Depression and addiction are mental health diagnoses that are more often than not linked in some form. Individually they are complex and Challenging diagnoses, which may seem impossible to manage. Combined, they are even more so. To learn how to manage them both and better understand if one causes the other, it is helpful to understand the risk factors symptoms and treatment options associated with each.
What is depression?
Depression is one of the most prevalent mental disorders in the United States. It is estimated that over sixteen million adults over the age of 18 experienced at least one major depressive episode in the last twelve months. That statistic does not include those younger than eighteen who are equally as likely to experience depression as the “older” segments of the population.
When people think of depression, they often view it as being upset or having a case of “the blues.” For those who struggle with depression or their family members, depression is so much more than being upset. Everyone will experience sadness at some point; however, for most, sadness or unhappiness tends to go away. Often, these emotions are directly related to a specific event for an experience they have had. Unlike these brief periods of sadness, clinical depression, or major depression, is a diagnosable condition characterized by a depressed mood for most of the day, nearly every day for two weeks or more. Common symptoms of depression include:
- Feelings of hopelessness
- Persistent feelings of sadness or emptiness
- Anger and irritability
- Excessive guilt or feelings of worthlessness
- Decreased energy
- Loss of interest in usual activities or hobbies
- Difficulties sleeping
- Difficulty concentrating or remaining attentive
- Changes in appetite or eating patterns
- Increased body aches and pains (without an apparent underlying medical reason)
There are also several different types of depression. The type of depression someone is experiencing is often related to the severity and duration of their symptoms. It can also be associated with a specific event or trigger that brings about symptoms.
Depression does not have one specific or singular cause; however, several genetic, environmental, psychological, and biological risk factors are commonly linked to the onset of depressive symptoms. The Diagnostic and Statistical Mental Disorders (DSM-5) outlines several potential risk factors for depression which include:
- Adverse or traumatic childhood experiences
- Family members (parents or siblings) with depressive disorders
- Certain chronic medical conditions (such as diabetes, cardiovascular disease, and obesity)
- A series of stressful life events or changes
Addiction refers to the problematic abuse of substances despite the occurrence of serious interpersonal, financial, or medical consequences. When someone has an addiction, they may display or experience at least a few of the following symptoms or behaviors.
- Using larger amounts of a substance than needed or intended
- Having the desire to stop using but the inability to follow through
- Spending excessive time and energy attempting to obtain the substance
- Feeling intense cravings and desire to use
- Continuing to use despite adverse consequences
- Taking risks to obtain the substance
- Using in hazardous situations (for example drinking and driving)
- Developing a tolerance for the substance
- Experiencing withdrawal when not using
Addiction is a progressive disease. This means the severity or intensity of the addicts’ symptoms are likely to get worse until the user seeks treatment for their addiction.
Substance addiction also has risk factors that may increase a person’s likelihood of developing a substance use or abuse disorder. As with most other mental health disorders, there is not one specific root cause of addiction. Some of the more common risk factors include:
- Family members with a history of substance use or abuse
- Excessive stress levels
- History of poor coping skills
- Poverty or financial distress (which is often exacerbated by their addiction)
- Early aggressive or violent behavior
- Lack of parental supervision or involvement.
- Stressful or traumatic family relationships
Dual Diagnosis: Depression and Substance use disorder
According to the National Survey on Drug Use and Health conducted in 2014, approximately eight million Americans also have a dual diagnosis. The term dual diagnosis means someone has a mental health condition, such as depression, and a substance use disorder at the same time. Research shows almost one-third of people with depression also meet the criteria for a substance use disorder. This co-morbidity (both diagnoses simultaneously) is associated with an increased risk of suicide, social and personal impairments, and other mental health conditions.
Substance use is very common among people who are also struggling with triggering circumstances. Alcohol operates as a depressant to the central nervous system, and therefore the use of alcohol while depressed tends to trigger depressive symptoms such as sadness, hopelessness, and lethargy. Also, people experiencing depression often reach for substances such as alcohol or drugs to elevate their spirits or numb themselves to painful triggering emotions. As a result, depression and substance abuse tend to feed on one another at one condition will often make the other worse. According to some research, approximately one out of every four adults with a mental illness such as depression will also have a substance abuse disorder.
Does Depression Cause Addiction?
Does depression cause addiction? Or does addiction cause depression? Depression and addiction often present together, and therefore it can be difficult to determine which one to treat first. According to the Substance Abuse and Mental Health Services Administration, there are approximately nine million adults with mental health and substance abuse problems. Unfortunately, of those nine million, only about 7% actually received treatment for both conditions if one diagnosis is treated without the other recovery from both tends to become less likely.
