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Depression and Substance Abuse Treatment



Medically Reviewed by Dr. Mohammed Saeed, MD.

Emotional lows are a part of life, but people with depression experience emotional disruptions that don’t go away. The Depression and Bipolar Support Alliance report that more than 17 million American adults in any given year experience some form of depression. Unfortunately, many people dealing with symptoms of depression like hopelessness, restlessness, agitation, isolation, and apathy turn to drugs and alcohol. Research shows that about a third of people dealing with clinical depression use drugs and alcohol. Sadly, these substances often make the symptoms of depression worse. Luckily, programs like ours at Into Action Recovery can help individuals successfully overcome depression and substance abuse challenges.

Understanding Depression

Despite what most people think, depression isn’t sorrow caused by grief or a personal setback. Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. This chronic, progressive condition impacts individuals’ physical and emotional wellbeing, relationships, occupations, and financial health. Symptoms of depression can last anywhere from 2 weeks to more than 2 months. Although most people are familiar with the emotional symptoms of depression, people with depression can also experience physical, psychological, and behavioral symptoms.

This wide range of symptoms can include:

  • An “empty” mood
  • Feeling irritable or angry
  • Persistent sadness or anxiety
  • Feeling hopeless or pessimistic
  • Loss of interest in hobbies and activities
  • Fatigue and decreased energy
  • Feeling guilty, worthless, and helpless
  • Moving or talking slowly
  • Restlessness and having trouble sitting still
  • Difficulty concentrating, remembering things, and making decisions
  • Changes in appetite and weight
  • Aches and pains along with headaches, cramps, and digestive problems
  • Difficulty sleeping, waking up early, oversleeping, and insomnia
  • Suicidal thoughts, thoughts of death, and suicide attempts

Even though most people with depression experience some combination of these symptoms, the condition can exist in a variety of forms.

Types of Depression

Most people are familiar with major depressive disorder, but there are actually 5 major types of clinical depression. They include:

  • Major Depressive Disorder (MDD). MDD is one of the most common mental health challenges worldwide. This form of depression is characterized by 2 or more weeks of a low, sorrowful mood. Usually, the loss of interest and persistent sadness associated with MDD provokes physical and behavioral symptoms. Often, these include changes in sleeping patterns, decreased energy levels, inability to concentrate, and low self-esteem. People experiencing severe cases of major depressive disorder may also have suicidal thoughts.
  • Persistent Depressive Disorder (PDD). People with persistent depressive disorder tend to have low moods and symptoms of depression that last for 2 or more years. Individuals with persistent depressive disorder, which is also called dysthymic disorder, can seem like they’re always melancholy, gloomy, irritable, and moody. Generally, people with persistent depressive disorder don’t have symptoms as severe as those with MDD, but they often have a less than ideal quality of life.
  • Bipolar I and II Disorders. Bipolar disorder is a mental health condition defined by episodes of extreme mood disturbance. Even though this form of depression mainly affects an individual’s mood, bipolar can also change a person’s thoughts and behaviors. While bipolar I involves episodes of severe mania followed by depression, bipolar II typically involves hypomania, a less severe form of mania. Many people with bipolar have episodes of depression that last for weeks or months. Common symptoms can be manic or depressive.

Manic symptoms can include:

    • Feeling upbeat, jumpy, and full of energy
    • Euphoric sensations
    • Decreased need for sleep
    • Unusual talkativeness
    • Racing thoughts
    • Poor decision making
    • An exaggerated sense of self

Depressive symptoms, on the other hand, can include:

    • Insomnia or sleeping too much
    • Loss of interest in most or almost all activities
    • Significant weight changes
    • Feeling sad, empty, or hopeless
    • Sudden loss of energy
    • Inability to concentrate and indecisiveness
  • Postpartum Depression. Generally, hormonal imbalances after pregnancy can cause this form of depression. New mothers that have a history of depression or anxiety as well as those under personal and financial stress often experience postpartum depression. Symptoms typically include insomnia, loss of appetite, irritability, and difficulty bonding with the baby.
  • Seasonal affective disorder (SAD). Changes in light and temperature trigger this form of depression. As seasons change and daylight hours decrease, people with seasonal affective disorder often experience low moods, decreased energy, sleep disturbances, and changes in their weight.

Unfortunately, all of these forms of depression can increase an individual’s risk of substance abuse.

The Link Between Depression and Substance Abuse

Data shows that depression and substance abuse often coexist. According to The National Institute on Drug Abuse (NIDA), an estimated 50 percent of people who have a substance use disorder also experience a mental health issue like depression. Similarly, 50 percent of people with mental health challenges such as depression are likely to develop an addiction to drugs or alcohol.

