Understanding Depression

Around five in ten people who experience a substance use disorder or addiction will also experience a mental illness, including depression, at some point in their lives, and vice versa. It might be surprising to know that people who suffer from a mild or severe depression cycle also have a higher risk of becoming addicted to illicit substances than people who don’t have depression.1

However, depression isn’t the cause of addiction, nor is addiction the cause of depression. Instead, depression, brought on by various circumstances like genetics or chemical deficiencies, increases a person’s susceptibility to addiction. This is because those who suffer from depression generally don’t have as high of levels of serotonin. This often means that they turn to drugs, alcohol, and other substances in order to help elevate their mood.

Depression and Addiction

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What Is Depression?

Depression is a mood and mental health disorder that can cause many difficulties in one’s daily life. It generally comes with intense feelings of sadness, emptiness and numbness, irritability, hopelessness, and isolation. This mood disorder plays a significant role in how you think, feel, and act. Depression has a negative impact on emotional and physical well-being, as well as personal relationships, jobs, and financial health.2

In the depression cycle, these feelings of sadness and hopelessness are often persistent and can last for periods of weeks, months, or years. After such a long time of feeling this way, many symptoms of depression can worsen, leading one to substance use.

Causes of Depression

There are various factors that can cause depression, including:

  • Brain chemistry
  • Family history or genetics
  • Events of life
  • Medical conditions
  • Medication
  • Personality
  • Hormone levels
  • Giving birth

There is no one particular cause of depression, and it changes from person to person.

Types of Depressive Disorders

There are six major types of depressive disorders. These will be detailed below.

Major Depressive Disorder (MDD)

This is one of the most common types of depressive disorders. Those with major depressive disorder experience a loss of interest in almost all activities, along with depressed mood, extreme sadness, irritability, lack of energy, appetite changes, agitation, change in sleep patterns, and suicidal thoughts. This disorder occurs for at least two weeks or more.

These symptoms interfere with everyday life and can lead to major depression reappearing throughout the person’s life if not properly treated.

Persistent Depressive Disorder (PDD)

This depression disorder is also known as dysthymia or dysthymic disorder. Its symptoms persist every day for at least two years or more. People with PDD may seem to be irritable, moody, or gloomy. They may also experience episodes of major depressive disorder, but the symptoms will be less severe.

Seasonal Affective Disorder (SAD)

This disorder is caused by changes in temperature and light that come with the year’s seasons. It mostly occurs during the winter period. People with this disorder may experience loss of energy, mood changes, sleep disturbances, overeating, and weight changes.

Postpartum Depression

New mothers have a history of falling into depression or anxiety. For many women, the shift from motherhood can cause them to have emotional difficulties, nutritional deficiencies, and exposure to chemical toxins, leading to postpartum depression.

Premenstrual Dysphoric Disorder (PMDD)

This is a severe type of premenstrual disorder (PMS). It affects women during the week or so leading up to the start of their menstrual period.

Psychotic Depression

People with this disorder experience delusions, psychosis, hallucinations, and severe depressive symptoms.

How Are Depression and Addiction Related?

Depression and addiction can, and frequently do, coexist. Determining which came first or led to the other is not always simple or even possible.

According to the National Institute on Drug Abuse, there are at least three potential connections between depression and addiction:3

  • Substance use disorders can result from mental health issues, including depression.
  • The use of drugs or alcohol can exacerbate the symptoms of depression.
  • Depression and substance abuse can coexist at the same time due to overlapping or underlying conditions.

However, it’s crucial to remember that having depression does not mean that you or a loved one will develop a substance abuse disorder or addiction. It just means you will have a higher chance of developing one, so it’s important to be safe and know the symptoms of both disorders.

Relationship Between Depression and Substance Abuse

The more a person tends to use drugs, the more dependent their body becomes on the substance’s effects, which can easily lead to tolerance and addiction. In this way, depression and addiction feed off of each other, with one illness frequently exacerbating the other.

Common Risk Factors

Here are some of the common risk factors associated with both depression and substance abuse:

  • Traumatic childhood experiences
  • Family members with a depressive disorder or substance use abuse
  • Severe medical conditions
    Changes in life events
  • Financial instability
  • History of poor coping skills
  • Long-term unemployment

These risk factors can cause a person to fall deeper into the substance abuse and depression cycle.

