to 4 days after the last use.1 Symptoms of opioid withdrawal include the following:1, 4 Dysphoria. Nausea or vomiting. Muscle soreness or spasms. Watery eyes. Runny nose. Enlarged pupils. Sweating. Yawning. Insomnia. Diarrhea. Increased heart rate, blood pressure, or body temperature. Increased respiratory rate. Goosebumps. Fever. Stimulant Withdrawal Stimulants are drugs that increase activity in the central nervous system.11 Prescription stimulants can be used to treat attention-deficit hyperactivity disorder (ADHD) and certain sleep disorders like narcolepsy.11 They also come in illicit forms, such as cocaine and crystal methamphetamine.11 Effects of stimulants include improved attention and concentration, increased physical energy and mental alertness, and feelings of euphoria (or a “rush”).11 Stimulant withdrawal usually does not produce medically dangerous symptoms, but it can result in significant psychological distress, notably severe depressive symptoms.1, 4 Symptoms of Stimulant Withdrawal Symptoms of stimulant withdrawal may include the following:1, 4 Feeling tired or weak. Having vivid, distressing dreams. Sleep changes, such as sleeping too little or too much. Increased appetite. Slowed movements. Anxiety. Paranoia. Irritability. Depressed mood. Marijuana Withdrawal Cannabis (other common names include marijuana, pot, and weed) is a psychoactive substance that can alter a person’s senses, perception, and mood.12 Chronic use of cannabis can lead to the development of cannabis use disorder and addiction.12 People who use cannabis for a long duration may find it difficult to reduce or quit their cannabis use as a result of withdrawal symptoms.12 Symptoms of Marijuana Withdrawal Cannabis withdrawal symptoms generally occur 24 to 72 hours after the last use and last approximately 1-2 weeks; however, sleep disturbances may last for a month or more.1 Symptoms of cannabis withdrawal syndrome include the following:1, 12 Feeling irritable, angry, or aggressive. Anxiety or increased nervousness. Depressed mood. Sleep difficulties, including insomnia or having distressing dreams. Eating less or weight loss. Agitation or restlessness. At least one uncomfortable physical symptom, including headache, stomach or abdominal pain, shakiness, fever, chills, or sweating. [vob-aktify-cta title="American Addiction Centers accepts many types of insurance" subtitle="Check your coverage online or text us your questions for more information"] What is Drug Detox? Detoxification, commonly referred to as “detox”, is the elimination of a substance from the body, and professional detox programs are available to help medically manage the acute and potentially dangerous withdrawal symptoms when someone stops using drugs or alcohol.14 Medically managed detox is an important first step in substance use treatment. Alone, it is not typically sufficient to support long-term abstinence. Residential, inpatient, outpatient, and aftercare rehab treatment that includes individual or group counseling and medication management can give people the skills and support they need to achieve lasting recovery.14,15 If you’re looking for drug or alcohol detox or rehab, there are options available to you. The SAMHSA treatment locator is a powerful tool that can help you find nearby or out-of-state detox and rehab facilities. You may also consider calling AAC’s addiction helpline. Our professionally staffed helpline can help you find answers about the detox process, locate nearby rehab facilities, and verify your insurance coverage for detox treatment. Don’t delay critical care; call us today at [phone]. [accordion title="Rehab at American Addiction Centers"] Laguna Treatment Hospital Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks [/accordion][accordion title="Rehab insurance coverage"] Aetna Ambetter American Family AmeriHealth Anthem Beacon BHO Blue Cross Blue Shield Cigna Connecticare Geisinger HCSC Harvard Pilgrim Health Plan of Nevada Highmark Humana Kaiser Permanente Magellan Magnacare Meritain Health Medicare and Medicaid Optum Oxford Health Providence Qualcare Sierra Health Tricare Triwest Tufts United Healthcare UPMC Zelis [/accordion][accordion title="Rehab near me"] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming [/accordion][accordion title="Rehab"] Choosing a rehab center Couples rehab Court ordered rehab COVID-19 and rehab Dual-diagnosis rehab Deciding you need rehab Helping a loved one go to rehab Preparing for rehab State-funded rehab Teen rehab Veterans rehab [/accordion][accordion title="Detox"] 24/7 detox hotlines Inpatient detox Outpatient detox Dangers of detoxing at home The cost of detox [/accordion] [sources] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, Fifth edition (DSM-5). Arlington, VA: American Psychiatric Association. National Institute on Drug Abuse. (2020, July 13). Drug misuse and addiction. Newman, R. K., Stobart Gallagher, M. A., & Gomez, A. E. (2021). Alcohol withdrawal. Treasure Island (FL): StatPearls Publishing. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006. Rahman, A. & Paul, M. (2021). Delirium tremens. Treasure Island (FL): StatPearls Publishing. National Institute on Drug Abuse. (2018, March). Prescription CNS Depressants DrugFacts. National Institute on Drug Abuse. (2020, August 20). Commonly used drug charts: Central nervous system depressants (benzos). Brett, J. & Murnion, B. (2015). Management of benzodiazepine misuse and dependence. Australian Prescriber, 38(5), 152–155. National Institute on Drug Abuse. (2021, June 1). Prescription opioids DrugFacts. Substance Abuse and Mental Health Services Administration. (n.a.). TIP 63: Medications for Opioid Use Disorder. National Institute on Drug Abuse. (2018, June 6). Prescription stimulant DrugFacts. National Institute on Drug Abuse. (2019, December 24.) Cannabis (marijuana) DrugFacts. Bonnet, U. & Preuss, U. W. (2017). The cannabis withdrawal syndrome: Current insights. Substance Abuse and Rehabilitation, 8, 9–37. National Institute on Drug Abuse. (2020, June 3). Types of treatment programs. National Institute on Drug Abuse. (2019, January 17). Treatment approaches for drug addiction DrugFacts. Recovery Research Institute. (n.a.). [/sources] ...
Read moreMethadone Withdrawal and Treatment
Published on February 10, 2019 Updated on September 07, 2022Methadone is a synthetic, long-acting opioid medication that may be prescribed to help manage symptoms of opioid withdrawal and treat opioid use disorder (OUD).1 Methadone is one of two opioid agonist medications approved for OUD treatment, and has been used in treating opioid addiction for over 40 years.3 When taken as prescribed, methadone is effective and safe as a treatment medication for opioid use disorder (MOUD).1 However, it is possible to misuse methadone,4 such as taking more than prescribed, in a way other than prescribed, or with the intent to get high.5 Understanding what methadone is, how it can be used to aid recovery, and how misuse could lead to addiction can help you achieve and maintain recovery. What is Methadone? Methadone, like many other opioid medications, was initially prescribed for pain management but has since been approved and primarily used for treating opioid addiction.6 In OUD treatment, methadone can be used to reduce opioid cravings, mitigate withdrawal symptoms, and blunt the effects of any other opioids misused while on treatment.4 Several studies show that methadone can be effective in treating opioid use disorder when taken as prescribed.7 When compared with patients who received a placebo and psychosocial treatment, those who were prescribed methadone (combined with psychosocial treatment) were more likely to experience reduced rates of opioid use, infectious disease transmission, and crime.7 Additionally, those taking methadone as part of a medication treatment program were 4.44 times more likely to stay in treatment.7 Like other opioid agonists, methadone produces its effects by activating opioid receptors throughout the brain; however, relative to many other opioids, the onset and duration of methadone’s effects develop over a slower or more gradual timeframe.3 This means that a person with an OUD is unlikely to experience a rewarding euphoria or high from taking methadone at the dose prescribed to them.3 Opioid Withdrawal Symptoms Although methadone may be used to manage withdrawal from other opioids like heroin or prescription pain relievers, it is still possible for people to experience methadone withdrawal symptoms if they abruptly stop using methadone after a period of sustained use. Symptoms of methadone withdrawal are similar to many opioid withdrawal symptoms and may include:2, 8 Low or sad mood. Insomnia. Anxiety. Fast heart rate. High blood pressure and/or high body temperature. Increased breathing rate. Muscle and bone pain. Muscle spasm. Runny nose. Watery eyes. Nausea or vomiting. Diarrhea. Fever. Sweating. Chills. Goosebumps. Yawning. Dilated pupils. [self-assessment] How Long Does Opioid Withdrawal Last? Exactly when opioid withdrawal occurs and how long it lasts depends on several factors including the type of opioid used, how long it was used, and the dose used.2 Withdrawal symptoms typically last for 3–5 days for short-acting opioids like heroin and 3 weeks or more for relatively long-acting opioids like methadone.2 Opioid Withdrawal Timeline For short-acting opioids, symptoms can appear as early as 6–12 hours after a person’s last dose, peak within 1–3 days, and slowly lessen over 3–7 days.2, 8 Withdrawal symptoms associated with a longer-acting opioid like methadone may develop relatively more slowly—first emerging within 2–4 days after the last dose. 8 Methadone withdrawal may peak in severity around day 3 and typically subsides over a 3-week period. 