Researchers do not believe that one diagnosis necessarily causes a person to develop the other, but they are aware that the conditions often happen together and the interactions between the two can worsen symptoms. So, what exactly is the link between substance use and depression? Let’s explore these two related concerns.

Common Risk Factors For Addiction and Depression

When it comes to determining the link between substance abuse and depression, there appear to be three shared risks.

1. Genetics

Genetics is believed to comprise anywhere from 40 to 60% of a person’s vulnerability to substance abuse. Genetic predisposition also increases an individual’s chance of developing depression or another disorder, according to the National Institute on Drug Abuse (NIDA).

It’s not only depression that afflicts individuals struggling with substance use disorder. NIDA finds that alongside depression, other conditions including bipolar disorder, attention-deficit hyperactivity disorder (ADHD), psychotic illness, borderline personality disorder, and antisocial personality disorder are the most common mental health disorders that co-occur among people dealing with substance use disorders.

2. Environmental Factors

The second risk factor found among people dealing with both substance abuse and depression is environmental. The human body interacts with the outside world on a molecular level that can affect an individual’s health and decision making. Factors like chronic stress, exposure to drugs, and traumatic experiences (especially as a child) have been shown to alter an individual’s neural circuits and even change their behavior.

Exposure to what mental health professionals call “adverse childhood experiences” such as assault, abuse, crime, and poverty can make people more likely to suffer from substance use disorders, depression, and anxiety as they get older. Researchers have also found that individuals who suffer from chronic stress and instability as adults are more likely to struggle with depression and anxiety, as well.

3. Similar Changes in the Brain

Finally, an individual dealing with a mental disorder and an individual coping with a substance use disorder show changes in similar areas of the brain. For instance, the brain circuits that control decision making and emotional control have both been shown to be affected by addictive substances and mental health conditions like depression. This suggests that our brains are vulnerable to both addiction and mental health challenges in similar ways.

Though research is ongoing, scientists also understand that imbalances in the brain’s chemical messengers, known as neurotransmitters, are linked to both depression and addiction. For example, dopamine, the “feel-good chemical” responsible for feelings of reward and motivation in the brain, spikes when addictive substances enter the bloodstream. On the other hand, low levels of serotonin, which regulates many of our bodily functions, have been linked to depression.

Depression and Substance Abuse: A Challenging Cycle

We’ve shown how depression and substance use share similar risk factors, including genetic predisposition, environmental factors, and the structure of the brain.

While researchers continue to study the relationship between these two challenges — including which typically comes first — we do know that depression can worsen substance use and vice versa.

For example, some individuals may choose to “self-medicate” their depression through substance use, which can quickly develop into addiction. In other cases, people struggling with substance use challenges can fall into depression if they feel they are unable to recover.

Unfortunately, these substances do very little to actually ease depression. In fact, alcohol and drugs can increase feelings of sadness and make users feel even more fatigued. This is why it’s important that individuals struggling with both substance use disorders and depression seek the appropriate treatment from an experienced and licensed provider. Luckily, there are effective, healthy ways to treat depression and addiction challenges.

Treating A Dual Diagnosis

A diagnosis of depression and substance abuse is also known as a dual diagnosis, meaning an individual is managing both a mental health disorder and substance use disorder at the same time. Although treatment options have improved in recent years, too often those with a dual diagnosis do not receive treatment for both of their challenges, if they receive treatment at all.

The key to dealing with substance abuse and depression is an integrated treatment approach that works to handle both issues at once. This allows a collaborative approach between mental health and addiction treatment professionals to determine a coordinated treatment that can truly assist an individual in their recovery. Since the mid-1990s, nearly ten studies have indicated that integrated treatment is the most effective method for treating a dual diagnosis.

When searching for a dual diagnosis treatment program, it’s important to choose a program that uses this integrated approach to treat both depression and addiction equally.

At Into Action Recovery, we use a dual diagnosis approach to treating mental health and addiction-related challenges. This means that we provide clinical care that integrates both mental health and substance use treatment. Often this requires individuals in our program to work with therapists and clinicians through individual and group therapy while gaining support from their peers and community.

If you or a loved one are struggling with depression and addiction challenges, we can help. Contact us today for a free assessment and start on the path towards your recovery.

Dr. Mohammed Saeed, MD.

Dr. Saeed is a psychiatry specialist with over 40 years of experience in the medical field. He received training in General Psychiatry at the University of Texas Medical Branch, where he was selected as the Medical Director of the Division of Child and Adolescent Psychiatry. He currently serves as the medical director at Into Action Recovery Centers. Full Bio

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