Introduction
A substance induced mood disorder is a mood disorder triggered by substance abuse (street drug, alcohol or medication) or where this mood disorder occurs when such a substance is terminated.
A few examples are as follows: the antihypertensive medication alpha-methyldopa has been linked to depression, particularly if it occurs in a patient who never was depressed before. Ritalin, steroids, antidepressants or anti-Parkinson disease medications can induce acute manic depression symptoms as side effects (Ref. 2). During alcohol withdrawal, withdrawal from cocaine, sedatives, amphetamines, anxiolytic medications, sleeping pills and others severe mood disturbances can occur as well. There are long lists of medications that can lead to substance induced mood disorders.
Things can really get complicated when a depressed patient attempts suicide with an overdose of one of these drugs that can produce a drug induced psychosis. In recent times many teenagers have experimented at rave parties with crystal meth. Parents may want to read this article by Dr. Milan Njegovan below for some background on the effects of crystal meth and what treatment is available.
Treatment
The physician needs to the detoxify and flush the stomach to remove the drug and at the same time treat the psychosis with an antipsychotic medication. Generally speaking the treatment for a drug induced mood disorder is to remove the drug. However, often a depression has to be treated with one of the SSRI antidepressants. It is important to involve a psychiatrist and/or psychologist well versed in street drug effects. Cognitive therapy and behavior modification may also be useful.
Tips for Parents: Warning Signs That Your Child May Be Using Crystal Meth
By: Milan Njegovan, Ph.D., Addictions Clinician at Bosco Homes, Edmonton, AB
Crystal meth use (also called crystal, crank, jib, meth, speed, or kiddie crack, to name a few) is on the rise in our communities. Crystal meth is a central nervous system stimulant. It is sold in pills, capsules, or powder and can be taken orally, injected, snorted, or smoked. It is cheap to buy, available, and highly addictive. Some users get hooked the first time they use crystal meth. One of the tempting effects of crystal meth for our youth is that users experience a heightened sense of well-being and experience feelings of elation and euphoria that last anywhere between 4 to 12 hours (depending on the dose). In comparison, a single dose of cocaine lasts only about 8 to 20 minutes. This makes crystal meth very appealing to our youth. It is a cheap and long lasting high.
Crystal meth can be made in many diverse locations, even the house next door. Over-the-counter cold and asthma medications containing ephedrine or pseudo ephedrine, red phosphorous, hydrochloric acid, drain cleaner, battery acid, lye, lantern fuel, and antifreeze are among the ingredients most commonly used in manufacturing crystal meth. Because of this there is a greater danger of users suffering a heart attack, stroke, or serious brain damage.
As parents, it is important to be aware of some of the signs that your child may be using crystal meth. Some “tell-tale signs” are:
| Rapid heart rate | Heightened sense of “well being” |
| Euphoric “high” state (excessively happy) | Decreased appetite/weight loss |
| Decreased sleep time | Anxiety, shaking hands, nervousness |
| Increased physical activity | Dilated pupils |
| Incessant talking | Irritable |
| Sweating not related to physical activity | Poor hygiene and self-care |
| Aggressive or violent behaviour | Dizziness or confusion |
| Mood changes are common | Dental problems |
| Nasal perforations and nose bleeds (among snorters) | |
Substance Induced Mood Disorder
If you are suspicious that your child may be using crystal meth do not ignore the warning signs. Crystal meth addiction is considered to be extremely difficult to treat and people addicted to crystal meth have one of the highest relapse rates. As parents you need to be vigilant about recognizing these warning signs in your child and seek treatment for your child at the earliest possible time. There is help out there. You may be saving your child’s life.
Treatment is available in Strathcona County
Bosco Homes offers a 6 to 9 month treatment program for adolescents dealing with an addiction to crystal meth. Our Adolescent Drug and Alcohol Prevention and Treatment (ADAPT) Centre is located approximately 16 km outside of Sherwood Park.
The actual length of treatment for each youth is determined by the severity level of their substance misuse/abuse at intake and their willingness to address their addiction. Youth at the ADAPT Centre are assessed and monitored regularly to determine their level of risk, medical impairments, and progress in treatment. Individualized treatment plans, interventions, and treatment strategies are comprehensive to include all areas of the youth’s life. Activating hope and strengths in youth is a central principle at Bosco Homes’ ADAPT Centre.
A highly structured program is offered which assists in maintaining consistency and predictability of the client’s environment. The program includes psycho-educational, cultural, and recreational group activities on a regular basis. We view all aspects of an average day for the client as effective tools for teaching positive social skills, life skills, positive behaviour, and for dealing with the emotional trauma that many of our clients have experienced.
Some of the treatment components include:
Individual Therapy
Individual therapy focuses on psychological aspects of the substance misuse/abuse and personal barriers to recovery such as depression, traumatization or problem avoidance.
Family Therapy
Family involvement and family therapy is an integral component of the ADAPT program. Family members are encouraged to participate in their child’s treatment.
Group therapy
Groups have the benefit of connecting with others having similar problems, thereby overcoming feelings of isolation. Groups provide clients with an opportunity to learn from, and give support to, each other. They can instill hope, encourage information sharing and provide role models. The group allows clients to find new ways to express themselves, or to review old conflicts in a supportive environment.
Some of the therapy groups offered at the ADAPT Centre include:
Drug and Alcohol Education Early Recovery/Relapse Prevention
Smoking Education, Prevention, and Cessation Parent Education
Social/Life Skills 12 Step Meetings
Overall, the focus of groups at the ADAPT Centre includes learning about what is a healthy, well-balanced and happy life, and learning about health hazards of addictive behaviors.
There is help for addicted teens.
For more information about the ADAPT Centre, call the Bosco Homes Central Intake Coordinator at (780) 440-0708 ext. 259.
References:
1. Dr. David Burns: “Feeling good –The new mood therapy”, Avon Books, New York,1992.
2. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-IV),American Psychiatric Association, Washington,DC,1994.
3. Dr. Shaila Misri at the 46th St. Paul’s Hosp. Cont. Educ. Conference, November 2000, Vancouver/B.C./ Canada.
4. JM Loftis et al. J Neurochem 2000 Nov 75(5): 2040-2050.
5. B. Zilbergeld et al. “Hypnosis – Questions& Answers”, W.W. Norton & Co, New York,1986: 307-312.
6. MH Erickson & EL Rossi:”Hypnotherapy, an exploratory casebook”, Irvington Publishers Inc., New York, 1979: chapter 8, 314-363.
7. G Steketee et al. Compr Psychiatry 2001 Jan 42(1): 76-86.
8. DS Mennin et al. J Anxiety Disord 2000 July-Aug 14(4): 325- 343.
9. J Hartland: “Medical &Dental Hypnosis and its Clinical Applications”, 2nd edition, Bailliere Tindall,London,1982, page: 326-336.