2 Opioid Detox A supervised opioid detox may be an initial step of more comprehensive treatment for OUD.9 Medical detox and withdrawal management occurs under the supervision of a medical provider who may prescribe methadone or buprenorphine (another opioid agonist medication commonly used to treat opioid withdrawal) for a brief period to help reduce and manage opioid withdrawal symptoms.4 Because a person may experience unpleasant withdrawal symptoms, the Substance Abuse and Mental Health Services Administration advises against attempts to manage significant opioid withdrawal symptoms without medication.2 If someone is considering detoxing, people are encouraged to talk with their primary care physician or another medical professional rather than attempting to detox on their own without medical support and withdrawal symptom management. [vob-aktify-cta title="American Addiction Centers accepts many types of insurance" subtitle="Check your coverage online or text us your questions for more information"] Methadone Rehab and Treatment Though medical detox for opioid withdrawal management is an important start to recovery, it’s not a replacement for more comprehensive treatment for opioid use disorder.11 Because of this, detox is often followed by more formal assessment and referral to or continuation with additional addiction treatment efforts. An important component of any professional detox program entails readying a patient for such additional, more comprehensive substance use disorder rehabilitation. 10, 11 Common settings of care and continued treatment elements may include: Inpatient or residential: Inpatient treatment involves a patient temporarily living at a facility while receiving 24/7 addiction treatment.. As part of treatment, patients may participate in individual or group behavioral therapy and counseling to change beliefs about and behavioral patterns related to substance use.9, 10 Inpatient treatment lengths vary, but can range anywhere from several weeks to months, as needed. Outpatient: Outpatient treatment programs allow patients to live at home while still receiving treatment for opioid addiction. Various types and intensity of outpatient care may be available to you based on your needs, with may offering a similar range of services as their inpatient/residential counterparts.9 Methadone maintenance treatment may be administered on an outpatient basis, with a patient going to a specialized opioid treatment clinic to receive supervised methadone doses.3 Aftercare: A plan for continued care will commonly be made prior to completion of treatment. With various outlets of addiction aftercare available, these programs can help promote continued sobriety and reduce relapse risk by providing ongoing recovery support after completion of a treatment program.10 If you or someone you care about is struggling with methadone misuse or opioid addiction, there are resources available to you. Speaking with your primary care physician is usually a good place to start as they can provide appropriate referrals. If you are already involved in a methadone treatment program and are concerned you may be misusing methadone, talk to your provider. You can also contact American Addiction Centers (AAC) by calling the AAC addiction helpline, and our team can connect you with opioid treatment programs near you. Don’t delay the care you need, contact us today at [phone]. [accordion title="Rehab at American Addiction Centers"] Laguna Treatment Hospital Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks [/accordion][accordion title="Rehab insurance coverage"] Ambetter American Family Beacon BHO Blue Cross Blue Shield Cigna Connecticare Geisinger HCSC Harvard Pilgrim Highmark Kaiser Permanente Magellan Magnacare Meritain Health Medicare and Medicaid Optum Oxford Health Providence Qualcare Sierra Health Tricare Triwest Tufts United Healthcare UPMC Zelis [/accordion][accordion title="Rehab near me"] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming [/accordion][accordion title="Rehab"] Choosing a rehab center Couples rehab Court ordered rehab COVID-19 and rehab Dual-diagnosis rehab Deciding you need rehab Helping a loved one go to rehab Preparing for rehab State-funded rehab Teen rehab Veterans rehab [/accordion][accordion title="Detox"] 24/7 detox hotlines The cost of detox [/accordion][accordion title="Other Types of Narcotics"] Codeine Fentanyl Heroin Hydrocodone Kadian Lorcet Lortab Morphine Norco Opiates Opium Oramorph Oxycodone Tramadol [/accordion] [sources] Substance Abuse and Mental Health Services Administration. (2022, June 23). Methadone. