Mood Disorders: Definitions and Diagnosis (Chapter 5) The word mood refers to a pervasive and long-lasting emotional state that can here by influence any aspect of a person’s life and perceptions. Mood disorders include full or partial periods of depression or mania, as well as pathologically elevated or depressed mood disturbances. Severe depression, dysthymia (dysthymic disorder), bipolar disorder, mood disorder attributable to a general medical condition, and substance-induced mood disorder are the most common forms of mood disorders. Mood disturbances have no obvious cause.
Mood disorders (like major depression) manifest themselves as a series of symptoms that occur simultaneously and last up to a few weeks. During the major depression, the individual has a depressed mood and feels indifferent to most or all activities for at least two weeks straight. There are almost always substantial changes associated with mood changes, including changes in energy, sleep patterns, concentration, and weight. There are many symptoms of psychomotor retardation, including persistent feelings of worthlessness and inappropriate guilt or recurrent thoughts of death or suicide.
Major depression must be diagnosed based on at least one episode without being specifically associated with other psychological, substance abuse, or medical conditions. There are several types of severe depression, including several mild depressions, major mood disorders, and chronic mood disorders related to severe depression. For DSM-IV draft to declare a patient depressed, at least five of the nine signs must be present for at least two weeks before the diagnosis.
Dysthymia refers to a chronic mood disorder in which you lose interest or pleasure in most of your daily activities but don’t meet all of the criteria for major depression. At least two years of mild or moderate mood disorders are necessary to diagnose dysthymia.
A manic episode is characterized by persistent periods of euphoria, irritability, or expansive mood that last at least one week. An individual with a mood disorder is hyperactive, grandiose, flight of thoughts, talkative, sleep-deprived, and distracted. There is a rapid onset of symptoms and symptoms in manic episodes within a few days. Hospitalization is commonly required to prevent harm or harm to others when mood disorders hamper functioning at work or in an active social environment. When you suffer from mania, you are likely to experience psychotic hallucinations and delusions. Intoxication by stimulants or schizophrenia can make it difficult to distinguish between these mood disorders.
A hypomanic episode occurs when an elevated mood is similar to but not as severe as a manic episode (a couple of weeks or months). Rarely, a hypomanic state requires hospitalization for mood disorders or affects social and occupational functioning. An individual with one or more manic episodes, usually in conjunction with one or more major depressive episodes, is often diagnosed with bipolar disorder. An individual with bipolar disorder may be classified as manic, depressive, or mixed, based on the clinical characteristics of the most recent episode. An episode of a manic or depressive mood disorder may accompany major mood disorders.
Cyclothymia refers to a bipolar disorder characterized by recurrent mood swings and greater severity. Psychosis and major depression are associated with cyclothymia mood disorders, consisting of hypomania and depressive symptoms. Cyclothymia must be diagnosed by a physician after two years, according to the updated third edition of the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-III-R). Two months after the patient began experiencing mood disorders, he has never experienced hypomania or dysthymia without medication.
Substance-Induced Mood Disorders Is Described in The DSM-IV Draft According to The Following Criteria:
Long-lasting symptoms of mood disturbance including either (or both) of the following:
- Excessive irritability or excessive anger; depressive mood or reduced interest in all activities, etc.
- Physical examination or laboratory evidence of drug intoxication or withdrawal from the past and the symptoms described in criterion A occur during intoxication or withdrawal caused by severe substances.
- Mood disorders unrelated to drugs or alcohol are not responsible for the disruption. These signs may appear before becoming addicted or abusing drugs or alcohol. A month or so (e.g.). Considering the substance used, its character, length, or amount, they are significantly greater than expected. Another body of evidence indicates that withdrawal or severe intoxication can be followed by an independent mood disorder caused by drugs or alcohol. As a result, the rates are far higher than one might expect based on the character, duration, or amount of the substance used (for example, a history of major depressive episodes unrelated to substance use).
- Clinically significant distress or disability is almost always triggered in social, educational, or other critical areas of functioning by the symptoms.
- Disruptions do not only occur when someone is delighted.
- A person who suffers from a mood disorder typically feels oppressed and can feel hopeless, irritable, and helpless. Symptoms can last for a long time without treatment, reducing life quality.
Mood Disorders Related to Substance Abuse May Be Classified as Follows:
- Mixed mood disorders.
Drug addiction may also begin while intoxicated or suffering from withdrawal. According to the draft DSM-IV, most major mental illnesses can be triggered by substances.
