Addiction and depression are very common co-occuring challenges, although it is not always clear which condition caused the other.
Alcohol is one of the most commonly used addictive substances. Sometimes people use alcohol as a mood enhancer. They are feeling down or unhappy and think a couple drinks will put them in a more sociable mood. In fact, alcohol is a depressant, so while it lowers inhibitions and may make people feel like partying, in the long run, it contributes to depression, and can indeed increase it.
Some people find themselves addicted to drugs that actually make them feel happy. Stimulants like cocaine give people the high they are looking for as an escape from emotions or stress. These drugs alter brain chemistry by increasing the production of feel-good chemicals. With prolonged use of stimulants, the brain can lose its ability to feel good on its own.
These are just two scenarios in which depression and addiction occur together, but there are many others. Whether a person turns to drugs to counteract depression or the drugs cause them to develop depression, these two conditions — addiction and depression — commonly co-exist, making treatment for each a little more complicated.
Addiction and depression
Depression, a mental illness with potentially serious consequences, affects roughly 10% of the American population, according to the Center for Disease Control (CDC). Untreated, depression can lead to obesity, diabetes, or malnutrition. It can also lead to heart disease, compromise your immune system, and potentially increase your chances of death from disease or suicide. Those most likely to develop depression are:
- Women
- Adults ages 45 to 64
- People who are unemployed
- Hispanics and African Americans
- People who are uninsured
While the exact causes of depression are unknown, certain risk factors are identified. These risk factors include:
- Any on-going stressful situation like financial problems or serious health challenges, as well as acute stress caused by an incident like death or divorce
- Any other mental health challenges like PTSD, eating disorders, anxiety or addiction
- Personality traits like being hyper-critical or pessimistic or having low self-esteem
- Sexual orientation other than heterosexual in a non-supportive environment
- Close genetic links to alcoholism, depression, suicide or bipolar disorder
Addiction is considered a risk factor for depression, although it is not cited as a cause. Approximately 20% of Americans suffering from depression also have a substance abuse disorder. The same statistic is true in reverse, with 20% of those suffering from addiction also struggling with depression.
After many years of study, addiction is classified as a mental illness and a chronic disease. Despite certain physical symptoms that occur in addiction, it always includes a mental component. Addiction also fits the pattern of a chronic disease. In most cases, it can be controlled but not cured. After rehabilitation, most people who suffered from addiction can lead normal and even happy, lives, but they cannot safely consume addictive substances like the one they previously abused.
Addiction and Depression: How Are They Related?
Chronic diseases generally do not occur in isolation. Unlike with acute diseases that resolve in a short period of time, these are on-going and therefore often overlap with other diseases. In 2010, 45% of Americans suffered from some chronic disease and 21% had more than one. Having two or more chronic conditions at the same time is referred to as co-morbidity, co-existing conditions or a dual diagnosis. In the case of addiction and depression, a common combination, dual diagnosis is the most common terminology.
Treatment for a dual diagnosis of addiction and depression is a bit more complicated than simply treating one or the other. It is impossible to separate these two mental disorders and treat them one at a time, just as it is difficult to discern which one caused the other. With this particular dual diagnosis, addiction and depression are happening in the same areas of the brain and causing many of the same symptoms. A change in one condition naturally affects the other.
A proper diagnosis is important in this situation. Addiction and depression are intertwined. Therefore, treating one without recognizing the presence of the other will be counterproductive. Each condition needs to be addressed at the same time, within an individualized treatment program, targeting the root of the challenges, focusing on specific goals and objectives.
Historically, people were denied treatment for mental disorders such as depression until they were “clean and sober.” This demonstrates a prejudice against addiction even within the mental health community. Under this old treatment model, the depression part of the dual diagnosis was seldom addressed because all of the focus was on the addiction, which could not be adequately addressed, because it was fueled and fed by the untreated depression.
Modern treatment techniques for dual diagnosis recognize the intricate relationship between addiction and mental health disorders such as depression. In most cases, the depression plays a role in the addiction, so without treating it, the addiction can never be overcome.
Dual Diagnosis Treatment
It is important to treat addiction and depression simultaneously when they co-exist, but each condition requires a different specialty. So, for dual diagnosis treatment, coordination is key. When working with two specialists for separate conditions at the same time, the chance of conflicting therapies is great. Overcoming mental illness is a challenge that doesn’t need to be complicated by simultaneous therapies that contradict one another.
Coordinating therapies that are individualized for a client’s specific needs is the best practice in dual diagnosis recovery. As research into addiction yields more information, it becomes clear that each case is different. Each person comes to addiction in a slightly different way, and each one brings a specific set of circumstances with them. Addiction involves genetics, physical health, mental health history, personal history, and a number of other factors, making each situation unique.