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD. National Institute on Drug Abuse. (2021, April 13). How do medications to treat opioid use disorder work? Substance Abuse and Mental Health Services Administration. (2021). Medications for opioid use disorder. Treatment Improvement Protocol (TIP) Series 63 Publication No. PEP21-02-01-002. Rockville, MD. National Institute on Drug Abuse. (2022, March 6). Mind matters: Teacher’s guide. Institute of Medicine (US) Committee on Federal Regulation of Methadone Treatment; Rettig RA, Yarmolinsky A, editors. (1995). Federal Regulation of Methadone Treatment. Washington (DC): National Academies Press (US). National Institute on Drug Abuse. (2021, December 3). How effective are medications to treat opioid use disorder? American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, Fifth edition (DSM-5). Arlington, VA: American Psychiatric Association. National Institute on Drug Abuse. (2019, January 17). Treatment approaches for drug addiction DrugFacts. National Institute on Drug Abuse. (2020, June 3). Types of treatment programs. National Institute on Drug Abuse. (2018, January). Principles of Effective Treatment. [/sources] ...
Read moreDepression and Addiction
Published on July 07, 2022 Updated on August 17, 2022Depression is a medical condition with potentially debilitating symptoms that can impact the way a person thinks, feels, and functions in their daily life.1 When someone is depressed, they may notice a change in their interests and energy levels, and may withdraw from activities they used to enjoy.1 Furthermore, research suggests that those with depression may be more at risk of developing a substance use disorder (SUD), and vice versa, making depression a common co-occurring mental health disorder.2, 3 Dealing with either depression or substance use disorders individually can be struggle enough, but when they co-occur, it can present an increasingly challenging hurdle. Luckily, integrated treatment that treats both conditions simultaneously can increase the overall quality of care as well as improve recovery outcomes.12 Understanding what depression is, how it interacts with substance use disorder, and how to find integrated treatment can help you achieve recovery from both conditions. Other common co-occurring disorders include bipolar, anxiety, and ADHD. What Is Depression? Clinical depression is a common mental health issue that can significantly interfere with a person’s daily functioning. In 2020, approximately 21 million U.S. adults experienced at least one major depressive episode in the past year.4 While symptoms can vary greatly, depression may be characterized by symptoms such as sadness, emptiness, hopelessness, or irritability that last for more than two weeks.1, 5 The symptoms of depression can be quite debilitating. Those diagnosed with depression may find it hard to complete tasks, engage with others, get out of bed, complete daily activities, and engage in basic self-care.5 Several factors may influence a person’s risk for developing depression. Having a family or genetic history of depression, experiencing major life changes, stress, or trauma, or struggling with certain illnesses or disabilities can make depression more likely to develop.1 Types of Depression Depression may present slightly differently from one person to the next. Different types of depression include the following:1, 5, 7 Major depressive disorder (MDD) can be an incredibly debilitating condition, making it difficult to function in several areas of daily life. To meet the diagnostic criteria, one must experience several characteristic symptoms, in addition to either persistently depressed mood or a loss of interest or pleasure, within a 2 week period, with such symptoms being a change from previous levels of functioning. Persistent depressive disorder (also called dysthymia) is a type of depression that, in addition to major depressive episodes, may include episodes of relatively milder symptoms than those seen with MDD. This combination of depressive symptoms must persist for two years or more before a person receives such a diagnosis (or at least one year in children and adolescents). Depression with psychotic features is characterized by severe symptoms of clinical depression where the person also experiences symptoms of psychosis, such as hallucinations (this may include hearing or seeing things that are not there) or delusions (such as believing something despite evidence or information that suggests it is not true). Seasonal affective disorder (also commonly referred to as seasonal depression) is a form