Managing depression is an everyday struggle; the situation becomes even more complex and challenging if you suffer from substance abuse. Both conditions feed off and reinforce one another, making them ticking bombs that must be defused as soon as possible.
Treatment requires a holistic approach, which acknowledges the complicated interaction between both conditions, and offers an effective treatment for their effect on your physical and mental health.
What Is Depression?
Depression is a mental disorder characterised by persistent sadness, melancholy and hopelessness. The condition often leads to a significant or complete lack of motivation to do activities, even ones that a person may have previously enjoyed, leaving the person feeling apathetic, emotionally numb and fatigued.
There is no clear scientific consensus on the underlying reason for depression; multiple factors, including genetics, family history, current life satisfaction, traumatic events, hormonal balance, and many others, can influence the chance of developing depression. The effect depression has on the brain is one that disrupts the production of essential brain chemicals, like serotonin, which disrupts mood and brain activity.
Signs of Depression
Although each person’s individual experience can greatly differ, there is considerable overlap in many symptoms, even if the degree to which they disrupt an individual’s life will vary. Here is a list of many of the most common signs that a person is going through some form of depression:
- Mood swings leading to angrily lashing out at people, irritation and impulsivity, and inability to control emotions
- Powerful and overwhelming feelings of despair, hopelessness, and emptiness
- Lack of interest and enjoyment in previously loved hobbies, sports and activities
- Sleep disruptions leading to insomnia or sleeping too much
- Physical and mental fatigue and a general lack of energy
- Brain fog, disorientation and slowed cognitive processing
- Hyper-focus on past mistakes and intense feelings of guilt, shame and self-doubt
- Heightened sensitivity to stress, restlessness and anxiety
- Thoughts about suicide and self-harm
Co-Occurring Depression and Substance Abuse
In many cases, there is an overlap, and you may be one of them. Are you abusing alcohol while suffering from depression? Although there is a wide variety of substances that people turn toward, alcohol and weed are the most popular choices that co-occur with symptoms of depression.
A possible explanation ties the popularity, accessibility and normalisation of alcohol as a possible reason, while some other experts claim that many misinformed people try to fight the side effects of antidepressants, like anxiety and restlessness, with alcohol since it’s a depressant. Unfortunately, such misguided actions cause more harm than good, as alcohol misuse can significantly worsen symptoms of depression.
Both conditions are deeply interconnected, as people who suffer from alcohol use disorder are more likely to experience depression symptoms and vice versa. For instance, alcohol consumption is often used as a coping mechanism for depressive symptoms. Unfortunately, the connection goes down ways because the way alcohol changes brain chemistry can exacerbate depressive disorders.
Describing Dual Diagnosis
A dual diagnosis recognises that two or more co-occurring disorders negatively impact a person’s life. In the case of drug and alcohol dependence and clinical depression, both conditions have their own individual symptoms, if side effects overlap, they worsen the symptoms, and in many cases, one condition can worsen the harm of the other. For example, the mood swings that one has due to depression can significantly worsen if they are actively drinking.
Why Do Patients Abuse Anti-Depressants and Alcohol
In many cases, patients abuse antidepressants and alcohol due to an outdated and misguided belief that taking both will smoothen the side effects of the other and increase the “high” you get out of both. Unfortunately, the total opposite is true since taking alcohol actually increases symptoms of depression, like lack of energy and mood swings, while also stopping antidepressants from working effectively to treat those symptoms.
In other cases, people abuse antidepressants and alcohol because their individual effects offer a chance for short-term relief from stress, emotional struggles, and other sources of dissatisfaction in life. For example, people go off prescriptions and take more frequent and higher doses of antidepressants if they don’t get the desired effect, and after mixing with alcohol because they often find that the prescription medicine doesn’t work, which creates a vicious cycle of abuse.
Signs of Prescription Medication Abuse
Prescription medication abuse often leads to a physical and psychological dependence in the victim, which shows itself in many of the following signs:
- Nausea and vomiting
- Flu-like symptoms
- Loss of memory
- Brain fog
- Mood swings
- Intense cravings
- Detachment and loss of interest in previous hobbies, passions and interests
- Social distancing and isolation from friends and loved ones
- Asking for prescription medication from friends and relatives and visiting multiple GPs
- Defensiveness and changing of conversation when confronted about a potential issue
Substance Abuse as a Mental Health Condition Correlated to Depression
Both substance abuse and depression can have an acutely negative effect on brain chemistry by suppressing the production of essential neurotransmitters. For depression its the brain’s inability to produce serotonin and other essential chemicals that stabilise your mood. In many cases, the euphoric sensation and flooding of energy which people experience when consuming a substance like alcohol, cocaine, crystal meth and many others come from the sudden release of “feel good” chemicals like dopamine.
Unfortunately, the effect doesn’t last forever, and once the “crash” comes, the person suddenly feels completely demotivated, depleted of energy, and full of negative emotions. The feelings of apathy, numbness, fatigue, and impairments in cognitive function show similarity to depression symptoms, which is why cases of substance abuse, like alcohol use disorder, can lead to the development of or exacerbate symptoms of depression.