As noted above, it is not uncommon for those experiencing depression to reach for substances to either numb the pain or improve their mood. Unfortunately, this often leads to a situation where substances are required for the person to achieve continued happiness. Without the use of substances such as drugs or alcohol, the individual will continue to struggle with their depressive symptoms. On the other hand, when the individual uses substances to dull the symptoms of depression, it can often exacerbate depressive symptoms as the “high” from the drug wears off.
Withdrawal from certain types of drugs or alcohol sometimes results in symptoms that tend to mimic or overlap with those often seen with depression. For example;
Alcohol withdrawal: The symptoms of alcohol withdrawal can include agitation and anxiety. After the acute withdrawal phase (the first stages of withdrawal), Many people will experience alterations and mood lethargy feelings of anger or hostility and difficulty sleeping. All of the above are common symptoms associated with depression as well.
Stimulant withdrawal: when someone withdrawals from stimulants (such as methamphetamines or cocaine), they can experience changes in mood and lack of pleasure or interest in their usual activities. Also, when a person “hits bottom” after stimulant intoxication, they may feel excessive fatigue and alterations in appetite.
Opioid withdrawal: withdrawal from opioids such as heroin or prescription pain medication can result in body aches and pains, severe irritability, and depression withdrawal from opioids can also cause anxiety changes in appetite or cravings and changes in sleep patterns for an extended time after their last use. Similar to withdrawal from alcohol or stimulants, many of these side effects mimic those of depression.
The use of and withdrawal from various substances can intensify preexisting or co-existing mental illness symptoms. In some cases, withdrawal symptoms coupled with symptoms related to a depressive disorder can be so intense and unmanageable that it can lead to self-harm or suicide. For this reason, it is essential not only to treat mental disorders and substance use disorders at the same time but to ensure treatment occurs in a safe space such as The Hills in Los Angeles, California. Facing withdrawal on your own can be dangerous and should be done with proper medical supervision to avoid potentially fatal medical emergencies.
Treating Depression and Addiction
Recovery from depression and addiction is possible. Ideally, both depression and substance abuse disorders should be treated simultaneously through an integrated treatment program to avoid relapse. Unfortunately, the recovery process from drug abuse can cause many of the symptoms of depression to return. There are several different types of treatment available for both substance abuse disorders and mental health disorders. At The Hills, we offer personalized addiction treatment programs designed to meet the needs of the individual. Each person struggling with depression, a substance abuse disorder, or a co-occurring disorder will experience different symptoms and require different treatments. Therefore, for treatment to be the most successful, it is necessary to design A specific treatment program designed with your symptoms and your needs in mind.
There are several different types of medications that may be used to help manage depression. This may sound strange if one is being treated for depression and addiction at the same time; however, many of these medications are also designed to help mitigate the symptoms associated with withdrawal. In addition, several medications are also used to help treat alcohol and opioid dependence and to reduce substance cravings to help make treatment and recovery more successful. While no single medication has been approved by the FDA to treat both depression and substance abuse disorders simultaneously, those with dual diagnoses appear to respond well to a combination of medications in conjunction with psychotherapy.
There is a wide variety of evidence-based therapies commonly used to help manage depression. These can include the following:
Cognitive behavioral therapy: this form of treatment helps people to alter negative thought patterns that contribute to depression. This technique aims to help people examine the environment around them, their behaviors and interactions, and their destructive thought patterns. Once they understand these, they are taught to reframe their thoughts and actions more positively.
Interpersonal therapy: interpersonal therapy helps individuals work through impaired or challenged interpersonal relationships. It focuses on changing behavior and exploring major issues or traumatic events such as grief, which can impact depressive symptoms.
Problem-solving therapy: problem-solving therapy helps people cope with difficult life stressors and traumatic experiences that contribute to their depression. Through a step by step process, the therapist will help pinpoint problems and develop effective, healthy, and realistic solutions.
Other conventional therapies also used for addiction treatment include contingency management, motivational enhancement therapy, and lifestyle changes. Cognitive-behavioral therapy is also commonly used in the treatment of substance abuse disorders.
There are many treatment programs available for people struggling with a dual diagnosis of depression and addiction. The most appropriate treatment program for you Will depend on the severity of your condition, your treatment history, and the type and duration of your substance abuse disorder.
The therapeutic programs outlined above can be delivered in both inpatient and outpatient care settings. Outpatient settings work well for those with less severe addictions or those who have not been through treatment before. Inpatient treatment programs work better for those with severe addictions inpatient care settings allow for 24/7 support, monitoring, and structure in a safe residential environment. Impatient programs can be short term or long term depending on the needs of the individual. It is essential to choose a program where all of your treatment needs can be met simultaneously. At The Hills, we understand the challenges faced when struggling with depression and a co-occurring substance abuse disorder. When one illness feeds the other, it can feel like a vicious circle that is impossible to get out of. If you are ready to seek treatment, contact your California treatment center today.