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1. Interplay Between
Addiction & Mental Health
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Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC, NCC, CCDC
Executive Director, AllCEUs.com

2. Objectives
 Define co-occurring disorders
 Identify the impact of addiction on the individual
 Identify the impact of mood disorders on the individual
 Identify the impact of chronic illness or pain on the individual
 Explore the interplay between the three
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3. Why I Care/How It Impacts Recovery
 Co-Occurring Disorders are the EXPECTATION, not
the EXCEPTION.
 A person who is sober but depressed is at risk for
addiction relapse
 A person who is using is actively in an addiction
(even a behavioral one) is altering the balance of
neurotransmitters.
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4. Define Co-Occurring Disorders
 Mental Health, Addiction, Physical Health
problems and their interaction
 Must be treated concurrently
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5. Think About It
 When you are stressed out how does it impact
your
 Mood
 Patience
 Ability to concentrate/productivity
 Problem solving/creativity
 Sleep
 Energy levels
 Appetite
 Headaches
 Muscle Aches
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6. Think About It
 People with addictions are:
 Trying to get some relief from emotional or physical
distress
 Inadvertently worsening the problem by altering the
neurochemicals
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7. Mental Illness Effects
 Emotionally
 Depression or anxiety
 Cognitively
 Difficulty concentrating
 Perception of hopelessness and helplessness (Victim
mentality)
 Physically
 Sleep disturbances
 Eating Disturbances
 Restlessness/agitation
 Achiness
 Fatigue
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8. Mental Illness Impact
 Socially
 Withdrawal/Difficulty dealing with people
 Low self-confidence
 Lack of energy or desire to interact
 Relationship deterioration
 Environmentally (The outside reflects the inside)
 Disorganization
 Lack of energy or desire to care for anything
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9. Mental Illness  Addictive Behaviors
 Emotionally
 Addiction numbs or medicates depression or anxiety
 Cognitively
 Addiction reinforces hopelessness and helplessness (Victim
mentality/stinking thinking)
 Physically
 Addiction helps people relax to get to sleep OR keeps them up
instead of sleeping
 Food is often used as a secondary self-soothing/addictive
behavior OR people get so caught up in their addiction they
forget to eat
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10. Mental Illness  Addictive Behaviors
 Physically
 Addiction helps soothe restlessness/agitation, but
detoxing can intensify it
 Achiness can be relieved or numbed by addictions, but
(especially in the case of opiates) may cause the body to
stop making or using endogenous opioids.
 Addiction to stimulants may be used to self-medicate
fatigue, but causes rebound exhaustion.
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11. Mental Illness  Addictive Behaviors
 Socially
 Addictions may be used to “loosen up” or make it
easier to interact with others
 The addiction may provide an alternate peer group
that is tolerant
 Environmentally (The outside reflects the inside)
 In active addiction, there is little concern for the
environment UNLESS the person is trying to hide the
addiction in which case, they may become more
attentive to cleanliness and organization.
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12. Addiction Effect (Benefits?)
 Emotionally
 Numbing
 Relaxation
 Euphoria
 Cognitively
 Stinking thinking
 Physically
 Energy
 Improved Sleep
 Relaxation
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13. Addiction Effect (Benefits?)
 Socially
 A new peer group
 Environmentally
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14. Addiction  Mental Illness
 Emotionally
 Addiction causes neurotransmitter imbalances
 As depression and anxiety worsen, the need for the
addiction/numbing increases. Life starts to revolve around using
 The brief benefits lead to a continued need for the addiction to
feel “normal”
 Mentally/Cognitively
 Addiction leads to lying, manipulation, and exacerbates cognitive
distortions (stinking thinking)
 Physically
 Addiction usually disrupts circadian rhythms through too much or
too little sleep
 Addiction can alter hunger/satiation cues
 Addiction can cause health problems leading to chronic pain
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15. Addiction  Mental Illness
 Socially
 Addiction becomes the person’s best friend
 Begin spending time only with using peers or alone
 Loss of healthy relationships
They don’t get it
They want to take away the addiction
 Environmentally (Inside | Outside)
 Addiction takes precedence over environmental
cleanliness or safety  feelings of depression
 Addiction can cause a person to become obsessively
neat to hide the fact that they are addicted
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16. Chronic Pain
 Emotionally
 Frustration
 Depression
 Anxiety
 Cognitively
 Difficulty concentrating
 Negative perceptions
 Physically
 Sleep disturbances
 Fatigue
 Pain
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17. Chronic Pain
 Socially
 Don’t feel like going out to do things with friends
 Friends get tired of hearing about the pain
 Friends may feel taken advantage of
 Environmentally
 Disarray
 May stay in bed or on the sofa all the time
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18. Chronic Pain Addiction  Mental Illness
 Emotionally
 Opiate medications often intensify depression
 Negative feelings can be numbed with addiction
 Cognitively
 Chronic pain creates a an environment for the victim
mentality/stinking thinking common in addiction and
mental illness
 Physically
 Sleep disturbances and fatigue leading to irritability,
depression and self medication
 Pain medications can actually intensify pain
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19. Chronic Pain Addiction  Mental Illness
 Socially
 Addiction helps people not care that they don’t have
healthy relationships
 Environmentally
 A depressing environment may intensify feelings of
hopelessness which can be self-medicated with
addiction
 An obsessive need for order, but being in too much pain
to clean can intensify anxiety which can be numbed
with addiciton
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20. Apply It
Depression Opiate Addiction Chronic Pain
• Lack of pleasure
• Sleep Disturbances
• Hopelessness/
helplessness
• Difficulty concentrating
• Low Self-Esteem
• Pain
• Fatigue
• Numbing/Dopamine
flood
• Helps people sleep
• --
• Difficulty concentrating
• Feels like uber self
• Numbs pain/Stops
endogenous opioids
• Increases fatigue
• Lack of pleasure
• Sleep disturbances
• Hopelessness/
helplessness
• Difficulty concentrating
• Low Self-Esteem
• Pain
• Fatigue
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21.  Addiction, mental health and physical illnesses all
impact
 Mood
 Eating
 Sleeping
 Pain
 Motivation
 Relationships
 Addiction may temporarily address the issue, but
it also intensifies all of the above problems when
the person is not actively using.
Summary
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22. Summary
 Comprehensive treatment of the whole person is vital
 Example: Lack of pleasure
 Address the neurochemical imbalances
 Find alternative coping strategies besides the addiction
 Identify cognitive issues that may be maintaining the negative
mood
 Identify any physical issues (chronic pain, hormone imbalances)
that are contributing
 Effects
 Improved motivation
 Improved ability to focus
 Improved mood
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23. Summary
 Comprehensive treatment of the whole person is
vital
 Example 2: Sleep Disturbances
Address neurochemical, pain and other issues causing
sleep disturbance
Create an effective sleep routine
Effects
 Less fatigue
 More time for the body to repair
 Improved concentration
 More energy to interact with others
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