Mental Health Matters 🧠 - Do Substance Offenses Equal Addiction?

What's up, Cadre fam? Evan here, your resident mental health and addiction therapist. This is mental health matters, where we talk about issues around mental health, addiction, because mental health is important. Today we have our every other week AMA. So essentially anyone can come in, ask me any questions. You could do that anyway on any live stream, but I gathered a bunch of questions that people have asked me here on social media and in general, you know, and then also stuff that's come up in my practice, interesting issues like that, that I could bring good stories and all that good stuff.

So we'll see if anyone. Oh, look at us. Right as I'm saying that we got a couple people hopping in recovery cafe. One of our regulars. We got Mary Gold. What's up? If you're around, let me know. Who are you, where are you from? And again, if you have any questions, mental health and addiction. We got Jules, another one of our regulars. What's up, Jules? How you going? Good morning. Good morning to my regulars and any newer people hopping in. We like to have fun here. We're a fun group, so. Yeah.

So if you guys got any questions, let me know. Remember, you can ask me a question on the community feed. Tag me, ask me a question. Any of my videos, reach out to me direct, otherwise, and then I will answer your question, even if it's not fully relevant. Maybe. We'll see. So we got some of those pulled up. Roll call, sherry recovery cafe. How's it going there at the cafe in St. Paul? Dog is extra needy here. Trying to get back into the swing center. Oh, a two week vacay. Jules, where'd you go?

I'm glad you got a vacay. I know that you were running. Running pretty thin there with everything you had going on, but. Yeah. Where'd you go? Vacay. Oh, my God. What do you need? You just want pets? Okay? That's all you need. Um, usually she just kind of sleeps. My dog here, that's Bella. Oh, Boston and Maine. Oh, cool. Cool. I've always wanted to go up that way. I mean, I've been. I was Boston one time, but I definitely wanted to check out Maine. It seems pretty cool. A lot of nature and that kind of thing.

Maybe in the fall too. I'm a big fan of autumn leaves. All right, so if not, let's go ahead and jump into some of the questions. All right, so first question. Someone said they were diagnosed with ASD, so. Autism spectrum spectrum disorder. Now what? That's an interesting question because, you know, oftentimes if someone's diagnosed with autism especially fits, you know, fella, come on, relax. All right? You're a passionate pit bull. I get it. All right, get up. Relaxed. So a lot of times, people who have more severe autism, they're diagnosed as kids.

And so then they're offered all sorts of different support services, especially for school. Maybe they go to a specialized school or programs or applied behavioral analysis programs to help with social skills and everything else, which could be really helpful as a kid. But typically, you know, you probably have to be a little bit more on the severe end to have that caught very early, because autism, compared to a lot of other disorders, is a very, very wide spectrum from individuals being able to fully function independently day to day on their own.

And they don't get diagnosed till much, much later in life. All the way. Why you're usually so chill. She's gonna go take a nap now, all right? So she'll relax. So it's a very, very wide spectrum. So a lot of times, people don't get diagnosed till much later. And that's what you're seeing as a trend right now. As people have developed more awareness of autism spectrum, more people are, you know, being diagnosed with it now. There's a little controversy with that. But anyway, there are a lot of people who.

It really fits for them and explains a lot of this unique struggles that they've had. So as an adult, it does kind of beg the question of, like, well, what now? I'm an adult. I'm. I have a job, maybe I have a family, maybe I have kids, and, you know, I'm functioning okay. But there are these unique struggles that I have. And so the. It is difficult because there's not, like, a ton. I mean, there are some specialty clinics that could be helpful or therapists who, you know, have a specialty in that.

And so, you know, you could find someone like that. Sometimes it could be challenging to find that kind of provider. There could be long wait lists and stuff. So if you could find that specialty. But a lot of times, too, I think people could just benefit from the general therapy process, you know, gaining a better understanding of how that neurodivergence for them impacts them in a negative way, because you could have some of those traits, but not have it be negatively impactful. So it's not like, you know, from a more neurodivergent perspective of people have different brains and not just they have a disorder, that doesn't necessarily mean that they need any kind of treatment, but if it is something that is causing negative impact and likely it comes up in certain areas, often relationships, interpersonal interactions, maybe difficulty, certain sensory inputs and difficulties with sensory, creating more anxiety, things like that.

