Depression is a mood disorder characterized by feelings of sadness, anger, and loss that disrupt everyday activities. According to CDC data, roughly 8% of adult Americans suffer from a major depressive incident during any given fortnight. People tend to have very different experiences of depression, but regardless of the specifics, constants include problems at work, school, and home. Interpersonal relationships are often impacted by depression, and the disorder exacerbates some chronic health conditions.
Unfortunately, depression and substance abuse often co-occur, and this complicates treatment as the symptoms of depression can often interfere with addiction recovery. Problems like suicidal thoughts, feelings of worthlessness, negative emotions, loss of interest, and more are all common side effects of major depression.
Today, then, we’ll be examining the link between comorbid depression and alcohol dependence, as well as exploring drug addiction therapy options and treatment modalities that can be used to conquer these problems.
Understanding the Link Between Depression and Addiction
NIDA (National Institute on Drug Abuse) data shows that depression and addiction are strongly interrelated. Either condition is problematic in isolation, but when both occur at the same time, treating the conditions becomes more complicated. If you have a mental health disorder like depression and you’re also suffering from alcohol use disorder or substance use disorder, this is known as co-occurring disorder or dual diagnosis. Data from SAMHSA (the Substance Abuse and Mental Health Services Administration) shows that almost 8 million adults in the US suffer from a mental health disorder and substance use disorder at the same time. This data also shows that those with mood disorders are more likely to abuse substances than those without mood disorders.
Drug addiction and alcohol abuse have both been linked to depression. It is estimated that one-third of those with depression also have a problem with alcohol or drugs. Whether addiction or depression comes first is an issue that’s been discussed over the years without a universal consensus being reached. The issues are believed to feed into each other as part of a vicious cycle.
Depression and Substance Abuse
When it comes to substance abuse and depression, it isn’t always clear which comes first, although depression may help predict first-time alcohol dependence, according to a 2013 study published in the Journal of Clinical Psychiatry.
These conditions share certain triggers. Possible connections between depression and substance abuse include:
- The Brain: Similar parts of the brain are affected by both substance abuse and depression. For example, substance abuse affects brain areas that handle stress responses, and those same areas are affected by some mental disorders
- Genetics: Your DNA can make you more likely to develop a mental disorder or addiction, according to research published in 2012 in Disease Markers. Genetic factors also make it more likely that one condition will occur once the other has appeared, according to NIDA
- Developmental Problems: Early drug use is known to harm brain development and make later mental illness more likely. The reverse also is true: early mental health problems can increase the chances of later drug or alcohol abuse
Environmental factors such as stress or trauma are known to prompt both depression and substance abuse. Family history is another factor.
A study published in the Journal of Affective Disorders in 2014 found that a family history of substance abuse is a significant risk factor for attempted suicide among people with depression and substance abuse.
These types of dual diagnosis may also be traced back to a time in early life when children are in a constant process of discovery and in search of gratification, according to David MacIsaac, PhD, a licensed psychologist in New York and New Jersey and president of the New York Institute for Psychoanalytic Self Psychology. Any interruption or denial of this natural discovery process can manifest clinically and lead people to believe that everything they feel and think is wrong, he explains.
This idea, which Dr. MacIsaac says is based on the work of Crayton Rowe, author of Empathic Attunement: The ‘Technique’ of Psychoanalytic Self Psychology, challenges the idea that people dealing with depression try to self-medicate using drugs or alcohol. In fact, people with a dual diagnosis may be doing just the opposite, MacIsaac suggests. “Individuals who are severely depressed drink to feed this negativity,” he explains. “Initially it’s soothing, but only for about 15 minutes. After that individuals sink deeper and deeper and feel worse than they did before.” For these people, MacIsaac points out, negativity is “where they get their oxygen.” Any inclination that treatment is working will trigger a need to go back into the black hole of negative discovery, and alcohol will intensify their depression, he adds.