Researchers at ECA found that 40 per cent of people with alcohol problems have psychological problems, based on standardized interviews with mood disorders. People with other opioid addictions have psychological symptoms more frequently than people with drug addictions (Regier et al., 1990).
The most common clinical diagnosis for patients suffering from an AOD condition is anxiety and mood disorders. Mood disorder is often accompanied by severe depression in many people. Methadone and heroin addicts may be more likely to suffer from mood disorders than other drug users. There is a higher incidence of heroin and methadone addiction than other addiction types. It is lower in an alcohol treatment setting than in a mental health setting that patients are diagnosed with major depression.
The findings of the ECA research can be used to estimate the prevalence rates of mood disorders in the general population (Regier et al., 1988; Robins et al., 1988).
According to These Reports,
- In the ECA sample of New Haven, Baltimore, and St. Louis, the lifetime prevalence rates for any mood disorders ranged from 6.1 to 9.5 percent.
- In the ECA sample of New Haven, Baltimore, and St. Louis, the lifetime prevalence rates for any mood disorders ranged from 6.1 to 9.5 percent.
- Dysthymia prevalence rates ranged from 2.1 to 3.8 percent over a lifetime.
- Manic episode prevalence rates ranged from 0.6 to 1.1 percent over a lifetime.
Several studies suggest that AOD users have no higher anxiety or mood disorders than the general public. There has also been researching that indicates that those with AOD disorders are more likely to develop these disorders. Many patients seek drug treatment for depression, but only a small percentage are formally diagnosed with major depression.
The first few months following sobriety are often a time of depression and mood disorders. The result is that depressive disorders may cause withdrawal and early recovery symptoms instead of an underlying condition like depression. When mood disorders have occurred for a prolonged period, depression should not be diagnosed.
Some women with a history of substance abuse are more likely to have mood disorders. Women with alcohol problems experience depression at a higher rate than men with alcohol problems. Even though women may experience clinical depression more than men in addiction and non-addiction care environments, counsellors should be mindful of this fact.
The needs of other classes, besides women, must be addressed. People with HIV, methadone patients, and older people may all be more prone to depression. Co-occurring mood disorders and substance abuse issues may be more prevalent among the elderly. People grow older and experience more mood swings. In addition, chronically using AODs leads to more mood disorders in older adults with a combined mood disorder and AOD usage disorder.
People at Risk for Mood Disorders
Everyone experiences sadness and depression from time to time. However, the negative emotions associated with mood disorders are more intense and harder to manage. Parents with disorders are more likely to have mood disorders and their children. However, life events and stress can expose or worsen feelings of sadness or depression. Feelings are harder to manage when this happens.
Problems with life can lead to depression sometimes. The loss of a loved one, financial difficulties, getting fired from a job, and getting divorced are difficult and can cause mood disorders. Life events and stress can trigger depression or sadness in individuals with mood disorders or make it difficult for them to manage their mood disorders.
Women are nearly twice as likely to suffer from depression as men. Mood disorders are known to pass down through families, so siblings and children will likely also develop them. Bipolar disorder is also more likely to affect the relatives of people who suffer from depression. An individual with bipolar disorder increases their family’s chances of having the same diagnosis, including their brothers, sisters, and children. Bipolar patients’ relatives are at an increased risk of developing depression and mood disorders.
Phase of Diagnosis
Mental disorders must be treated as provisional diagnoses, and mood disorders need to be reevaluated constantly. In addiction treatment populations, many psychiatric disorders are substance-induced disorders caused by AOD use. Treatment of the AOD disorder and an abstinent period of weeks or months may require a definitive diagnosis of an independent mood disorders. Unfortunately, the severely depressed person may drop out of treatment or even commit suicide while the clinician is trying to sort things out (see the section on “Assessing Danger to Self or Others.”)
Mood disorders may be triggered by intoxication with stimulants, hormones, hallucinogens, or polydrugs. They can also be brought about by removing depressants like alcohol and medical conditions like AIDS and thyroid disorders. Mood disorders such as acute mania are medical emergencies characterized by hyperactivity and psychosis and violent and impulsive behaviours. This is so regardless of the underlying causes.
Mood disorders may be confused with other mental disorders. Addiction is one type of disease that mimics mood disorder, and it is often undiagnosed or misdiagnosed. Schizophrenia, brief reactive insanity, and anxiety disorders are all disorders that can make diagnosis difficult.