So I don't know often in that case, if someone's not getting diagnosed away later, people don't love this word, but I don't know what else word. Coping, functioning. Let's just say able to navigate their day to day responsibilities and that kind of thing. Then maybe even just finding a good therapist and gaining insight, doing some research. There's coaches, there's a lot of good material out there. Connecting with your community, others who have it, and you could learn, you know, from what they found is helpful, too.

So a lot of people have found benefit that way. And so that goes for really any disorder like ADHD, you know, something similar like that as well, to connect in that way. So I think those are all things that could be helpful, but there's, you know, no cure for it. There's no medication for it. You know, it's really just kind of learning, you know, gaining insight, learning skills to kind of mitigate the challenges that come with it. So I hope that is helpful. See what cover. I've been wanting to try to focus a little more, finish a thought before moving on to the next.

I've been anxious to read what Miss Sherry has said here. So what. What I've experienced and witnessed with many people over the years, many individuals go undiagnosed with many mental health challenges. Unfortunately, because of the stigma, shame not and non education of managing. Okay, yeah, that's a very good point, too. You know, there's a lot of shame, stigma, you know, an idea of what, let's say in this case, someone with autism, you know, how can I identify, you know, me, someone with autism, you know, it's kind of like someone who struggles to identify, having a problem with, like, say, alcohol because their view of it is someone who's on the street drinking out of a bottle, cheap vodka with a paper bag over it, not able to function, work like that.

So there's always, again, another disorder with a pretty broad spectrum. Some very good points. Very good points. So that was question number one, which is one that we don't really talk about all that often. I can't remember. Yeah, I don't think we did cover this last time, but this could kind of open a broader conversation. So a father in law is expecting to have DT's. So delirium tremens, which is a symptom of alcohol withdrawal. Alcohol withdrawal is one of the most dangerous because you would actually die from it due to seizures and these things called delirium tremens, which is just like a severe form of alcohol withdrawal that could be defined by uncontrollable shaking, seizures, having delusions, confusion, panic.

So it's very severe. It's like, okay, so since you're expecting it. Question I always have. Why are they expecting it now? You could expect it if, you know, you have a history of it and you have a very heavy drinking pattern and you know that if you just stop, then that will happen. Now, the thing is, there's something you can do about it. Now, unless this individual is like, well, I'm just going to stop, which most people who are in that situation don't want to just stop. It's really hard to want to stop drinking in the first place.

However, if they do have the motivation to stop, it's probably anyone who's been through DT's could tell you it's probably one of the most unpleasant things ever. So this really goes for being dependent on any substance. Now, it doesn't necessarily mean it's always a bad thing. You know, for example, like, if I'm on a psychiatric medication, I take it every day, I'm likely going to have a physical dependence on it, though it may not be an addiction. So let's say for some reason I want to come off that medication and I just stop.

I'm going to experience some withdrawal symptoms, may not be as severe as that, but even with some of the antidepressants, it can be pretty severe and it could have a rebound effect as well. Even if it's not, like, dangerous, it could just be those mental health symptoms returning, which those in and of themselves could be unpleasant or dangerous if there's something like suicidal ideation or something like that. So even though I'm not a med provider, people ask me a lot about this. I have to know about this because a lot of my clients are on meds and I'm their kind of primary point of contact if they're meeting with me every week and maybe not as much their psychiatrist.

I mean, I just have to know these basic things. Again, I think any med provider, any of my friends in that realm would tell you, yeah, pretty safe to say, just don't get off the meds abruptly. Now, there's certain exceptions to that that you would work with your provider on, and you want to work that out with them. But just as some general principles, they may say, okay, hey, I'm going to be putting you on this new psych med. Everyone's mind and body reacts differently. And so some people may have an adverse reaction.

They could get on a medication and all of a sudden have a big personality change. They start having dark thoughts, suicidal ideation, just the way that medication affected them. And so in that case, the provider would probably say, yeah, in that case, you want to just stop. But again, don't be taking my advice for your individual situation. This is something you want to work with on your provider. Now, if you had a provider that said, oh, yeah, you've been antidepressant, just stop. Or, yeah, if you have those really horrible, dark thoughts, just stay on them.

