Differential
Diagnosis:
Mental Health Disorders vs Substance Abuse
In
many instances those abusing substances compromise their mental health or
realize symptoms common among mental health disorders. Excessive use of varying drugs or alcohol may
induce any number of these (Butcher, Mineka, & Hooley, 2010). As a practitioner, one must consider the
signs, symptoms, and affects of these phenomenon when assessing and treating
clients.
For instance,
alcohol abuse is prone to promote personality disorders such as depression,
delirium, or anxiety. Furthermore,
victims are susceptible to suicide, self-harm, psychosis, stomach pains,
cirrhosis of the liver, malnutrition, chronic fatigue, oversensitivity, or
behavior modifications. In addition,
signs of alcoholism include (a) repeatedly neglecting responsibility, (b)
drinking when it may be physically dangerous, (c) having legal issues as a
result of drinking, (d) drinking ruining personal relationships, and (e)
drinking to relax (Smith, Robinson, & Segal, 2012).
Next,
opium causes delirium, anxiety, hallucinations, and manic reactions. Additionally, abusers may suffer from
cardiovascular issues. Those abusing opium
may experience mood swings, depression, tension, insecurity, inadequacy,
problematic relationships, or impulsiveness (Butcher, Mineka, & Hooley,
2010).
Another
drug which compromises mental health is cocaine. Users may experience cognitive
impairment. Furthermore, during
treatment victims are susceptible to tension and depression. Common factors associated with cocaine usage
are hallucinations, acute schizophrenia, or apprehensiveness. Furthermore,
the subject may have employment, family, psychological, and legal issues
(Butcher, Mineka, & Hooley, 2010).
Lastly,
marijuana smokers are liable to suffer from short-term memory impairment, mood
swings, paranoia, anxiety, hallucinations, delusions, or depression. Symptoms of marijuana abuse include increased
heart rate, reduced reaction time, contraction of the pupils, bloodshot eyes,
dry (cotton) mouth, or increased appetite (Butcher, Mineka, & Hooley, 2010).
As a practitioner, one must realize that the
previously mentioned occurrences frequently run concurrent to mental health
disorders. Hence, researchers suggest
“there is a need to focus more intently on mental health issues…given that
mental health disorders are often comorbid with substance use” (Coleman-Cowger,
2012, p. 345). Furthermore, “substance use
disorders represent the most frequently occurring mental health problem. The prevalence of problematic alcohol / drug
use is reliably higher in health care delivery settings than in the general
population” (Miller & Brown, 1997, p. 1269). Thus, much of the research offered on the
topic appropriately suggests utilizing risk or comprehensive, structured intake
assessments in effort to determine what substances, if any, the subject is
abusing. For instance, criminal
offenders are often evaluated using the quadrants of care model. This tool determines the severity of mental
health and substance levels within subjects, separating mild and severe cases
(Ruiz, Douglas, Edens, Nikolova, Lilienfeld, 2012). Additional research regards the manner in
which intake assessment ascertains problem identification, referral, and
treatment of individuals exhibiting alcohol and drug abuse symptoms as well
(Winters, Latimer, & Stinchfield, 2002).
Personally, in effort to provide an accurate diagnosis the utilization
of such tools would be advantageous. Addressing
and evaluating the client’s reasons for seeking professional assistance,
present life conditions, health history, and actual drug history enables the
practitioner to familiarize themselves with the client’s situation, start to
determine the client’s needs, and acclimate the client to treatment (Seligman &
Reichenberg, 2009).
References:
Butcher, J.N., Mineka, S., &
Hooley, J.M. (2010). Abnormal psychology (14th ed.).
Boston: Allyn & Bacon.
Coleman-Cowger, L.H. (2012). Mental
health treatment need among pregnant and
postpartum
women / girls entering substance abuse treatment. Psychology of
Addictive Behaviors, 26(2),
345-350.
Miller, W.R. & Brown, S.A.
(1997). Why psychologists should treat alcohol and drug
problems.
American Psychologist, 52(12),
1269-1279.
Ruiz, M.A., Douglas, K.S., Edens, J.F., Nikolova, N.L.,
& Lilienfeld, S.O. (2012).
Co-occurring
mental health and substance use problems in offenders:
Implications
for risk assessment. Psychological
Assessment, 24(1), 77-87.
Seligman,
L. W. & Reichenberg, L. W. (2009). Theories of counseling and
psychotherapy:
Systems, strategies, and skills (3rd ed.). Boston: Pearson.
Smith, M,
Robinson, L., & Segal, J. (2012). Alcoholism and alcohol abuse: signs,
symptoms, and help
for drinking problems. HelpGuide.org.
Retrieved from
Winters, K.C., Latimer, W.W., &
Stinchfield, R. (2002). Clinical issues in the assessment
of
adolescent alcohol and other drug use. Behaviour Research and Therapy,
40(12), 1443.
