Substance-Induced Mood Disorder

What is substance-induced mood disorder?

When taking a drug or stopping a drug causes days or weeks of mood changes, the problem is called substance-induced mood disorder. Many medicines and illegal drugs can cause you to be depressed. The drugs make you feel sad, uninterested in daily events, and hopeless. You may also get manic symptoms. When you are manic you are overexcited, have too much energy, and have difficulty controlling your actions.

If you were depressed or manic before beginning drug use and it worsens with drug use, it is not called substance-induced mood disorder.

How does it occur?

Many drugs change the way brain cells communicate with each other. Drugs can change the amounts of chemical messengers, called neurotransmitters, in your nervous system. Having the right balance of these chemical messengers in your nerves and brain is important for good mood. Two important neurotransmitters are dopamine and serotonin. Too little or too much of these chemicals can cause mood problems. Many drugs and medicines change how dopamine and serotonin work. This can upset the balance of these chemicals.

Frequent or daily use of some drugs can cause mood problems. Withdrawal (stopping use of some drugs) can cause mood problems for up to 4 weeks after you quit. Drugs and medicines that can cause mood problems while you are using them are:

• amphetamines such as speed, Ritalin, and Dexedrine
• decongestants such as pseudoephedrine (Sudafed)
• heart and high blood pressure medicines
• inhalants such as gasoline and spray paint
• antianxiety medicines such as clonazepam (Klonopin)
• steroid medicines

Drugs that can cause mood problems while you use them and during withdrawal are:

• alcohol (beer, wine, or hard liquor)
• cocaine
• hallucinogens such as LSD and hallucinogenic mushrooms
• marijuana
• sedatives and antianxiety medicines such as diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), and alprazolam (Xanax)
• opiates such as heroin, and pain medicines including morphine, codeine, Percocet, Darvon, and tramadol (Ultram)

Other prescription medicines can cause mood problems. Some of these are antidepressants, birth control pills, steroids, some antibiotics, certain acne medicines, and medicines for high blood pressure. If you think one of these is causing your mood problem, check with your healthcare provider.

What are the symptoms?

You may have the symptoms of depression or mania, or you may cycle between the two. The symptoms may come when you are using drugs or in the month after you stop.

Depression symptoms

Besides feeling somewhat sad and uninterested in things, you may also:

• be irritable
• have trouble falling asleep, wake up very early, or sleep too much
• have little appetite or eat too much
• be easily tired and low in energy
• have low sexual desire and function
• feel worthless and guilty
• have trouble concentrating or remembering things
• feel hopeless or just not care about anything
• have unexplained pain in your back or abdomen, or get headaches
• worry that you will never feel better
• think about suicide

Mania symptoms

During the manic periods you have days when you may:

• have a very high self-worth and feel "on top of the world"
• be very talkative and talk fast, maybe so fast that others have trouble following what you are saying
• have racing thoughts and ideas to the point of being disorganized and muddled
• have trouble concentrating and find yourself jumping from one idea to the next
• be very restless and hyperactive
• go for days with little or no sleep without feeling tired
• be very irritable and get into fights with others
• have bursts of high interest in sex and sexual activity
• be too active and act on impulse. For example, you might spend all your money and go into debt, or take sudden trips

How is it diagnosed?

Your healthcare provider or a mental health professional can tell you if your symptoms are substance-induced mood disorder. He or she will ask about your symptoms and your drug or alcohol use. You may be asked to have some lab tests to rule out medical problems such as hormone imbalances. There are no lab tests to diagnose substance-induced mood disorder. There are blood and urine tests to check for substance abuse.

How is it treated?

If you have been abusing drugs, go to a substance abuse therapist or program for help with stopping and handling withdrawal symptoms. Do not suddenly stop using drugs without professional help. Stopping some drugs abruptly can be very dangerous, and may even result in death.

See your healthcare provider if you believe that a medicine may be causing your depression. Your healthcare provider may prescribe a change in medicine or treatment for depression.

Psychotherapy

Substance-induced mood disorder can be successfully treated with either group or individual psychotherapy. Therapy in a group with other people having substance abuse problems is often very helpful. In some cases, medicines for depression or anxiety may help you to stop substance abuse. Discuss the options with your healthcare provider or therapist.

Community Support Groups

Most towns and cities have chapters of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Look for these in your community.

Natural and Alternative Treatments

Claims have been made that certain herbal and dietary products help you avoid a return to substance abuse. There are no natural treatments known to help you stop substance abuse.

Many types of alternative treatments are possible to help you avoid future substance abuse. Some of them are:

• Biofeedback: Through biofeedback you learn to control body functions such as muscle tension or brain wave patterns. Biofeedback can help with tension, anxiety, and concentration, and indirectly may help to avoid a return to substance abuse. Biofeedback should be done only in addition to psychotherapy.
• Massage Therapy: Massage therapy may help lower stress, but it does not cure mood problems or substance abuse.
• Relaxation Therapies: Learning special relaxation methods can help with mood problems or substance abuse, along with psychotherapy. Yoga and meditation may also be helpful.
• Art and Music Therapies: Some people find art and music therapy, along with psychotherapy, to be helpful.

How long will the effects last?

Substance-induced mood disorder usually lasts as long as you continue substance abuse, or until you have gone a month or more without abusing substances. The treatments listed above most often will help you to remain free of drug use.

What can I do to help myself or my loved one?

If you have been abusing drugs, go to a substance abuse program or skilled mental health professional for help with stopping the substance abuse and handling the withdrawal symptoms.

If you have been depressed due to side effects from medicine, there are things you can do that will help reduce your depression.

Maintaining a healthy lifestyle is crucial. Staying physically and socially active is very important. Having regular sleep and eating patterns will also help you.

To help prepare you to stop substance abuse and prevent a return to drug use:

• Exercise for at least 20 minutes every day, for example, a brisk walk.
• Talk to your family and friends.
• Eat a healthy diet.
• Avoid caffeine.
• Learn ways to lower stress, such as breathing and muscle relaxation exercises.

When should I seek help?

Seek professional help if you or a loved one frequently uses any of the substances listed above under "How does it occur" without a healthcare provider's prescription.

Get emergency help immediately if you or a loved one have serious thoughts of suicide or harming others. Call for police help if you or a loved one have violent behavior, such as destroying property or threatening others.