Substance - Induced Mood Disorders- Symptoms, Risk Factors, and Treatment.

What Are Substance-Induced Mood Disorders?

It is very normal for a person to experience a hangover on a subsequent morning after alcohol consumption the previous night, but few people experience depression and can become maniacs, mood disorders that are evaluated only in association with the use of the substance of abuse are termed as substance-induced mood disorders.

Substance-induced mood disorders result from the long-term use of substances of abuse, including alcohol, opioids, cocaine, or addictive medications like interferon ( IFN), corticosteroids, digoxin, and antiepileptic drugs, that are used to treat conditions such as epilepsy, arthritis, etc. These disorders include depression, anxiety, hallucinations, and other mental health disorders. Various theories have proven that these substances alter the transmission of neurotransmitters to critical neural circuits. It is also believed that substance-induced mood disorders result in changes in cerebral structures.

What Is the Substance of Abuse?

Various drugs, when consumed for a longer duration or in large quantities, can prove to be harmful, causing mood disorders.

These substances can be divided into the following categories:

• Prescription medications: medications generally used for treating chronic diseases have shown dependence due to their long-term use and have led to mood disorders. Such medications include Opioid painkillers, blood pressure medicines, anti-anxiety, and antidepressant prescriptions, as well as steroids and antibiotics.

• Over-the-counter medications: these are the drugs sold legally and can be purchased without any prescription by the physician. These drugs do not have any side effects if taken in recommended doses, but still are the most commonly used substance of abuse and are a most harmful way of abuse as a person uses multiple drugs. This class of medications includes decongestants, Cough medicines (Dextromethorphan, or DXM), Cold medicines (Pseudoephedrine), and Motion sickness pills (Dimenhydrinate).

Drugs, when swallowed in large quantities of the medicine, sometimes mixing it with soda for flavor, are called "robo-tripping" or "skittling."

Individuals are most likely to get addicted to such drugs and may overdo the side effects, or the toxicity of these drugs is presented as irritability, difficulty in sleeping, mood swings, loss of sex drive, etc.

• Alcohol: Alcohol is a socially used mood-altering substance that is legal but causes depression in many individuals.

It becomes abusive when it interacts with the medications that a person is on for chronic medical conditions like blood pressure, diabetes, depression, anxiety, etc.

• Recreational Substances: These are illegal substances which include cocaine, methamphetamine, and heroin. They are most likely to cause mood disorders when used excessively.

What Are the Symptoms of Mood Disorders?

The signs and symptoms of mood disorders differ from one person to another, not everybody experiences the same symptoms, but there are few behavioral changes or certain characteristics that can help in the diagnosis.

An individual with a history of substance abuse is most likely to develop symptoms like,

• Hallucinations: include seeing and hearing things that are not present.

• Delusions: where a person experiences he is being called or watched. It also includes religious delusions where it is believed that the almighty is sending special messages.

• Inability to distinguish between reality and fantasy.

• Inability to take care of oneself, like forgetting to bathe or eat.

• Feeling that someone is trying to harm them constantly.

• Difficulty in communication, slurred speech, unclear thoughts.

• Expressionless face.

• Hypersensitive to sensory impulse.

Who Is At Risk?

Generally, people with a family history of psychotic disorders are more likely to experience dependence even on consuming small quantities of the substance of abuse.

• History of brain injury or stroke.

• History of psychotic disorders.

• Alzheimer's disease.

• Brain tumors, lesions, a cyst.

• Genetic abnormalities.

Can Substance-Induced Mood Disorders Be Treated?

Treatment for substance-induced mood disorders mainly depends on an appropriate diagnosis which can be done only with a definitive history. Substance-induced disorders are generally diagnosed when an individual visits with the chief complaint of anxiety or depression.

When diagnosed, a team of experts helps in finding the best available treatment option which includes medications, therapies, rehabilitation, etc. Choice of treatment is made based on chronicity, frequency, and drug used for the abuse. Irrespective of the treatment modality, the first and foremost step during the treatment is discontinuing substance of abuse. Some patients recover with just one method of treatment while others may require a combination of the treatment options available.

• Medicinal Treatment: No definitive medicinal treatment is available to treat substance abuse, experts prescribe medications to control the symptoms and promote discontinuing the abusive substances. Those with prescribed medicinal substance abuse are controlled by altering the doses, prescribing alternate medications, etc.

• Therapy: It has been considered one of the most effective means of treatment for individuals with mood disorders, this treatment mainly emphasizes counseling and altering the thought process of an individual so that the urge to consume the substance of abuse is avoided. Various therapies include cognitive behavior therapy, psychotherapy, etc.

• Rehabilitation: These centers are where a person undergoes observation, and extensive counseling and activities are carried out to distract an individual from abuse. This is recommended for individuals who have a severe mood disorder or addiction that cannot be treated with the above treatment modalities. Rehabilitation is also considered an adjunct option to many other treatments as it is also used in the remission period of the disorder to prevent relapse. Rehabilitation is most commonly used for people with alcohol and illegal substance-induced mood disorders.

Conclusion:

Substance-induced mood disorders are mainly caused due to consumption of abusive OTC medications, prescribed medications, alcohol, and illegal substances in quantities more than recommended. For a person to develop a mood disorder might not take a year, but it is difficult to overcome the addiction once developed. A common presentation of the patient is being disoriented, having a hangover, sleeplessness, etc. Treatment options include medications, therapy, rehabilitation, etc.

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