The number of factors to consider in addiction treatment are compounded when you add depression. Recovery from two mental illnesses at the same time works best with an individualized treatment program meant to address each condition and coordinate all treatment.
Because depression affect every aspect of a person’s life, a holistic approach to treatment is most effective. Just treating the brain, where the conditions manifest, with some type of behavioral therapy does not produce the greatest success rate. It is important to look at physical health, mental health, nutrition, education and lifestyle. Every aspect of a person’s life is affected by these two diseases. Therefore, the treatment must touch all areas.
Whether it is addiction or depression, people suffering from mental health challenges find it difficult to maintain healthy relationships with their family, friends, and co-workers. In turn, without the support of friends and family, most people find their lives increasingly more stressful.
Stress is a major factor in all mental health challenges, including addiction and depression. Recognizing the source of that stress is just one important aspect of treatment. Learning strategies to reduce stress and manage it in the future is also important.
Poor physical health and nutrition contribute to stress. A successful treatment program for dual diagnosis includes some type of exercise routine, good nutrition training and yoga or meditation. The mind and body work together to create a healthy life. Treating each simultaneously is important for successful results.
There are many formal treatment modalities available for addiction and depression recovery. Here is just a small sample of some of the more popular ones:
- Experiential Therapy — Physical activity in nature and artistic expression are used to elicit emotions and resolve them
- Trauma Therapy — Through the analysis of a past trauma, emotions are felt and dealt with and strategies are learned for addressing fearful situations in the future
- Interpersonal Therapy — Addresses the decline in social functioning by fostering improvements in interpersonal skills and self-esteem through positive interactions with others
- Cognitive Behavioral Therapy — Recurring destructive thought patterns are examined and altered to be more positive and healthy
- Family Therapy — Including family members in activities and discussions designed to help them heal and address their own addiction or enabling behaviors
The proper treatment for a dual diagnosis might involve several different specialty areas — behavioral therapy, nutrition counseling, exercise training, mental illness education, etc. — but the individualized program needs to coordinate these separate pieces into one comprehensive treatment. Individualizing the treatment program means assessing and re-evaluating progress frequently and making adjustments to the course of treatment. Coordinating that constant flow of information and responding to it is key. Communication between the various specialties is important in facilitating recovery from co-existing addiction and depression.
Diagnosing Addiction and Depression
Feeling sad or lethargic is different from being depressed. In fact, some people with depression don’t feel sad. They are apathetic, anxious, angry or aggressive. Depression can make people feel tired or just unhappy all the time.
Here are some signs of depression:
- Loss of energy
- Changes in sleep patterns
- Weight gain or loss
- Reckless behavior
- Overwhelming hopelessness
- Self-loathing
- Mysterious aches and pains
- Inability to concentrate
People who are experiencing depression may not notice the subtle changes in their behavior. They suddenly don’t have the energy or interest to engage in their favorite activities or the patience for simple tasks. They struggle with skills they used to be good at. They become emotional, either sad or aggressive, with increasing frequency. Depression can worsen quickly without intervention.
The signs of addiction can be very similar to those of depression. Everything listed above also applies to addiction, making it difficult to recognize when someone is suffering from both addiction and depression at the same time. In some cases, the addiction is more obvious because the connection to a substance can be established, but the depression is only diagnosed after addiction treatment has begun.
Addiction does not always lead to depression, and depression does not always end up in addiction. These two mental illnesses, although related in several ways, can be mutually exclusive. Like with many diseases, early diagnosis and treatment of either one can keep it from progressing to a dual diagnosis. Getting help from a treatment facility as quickly as possible will make the journey back to health that much easier.
Getting Help for Dual Diagnosis
Getting help for addiction, depression or any mental health challenges can be the first step in moving your life in a positive direction. Addiction and depression can make a person feel hopeless, but it is important to realize that feeling can be lifted with the right treatment. Following through on treatment and recovery activities can even keep you from returning to that dark place in the future.
Reaching out for help from a professional is a great beginning. A proper diagnosis from a qualified professional is the best place to start. It is also important to continually be evaluated by your provider/clinician to ensure your challenges are being addressed correctly. The process of recovery is like peeling an onion — when a layer is pulled back, another one is revealed. This reality keeps you from trying to fix everything at once and becoming overwhelmed.
With a professional diagnosis, the next step is an individualized program to treat the combination of mental disorders that is diagnosed. Treatment needs to be simultaneous and coordinated. A holistic approach, addressing the needs of the whole person, is the best way to deal with addiction. The best treatment facilities include specialists in all areas who work together across disciplines to support and guide clients on their journey to health.
For more information on treating depression, addiction and other mental health challenges, contact JourneyPure Emerald Coast. By offering the newest effective treatment modalities in the industry, we treat addiction, mental health and trauma simultaneously, including dual diagnosis. Emerald Coast will help you get healthy and stay healthy.
