Depression is one of the most common co-occurring disorders of addiction. Trying to determine if the addiction caused the depression or vice versa, is pretty much impossible but what is known is that each of these conditions contribute to and worsen the symptoms and effects of the other.
What is Depression?
Depression, known as major depression or major depressive disorder (MDD), can encompass a long list of symptoms, but overall leaves people feeling sad, tired, worthless, guilty, isolated and can have trouble sleeping, eating or focusing. People present with irritability, brooding and obsessive rumination. They report pain, anxiety, phobias and excessive worry over physical health.
Major depressive disorder (MDD) is associated with high mortality. Self-harm and suicidal ideations are a serious concern for people with depression and threats should always be taken seriously. These people are not simply trying to get attention, they are crying out for help. Encourage them to seek help from a mental health professional, inpatient treatment centre or emergency room.
Depression is more than feeling sad. Sadness is a normal human emotion that everyone experiences after a life event such as the death of a loved one or divorce. The feelings last for a few days but the person still enjoys things in their life like seeing friends or going to dinner. A person suffering from depression feels overwhelming sadness and hopelessness about everything in their life, as if the ability to experience pleasure has been lost. Many people have serious disruptions with eating and sleeping, many not wanting to get out of bed all day.
How Depression Can Cause Addiction
Living with any mental health disorder increases your risk of addiction because you may want to self medicate to escape from the stress, sadness and other negative emotions.
Also, when you are going through something like the death of a loved one, job loss or divorce, you may be prone to use drugs or alcohol to cope with the feelings.
And then there’s COVID-19. The ongoing pandemic is responsible for a surge in mental health and substance use issues due to severe social isolation, living in fear, financial struggles from business closures and high rates of unemployment. And to top it all off, accessing services for the depression or substance use caused by the pandemic, well good luck, with wait times of several months most people sought no help at all.
Self-medicating is only effective in the short-term when the substance may provide some relief. But as tolerance develops and more of the substance is being used to achieve the same effects, the depression symptoms actually worsen the risk of developing a full blown substance use disorder is very possible.
Alcohol, benzodiazepines (xanax, clonazepam) and opiates (morphine, oxy) are commonly used to numb the pain of emotional distress but these substances (opiates in particular) all have a high potential for addiction, and can lead to financial consequences, withdrawal and risk of overdose.
How Addiction Can Cause Depression
The high that you experience from using substances is caused by the release of neurotransmitters in the brain – serotonin, norepinephrine and dopamine – which are the messengers for reward and mood regulation.
With repeated use of substances, the brain can no longer sustain the neurotransmitters at adequate levels, causing you to feel sad, empty, unmotivated and leading to the onset of depression.
Risk Factors & Causes of Depression
The correlation between depression and substance has been made clear, but there are more risk factors that contribute to one developing depression. They include:
- Genetic inheritance
- History of trauma
- Unresolved grief or loss
- Childhood experiences
- Life events
- Chronic stress
- Personality traits
- Medical conditions
- Sleep, diet and exercise
- Other mental health issues
Symptoms of Depression
- Feeling sad, empty, hopeless
- Excessive crying
- Angry outbursts, irritability, easily frustrated
- Loss of interest or pleasure in most activities including sex, hobbies, friends
- Sleep disturbances, insomnia, fatigue
Co-occurring Disorder Treatment
Treatment is available for co-occurring disorders (mental health and substance use). While some people may feel relief from the depression symptoms after a short period of abstinence, most people require professional treatment. Inpatient treatment is the most effective option as it allows you time away from your home environment to focus on yourself and the recovery journey ahead.
A combination of therapeutic interventions including detox, medications, counselling, group therapy, 12-steps, holistic activities and exercise are provided to address the individual needs of the person.
There are several antidepressants that can be used to treat specific depressive symptoms. The doctor will want to assess the symptoms, the client’s history with medications, health and family factors to determine which medication is best. The most common are selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). Both work by increasing the level of serotonin or norepinephrine in the brain, reducing depressive symptoms and enhancing mood. Some meds target anxiety and moods, others are more stimulating while others are more sedating. So, whether you are experiencing a lack of motivation and lethargy or having trouble sleeping, there is an antidepressant that may help.
Medication can help treat some of the depressive symptoms but it’s not enough to effectively treat depression and addiction. Individual and group therapies with various holistic activities and exercise are needed to treat the whole person. Through therapy you can gain insight into your issues and the contributing factors and learn coping skills and tools to help you achieve and maintain recovery.
Psychotherapy is delivered by a licensed clinician through individual, group or family sessions. Therapy is highly effective for treating depression and other mental health conditions. Research shows that about 75% of people who engage in therapy report improvements.
Cognitive behavioural therapy (CBT) is one of the most effective and commonly used therapies for depression. CBT involves changing unhealthy thoughts and behaviours into positive thoughts and behaviours. Therapists work with clients to identify coping skills and things that help reduce symptoms and replace behaviours. Clients will gain an understanding of the link between their thoughts, feelings and actions and are challenged to change the negative perceptions they have of themselves, their life and future. Clients are also encouraged to be more active and social and practice self-care.
If you or someone you love are struggling with a co-occurring disorder, The Hills can provide you with a highly effective treatment program delivered in a luxury setting with 5-star amenities to ensure you are comfortable throughout treatment. Give the team a call to discuss your issues and learn more about the program.