Not only can the patient not know the difference, the doctor doesn’t know the difference either. Because you typically can’t tell the difference. In other words, mood instability can look like bipolar disorder. Well, I have no idea if somebody who is coming off opiates their first year is truly bipolar or if they’re suffering from Post-Acute Withdrawal Syndrome. There’s no way to tell.
However, I will treat the symptoms accordingly because if you don’t treat symptoms that are overwhelming, you’re preventing recovery from being possible. Now, the patient needs to be in the hands of a doctor who really understands addiction. An expert who does not cave into too many symptomologies, continues to reinforce the behavioral and 12-step process of treatment, keeps motivation on hand, uses cognitive behavioral intervention, and does not merely label somebody with a psychiatric condition when there’s just simply no way to tell. But, you have to treat cautiously and accordingly without using anything that fuels the addictive process.
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