of depression that varies with the seasons. This means there are times during the year when someone is more likely to become depressed, such as during the winter months when there are fewer hours of sunlight. For many, the depression associated with seasonal affective disorder begins to resolve during the spring and summer months. Depression with peripartum or postpartum onset occurs when a woman experiences clinical depression during pregnancy (perinatal or peripartum onset) or after giving birth (postpartum onset). For depression with peripartum onset, the woman must experience symptoms during pregnancy, whereas, for postpartum onset, the woman must experience symptoms between birth and 4 weeks following delivery. Signs and Symptoms of Depression Due to the wide variance in the types of mood and depressive disorders, symptoms may present themselves differently from person to person. Though there are some commonalities in terms of changes in mood and behavior across the various conditions, the specific diagnostic criteria vary for different types of depressive disorders.7 For example, to receive a diagnosis of MDD, a person would need to experience five of the following nine symptoms during the same two week period, with at least one of these symptoms being depressed mood or loss of interest/pleasure: 5 Depressed mood daily or almost daily for two weeks. Loss of interest or pleasure in activities that were previously enjoyed. Significant, unintentional changes in body weight (e.g., a loss of more than 5% body weight without dieting), or marked changes in appetite on most days. Insomnia or hypersomnia (sleeping too much). Externally observable psychomotor agitation (repeated, purposeless movements) or retardation (unusually slowed movements) on most days. Reduced energy levels or increased fatigue. Feeling of excessive/inappropriate guilt or worthlessness. Difficulty concentrating or making decisions. Recurrent thoughts of death, suicidal ideation, or suicide attempts. The Link Between Depression and Addiction Depression and addiction may co-occur due to having shared risk factors. Though it may be difficult to determine which, if either, occurred first, nor does the co-occurrence mean that one necessarily caused the other, the presence of each condition can definitely influence the course of the other.8, 9 One theoretical explanation as to why co-occurring disorders develop is that a person may begin drinking alcohol or using other substances in an attempt to manage some of the troublesome symptoms of the comorbid mental health condition.10 In a somewhat different theoretical direction, substance use and addiction may themselves alter the way the brain in ways that make mental illness development more likely. 10 Though the precise timing and directionality and timing of the co-occurrence of depression and SUD may not always be easy to determine, it doesn’t need to be for effective treatment to commence. Individually, each condition may have separate approaches to management, however their co-occurrence calls for a comprehensive and integrated approach to the treatment of both conditions. Treating Co-Occurring Depression and Addiction An integrated approach to co-occurring disorder or dual diagnosis treatment that simultaneously addresses both disorders may improve the quality of care as well as health outcomes of those who receive such care. Some examples of the improved treatment outcomes and overall quality of life promoted by an integrated model of care include:12 Reducing or quitting continued substance use. Relief from depression and other improvements to mental health. Improved functioning in daily life. Decreased rates of hospitalization. Improved management of therapeutic medications. Greater chance for successful treatment completion and recovery for both SUD and depression. There is seldom one universal treatment experience, since effective treatment programs commonly tailor a combination of therapeutic approaches to best fit a patient’s needs. There are several types of behavioral therapies and other elements of care that can be integrated into such a tailored treatment program for managing co-occurring depression and SUD, including: There are6 Cognitive-behavioral therapy (CBT) focuses on identifying and changing unhelpful thoughts and behavioral patterns. Dialectical behavior therapy (DBT) can help teach people how to regulate their emotions, increase effective communication in relationships, tolerate distress, and practice mindfulness. This therapy can also help reduce self-harm behaviors as well as suicidal thoughts and behaviors. Motivational interviewing is a technique often used to understand a person’s desire to change and the goals they have. Motivational interviewing