Heroin Addiction and Depression
People had been using opium for thousands of years by the time morphine and heroin were first synthesized back in the 1800s. Opium-derived painkillers work so effectively due to the way they mimic chemicals that occur naturally in the brain. Research shows that physical pain and emotional pain trigger identical neurochemical responses in the brain. In the event of any form of pain, the brain releases endogenous opioids to counteract the pain signals and attenuate your subjective experience of pain.
When someone has clinical depression, they experience chronic and persistent emotional pain, often accompanied by physical pains like headaches, joint, back, and limb pain. This is due at least partly to lowered levels of norepinephrine and serotonin increasing your sensitivity to pain. In some cases, a combination of physical discomfort and chronic emotional pain leads people to use heroin. This powerful and addictive narcotic binds to opioid receptors in your brain, efficiently blocking the sensation of pain.
While using heroin can undoubtedly soothe feelings of depression short-term, things change when addiction sets in. Given the addictive potential of heroin, this can happen rapidly. After initially using heroin to feel better, it ends up propping up depressive symptoms rather than curing them.
People entering treatment for heroin use disorder are up to four times more likely to have major depressive disorder. Not only can using heroin inflame the symptoms of existing depression, it can also contribute toward the development of depression. This is due to the long-term chemical imbalances heroin abuse causes. For those physically dependent on heroin, the accompanying and co-occurring depression can be severe. By reducing depression, treatment outcomes for those suffering with heroin use disorder are improved.
Marijuana Addiction and Depression
For many years, it was widely believed that marijuana was non-addictive. Just like the drug laws surrounding this drug are changing, so is medical opinion. NIDA research shows that 30% of marijuana users have some form of marijuana use disorder. Some recent research suggests that marijuana smokers are more frequently diagnosed with depression – especially regular, heavy users – it is not believed that using marijuana directly causes depression.
For some people suffering from depression, using marijuana allows them to detach from the depressive symptoms dragging them down. As with all forms of self-medication using illicit substances, the strategy is ineffective long-term, although it may provide short-term relief. When someone is using marijuana heavily, they may appear outwardly depressed due to the way the drug can blunt emotions and feelings. There is some evidence linking marijuana use with psychosis and schizophrenia in people at heightened risk of these disorders. Also, using marijuana can aggravate the symptoms of a diagnosed psychotic disorder.
More research is needed to flesh out concerns about marijuana use and attempted suicide in teenagers. So, while depression often co-occurs with marijuana use disorder, there is no clear evidence that cannabis causes depression.
Cocaine Addiction and Depression
If you are depressed, it may seem logical to use cocaine to counteract these feelings, since cocaine is a powerful stimulant capable of inducing feelings of euphoria. While this might work short-term, with your mood boosted and your depression lifted, the effects are strictly short-term. It’s easy to get caught in a cycle of repeated use in an attempt to recreate the high. Not only does this not work, it can also lead to cocaine addiction.
Even if you use cocaine to alleviate depression without developing a substance use disorder, you could still make your depression worse over time. Abusing cocaine leads to changes in brain chemistry and makes it harder to feel happy without chemical assistance in the form of cocaine. In long-term cocaine users, even if use is not frequent, depression following use is commonplace.
The main way cocaine causes depression is due to directly changing brain chemistry. As well as norepinephrine, cocaine also increases dopamine and serotonin levels. This leads to feelings of euphoria with these chemicals flooding the brain. In the aftermath, your brain enters a period of recovery so the depleted neurotransmitters can return to their normal levels. You can expect to feel depressed during this phase of recalibration. Cocaine, unlike alcohol or opiates, does not cause physical withdrawal symptoms. Instead, you can expect a range of recurring psychological outcomes. Depression is the most pronounced of these. Fortunately, sustained recovery from cocaine abuse lets your brain heal and resume its previous level of functioning.
Alcohol and Depression
Worldwide, more than 300 million people suffer from depression. Millions more struggle with alcohol use disorder. Alcohol addiction is a chronic and relapsing disease, and it’s characterized by an inability to stop drinking despite adverse consequences. As with substance use disorder, alcohol use disorder and depression are closely linked.
