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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 Research207, 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 Behavior21(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 Journal50(2), 236-240.