Co-Occurring Disorders: Depression and Addiction
Depression and addiction are two of the most common illnesses found in American people. Many individuals suffer from both at the same time. Because depression causes a user to feel extraordinarily sad and drugs offer a temporary form of relief, it is common for depressed people to develop substance abuse problems.
At the moment, it is estimated that nearly one-third of all clinically depressed people abuse drugs and alcohol. The connection between depression and addiction is so strong that the two conditions are often diagnosed as co-occurring disorders.
What is the Definition of a Dual Diagnosis or Co-occurring Disorder?
"Co-occurring disorders" are diagnosed when a person suffers from a mental illness and a substance abuse problem simultaneously. When someone is clinically depressed and addicted to drugs at the same time, for example, the doctor will diagnose them with co-occurring disorders. This dual diagnosis is important, as the patient may require a special form of treatment. Because they have addictive tendencies, the patient will need to avoid certain antidepressant medications.
Oftentimes, someone with depression and addiction disorder will be treated for both conditions at the same time. The root causes of both conditions usually overlap. A person who develops techniques for coping with depression often finds that they are able to manage their addiction as well. Similarly, an individual who overcomes addiction will often find that their depressive tendencies become much more manageable with time.
Depression and addiction seem to go hand in hand. People who suffer from depression are more likely to abuse drugs or alcohol than folks who don't. This isn't surprising, given the fact that depressive disorder is a debilitating condition that leaves some individuals unable to function properly. Alcohol and drugs can offer a temporary form of relief, uplifting them for a short period of time.
Of course, the effects of drugs don't last very long. A person who uses drugs as a coping mechanism is only providing themselves with short-term satisfaction. When someone treats a chemical as their gateway to happiness, they are sure to be let down. As they use more and more of the drug, their tolerance will increase and they'll require larger quantities of the substance to feel its effects. Before long, the individual can find themselves struggling with a full-blown addiction.
Identifying Depression and Avoiding Addiction
It can be difficult to distinguish clinical depression from a simple case of sadness or grief. If a member of your family dies, you lose your job, or something upsetting happens, it is normal for you to feel down for a little while. Clinical depression, on the other hand, is persistent and can last for months or years on end. If left untreated, it often gets worse with time.
Someone who has medical depression should avoid using drugs or alcohol as coping mechanisms. Instead, they should speak to a doctor or therapist about their experience. Medical professionals and mental health specialists will be able to identify the best form of treatment for the individual.
Here are a few symptoms of depression to look out for:
- An inability to feel happy no matter the circumstances
- A loss of interest in activities that used to be enjoyable
- A diminished sense of self-worth
- Regular feelings of self-hatred or guilt
- Constant feelings of fatigue and exhaustion
- An inability to focus or concentrate
- Regular thoughts of death and suicide
According to the DSM-5, a person can be diagnosed with major clinical depression if four or more of these symptoms persist for more than two weeks. At that point, the individual should receive treatment for their condition. Treatment may include therapy or prescription medication. The individual will want to avoid using drugs or alcohol, particularly if they have addictive tendencies.
Understanding the Causes of Co-Occurring Disorders
Although depression is a very common condition that affects millions of people worldwide, scientists still don't understand it entirely. There are a few key theories that doctors use to explain where depression comes from, including:
Heredity: It is known that genetics increase the likelihood of depression. If your parents or grandparents had depressive tendencies, you have an increased risk of experiencing symptoms at some point during your life. Research has shown that people with family members who suffer from depression are nearly 30% more likely to develop the condition themselves. However, scientists have not yet been able to pinpoint which gene the condition is linked to.
Trauma and past experiences: People who experience abuse as children are far more likely to develop depression later on in their lives. The likelihood that these folks will develop a drug addiction or alcohol abuse problem is also much higher.
Brain shape: Some research has shown that the brain of a depressed person has a fundamentally different shape than those of other people. The parts of the brain that regulate mood, memory, sleep habits and metabolism are structured differently in people who suffer from depression. Scientists have not yet pinpointed how the shape of the brain affects mental health.
Chemical make-up: There is no doubt that a chemical imbalance in the brain can cause depression in some people. Neurotransmitters such as dopamine, serotonin, and norepinephrine which help to regulate our emotions are found to be insufficient in many depressed individuals. Scientists still do not understand what causes this imbalance to occur. However, antidepressant mendicants like SSRIs and SNRIs were developed to help calibrate the balance of these chemicals in the brain.
Similar to the causes of depression, addiction is not entirely understood by modern science. We do know, however, that many of the factors believed to cause depression symptoms are responsible for causing someone to develop addictive tendencies. Genetics, trauma, childhood environment and chemical imbalances are all cited as causes of addiction. It is possible that co-occurring disorders stem from the same root causes in some people.
Signs and Symptoms of Addiction Disorder
If someone with depression begins using drugs to fend off the negative feelings, they can quickly become addicted to their drug of choice. Whether they are drinking alcohol, smoking marijuana, taking prescription pills or using any number of narcotics, they can easily develop a chemical dependence on that drug.
Some early signs and symptoms of addiction disorder include:
Addicts often need to increase their drug intake over time in order to continue feeling its effects. A person who starts drinking alcohol as a way of dealing with their depression, for example, will find that one or two drinks doesn't cut it after a while. As a result, the individual will most likely drink more and more in order for the alcohol to keep working.
Part of the problem with drugs is that, while they might make you feel good for a little while, they'll leave you more depressed than you were when you first started using. Depression has a lot to do with a lack of serotonin and dopamine in the brain. Drugs can provide a quick flood of those chemicals. When the drugs wear off, however, your neurotransmitter levels often drop far lower than they originally were.