Connection Between Alcoholism and Major Depression
People with depression are more likely to drink too much or become dependent on it. Depression is a mental health condition that causes people to feel sad and without hope all the time. People’s thoughts and actions change over time because of how they feel. This can have an effect on many parts of a person’s life, such as work, personal goals, and relationships with family and friends.
If you are suffering from depression and are using alcohol to get rid of the symptoms of your illness, like irritability, loss of interest, anxiety, restlessness, and trouble sleeping, you are fuelling the condition instead of helping. Drinking as a way to escape reality and unwind is, unfortunately, using alcohol to treat your depression. It can have an enormous effect on your physical and emotional health.
Neurotransmitters in the brain are changed by drinking a lot of alcohol. Chemicals like serotonin and dopamine will change quickly when you drink alcohol. Serotonin helps keep a person’s mood in check, while dopamine controls the reward system in the brain. When these chemicals are at levels that are too high or too low, they can cause (or worsen) your depression and many other health problems.
Rehabilitation for Depression and Addiction
Enrolling on a residential rehabilitation centre that offers a dual diagnosis and treatment of co-occurring conditions can be an effective way to treat the complex way in which both conditions affect a person’s life under medical supervision, the guidance of highly experienced addiction counsellors, and with the support of people going through a similar struggle.
Since both conditions are deeply interconnected and feed off one another, any depression treatment must necessarily keep in mind addiction and any other overlapping conditions like a mood disorder, or bipolar disorder, that a person may have. For example, medical professionals must balance reducing a person’s dependence on a prescription drug while managing the acute withdrawal symptoms with other types of medicine, if necessary, so that symptoms of depression don’t become overwhelming and unbearable.
The Three Stages of Rehabilitation
Usually, there are three stages of rehabilitation upon admission for a dual diagnosis when you are suffering from depressive disorders and an addiction to substances, such as alcohol: Detox (if needed), rehab & aftercare. They are valid for all kinds of addiction treatment, but will happen differently if you are also suffering from PTSD>
Detox (if required)
Therapies in Dual Diagnosis with Depression
Cognitive behavioural therapy is an evidence-based approach to addiction treatment, which focuses on uplifting a person’s mental health by eliminating “automatic negative thoughts”. Many people who suffer from depression are used to cycles of scathingly negative thoughts full of shame and self-doubt, which are not only painful but can trigger cravings for a substance. CBT seeks to teach people how to understand those thoughts, deconstruct them and reshape personal narratives they have about themselves.
Stress and anxiety are some of the most severe negative sensations we, as humans, can experience, but the accumulating distress is often responsible for compulsive behaviour, leading to relapse in addiction treatment. Through building a positive self-image, teaching mindfulness practices for anxiety management, and stress tolerance skills, DBT helps you manage the distress in your everyday life better and teaches you how to effectively communicate problems and seek help.
The way a person treats other people, the respect, love and validation they receive from relationships, and the ability to effectively communicate thoughts and feelings are all crucial for the strength of relationships. In many cases, family issues and conflicts with loved ones can cause immense amounts of stress that worsen symptoms of depression and push you, or your loved ones, toward addiction. Inversely, dual diagnosis puts a strain on your relationships.
Interpersonal therapy focuses on the patterns of behaviour in relationships, evaluates current situations with close ones, and offers practical solutions to improve the strength between those close bonds.
Group therapy offers a safe and inclusive space where you can share your struggles, hear about the issues that other people are facing, maybe offer help yourself, and get motivation, guidance and inspiration from those around you who are also fighting their own demons.
Dealing with substance abuse, like alcohol addiction, alongside mental disorders like depression, requires a fine balance. In residential rehabilitation, patients who have a dual diagnosis will undergo a gradual reduction of the substance they are taking so that the physical dependence is slowly removed. Since the withdrawal symptoms can worsen the effects of depression, upon consultation with medical experts, they may get prescribed other medications, like selective serotonin reuptake inhibitors, to reduce the intensity of depressive symptoms.
The Trauma Recovery Model
The trauma recovery model recognises a trauma that you may have experienced in the past and its various effects on your mental health. This science-based approach seeks to help recognise the symptoms of trauma, empower you to believe you can improve and offers subtle interventions that help cope with trauma and its consequences.
Taking Medication during Rehabilitation for Addiction
The utmost priority of medical professionals during inpatient rehab is to preserve a person’s mental health and general well-being. Although eventually eliminating the intake of the abused substance completely is necessary for long-term recovery, over the short term, it can exacerbate symptoms of depression. For that reason, some selective use of medications may happen in cases where it’s necessary and medical approval is given.
Is Online Addiction Counselling Useful for Co-Occurring Depressive Disorders?
Online addiction treatment can be useful if you have productive conversations with an addiction counsellor. However, many of the aspects essential for long-term recovery and sobriety, like the detox process, the various therapeutic practices, and workshops on healthy habits and coping mechanisms, can most effectively happen in residential treatment.
Helplines and Listening Services
Here are some essential helplines which can help you find assistance. These UK helplines will also be an invalunable friend during your recovery:
Are you or a loved one in immediate danger? Call 999 and do not hesitate to ask for help!
In Wales, you can call the Community Advice and Listening Line (C.A.L.L.) on 0800 132 737
‘Shout’ crisis text line – text SHOUT to 85258