Patients with personality disorders, especially borderline, narcissistic, and antisocial styles, often exhibit mood disorder symptoms. These signs are often intermittent and do not satisfy the diagnostic criteria of long-term persistence. Furthermore, all of the psychiatric conditions listed here can occur alongside AOD and mood disorders.
Examples of Case Studies: George and Mary
George, a divorced 37-year-old man, was taken to the emergency room inebriated. His blood-alcohol level was 152, and he tested positive for cocaine on a toxicology sample. He was also on the verge of committing suicide ( “This time, I’m going to get it right! I’ve got a weapon “(Imaginative+ paraphrase). He has three psychiatric hospitalizations and two inpatient AOD services on his record. AOD usage followed each psychiatric admission. George has never completed his medical therapy. His mood disorders have caused him to attend AA meetings in the past, but not in recent times.
Mary is a divorced 37-year-old woman admitted to a detoxification unit with a blood alcohol level of 150 and was described as depressed and withdrawn. Her drug use is entirely non-existent and she has been drinking for only three years. This is because of mood disorders. She has, however, had some alcohol-related issues since then. At the ages of 19, 23, and 32, she had three medical hospitalizations for depression. She claims that antidepressants have helped her. Her mood disorders are not being treated by either alternative or conventional medicine.
Case of Differential Diagnosis Problems.
If you are going to make an initial diagnosis and decide on treatments for mood disorders, there are several factors you will need to consider. What if George’s psychiatric admissions lasted two to three days, with discharges typically linked to leaving against medical advice? During his two psychiatric admissions of four to six weeks, well-established manic and psychotic symptoms persist despite intensive mental health care and medication. Treatment plans would differ drastically because mood disorders would have been diagnosed.
What if Mary had abstained from alcohol for six months “on her own” but had become steadily depressed, exhausted, and withdrawn over the previous three months, with disturbed sleep and poor concentration, as well as suicidal thoughts? Last night, she relapsed with mood disorders, trying to kill herself. If Mary had been taking antidepressants for a year and had intensified her heavy drinking in the last month, she would have a different diagnosis. The drinking mood disorders that she suffers would have caused her to lose her job yesterday.
What Methods Are Used to Treat Mood Disorders?
Mood Disturbances Are Often Successfully Treated. the Following Treatments Can Be Used:
- Antidepressant and mood-stabilizing drugs have been shown to be effective in the treatment of depression, particularly when combined with psychotherapy. Psychotherapy—The most popular forms of counseling are cognitive-behavioral and/or interpersonal therapy. The aim of this therapy is to change the person’s skewed perceptions of himself and the world around him. It also assists in the growth of interpersonal relationship skills and the detection of environmental stressors and how to prevent them.
- Family therapy
- Other therapies, such as electroconvulsive therapy and transcranial stimulation
In every recovery process, families play a crucial supporting role. People with mood disorders will live happy, prosperous, and healthy lives if they are properly diagnosed and treated.
Mood Disturbances Caused by AOD
I believe it is important to note the differences between mood disorders and the symptoms of alcoholism, drug withdrawal, and chronic use of these substances. After long-term usage of drugs that cause physiologic dependence, we need to understand the distinctions between these drugs. As with any psychoactive substance, there is a change in the way you feel. Many variables affect the severity and manner of such changes, including preexisting mood states, the form and volume of the substance consumed, the duration of drug use, how it is administered, current medical status, and the history of mood disorders.
AOD-induced mood changes may occur as a result of short-term and long-term drug use, as well as drug withdrawal. Sedative-hypnotic intoxication can cause AOD-induced mood disorders, most commonly acute depression lasting hours to days. In the same way, chronic or subacute withdrawal, which can last anywhere from weeks to months, can lead to depressive symptoms, which are often followed by suicidal ideation or attempts.
Also, particularly after long-term, high-dose stimulant use, stimulant withdrawal may trigger depressive symptoms that last from hours to days. Symptoms of hysteria can last anywhere from hours to days during stimulant-induced mania. An addiction can result in biopsychosocial disintegration, a situation that can result in chronic depression or dysthymia that is likely to last for several months or longer. There must be sufficient time to pass before a definitive diagnosis of a separate mood disorder can be made since the symptoms of acute withdrawal syndromes are often the symptoms of the withdrawal product.
