Everyone experiences bad days. Whether from problems at work, at home or in relationships, there are down periods for everyone throughout life. For most individuals however, those down times resolve within time and in a fairly ordinary manner. Most people can temper the bad times by participating in things that make them happy. But for individuals who suffer from depression, these emotional lows don’t resolve easily or quickly. Depression affects millions of people worldwide, often with severe consequences. The Centers for Disease Control and Prevention (CDC) reports that an estimated 10 percent of Americans live with depression.
Current research has revealed that many of the factors contributing to depression also play a major role in substance abuse disorders. Imbalances in the brain’s chemistry, as well as an individual’s family history or instances of past trauma, all are frequently associated with both depression and addiction. In fact, in a nationwide study of over 43,000 adults, evidence showed that over 20 percent of participants suffered from both depression and a concurrent alcohol addiction. These statistics point to an overwhelming connection between substance abuse, especially alcoholism, and major depression.
When a person suffers from both an addiction and depression, it is called a Dual Diagnosis. A Dual Diagnosis can be any combination of a mental disorder (anxiety, bipolar disorder, depression, etc.) alongside an addiction (drugs, alcohol, gambling, etc.). However, dual diagnoses that include depressive disorders are some of the most common forms. Let’s take a closer look at the dangerous connection between depression and substance abuse.
What is Depression?
Most people go through short periods of sadness, frustration, irritability or grief. However, there’s a huge difference between clinical depression and a case of the blues. The Diagnostic and Statistical Manual of Mental Disorders classifies clinical depression as a condition lasting for a minimum of two weeks and which interferes with one’s ability to work, function in a social setting and maintain healthy relationships. People who suffer from depression typically experience five or more of the following symptoms on a daily basis:
- Loss of appetite/weight loss
- Feelings of hopelessness
- Sleeping too much or too little
- Loss of energy
- Feelings of guilt
- A sense of worthlessness
- Aches and pains
- Difficulty concentrating
- A loss of interest in general tasks or hobbies
- General irritability
- Suicidal thoughts or suicidal attempts
Depression symptoms often manifests as feelings of sadness, hopelessness or depleted energy. Some people, specifically males, experience depression as anger, hostility or irritability. Regardless of how depression appears, there is a clear difference between a depressive mental disorder and one’s normal mental and emotional state. Feelings of grief after a serious loss or the death of a loved one are not considered clinical depression unless these feelings continue for two or more months. Clinical depression presents an elevated risk for injury, self-harm and suicide. Depression also works to weaken the immune system and the body, making an individual substantially more susceptible to depleted physical and emotional health.
Typically, depression interferes with an individual’s ability to work or maintain healthy relationships. Basic day-to-day tasks may seem impossible and the depressed state may appear to be permanent to the individual. Many people turn to alcohol or drugs as a way to resolve the pain and emptiness associated with their depressive disorder. When drugs or alcohol are added to the equation, the emotional and physical risks are increased. As a result, both depression and substance abuse begin to feed into each other, each condition making the other worse.
Who is at Risk for Depression?
The CDC reports that the following demographics are at an elevated risk for depression:
- African Americans and Hispanics
- Middle-aged adults between the ages of 45 and 64
- People who are unable to work or chronically unemployed
- People without medical insurance or health benefits
Depression and Substance Abuse
Both mental illness and drug and alcohol abuse disorders share similar underlying causes. For some people, depression precedes their substance abuse. Sometimes, an individual may be trying to self-medicate and treat the symptoms of their depression. Yet over time, substance abuse will only contribute to their depression. Drug and/or alcohol abuse often causes hardship and chaos in every aspect of life, and ultimately substance abuse will only serve to exacerbate depressive disorders.
For other individuals, addiction, especially to alcohol, can induce depression. The National Institute of Health reports that drugs and alcohol alter the levels of serotonin in the brain, which can lead to symptoms of depression. Serotonin is a neurotransmitter commonly associated with depression and other mood disorders. As substance abuse continues, an individual’s serotonin levels will be further depleted, contributing to an overall disorder of chronic depression.