You know, maybe you want to get a second opinion in that case. But no, those are just general principles. So in this case, two, if you're expecting that, you know, you, you're not, like, helpless in this because there are ways of mitigating withdrawal, which is with that, you know, with your doctor, someone, a general doctor, let's say with. Okay, so say alcohol. Best case in that situation is go to a detox facility or treatment facility that could do detox. Basically, they give you medications, very often a sedative like a benzo or a barbiturate that mimics a very similar process in your brain as alcohol, but it doesn't give you that, like, highly intoxicating effect at lower levels.

So that, and then you taper down over time, so your body becomes less and less dependent without going into withdrawal. So same thing. Like, if you're on a medication and you really, for some reason, want to get off of it, you know, that's, I think sometimes people maybe get off their meds for the wrong reasons, because sometimes it could be that stigma or they feel like, I feel like I shouldn't need it anymore or something, but, you know, where they, you know, so sometimes it's question, okay, well, why are you getting off in the first place if it's working?

But, I mean, I think there's some situations where it's like, I've been out for years, you know, my life, circumstances are different. I have new coping skills. I feel better. So maybe one could thrive off the medication, and maybe that would be a time appropriate to try it out. But then again, you want to do it with your provider. You want to taper slowly and be sure you're under good monitoring, as that is a risk time. So if there's withdrawal, it can be avoided. Seek the means to avoid it. So alcohol, detox, seeing a general practitioner who has experience with it, and they could help detox you on an outpatient basis.

Now, typically, if you have that severe of withdrawal, that probably means your addiction is a bit more severe and probably treatment isn't necessitated. But at the very least, you got to stay safe. Safety is the number one thing. So that's question number two. And then a similar question, too, of what anti someone was. People just always ask me this, and again, maybe I shouldn't delve into this realm as much with people. Again, these are questions people are asking me, so I'm just going to answer them because I have to know some of these things.

Now, some people ask, well, what antidepressants should I take? How do I know? And again, this is something, and I'm just going to give you general principles here, which is with psychiatry, essentially, you're shooting in the dark quite a bit, especially at the beginning, because you don't know how a client's going to react to certain meds. You can't go in their brain and diagnose them perfectly that way, and you can't know for sure how their mind and body is going to react. So usually psychiatrists will kind of have their own formula, like, okay, you're having these types of symptoms, or you're this type of person with this genetic whatever they often do, like a gene test you could do to have a better idea of how you may react, or looking at family history and what meds have worked for other people, you know.

So those are things that could increase the odds that they're going to prescribe that first medication. That's hopefully going to be helpful. Maybe they start you on that. They up the dose very often to see if that works. But if not, there's all these different options of meds they could try. And each provider has different reasoning for different meds and which ones they try first and which ones are more second line and is it an SSRI for Olme, serotonin? Is it an snRi for serotonin and norepinephrine?

Which one has a less impetus? Also, like other health conditions, if you have other health conditions in a med as a potential side effect to impact that health condition, that's why, another reason why they may decide that, or if you're on another medication, some meds don't interact as well with each other, so it's hard to say, like, which. How do I know which one's best? That's something you want to work with your doctor on. And I always say this too, like, if you can, not everyone has the luxury, especially if you're, let's say, in like a rural area or something because there's a huge psychiatrist shortage or a psych NP or something like that.

Psych NP. So nurse practitioner, physician assistant under a psychiatrist. I'm actually looking at this now because my psychiatrist retired. I got that email. So I'm like, okay, now I gotta find a new one. So I'm kind of doing a little shopping myself. So I'm looking into that. So I'm kind of in that position too. So looking at, okay, if I have the ability to see someone who specializes in mental health, I may as well do that if I have that luxury now. Otherwise, other options are seeing a general practitioner.

So with something like depression, anxiety, you know, they could prescribe for ADHD, but find a GP who has maybe a little bit more background and training in mental health. But if you could see that specialist, I think you're typically better off, even though some of these gps can be quite confident. So that is my advice for the day on that, and I will be back next week, Wednesday for another episode. I will be bringing a topic, can't remember off the top of my head what that topic is or if I even said it exactly.

But it'll be something fun, something interesting. Be sure to check out some of my other videos here on Cadre that dive deeper into all these topics in mental health, addiction. Also video series that we have available, so check those out. Anyway, folks, it's been awesome. Talk to you later. Have a good week. Bye.