Nevertheless, other conditions that, although similar to AOD-induced conditions, may cause and mimic symptoms and symptoms of mood disturbances must be distinguished from them. Symptoms that persist over time or worsen as time goes on can indicate mental disorders related to AODs. If you experience transient dysphoria after stopping stimulants, this may be mistaken as an episode of depression. As per the draft of the DSM-IV, a clinically significant depressive episode is present after a period of acute withdrawal characterized by severe symptoms lasting more than a month. If the symptoms do not last for more than a week, it may be possible to diagnose a substance-induced mood disturbance.
Based on generalizations about how specific medications will cause specific behavioural symptoms, mood disorders are difficult to diagnose. The problem with multiple substance abuse involves a wide range of different aspects, which further complicate the differential diagnosis process. Toxicology screens and urinalysis are diagnostic procedures used to resolve the issue if feasible. The symptoms of withdrawal for a mood disorder treated with one medication may also appear for a different mood disorder treated with a different medication.
Psychedelics, such as amphetamines and cocaine, stimulate the brain and cause mood disorders. Increased mental and physical capacity, feelings of well-being and grandiosity, and rapid pressured expression are all symptoms of stimulant intoxication. Chronic, high-dose stimulant intoxication can lead to mania, particularly when combined with sleep deprivation. In addition to a state of euphoria, expansiveness, or irritability, mood disorders such as insomnia are also often associated with the condition.
Mood disorders such as anxiety, exhaustion, weight gain, insomnia, and hypersomnia are typical symptoms of acute stimulant withdrawal, which may last anywhere from a few hours to several weeks. Depression induced by stimulant withdrawal can be intense, and it can be compounded by a person’s knowledge of addiction’s negative consequences. Stimulant addictions will likely exhibit symptoms, while mood disorders may lead to suicide.
Anhedonia and lethargy are common symptoms of long-term stimulant withdrawal, as are repeated ruminations and dreams about stimulant use. Many months of mood disorders and dysphoria may follow the discontinuation of stimulants. The quality of the patient’s treatment program can intensify or relieve these symptoms.
Depressants Are Sad Individuals.
Mood disorders can be inhibited by alcohol, benzodiazepines, opioids, and other depressants of the central nervous system. Acute alcohol and opioid overdose, on the other hand, often includes two phases: euphoria at first, accompanied by a longer period of relaxation, sedation, lethargy, apathy, and drowsiness. Sedative-hypnotic intoxication can be caused by alcohol, barbiturates, and benzodiazepines, particularly when taken in high doses. There are many psychomotor symptoms of mood disorders, including mood swings, difficulty with memory and concentration, poor balance, unsteadiness, slurred speech, and confusion.
PCP, Hallucinogens, and Marijuana
Hallucinosis is a state of intoxication caused by hallucinogens that shares many characteristics with psychotic disorders and a few with mood disorders. LSD and other hallucinogens, as well as drugs like MDMA (methylenedioxy-methamphetamine, or Ecstasy) and MDA (methylenedioxyamphetamine), may cause extreme emotional experiences that the user can interpret as positive or negative mood states.
Interactions with mood disorders are affected by personality, current mood, personal expectations, medication dosage, and environmental surroundings. While many users will encounter sensory and visual distortions, others will have euphoric religious or philosophical experiences comparable to those associated with a manic or psychotic episode. Others may have a highly distressing introspective experience that leads to depressive symptoms.
Cannabis may have sedative and psychedelic effects, leading to mood disorders. High doses of marijuana can cause acute marijuana overdose with euphoria or anxiety, grandiosity, and “profound thoughts” in people who have not built a tolerance for the drug’s effects. These signs and symptoms may be mistaken for mania. Mood disorders are caused by marijuana use since marijuana is slowly removed from the body. As a result, daily marijuana use will result in chronic marijuana intoxication. Symptoms of chronic, low-grade lethargy and depression, possibly followed by anxiety and memory loss, may be present. Phencyclidine (PCP) intoxication can lead to euphoria, mania, depression, sensory dissociation, hallucinations, paranoia, delusional thinking, disorientation, along other mood disorders.
Mood Disturbances As A Result Of A Medical Condition
Diagnostic criteria for mood disorders caused by a general medical condition are defined in the DSM-IV draft.
The Following Are the Five Criteria:
- One (or both) of the following characteristics describe a prominent and recurrent mood disturbance:
- A depressed mood or a major decline in interest or enjoyment in all, or nearly all, activities
- A mood that is elevated, expansive, or irritable.
- There is evidence of a general medical disorder that is etiologically linked to the disruption based on the history, physical examination, or laboratory results.