Signs and Symptoms

The signs and symptoms of depression and substance abuse vary, depending on the type of disorder and the person. However, there are some common signs of both disorders to be aware of. Here are some common signs and symptoms of depression:

  • Changes in appetite and sleep
  • Irritability
  • Feelings of hopelessness or uselessness
  • Lack of interest in things the person used to enjoy
  • Low self-esteem or worth
  • Feelings of guilt
  • Lack of concentration
  • Physical aches and pain
  • Suicidal thoughts
  • Constant feelings of agitation
  • Engaging in less physical activity

Indications of Substance Misuse

Here are some of the symptoms of substance abuse as well: 

  • Reduced daily functioning
  • Decreased physical health
  • Weight loss
  • Mood swings
  • Financial strain and instability
  • Reduced participation in hobbies
  • Increased isolation and less social interaction

It is essential to get immediate treatment if you are experiencing depression and addiction symptoms.

Depression’s Relationship to Certain Substances

Depression often has varying symptoms depending on the type of substance abuse one is struggling with as well.

Depression and Alcohol

There is a strong relationship between depression and addiction to alcohol abuse. Alcohol is the most common substance used to self-medicate. When people are experiencing a difficult day, such as a job loss or a fight with friends or family, they often turn to alcohol to help reduce stress or relax the physical body. However, it generally has a long-term adverse effect on the body and mind.

According to the National Institute on Alcohol Abuse and Alcoholism, 12.3% of people who abused alcohol also had a mood disorder, such as bipolar disorder or major depression. This points to the fact that many people have found it easier to start self-medicating depression with alcohol. However, it is important to note that alcohol treatment for depression is temporal and does not get to the root of the issue.4

Depression and Marijuana Abuse

Due to its euphoric effects, more people are starting to use marijuana to self-medicate without the knowledge that it can cause severe health problems for people dealing with depression and addiction.

Because marijuana produces compounds that affect emotions, behavior, cognition, and motor control, it may temporarily reduce the symptoms of depression. In contrast, it can cause the person to experience negative emotions, such as sadness.

Depression and Stimulants

Stimulants, like other drugs, can exacerbate the symptoms of depression. Stimulants may create complicated reactions, including a rise in substance cravings. While stimulants like cocaine and MDMA may temporarily make you happy, after the high wears off, they can make you even more depressed. As a result, you may need more stimulants to get the same results, which can start an addiction and depression cycle.

Depression After Using Drugs

Many people experience various symptoms after using drugs while depressed. A combination of symptoms associated with withdrawal from certain drugs and alcohol can occasionally mirror or overlap those experienced in depressive episodes.

Here are some of the withdrawal symptoms in depression and addiction recovery:

Alcohol Withdrawal

There are two common symptoms associated with alcohol withdrawal, which are anxiety and agitation. Many experience mood swings, insomnia, exhaustion, decreased sexual desire, and feelings of rage following the severe withdrawal phase.

Stimulant Withdrawal

The withdrawal symptoms from stimulants (such as cocaine) include depressed mood and a lack of pleasure that can continue for several weeks. Following a stimulant intoxication, a person may experience “crashes,” which are characterized by extreme exhaustion and intense desires.

Hallucinogen Withdrawal

The withdrawal symptoms from hallucinogenic use include delusions, hallucinations, and a sense of depersonalization. Some users of hallucinogens report having persistent depressive sensations, psychotic symptoms, and flashbacks.

Opioid Withdrawal

Opioid withdrawal can cause extreme agitation, physical pain, and despair. Common opioids often include heroin and pharmaceutical medications. Additionally, withdrawal from opioids can cause anxiety, insomnia, and intense cravings for several weeks. Opioid withdrawal can be dangerous, so it’s best to undergo detox and withdrawal with medical supervision.

As previously mentioned, the use and withdrawal of these common drugs and alcohol may also exacerbate symptoms of pre-existing depression. For this reason, an addiction professional must evaluate people with depression and addiction to receive a complete diagnosis and treatment.

Treatment for Co-Occurring Depression and Substance Abuse

When a person experiences depression and substance abuse disorder simultaneously, they are called co-occurring disorders or dual diagnoses.

In the management of depression, various evidence-based and approved therapies are used. Some of the therapies used to manage depression will be discussed further below.