Because both mental illness and addiction stem from issues in the brain, when one person is vulnerable to one disorder, they are often vulnerable to the other condition as well. Both mental health disorders and addiction affect similar chemical pathways and molecules in the brain. In the same way that serotonin levels are affected by depression and substance abuse, dopamine levels are similarly affected. Research indicates that dopamine levels are lower in people who suffer from depression. Some people turn to stimulants, like cocaine, to increase dopamine levels in the brain. However, those increases are temporary and over time will contribute to depleted levels of dopamine and other neurotransmitters.
Other Contributing Factors
Clinical research shows a direct connection between depression and heredity, reporting between 40 and 50 percent of depression being linked to heredity. On average, a person with a sibling or parent who suffers from depression is 2-3 times more likely to suffer depression than the average person.
Additionally, trauma or chronic stress during childhood increases a person’s risk for both depression and substance abuse. Although continued research is still needed to determine why the link exists, the Brain and Behavior Research Foundation confirms there is a strong connection between childhood trauma and depression. Possible contributing events include neglect, domestic abuse, death of a parent at a young age, or physical, emotional or sexual abuse. Studies show 25-76% of people who suffered trauma during childhood began abusing substances in order to cope with their emotions. Those individuals may find it even harder to quit an addiction due to reoccurring negative thoughts after stopping.
Stress is another major risk factor for depression, regardless of age. When the human body comes under stress, it releases the hormone cortisol, which can simulate symptoms similar to depression. As an individual becomes more stressed, they also tend to become more depressed as they are unable to cope with that stress on both a psychological and physiological level. A revolving cycle of stress and depression can often lead individuals to start using various substances to treat the symptoms of both issues.
An Open Door to Addiction
Depression is too often an open door for alcohol and drug abuse. The temptation is easy to understand as those who constantly struggle with the negative feelings of depression seek a way to escape. However, if those who are clinically depressed do not seek treatment, they will continue to stay depressed. If these individuals begin using drugs or alcohol on a regular basis, the risks of their usage turning into a dangerous addiction are significantly increased.
A few of the warning signs of addiction include:
- Tolerance: The body becomes used to the effects of drugs or alcohol and requires larger amounts to achieve similar effects.
- Withdrawal: When intake is reduced, an individual will experience painful physical symptoms which can include nausea, tremors and cold sweats.
- Regret: Many individual’s experience feelings of regret after using, even though they began taking drugs or alcohol to feel better.
- Relapse: If a person tries to stop using drugs or alcohol, the cravings and withdrawal symptoms will be too intense, causing them to relapse to their destructive behaviors.
For many people who suffer from both depression and substance abuse disorders, trying to quit drugs or alcohol can actually make the symptoms of depression worse. Some individuals who may have been using for years may find their depression becomes even harder to deal with during periods of sobriety. For this reason, those who share the dual diagnosis of depression and substance abuse should receive an integrated treatment which addresses both issues at the same time.
Treatment and Recovery
Treating the dual diagnosis of depression and substance abuse disorders can be especially difficult because each intensifies the symptoms of the other. If treatment fails to address the depression that drives addiction, or vice versa, a person is much more likely to relapse back into addiction and/or depression once their treatment program is over. Most traditional, one-dimensional rehabilitation programs do not offer the integrative treatment necessary to approach dual diagnoses. In fact, many people drop out of these traditional rehab programs because they may find the treatment too intense without the necessary supportive and therapeutic counseling required to treat both conditions at once.
Effective programs which are prepared to handle both mental illnesses as well as substance abuse disorders are best equipped to assist with detox, counseling and post-care planning. The best programs incorporate counseling, education, peer support and relapse prevention for both substance abuse and depression.
Blu by the Sea in Destin, Florida is a professional rehabilitation program equipped to treat both substance abuse and depressive disorders. Our program provides the support, motivation and encouragement needed for individual’s to overcome each of these issues. Finding the right program makes all the difference on the journey to recovery. Contact us today to find out more about our treatment programs.