- Another psychiatric illness does not account for the disruption (e.g., adjustment disorder with depressed mood, in response to the stress of having a general medical condition).
- Clinically serious distress or disability in social, educational, or other critical areas of functioning is triggered by the symptoms.
- The disturbance does not only occur in the case of delirium or dementia.
A mood disorder caused by a general medical condition can be classified as 1) manic, 2) depressed, or 3) mixed, with signs of both mania and depression present but none of them predominating.
The Following Are Medical Conditions that Can Either Cause or Imitate Mood Disorders:
- Malnutrition is a problem that many people face.
Anemia is a condition in which a person
Thyroid hyperthyroidism and hypothyroidism
- Dementia is a form of dementia.
- Ailment of the brain
- Lupus is a disease that affects the immune
- Condition following a heart attack
- Stroke, especially in the elderly.
Medications for hypertension and hypotension, such as reserpine and other blood pressure medications, may trigger symptoms that are similar to psychological or AOD disorders. Prescription and over-the-counter (OTC) drugs both can induce depression. Mania mood disorders may be caused by over-the-counter diet pills and other types of medication. A pronounced constriction of effect in patients treated with neuroleptic (antipsychotic) medications may be misinterpreted as a symptom of depression.
When a patient has coexisting AOD and mood disorders, both disorders must be diagnosed and treated. The evaluation process can be broken down into three stages: acute, subacute, and long-term. In certain clinical settings, acute and subacute assessment may not be appropriate for some patients. Outpatient AOD treatment program staff, for example, can see fewer patients with acute psychiatric symptoms than detoxification program staff.
Estimating the Risk to Oneself or Others
In the assessment process, it’s important to determine if a patient is a threat to themselves or others with mood disorders. This assessment will help decide whether there is a responsibility to protect patients from self-harm, disrupt violent intentions toward others, and alert intended victims of patients’ stated violent intent. About AOD addiction, confidentiality laws do not mitigate the obligation to shield any patients from suicide or violence related to mental illness. Many states’ laws justify and warrant the dedication of patients or the alert of possible victims when there is an immediate danger. AOD confidentiality rules are generally rather strict. However, although some states prohibit involuntary commitments for AOD violence, they do not restrict the psychiatric state that may predispose an individual to mood disorders.
Suicidal thoughts should be assessed by screening staff to see whether they are temporary or indicative of a chronic illness. Consider this: Do patients have any plans to commit suicide or have serious intentions? Have they attempted this before? Assess whether the patients have already been committed to a psychiatric facility or are currently receiving treatment for mood disorders. If patients are extremely dangerous to themselves or others, local services should follow either voluntary or involuntary interventions such as commitment. Before and in anticipation of emergencies, AOD workers should clearly understand local resources.
It may be beneficial for patients with apparent suicidal feelings to be held in a secure holding area for mood disorders. If an admission facility cannot handle such patients, a referral to another facility is suggested. Suppose someone comes into a facility on Monday at 8:00 a.m. and says he wants to kill himself. Then you should be able to talk down the patient, evaluate his treatment needs, and begin treatment or refer him for evaluation if he is showing symptoms of mood disorders. A rapid triage should be included in an assessment if it is required. See the sections on determining high-risk conditions in and (Psychotic Disorders) Chapter 8 for more detail.
Recent suicide attempts and AOD use are often closely related, leading to mood disorders. Having these factors at the same time increases the risk of suicide. Patients with manic symptoms who reach psychotic levels need immediate assessment and treatment. Mania should be assessed as soon as possible, and it should be tracked during subacute evaluations.
Mood disorders such as manic and hypomanic are often minimized in association with AOD. Manic patients may have poor insight into their AOD condition, mania, and social situation due to the symptom of grandiosity. Patients who are manic do not recognize themselves as sick. These people are typically hyperactive and irritable, and their impulsivity, irritability, and bad judgment put them at risk of mood disorders and themselves. Most of these individuals will need involuntary commitment if they are not inebriated. A discussion of psychosis evaluation can be found in Chapter 8.
Patients with mood disorders, especially the elderly, are at risk for life-threatening medical conditions such as hypoglycemia (insulin overdose), stroke, or infections. These symptoms, as well as withdrawal and adverse drug reactions, must be taken into account at all times and necessitate a thorough physical examination and laboratory evaluation. Referrals for medical examination and care should be provided by assessment staff. Assessment personnel in non-medical facilities should be qualified in triage and referral.
