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Recently, former Surgeon General Dr. Vivek Murthy spoke about a “social recession,” marked by a growing loneliness and isolation. Today, while social distancing and quarantine measures are in place to protect our health and physical safety, they are also fueling our loneliness. This is a common theme in calls to our helpline, where parents have expressed their own and their child’s feelings of isolation, anxiety, fear, grief and loss. This is especially true for those who have a child struggling with a substance use disorder, a mental health disorder, or both. A crisis like this can have an impact on your child’s mood because they don’t have access to the substances they were used to having.
If your child or loved one has already been diagnosed with co-occurring disorders, it can be helpful to keep track of symptoms and their severity, especially during this time of social distancing. These symptoms can include higher levels of anxiety, insomnia, agitation, inability to focus, etc. Regardless of which disorder is contributing to their symptoms, it’s also important to let providers know what your child is experiencing and/or encourage them to do so as well. A next step may be to seek a telehealth appointment, an alternative to in-person care during the pandemic.
Managing Medications
Often people with co-occurring disorders struggle with medications because they do not like the side effects or are reluctant to take them at all: “I took it for a few days, but it didn’t help.” In cases like these, the medication most likely never reached a therapeutic dose.
Others may say, “I was doing well, so I thought it was okay to stop taking the medications.” Stopping medications abruptly can cause numerous problems, including a significant rebound of the disorder that was being treated in the first place.
While substances can alter the way a person feels with an immediate, but temporary effect, they can also worsen mental health symptoms over time. Your child may say, “I don’t like the way the medication makes me feel. It doesn’t work as well as (fill in the substance) to make me feel better.”
These thoughts and feelings may signal that your child could benefit from an adjustment in their medication. Talking with their treatment provider more often and participating in self-help groups like the Depression and Bipolar Support Alliance (DBSA) and National Alliance on Mental Illness (NAMI), as well as substance use support groups might be beneficial. We’ve compiled a list of remote and online support options that may be useful in locating groups that may best suit your family’s needs during this pandemic. You can also reach out to local mental health agencies, as well as recovery centers.
In addition to telehealth services, many providers are now prescribing higher quantities of medications to reduce the number of visits to the pharmacy. While this practice can be helpful, it can also create a potentially unsafe situation. Here are some tips for managing medications and taking safety precautions at home:
- Use a weekly pill container. Set aside medications for the week to make it more convenient than counting out pills each day.
- If misuse or overdose risks are a concern, a pill bottle that has a 4-digit lock on the cap or a timer to see when it was last opened may be useful. This assumes that the medication is being dispensed by a responsible adult in the home.
- Mix unused or expired medications with coffee grounds or kitty litter, or use a medication disposal product like Deterra or DisposeRX.
- Know the signs of an overdose for both prescription medication and substances. Watch out for vomiting, unconsciousness or slow breathing, as they can be signs of an alcohol overdose. Additionally, shallow breathing and loss of consciousness can be a sign of opioid overdose, while hallucinations, agitation and rapid breathing can be signs of stimulant overdose. Recognizing those symptoms and creating a plan in case of overdose can be an essential part of protecting your child’s health.
- Create a safety plan with your child to put in place in case of an emergency. It can be challenging to create a safety plan without feeling like you’re endorsing your child’s use, but it’s an integral part of recognizing the risks of substance use and keeping your family safe.
- Keep naloxone in your home and know how to use it. This can be life-saving in the event of an opioid overdose.
Substance Use & Mental Health: Your Guide to Addressing Co-occurring Disorders
We worked closely with Child Mind Institute to develop a guide to mental health disorders and the related impact of substance use. Included in the guide is information on what to look for in terms of quality treatment and how families can support their loved ones.
Communicating with Your Child
It can be difficult to talk with your child about their mental well-being, but an essential component of addressing your child’s co-occurring disorder is effective communication. In order to begin the dialogue, try finding a time that works for both of you, and approaching the start of your conversation with an open mind. It also can be helpful to create a plan together to reduce some of their stress, and be sure to include some positive comments between the constructive ones. Talk with them about building a routine, staying connected socially and establishing healthy activities. You can offer suggestions and reinforce how you can help.
Prioritizing Your Self-Care
This time is stressful for everyone and self-care is especially vital. It’s natural to feel anxious, confused and scared right now, and it may even feel like you need to be in “panic” or “emergency” mode at all times. But taking a break from the news and engaging in fun and relaxing activities can make you less stressed and anxious, which will benefit both you and your child.