Dual Diagnosis: Eating Disorders and Alcohol/Substance Abuse

Dual Diagnosis: Eating Disorders and Alcohol/Substance Abuse Alcoholism is characterized by a strong craving to drink, an inability to stop drinking once beginning, a physical dependence upon alcohol to prevent symptoms of withdrawal, and a need for greater amounts of alcohol due to increased tolerance. Substance abuse is defined as the routine use of harmful substances for mood-altering purposes and can include illicit drugs, such as cocaine or heroin, prescription or over-the-counter drugs. Because alcoholism and substance abuse are known as co-occurring disorders, it usually develops alongside other illnesses, such aseating disorderor anxiety disorder. Eating disorders have been associated with high risk substance abuse as the individual has extremely low self-esteem and anxiety, to cope with their painful feelings they turn to stimulants like cocaine or meth, alcohol, laxatives, diuretics, emetics and amphetamines with are frequently used to decrease appetite, increase metabolism, promote weight loss or to purge unwanted calories after eat ing. Symptoms that occur with eating disorders vary a lot. You can experience obsessive thoughts about food and body weight can change eating patterns such as dieting, making excuses not to eat, avoidance of social situations involving food, going to the bathroom straight after meals, your mood can fluctuate from feeling depressed, irritable or anxious, daily activities are affected as you don’t want to go out socially, exercising excessively, spending a lot of time talking about appearance or weight or looking in the mirror and appearance such as wearing baggy clothes to disguise their weight, losing or gaining weight, greasy or dry hair and skin. As a result of these symptoms many individuals turn to alcoholism or substance abuse especially when they become stressed, depressed, have anxiety, low self esteem as it can elevate their mood and become more relaxed in their own skin. Especially people with eating disorders can rely heavily on alcohol as they have symptoms that alcohol reduces for that period of binging. It also can eliminate their feelings of worthlessness. It is also used as a hunger suppressant and to lose weight.The coping mechanisms of purging, bingeing, restricting, drinking is used as they have lost their connection with the original problem, in other words to forget about reality.Or alcohol can have the opposite effect on the individual about their lifestyle and it could result in suicide. Diagnosis of condition: there are two ways to find out the diagnosis of eating disorders and they are a physical evaluations and psychological evaluations. The physical evaluations can include recording their weight and height to get their body mass index, check their vital signs such as heart rate, blood pressure, pulse, temperature. You need to check their skin integrity to see whether there are any skin tears or is dry and flaky. Also need to do an abdomen examination, urinalysis, blood test to check their electrolytes; as theses will show us if the liver, kidney and thyroid functions are healthy or not. Psychological evaluations involves asking questions regarding their eating habits, behavior, purging, bingeing, exercise, self image, alcohol and substance abuse. These questions can be administered by your doctor or a mental health professional. After undergoing both physical and psychological evaluations the doctor will then see if you fit the criteria by reviewing all your sign s and symptoms and then a diagnostic is given. Management of the condition is to be referred to a nutritionist, undergo psychotherapy and be placed on medication to prevent hospitalization. The nutritionist will educate you and get you back to a healthy weight range; psychotherapist will help you exchange your unhealthy habits for healthy ones to ensure you have changed your eating habits and also educate them on the effects that the alcohol is having on their bodies. There is no medication that can cure eating disorders but can assist you with your sudden urges to binge or purge. They can also be given anti-depressants for depression and anxiety as this will most likely occur in eating disorders. Relaxation therapy is also extremely effective such as yoga, acupuncture, and massage and chamomile tea. They can also get counseling about their alcohol and drug addiction and slowly withdraw them off the substances. There are many companies and support groups out now that can help individuals with both drug and alcohol abuse. What is the prevalence of the condition in the Australian population? Eating disorders affect 9% of the Australian population, with up to 20% of females being not yet diagnosed. There has there been an increase in the prevalence in the past decade as it has doubled for both males and females. The reason for this change is that more teenagers are more susceptible to the pressures of social media and self image of being the perfect shape and size. It is becoming easier to access drugs and alcohol off the streets or have connections with individuals that are older and can buy it for them. Bullying in primary, secondary and tertiary schools and workplace related bullying. As a health professional, what could you do to participate in the ongoing education of people in society in relation to mental health and the disorder you have chosen? By going to local primary schools, high schools and tertiary schools to educate the students on the real risk factors of eating disorders drugs and alcohol have on their health and also talk about not falling to the social media pressures of being size 0 and trying to fit in. Place flyers up in local shops/companies/doctors clinic for people to read. Place adds in the news papers and online to spread the awareness of the affects that eating disorders and substance abuse can have on our selves, friends, families, co-workers and communities. How could you improve or maintain the flow of information between service providers and the community in relation to mental health? By running weekly forums on eating disorders and alcoholism to all ages, having various websites that the community can visit at any time, place ads on the TV about the impacts of eating disorders and advise everyone to get regular checkups at their local general practitioner. Dual diagnosis services are to support the development of responses of mental health and drug treatment services to individuals with both mental illness and substance use problems. They strive to develop the potential of hospital and community based alcohol and drug, and mental health treatment and support services to improve health outcomes of individuals with a dual diagnosis. Desiree Wyatt References Sane Australia. 2010.eating disorders. [ONLINE] Available at:http://www.sane.org/information/factsheets-podcasts/179-eating-disorder. [Accessed 17 March 14]. The free dictionary. 2013.compulsive eating. [ONLINE] Available at:http://medical-dictionary.thefreedictionary.com/Compulsive+Eating. [Accessed 17 March 14]. Mayo clinic. 2013.eating disorders. [ONLINE] Available at:http://www.mayoclinic.org/diseases-conditions/eating-disorders/basics/tests-diagnosis/con-20033575. [Accessed 17 March 14]. National eating disorders collaboration. 2013.eating disorders in Australia. [ONLINE] Available at:http://www.nedc.com.au/eating-disorders-in-australia. [Accessed 17 March 14]. eastern heath great health and wellbeing. 2013.dual diagnosis. [ONLINE] Available at:http://www.easternhealth.org.au/services/mentalhealth/adult/dualdiagnosis.aspx. [Accessed 17 March 14]. Integrated Treatment of Substance Abuse Mental Illness. 2014. dual diagnosis, eating disorders. [ONLINE] Available at:http://www.dualdiagnosis.org/eating-disorders/. [Accessed 16 July 14].