Mood Disorders and Alcohol/Drug Use

By Richard K. Ries, M.D.

Hallucinogens, Marijuana, and PCP

The hallucinogens can cause a state of intoxication called hallucinosis, which has several features in common with psychotic disorders and a few in common with mood disorders. Hallucinogens such as LSD and drugs such as MDMA (methylenedioxy-methamphetamine, or Ecstasy) and MDA (methylenedioxyamphetamine) may precipitate intense emotional experiences that may be perceived as positive or negative mood states by the drug user.

These experiences are affected greatly by personality, preexisting mood state, personal expectations, drug dosage, and environmental surroundings. While many users will experience sensory and perceptual distortions, some will experience euphoric religious or spiritual experiences that may resemble aspects of a manic or psychotic episode. Others may have a deeply troubling introspective experience, causing symptoms of depression.

Marijuana, which has sedative and psychedelic properties, can cause a variety of mood-related effects. In the individual who has not developed tolerance for the drug’s effects, high doses of marijuana can cause acute marijuana intoxication with euphoria or agitation, grandiosity, and “profound thoughts.” Together, these symptoms can mimic mania. Because marijuana is only slowly eliminated from the body, chronic use results in relatively constant marijuana levels. Thus, daily marijuana use can be, in effect, a chronic marijuana intoxication. This state may include symptoms of chronic, low-grade lethargy and depression, perhaps accompanied by anxiety and memory loss. Phencyclidine (PCP) intoxication can include symptoms of euphoria, mania, or depression, in addition to sensory dissociation, hallucinations, delusions, psychotic thinking, altered body image, and disorientation.

Mood Disorders Due to A Medical Condition

The DSM-IV describes diagnostic criteria for mood disorder due to a general medical condition. The five criteria are:

  • A prominent and persistent mood disturbance is characterized by either (or both) of the following:
    1) depressed mood or markedly diminished interest or pleasure in all, or almost all, activities,
    2) elevated, expansive, or irritable mood.
  • There is evidence from the history, physical examination, or laboratory findings of a general medical condition judged to be etiologically related to the disturbance.
  • The disturbance is not better accounted for by another mental disorder (e.g., adjustment disorder with depressed mood, in response to the stress of having a general medical condition).
  • The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • The disturbance does not occur exclusively during the course of delirium or dementia.

Mood disorder due to a general medical condition can be described as having 1) manic features, 2) depressive features, or 3) mixed features in which symptoms of both mania and depression are present and neither predominates.

Medical conditions that can either precipitate or mimic mood disorders include the following:

  • Malnutrition
  • Anemia
  • Hyper- and hypothyroidism
  • Dementia
  • Brain disease
  • Lupus
  • HIV/AIDS
  • Postcardiac condition
  • Stroke, especially among elderly people.

Medications, including reserpine and other medications that treat hypertension and hypotension, can cause conditions that may be confused with psychiatric or AOD disorders. Both prescribed and over-the-counter (OTC) medications can precipitate depression. Diet pills and other OTC medications can lead to mania. Patients treated with neuroleptic (antipsychotic) drugs may have a marked constriction of affect that can be misinterpreted as a symptom of depression.

 

APA Reference
Ries, R. (2007). Mood Disorders and Alcohol/Drug Use. Psych Central. Retrieved on October 23, 2014, from http://psychcentral.com/lib/mood-disorders-and-alcoholdrug-use/0001151
Scientifically Reviewed
    Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
    Published on PsychCentral.com. All rights reserved.