is effective in enhancing engagement in treatment and can increase a person’s confidence in their ability to change. This approach can be used to elicit behavior changes in a person with co-occurring depression and addiction.14 Pharmacological treatment involves the use of medications to manage symptoms. Some antidepressants may result in reduced depressive symptoms and substance use behaviors among people with co-occurring depression and SUD.13 Oftentimes, medications for addiction treatment (MAT) are paired with counseling and therapy to maximize their effectiveness. Mutual support programs are group-based and include groups focused on co-occurring disorders. Some examples include Dual Disorders Anonymous, Dual Recovery Anonymous, Dual Diagnosis Anonymous, and Double Trouble in Recovery.14 [vob-aktify-cta title="American Addiction Centers accepts many types of insurance" subtitle="Check your coverage online or text us your questions for more information"] Finding Depression and Addiction Treatment Near Me If you’re seeking recovery from substance use disorder and depression, there are several steps you can take to find a dual diagnosis treatment program near you. It may be helpful to first consult with a doctor or other trusted medical professional regarding your recovery needs and treatment options. The Treatment Locator is a helpful tool made available by the Substance Abuse and Mental Health Services Administration. This tool can help you find treatments for specific conditions by location and learn more about the treatment options available. Addiction helplines, including the one owned and operated by American Addiction Centers (AAC), are another resource. Our admissions navigators stand ready to help answer any questions you may have about depression, addiction, or finding treatment. If you’re ready to start your journey to recovery, reach out to us today at [phone]. [accordion title="Rehab at American Addiction Centers"] Laguna Treatment Hospital Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks [/accordion][accordion title="Rehab insurance coverage"] Ambetter American Family Beacon BHO Blue Cross Blue Shield Cigna Connecticare Geisinger HCSC Harvard Pilgrim Highmark Kaiser Permanente Magellan Magnacare Meritain Health Medicare and Medicaid Optum Oxford Health Providence Qualcare Sierra Health Tricare Triwest Tufts United Healthcare UPMC Zelis [/accordion][accordion title="Rehab near me"] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming [/accordion][accordion title="Rehab"] Choosing a rehab center Couples rehab Court ordered rehab COVID-19 and rehab Dual-diagnosis rehab Deciding you need rehab Helping a loved one go to rehab Inpatient rehab Outpatient rehab Preparing for rehab State-funded rehab Teen rehab Veterans rehab [/accordion][accordion title="Detox"] Detox 24/7 detox hotlines Inpatient detox Outpatient detox Medical detox Dangers of detoxing at home The cost of detox [/accordion] [sources] National Institute of Mental Health. (2018, February). Depression. Hides, L., Quinn, C., Stoyanov, S. Kavanagh, D., & Baker, A. (2019). Psychological interventions for co‐occurring depression and substance use disorders. Cochrane Database of Systematic Reviews. Substance Abuse and Mental Health Services Administration. (2022, April 21). Co-occurring disorders and other health conditions. Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, Fifth edition (DSM-5). Arlington, VA: American Psychiatric Association. National Institute of Mental Health. (2021). Chronic illness and mental health: Recognizing and treating depression. National Institute of Mental Health. (2021). Depression. National Institute on Drug Abuse. (2018, August 1). Comorbidity: Substance use disorders and other mental illnesses DrugFacts. World Health Organization. (2022, June 8). Mental disorders. Turner, S., Mota, N., Bolton, J., & Sareen, J. (2018). Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and Anxiety, 35(9), 851–860. National Institute on Drug Abuse. (2020, July 13). Drug misuse and addiction. Substance Abuse and Mental Health Services Administration. (2022, June 27). The case for screening and treatment of co-occurring disorders. Igbal, M. N., Levin, C. J., & Levin, F. R. (2019). Treatment for substance use disorder with co-occurring mental illness. Focus: The Journal of Lifelong Learning in Psychiatry, 17(2), 88–97. Substance Abuse and Mental Health Services Administration. (2020). Substance use disorder treatment for people with co-occurring disorders. Treatment Improvement Protocol (TIP) Series, No. 42. SAMHSA Publication No. PEP20-02-01-004. Rockville, MD: Substance Abuse and Mental Health Services Administration. [/sources] ...
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