Even when they recognize that the drugs aren't helping, a true addict won't be able to quit. Depression and addiction are particularly dangerous because the addict often realizes that their drug use is making their mental disorder worse. Because they've become dependent on the drug, though, they may not be able to stop using it no matter how bad the side effects are.
When someone is chemically dependent on drugs or alcohol, their body will respond negatively if they try to stop using. Depending on which drug they are addicted to, they will experience a number of side effects when the substance is not in their system. Someone who is unable to abstain from drug use without getting nauseous, anxious or sweaty is most likely addicted to their substance of choice.
Using Alcohol to Cope with Depression
Alcoholism and depression are a common co-occurring disorder. When someone shows signs of depression, therefore, it is important for them to avoid drinking alcohol as a coping mechanism. Researchers have shown that more than 20% of alcoholics also show symptoms of major depression.
The problem with depression and alcohol is that the chemical only exacerbates the symptoms of a person's mood disorder. Alcohol, after all, is a depressant drug. This means that it slows down their central nervous system. When a depressed person starts drinking, they may find that the drug makes them feel happier for a short amount of time.
Before long, however, the drug's depressant effects start to take hold. Their exhaustion, sleepiness, and feelings of sadness will only worsen as the alcohol wears off.
Of course, a person's relationship with alcohol doesn't always end when its effects wear off. Someone who struggles with depression and addiction disorder will often reach out for another drink because they believe that alcohol can cure their problems. Over time, the individual can find themselves with a serious problem on their hands.
Finding Treatment for Co-Occurring Depression and Addiction
Overcoming depression and addiction at the same time is a challenge. However, it is possible. There are a variety of treatment options available to people who suffer from this particular dual diagnosis.
Some methods used to treat addiction and depression at the same time include:
If someone is addicted to drugs or alcohol, the first step on the path to recovery is detox. Detoxing is the process through which the addict will flush all traces of the drug out of their body. When they stop using the drug, their system will begin to metabolize the substance and clear it out of the body through the digestive system. The addict may experience withdrawals. However, once the process is completed, the addict can start working toward a healthier lifestyle.
In many cases, depression is treated with specific medications. SSRIs like Zoloft and Lexapro as well as SNRIs like Effexor are often used to restore a chemical balance in the patient's brain. Many people with depressive tendencies find that these drugs help them to cope with depression. Most antidepressants cannot be used recreationally. Therefore, they are seen as an alternative to habit-forming substances like opioids, alcohol, and marijuana.
Detox and medications address the physical symptoms of co-occurring disorders. However, both depression and addiction are largely psychological conditions. In order to properly treat these disorders, the patient should meet regularly with a therapist or drug counselor. In those meetings, they'll talk about the root causes of their substance abuse habit. They'll also work to develop positive coping skills for dealing with depression.
Organizations like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are helpful tools in the recovery process. Members of these groups come from all walks of life. Many people in AA and NA suffer from both depression and addiction disorder, so it is a helpful place for people with dual diagnoses to find support.
At NA and AA meetings, members take turns sharing stories and offering advice. Someone who struggles with addiction and depression will find that these organizations are filled with people who have gone through some similar experiences. Group meetings are a great place for newly sober addicts to meet people that have been able to find a life beyond drug addiction.
Rehab is a form of treatment where addicts meet regularly with therapists and counselors to address the nature of their problem. These programs come in a variety of forms. Some treatment centers have inpatient rehab programs where the addict will live on-campus at detox facility and spend their day attending various counseling sessions. Other programs are outpatient-based, meaning that the addict will live outside of the treatment center itself and attend regular meetings during the daytime. The goal of every rehab program is to prepare addicts for a sober life.
Most rehab programs have therapists on-staff. This is particularly helpful for people who suffer from both depression and addiction as the staff can work with them to address the specific nature of their co-occurring disorders.
How Families Can Help with Depression and Addiction Disorder
If someone you love struggles with co-occurring depression and addiction disorders, you may want to get them help before the problem worsens. Oftentimes, people in your position feel helpless and overwhelmed. When someone struggles with mental illness, after all, you may avoid confronting them out of a fear of making their problem worse.
It is important to remember that helping them is the best way to show them that you care. If you approach them in the right way, you can let them know that you love them and simply want the best for them.
Here are a few tips on how to help a family member with depression and addiction disorders:
Have a plan: Many people who struggle with addiction issues and mental illness are unmotivated or unable to take action on their own. They may know that they need help but feel overwhelmed by the prospect of seeking treatment. By approaching them with a plan (detox, rehab, therapy or another form of treatment), you can offer them a potential solution to their problems.
Address the problem directly: You aren't going to make the situation better by beating around the bush. You should tell them that you think they have a problem with addiction. If they have not yet sought treatment for depression, you may want to let them know that you think it could be contributing to their addiction. Handle this step in the kindest possible manner, but make sure that they understand how you feel.
Show empathy: It can be tough to understand exactly what someone else is going through. Oftentimes, people with depression and addiction think that no one really understands how they feel. If you show the person that you are empathizing with them, you are far more likely to convince them to get help.
Don't judge: Some people think that addiction and depression are choices. It is important to remember that these conditions are complex illnesses. If you truly want to help them, avoid coming across as critical or judgmental.
Recovery from Co-Occurring Disorders
It's never easy to recover from drug addiction or depression. Both of these conditions are things that some people struggle with for their entire lives. By seeking treatment and committing to recovery, it is entirely possible to move beyond these co-occurring disorders.
If you or someone you love has a drug addiction and depressive tendencies, it could be time to reach out for help. There are plenty of resources for people with this dual diagnosis. The road to recovery starts with a single step.