Cognitive Behavioral Therapy (CBT)

CBT is an effective therapy option used to treat various addictions, and it is also effective for treating depression. CBT helps people channel and change the negative thought patterns that contribute to depression. The treatment method helps people critically analyze their interactions, activities, behaviors, and environment in order to reframe things and see them in a more positive light.

Interpersonal Therapy (IPT)

This type of therapy helps patients repair damaged interpersonal relationships that may have been strained due to symptoms from either depression or substance abuse. IPT focuses on altering behavior and looking for issues that have an impact on the depression cycle.

Problem-Solving Therapy (PST)

PST aids patients in overcoming challenging life events and experiences. Therapists guide patients through a step-by-step procedure to identify issues and develop practical, workable remedies.

In the treatment of addiction, various evidence-based and approved treatment processes are also used. Here are some of the therapies used to treat addiction:

Contingency Management (CM)

Contingency management is a treatment plan that is highly effective in treating the cycle of substance abuse. CM is a form of behavioral treatment where people are “reinforced” or rewarded for showing signs of changing their behavior for the better.5

Motivational Enhancement Therapy (MET)

Motivational enhancement therapy offers clarity and resolution for people battling uncertainty about soberness and treatment. This strategy helps to accelerate internal change by boosting one’s drive and optimism.

The Matrix Model

The Matrix Model uses organized support to assist those addicted to stimulants. This treatment includes relapse prevention, family and group therapy, peer support groups, and addiction education.

Treatment Programs

Here are the three most common treatment programs for those struggling with co-occurring disorders. The severity of the depression and addiction cycle will determine what treatment plan works for each individual.6

Inpatient Care

Those who have severe substance abuse disorders or depression might need to receive inpatient care. Depending on the client’s needs, inpatient care may be long-term or short-term. This level of care offers constant structure, supervision, and assistance in a residential setting in order to help those who need more intensive care.

Outpatient Care

Outpatient care comprises routine visits to a treatment center or a behavioral health counselor, which benefits those with less severe cases of depression or substance abuse disorders. Under this care, patients undergo both individual and group counseling but are free to go home afterwards for work or family care.

12-Step Programs

12-step programs encourage active participation in fellowship and sobriety. These programs advocate normalizing the struggles of addiction, embracing helplessness, and yielding to a greater power. They are also often included in outpatient and inpatient care programs.

Medication Management

Depression and Addiction

One of the ways that the depression cycle can be managed is by using antidepressant medications. Due to the advancement of scientific research, the scope of treatment has improved, and the side effects associated with some of the most commonly used medications have been decreased.

Medications Used to Manage Depression

Some of the most commonly prescribed antidepressant medications include:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Atypical antidepressants
  • Tricyclic antidepressants
  • Monoamine oxidase inhibitors (MAOIs)

Additionally, the medications listed below are commonly used in order to treat alcohol and drug addiction.

Naltrexone

This medication is an opioid rival. It treats alcohol use disorder and opioid drug dependence by blocking the opioid receptors. The purpose of this drug is to help prevent people who have been addicted to some opioid drugs and have fallen into substance-induced depression from retaking them. It is part of a complete drug and addiction recovery depression treatment.

Disulfiram

Disulfiram is one of the drugs approved by the Food and Drug Administration to treat chronic alcoholism and dependence. With naltrexone being the first-line treatment, disulfiram is the second-line option for patients under enough clinical supervision. Disulfiram causes you to have bad and unpleasant reactions whenever you drink alcohol, leading to a decrease in usage of the substance.

Topiramate

In certain studies, topiramate, while not approved by the FDA for treating alcohol addiction and dependence, has been shown to improve drinking consequences. It is a treatment medication used in outpatient settings.

Methadone

Methadone is an FDA-approved synthetic opioid agonist medication used to treat opioid addiction. This medication works by reducing the craving for opioids and severe withdrawal symptoms. When used as prescribed, it is effective and safe.

Buprenorphine

Buprenorphine is an FDA-approved synthetic opioid used to treat opioid dependence. It can also be used to reduce withdrawal symptoms of opioids and is also often used for maintenance and detoxification.

Pursue Treatment Today

Without proper treatment for depression, addiction, or co-occurring disorders, the conditions may persist and impact your life. Contact Ripple Ranch Recovery today to discuss available treatment options. We will be with you every step of the way during recovery.

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