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Co-Occurring Disorder – Anxiety Disorder and Substance-Use Disorder

What are the unique challenges in treating someone with an anxiety disorder and a substance use disorder? 

There are unique challenges in treating someone with an anxiety disorder and a substance use disorder. I have personal experience with someone who had an anxiety disorder. She used to have panic attacks on a regular basis. If she had a few drinks, she would not have a panic attack The drinks would help her relax. She would also take xanex on a regular basis. The xanex or alcohol was a way to self-medicate. Therefore, after the medication would wear off, the anxiety would surface. Often times, the anxiety would be worse than it was prior to drinking alcohol. I also had to take this woman to the emergency room several times because she literally thought that she was dying. When I would take her to the emergency room, the doctors would look at her like she was crazy. She was obviously not the first person that came to the emergency room due to a panic attack. It is so interesting how a person can actually think that they are going to die even though everything is perfectly okay.

 

When treating someone with both anxiety and a substance abuse disorder, both disorders need to be treated. The client could have resorted to self-medicating the anxiety, which in-turn could have caused the substance use disorder. Or the substance use disorder could have caused the anxiety disorder.

Risk Assessment of an Alcoholic (cont’d)

In general, males have a higher risk of suicide. Jay is a male, which increases the risk of suicide. This risk of suicide increases as a person gets older. Jay is 56 years old, which increases the risk the risk of suicide. Not being able to see his family, being unemployed, and going through a significant amount of his retirement has sent him into severe depression. Being depressed increases the risk of suicide. Based upon the information given, Jay has not attempted suicide in the past. Jay’s alcoholism is at its worst. He cannot stop drinking. Even though his life is falling apart, he could not keep his job, and his friends want nothing to do with him, he is not able to stop drinking. Having a substance abuse disorder increases the risk of suicide. Based upon the information provided, it is not obvious that Jay is experiencing rational thinking loss. Jay has lost all of his social and family supports due to his alcoholism. His friends and family want nothing to do with him as long as he is active in his addiction. Having a lack of social supports increases the risk of suicide. Based upon the information provided, Jay does not have an organized plan to commit suicide. Jay is separated and his wife has filed for divorce. He lives by himself. Being single increases the risk of suicide. Based upon the information provided, Jay is not experiencing any sickness.

According to Assessment in Counseling, the higher an individual scores on the SAD PERSONS Scale the higher the risk of suicide. An individual with a score of 0 to 4 has a low risk of suicide, 5 to 6 medium, and 7 to 10 high. Jay’s score is a 7 out of 10 and the risk of suicide is high.