A strategy for identifying and treating medical conditions that cause or intensify mood disorders should be formulated. Endocrine conditions (like thyroid problems), neurological disorders (like multiple sclerosis), and HIV infection should all be taken into account. In addition to apparent medical concerns, it’s fair to say that patients with dual disorders’ basic medical needs aren’t being met, and a strategy for resolving these shortcomings should be formulated.
An Initial Addiction Evaluation with The Cage Questions
The CAGE questions are easy to use for screening (check Chapter 3) and to adjust for use with patients who may have mood disorders. Consider the following questions, which were adapted from the CAGE questionnaire. “Have you ever diminished or increased your AOD use as a result of being seriously depressed (or psychotic, for example)?” “When you use AODs, do you ever get more irritable, frustrated, depressed, or annoyed?” “Do you use alcohol or other medications to cope with guilt?” “Are you moodier in the morning or evening?” “Have you ever attempted suicide while inebriated?”
An initial alcohol and substance abuse assessment should emphasize recent alcohol and substance use and behavioral mood disorders. The assessor wants to know what medication was used, how much it was used, how frequently it was used, and how recently it was used. The following symptoms should be noted as mood disorders: drug use or psychosis, hallucinations, blackouts, and disruptive behavior.
Assessment of Social Conditions
The patient’s social environment should be evaluated, particularly about AOD and mood disorders. It’s vital to determine whether the patient is experiencing housing insecurity or homelessness. What is the location of the patient’s residence? Is the patient a resident of a nursing home? Who does the patient live with? Who does the patient socialize with daily? Is it possible to maintain a healthy social and domestic environment?
Is there a possibility for a social problem in the patient’s life? What is the patient’s current support system at home and in the community? What part do others play? Are there any AODs in your house? Is it possible to go home and socialize in a non-violent environment? Is it possible to sustain an abstinent lifestyle in your home and social environment? It is essential to assess whether the patient has the necessary resources to overcome the negative effects of non-supportive living situations on mood disorders related to abstinence and rehabilitation.
The screening interview is ideal for determining if the patient’s family members are physically violent and if they suffer from mood disorders. If the patient is at risk, it must be decided. Observation of physical and behavioral attributes may be an important part of the assessment process. Prior acts of violence are a strong indicator of potential violent mood disorders, and they should be taken seriously.
Symptomatology of Mood Assessment
When AOD use history is taken, and psychiatric screening and evaluation sessions are conducted, patients with AOD disorders may overstate or understate their psychiatric symptoms mood disorders. If the patient is depressed during the evaluation, potential misinterpretations of psychological history could occur due to overstating the severity or frequency of previous depression or mood disorders. Patients who are severely depressed during the evaluation, on the other hand, can downplay their depressive disorder because they believe it is a normal state. However, some people may believe that they “deserve” to be depressed rather than recognizing that depression is a mood disorder that differs from normal mood disorders.
Some patients experience excessive and unnecessary guilt feelings. Some patients do not correctly mark their depression and do not recall having been depressed mood disorders previously. Since patients often associate depression with sadness and other feelings, it’s important to ask questions like “Have you ever seen a psychiatrist or therapist?” during the evaluation. (If you answered yes, ask why.) “Are you able to get out of bed in the morning, or are you exhausted all of the time?” “Have you noticed any recent changes in your sleeping or eating habits?”
Patients may choose information from their medical background that are important to their present state of mind. It appears that people with depression are more likely than healthy people to self-report mood disorders in a negative way. Psychiatric symptoms are frequently overemphasized in addicted patients, although they are often underemphasized in psychiatric patients. Unhappy addicted patients experiencing temporary mood disorders will often rationalize their past as lifelong depression. As a result, obtaining additional information from other individuals and documentation such as medical and psychological reports is important. Continuation of the evaluation process following the opioid withdrawal phase is vital to treating mood disorders.
The following are some examples of questions to ask during the evaluation.
To Help with Depression, Try:
- “Have there been a moment in the last month that you felt down for the majority of the day almost every day?”
- “Have you gained or lost any weight during this time?”
- “Did you have any trouble focusing?”
- “Did you have trouble sleeping, or did you oversleep?”
- “Did you make an attempt to injure yourself?”
- “Have you had moments in the last month that you felt so hyperactive that you got into trouble or were told by someone that your conduct was out of character for you?”
- “Have you recently had episodes of irritability where you screamed or fought with others?”
- “Did you feel more self-assured than normal during this time?”
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