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Practicum Experience: Addiction Issues and Depression
Treating substance and addiction disorders is an important step in helping the patient return to normal life. Fuentes & Hoffman (2016) explain that many patients may be suffering from growing addiction-related issues at younger ages than historically known. In my practicum experience, there have been patients that have comorbid symptoms including depression, anxiety, fatigue, and in extreme cases agoraphobia. When these patients present for the treatment they may not know the root cause of their condition nor all the comorbid symptoms. In some cases, the initial meeting establishes the scope of their condition as well as incumbent challenges they may not have identified earlier. This sets the parameters for a treatment approach that is relevant and specific to their needs.
One patient that I met during practicum was a 43-year old caucasian male. He had lost his job during the early months of the year and was experiencing depression as a result of it. There are a lot of issues his family has faced resulting in him downsizing and moving in with his mother. The relationship between the two of them and the pressure to care for his ill father has added stress to the situation further. Aside from these problems he has developed an addiction to alcohol frequently having drinks several times throughout the day.
These conditions and the patient’s perspective of hopelessness are some of the persisting circumstances in his life. These problems have continued for more than six months and have contributed to a sense of loss and a lack of self-worth. He used to be creative and make art projects with friends or coworkers. However, this has not been possible as he feels there is ‘no point to anything’. Instead, he has taken larger drinks more frequently over the past year. This was a remarkable example of his growing sense of despair that interferes with activities that may have been fun in the past. Davis et al. (2017) explain it is important to diagnose comorbid conditions early on to improve chances for patient improvement. According to DSM-V, the patient could have Major Depressive Disorder as well as Alcohol Use Disorder. With only three symptoms persisting for the specified amount of time the case would be mild.
For this patient, two treatment options were suggested. Psychological therapy was offered on a weekly basis to help the patient rectify some of their underlying issues while addressing depression. In my experience, cognitive behavioral therapy is the most interesting because it offers a good solution for long-term symptom management. Acamprosate is a relatively new medication that makes the desire to drink lower for the patient. Choi et al. (2019) demonstrate the ability for this treatment to improve the chances of changing alcohol abuse over time. This is medication best regulated with small doses initially and increased based on how well the patient can handle it. At these early stages, the patient is willing to take the medication and will return for follow-up changes with treatment in the future.
Choi, B. Y., Lee, S. H., Choi, H. C., Lee, S. K., Yoon, H. S., Park, J. B., … & Suh, S. W. (2019). Alcohol dependence treating agent, acamprosate, prevents traumatic brain injury-induced neuron death through vesicular zinc depletion. Translational Research, 207, 1-18.
Davis, E. C., Rotheram-Borus, M. J., Weichle, T. W., Rezai, R., & Tomlinson, M. (2017). Patterns of alcohol abuse, depression, and intimate partner violence among township mothers in South Africa over 5 years. AIDS and Behavior, 21(2), 174-182.
Fuertes, J. N., & Hoffman, A. (2016). Alcohol consumption and abuse among college students: Alarming rates among the best and the brightest. College Student Journal, 50(2), 236-240.