Do You have Mixed Drinks About your Feelings? - Q&A with Dr. Anuneet Sabharwal

Have you ever used alcohol or drugs to cope with unpleasant memories or feelings, to control the pain or the intensity of your emotions? Or do you know someone who has?

According to WebMD, Substance abuse is when you take drugs that are not legal. It’s also when you use alcohol, prescription medicine, and other legal substances too much or in the wrong way.

Substance abuse differs from addiction. Many people with substance abuse problems are able to quit or can change their unhealthy behavior. Addiction, on the other hand, is a disease. It means you can’t stop using even when your condition causes you harm.

We spoke to Dr. Anuneet Sabharwal, from The Happy Tree, to address some of these questions and find out the link between alcohol, drugs and mental health.

1. How do drugs and alcohol affect mental health?

The short-term effects of alcohol and drugs may initially bring a somewhat pleasurable experience to the user, but this impact is only temporary. In the long-term, it can cause serious issues for their mental well-being. Alcohol and drug abuse is a major cause of stress, anxiety and depression. Substance abuse may sharply increase symptoms of mental illness or even trigger new symptoms. This is called Dual Diagnosis in Psychiatric terminology and makes treatment more complicated. Abuse of alcohol or drugs can also interact with medications such as antidepressants, anti-anxiety pills, and mood stabilizers, making them less effective at managing symptoms.

2. Could you throw some light on the vicious cycle between substance abuse and deteriorating mental health?

Alcohol and drug abuse can increase the underlying risk for mental disorders. Mental disorders are caused by a complex interplay of genetics, the environment, and other outside factors. If you are at risk for a mental disorder, abusing alcohol or illegal or prescription drugs may push you over the edge. There is some evidence, for example, that certain abusers of marijuana have an increased risk of psychosis while those who abuse opioid painkillers are at greater risk for depression.

3. What are the signs of mental health issues arising due to drug abuse?

Signs and symptoms of Substance abuse:

• Have you ever felt you should cut down on your drinking or drug use?
• Do you ever lie about how much or how often you drink or use drugs?
• Have you tried to cut back, but couldn’t?
• Have your friends or family members expressed concern about your alcohol or drug use?
• Do you ever feel bad, guilty, or ashamed about your drinking or drug use?
• On more than one occasion, have you done or said something while drunk or high that you later regretted?
• Have you ever blacked out from drinking or drug use?
• Has your alcohol or drug use caused problems in your relationships?
• Has your alcohol or drug use gotten you into trouble at work or with the law?

Signs and symptoms of common co-occurring disorders:

The mental health problems that most commonly co-occur with substance abuse are depression, bipolar disorder and anxiety disorders. Other mental health problems that also commonly co-occur with substance abuse include Schizophrenia, Borderline Personality Disorder, and Post-Traumatic Stress Disorder.

• Feelings of helplessness and hopelessness
• Loss of interest in daily activities
• Inability to experience pleasure
• Excessive tension and worry
• Feeling restless or jumpy
• Irritability or feeling “on edge”
• Racing heart or shortness of breath
• Nausea, trembling, or dizziness
• Muscle tension, headaches
• Trouble concentrating
• Insomnia Feelings of euphoria or extreme irritability
• Unrealistic, grandiose beliefs
• Decreased need for sleep
• Increased energy
• Rapid speech and racing thoughts
• Impaired judgment and impulsivity
• Hyperactivity
• Anger or rage

4. What are de-addiction centres?

De-addiction centres is a residential rehabilitation program that treats alcohol and drug addiction. Centres vary in focus and size, with some treating 30 or more clients at a time. Other treatment centres focus on small groups with no more than six clients in a residential house.

5. What do substance abuse mental health treatment centres do?

Contemporary treatment centres offer detoxification and 30 days with supervised abstinence from alcohol and drugs whereas some treatment centres are focusing on providing individual therapy in a variety of styles including cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT) and more traditional group and family therapy. Treatment centres may also offer alternative or complementary therapies as part of their programs, such as music therapy, art therapy, neuro-feedback, Eye Movement Desensitisation and Reprocessing (EMDR), acupuncture and yoga. One of the latest modalities for managing craving is Trans-cranial Direct Current Stimulation (tDCS). I personally use tDCS for all my patients with substance use and mental health issues and have found almost 80% response to the treatment. It carried minimal to no side effects, and can be given without administering any injections/anaesthesia/electric shocks.

6. How can I get help? Who should I talk to about my problems?

You can take help and professional advice from a psychiatrist, de-addiction specialist and counselling psychologist.

7. Do I need professional help?

If you are unable to cut alcohol and substance use, and are experiencing the above mentioned symptoms of depression, anxiety and substance abuse craving, you should consider taking professional help for your physical and mental well-being.

8. Are online support groups effective?

Online support groups typically target specific issues or illnesses. Mental health support groups are very common these days and have proven to be effective for helping those experiencing any number of conditions, from alcoholism to depression to obsessive-compulsive disorder.

Benefits of participating in online support groups may include:

• Feeling less lonely, isolated or judged.
• Gaining a sense of empowerment and control.
• Improving your coping skills and sense of adjustment.
• Talking openly and honestly about your feelings.
• Reducing distress, depression, anxiety or fatigue.

9. How can I help my friend?

Helping a loved one with both a substance abuse and a mental health problem can be a roller coaster. The best way to help someone is to accept what you can and cannot do. You cannot force someone to remain sober, nor can you force someone to take their medication or keep appointments. What you can do is help them make positive choices for themselves, encourage your loved one to get help, encourage them to keep up with their treatment and offer your support, warmth and understanding while making sure you don’t lose yourself in the process.

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Dr. Anuneet Sabharwal's experience, as a mental health professional over the last 8 years, has ranged from not only managing people with severely debilitating psychiatric illnesses along with their caregivers and friends but also, advising those who were simply going through stress in any form or shape.

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