Many people with depression turn to alcohol as a form of self-medication. As with all attempts like this, it can be effective short-term, with feelings of anxiety reduced, and mood temporarily boosted. This won’t address the root cause of the depression, though, and is likely to worsen symptoms. For others drinking heavily, this can worsen feelings of depression, and in turn drive further alcohol consumption.
It isn’t clear which comes first, alcohol or depression. Indeed, this will vary from person to person. The right dual diagnosis treatment program can help you tackle both issues successfully and simultaneously and conquer the symptoms of depression as well as your substance abuse problem. Depression and addiction recovery might seem like an insurmountable project if you’re struggling with both of these debilitating issues. How can you best fight back if you feel like you’re going under?
How to Deal with Addiction and Depression
Some people find themselves addicted to drink or drugs and then developing a mental health disorder like depression. For others with depression, especially when it’s undiagnosed, self-medicating with drink or drugs can offer short-term relief. Not only does abusing substances do nothing to address the underlying cause of depression, but it can often exacerbate symptoms rather than making them better.
Regardless of which condition occurs first, integrated drug addiction and depression treatment is the most effective route to recovery. For many people with a dual diagnosis, inpatient treatment programs offer the most structured and secure environment for rehab.
If inpatient treatment doesn’t make the right fit for your needs or your budget, you could engage with an outpatient treatment program for dual diagnosis. Here at TDRC we offer intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs) to help you tackle your co-occurring disorder. What can you expect if you or your loved one engages in treatment for a co-occurring disorder, then?
How to Help Someone with Drug Addiction and Depression
Everyone has a different experience of depression with varying symptoms and consequences. All addictions are different, too. This variation means there is no catch-all solution for dual diagnosis.
Imagine one person with no history of drink or drug abuse. After a serious car accident, they are prescribed opioid painkillers and become addicted. They resultantly also develop depression, as their life unravels through seemingly no fault of their own. Think of another person who has suffered for years with undiagnosed depression. Unaware of the reason for being persistently sad, they turn to drink or drugs to self-medicate.
There are myriad other scenarios in between these examples, so the best dual diagnosis treatment can only get underway after a precise diagnosis. Despite the many differences, most dual diagnosis treatment programs operate along similar lines.
You’ll first need to detox from drink or drugs, with medication and medical supervision if required. FDA-approved medication can help alleviate some of the more intense withdrawal symptoms. After detox, your body will be purged of alcohol or substances and your mind will start clearing. In many cases, you’ll continue taking medication throughout treatment, for both your addiction and your mental health condition The other core component of dual diagnosis treatment is access to psychotherapies like CBT (cognitive behavioral therapy) and DBT (dialectical behavior therapy). These forms of talk therapy are effective for treating both substance use disorders and alcohol use disorders. Psychotherapy can also be applied to mental health conditions like depression or anxiety.
You’ll explore how your thoughts, feelings, and emotions can impact your behaviors. You’ll also learn how to change these behaviors through implementing superior coping strategies.
TDRC and Dual Diagnosis Treatment
At The District Recovery Community, we have personalized dual diagnosis treatment programs for anyone suffering from depression with a co-occurring alcohol use disorder or substance use disorder.
We will ensure that the following take place:
- You can detox in a medical setting if required
- You will have access to information about the effects of alcohol and drug abuse on your physical and mental health
- Medication-assisted treatment will be available as appropriate for stabilizing mental health conditions. This will be administered in combination with psychotherapy like CBT (cognitive behavioral therapy)
- You will build healthy coping skills to avoid substance use or alcohol abuse, and you’ll also create a risk management plan to minimize your chances of relapse
- You’ll get chance to dive deep into the underpinning reasons for your addiction to drink or drugs
- With your dual diagnosis treatment complete, you’ll be encouraged to continue building a robust support network while adopting a healthier and balanced lifestyle
- You’ll benefit from access to a variety of drug and alcohol services, as well as self-help groups and 12-step support groups like AA, NA, and Dual Diagnosis Anonymous
So, with the right addiction treatment and the correct aftercare in place, there’s no reason you can’t attack depression and addiction simultaneously. To take the first step toward sustained recovery, call the friendly TDRC team at 844-287-8506 and find a treatment center to help you today.
