Depression and Addiction Go Hand In Hand
Anyone who deals with substance abuse is probably no stranger to the blues. Scientists, therapists and addicts agree that depression and addiction often go hand in hand. Experts call this “bi-directional.” This means that depression can cause addiction and addiction can cause depression. Depression is something far more involved than passing sadness or the blues. Addiction, also, is vastly different than just drinking too much once in a while. They are both very serious, life-threatening illnesses. When these two are mixed, specialized dual diagnosis treatment is the best option for relief and recovery from both. With a bit of knowledge and help, there is hope.
When you are depressed you don’t control your thoughts. Your thoughts control you.
The Depression/ Addiction Connection
Depression can lead to addiction when someone tries to self-medicate. For a short while, drugs and alcohol seem to ease the emotional pain of depression. “I felt like the world was so dark I couldn’t cope without booze,” recounts one alcoholic. “Eventually, I was addicted to alcohol and couldn’t even cope with the good times. I drank when I was happy AND I drank when I was sad.” It has been proven that 34.5% of those with major depression also suffer from alcohol or drug addiction.
Likewise, one third of those who struggle with substance abuse also experience depression. In the short term, these feelings are quite literally “all in our heads.” Large amounts of dopamine, serotonin and norepinephrine are released in the brain when someone gets “high.” These are the mood-elevating neurotransmitters that make us feel good. After a drug or alcohol spree, the brain is depleted and we feel sad and useless. Longer-term depression can be caused by the shame and remorse we experience after prolonged drug and alcohol abuse. One woman in recovery remembers, “I said and did terrible things when I was drunk. I felt guilty and depressed and horrible the next day. With time, the pain and self-hatred became a daily thing, which made me want to drink more. I was caught in a never-ending cycle of sadness and alcoholism.”
“Sad hurts but it is a healthy feeling. It is a necessary thing to feel. Depression is very different.”
What is Depression?
Depression is a serious mental disability that affects millions of people. Experts estimate that 10% of Americans suffer from clinical depression and these numbers continue to grow. Symptoms of depression are so severe that they interfere with normal daily activities like going to work, maintaining relationships, self-care and social life. Someone with depression can feel sad, have low energy and feel hopeless. Many people can have these feelings after losing a loved one or experiencing a traumatic event, but it is not classified as depression unless these feelings persist for more than 2 months.
Symptoms of Depression
According to the Diagnostic and Statistical Manual of Mental Disorders, someone with depression experiences at least 5 of these symptoms every day for at least 2 weeks:
- Feeling Hopeless
- No appetite/ weight loss
- Increased appetite/ weight gain
- Not sleeping enough or sleeping too much
- Aches and Pains
- Low energy
- Feeling Guilt
- Feeling Useless
- Difficulty concentrating
- Lack of interest
- Suicidal thoughts or attempts
The “Answer” Can Be a Problem
If someone has clinical depression, chances are it will not just go away without some treatment. Therapy, medicines and alternative treatments can alleviate the symptoms of depression. Unfortunately, many people don’t want to go to the doctor or a therapist. They may think their depression will pass. Some feel that admitting they have a problem is a sign of weakness. In these cases many reach for drugs or alcohol to ease the emotional pain of depression. While this may seem to work at first, self-medicating depression with alcohol or drugs can make people feel even worse. Alcohol is a depressant, which causes increased sadness and fatigue. Not knowing this, many turn to more alcohol and drugs to “feel better” when, in fact, they are making themselves feel worse. This cycle can easily lead to addiction.
What is Addiction?
Addiction is also called “substance use disorder.” Initially, most people drink alcohol or take drugs to feel good. A depressed person will drink or use drugs to feel better. With increased use comes tolerance. This means someone needs more and more of the drug or alcohol to achieve the same “high.” This leads to consistent increased drug and alcohol use and addiction. Someone who is addicted to drugs or alcohol will compulsively use the substance despite experiencing negative consequences. Someone may lose their job or harm relationships because of drug use, but cannot stop taking the drug even though they want to. At this point, no amount of “willpower” will cure drug addiction or alcoholism. Changes in brain chemistry cause intense cravings and impaired cognitive function that can affect judgment, memory and decision-making. At this point, addicts need help from an outside source to find recovery.
What Are The Signs of Addiction?
- Unable to stop: Once someone takes the substance they experience craving and cannot stop or moderate
- Obsession to use: Thinking about drinking or taking drugs, craving drugs or alcohol
- Wasted time: A large amount of the days are spent thinking about the next high, getting high, or recovering from being high
- Tolerance: The body adjusts to the substance and requires more and more to achieve the same “high.”
- Interference: Work, home, school and social life suffer because of substance use
- Taking Risks: Entering into dangerous situations to get drugs or take drugs
- Reckless: Taking drugs or drinking alcohol while aware that it causes problems in other areas of life
- Withdrawal Symptoms: Reducing or stopping the intake of drugs and alcohol can make the body react adversely. Some physical symptoms include nausea, tremors, anxiety, cold sweats and mood swings.
Treating Depression and Addiction Together
When someone suffers from mental illness and substance abuse at the same time, it is best they seek dual diagnosis treatment. Facilities that offer inpatient dual diagnosis drug and alcohol rehabilitation have specific programs that treat both ailments. Usually, drug and alcohol detox is necessary first, to eliminate toxins and allow the mind and body to begin to heal. A psychiatrist will diagnose the mental state and prescribe medication, if needed. Prescription antidepressants like Lexapro or Prozac can help boost serotonin levels in the brain so the client can start to feel emotional relief. Medication coupled with therapy and behavioral support has been proven to be most effective for dual diagnosis patients.
Peer group support and coping skills training help replace addictive behavior patterns. It is important that both the depression and addiction are treated simultaneously, as depression can return and cause relapse if someone is treated for addiction alone.
Which Came First, the Depression or the Addiction?
It is important to know whether depression precipitated the addiction, or it is the other way around. Why? If the depressive disorder occurred first, a different kind of treatment is needed. Medical intervention and more intensive therapy may be required to heal major depression. If the depressive disorder developed as a result of addiction, it has been present a shorter period of time and many symptoms may subside with profound sobriety.
It can be difficult to know if the depression came first and often requires qualified personnel to unravel the mystery. Often, the client really can’t tell if they were depressed before they became addicted to drugs or alcohol. A well-trained and seasoned psychotherapist can uncover the source of depression with therapy and family interactions. With this bit of knowledge, a more comprehensive dual diagnosis treatment plan can be devised.
Is There Hope?
One thing addicts and alcoholics have very little of is hope. We know the depths of despair when we are in the relentless grip of addiction. Many of us lost our families, our jobs and homes and, perhaps the most important thing, our self-worth. True clinical depression is also a very serious condition. It can cause damage to the immune system, self-harm and even death. Surely it can seem almost impossible to address two dire conditions simultaneously. Luckily, with proper dual diagnosis treatment, long-term sobriety and freedom from depression are possible. Someone with addiction and depression can indeed experience something they rarely if ever had: HOPE.
“When I think back on those dark days, I feel like that was almost a different person. The world and everything in it seemed so…dark. Now, I am free of alcohol and the way I look at the world is completely different. I don’t even think about drinking anymore. I have true happiness now that I am sober.”