Depression and Addiction

If there’s one fact that mental health experts and researchers agree upon, it’s that depression and substance abuse are directly related. The effects of depression are felt in weight change, performance, mood, sleep, inactivity and addiction. The most common problem is using alcohol and/or other drugs to numb the effects of depression – a combination that serves to worsen mental health disorders.

The International Journal of Medicine reports that men who have Major Depressive Disorder are three times more likely to become alcoholics, while women are four times more likely. According to the World Health Organisation (WHO), depression is the leading cause of global disability.

What is Depression?

Depression (or Major Depressive Disorder) is a serious yet common mental health condition that has a negative effect on how a person thinks, feels and acts. It can lead to a series of physical and emotional problems, causing sufferers to feel extreme sadness and a loss of interest in day-to-day affairs – and possibly in everything they have enjoyed in the past.

Contrary to public opinion, depression is not just a case of “the blues” or a weakness which can be “shrugged off”. The love and care of family and friends might not be enough to pull someone out of a depressive mood and they may need professional treatment to get better.

There is a plethora of factors that might trigger depression, which afflicts 6.7% of adults – including up to a third of women – and which can strike at any time. Thankfully, it is a treatable condition, and between 80%-90% of patients diagnosed with depression respond to treatment.

Signs and Symptoms of Depression

Symptoms vary from mild to severe. While it might happen only once in a lifetime, most sufferers experience several episodes. Symptoms of depression include:

  • Restlessness, anxiety, agitation
  • Slow body movement (thinking or speaking)
  • Sleep disturbances (including oversleeping and insomnia)
  • Lack of energy (small tasks feel like over-exertion)
  • Weight loss and reduced appetite
  • Suicidal ideation and suicide attempts
  • Loss of interest in activities enjoyed in the past, such as hobbies, sex and sports
  • Inexplicable physical pain (such as headaches and back pain)
  • Feelings of guilt, worthlessness, self-loathing, shame and low self-esteem
  • Feeling of sadness, hopelessness and emptiness
  • Difficulty concentrating
  • Memory problems
  • Reckless behaviour(such as compulsive gambling, dangerous driving and substance abuse)

Recognising Depression vs. “the Blues”

It may be hard to distinguish a case of “the blues” from depression; however, there is a huge difference between a brief period of feeling down and having a diagnosis of clinical depression. The Diagnostic & Statistical Manual of Mental Disorders (DSM) IV states that symptoms of depression last at least two weeks and interfere with a person’s ability to maintain healthy relationships, work or function socially. A person with depression will also experience at least five of the above symptoms on a daily basis.

Mental illness is different from a temporary emotional state. Feelings of bereavement after the death of a loved one, a break up with a partner or loss of home are not the same as depression, unless they extend longer than two months. Experiencing “the blues” doesn’t prevent one long-term from going to work or enjoying one’s usual activities; however, everything feels impossible when you’re depressed and that mood is permanent.

Get Confidential Help Now

Call our admissions line 24 hours a day to get help.

Types of Depressive Disorders that can be encountered with addiction

There are many forms of depression related to addiction. Psychiatric experts have recognised several categories of depressive disorders associated with psychological conditions, life stressors and emotions. They include:

  • Major Depressive Disorder (MDD)
  • Persistent depression (dysthymia)
  • Bipolar disorder
  • Postpartum depression
  • Seasonal Affective Disorder (SAD)
  • Psychotic disorder

Atypical Depression

This is a common type of depression that responds better to some medications and therapies than others. A person with atypical depression may feel happy and experience pleasure when positive events happen, but this is temporary. Other symptoms include increased appetite, weight gain, sensitivity to rejection and a heavy feeling in the legs and arms.

Chronic Depression (Dysthymia)

Dysthymic disorder is marked by depressive symptoms and low moods that extend beyond two years. A sufferer may be consistently gloomy, moody and irritable. It’s not as severe as Major Depressive Disorder, but has a negative effect on overall wellbeing and quality of life. Genes play a role in chronic depression, alongside abnormal function in certain brain circuits, interaction of medications, chronic illness, life stressors and work or relationship problems.

Chronic Depression Symptoms

Symptoms include:

  • Excessive sleeping or insomnia
  • Loss of energy on a daily basis
  • Feelings of worthlessness and hopelessness
  • Difficulty concentrating
  • Loss of enjoyment in pleasurable activities
  • Sadness most of the day
  • Suicidal ideation and attempts

Psychotic Depression

This is a type of severe depression that occurs with a form of psychosis. Psychotic depression affects one in every four people; a person is considered psychotic when s/he has lost the ability to differentiate between what’s real and what’s imagined. Symptoms include:

  • Delusions (including feelings of failure, worthlessness and guilt for sins)
  • Hallucinations (including hearing voices telling a sufferer that s/he is worthless and no good)
  • Disconnection from reality
Get Confidential Help Now

Call our admissions line 24 hours a day to get help.

Investigating the Causes of Depression

Genetics: Research from Stanford University shows that a person is more likely to become depressed (20%-30%) at some point during their lifetime if one parent also suffered from depression. Neurological differences are partially inherited and linked to several genes.

Brain Chemistry: There are naturally occurring chemicals that stabilise mood; insufficient levels play a role in depression. Research has shown that changes in the effects and function of specific neurotransmitters (and their interactions with neurocircuits directly involved in mood stability) might lead to depression and also impact treatment.

Hormones: Depression could be triggered by a change in hormone balance in the body. These changes may happen during or after pregnancy, or result from menopause, thyroid problems and other conditions.

Environment: Just like addiction, environment plays a role in depression. If a person has experienced or witnessed traumatic events as a child, this increases the risk of developing depression later in life. Trauma therapy may be required to address any unresolved issues and begin the healing process.

Situational Factors: Certain events in life may trigger depression, such as unemployment, the breakdown of a marriage, the death of a child or the loss of a home or business. These events may start out as bereavement and worsen into depression if the emotions related to those events are not suitably addressed. Feelings of self-loathing, worthlessness and a desire to die frequently also accompany depression.

The Relationship between Addiction and Depression

It’s hard to tell where depression starts and where it overlaps into substance abuse, because they both share many of the same risk factors, causes and symptoms. For instance, past trauma, brain chemistry, environment and family background are some of the causes of addiction. Psychological and physical effects of addiction may also mask the signs of depression or worsen symptoms.

The link is especially strong with alcohol abuse and depression: a study in Psychiatric Times notes that 20% adults who are alcoholics also suffer from depression. Alcohol depresses the central nervous system, intensifying drowsiness and lethargy and worsening symptoms of depression and other mental health issues.

Alcohol also impairs judgment and lowers inhibition, increasing the chance of risky and damaging behaviour (including suicide). This argument is supported by data from the American Association of Suicidology that shows half the people who attempt suicide have Major Depressive Disorder, while The New York Times reports that a third of people with depression have alcohol use disorder.

When someone with a current diagnosis of depression abuses alcohol, it increases the chances of hospitalisation, exacerbates depressive symptoms and interferes with the efficacy of any treatment that person may currently be receiving.

Get Confidential Help Now

Call our admissions line 24 hours a day to get help.

Which Comes First: Addiction or Depression?

This is difficult to ascertain, as symptoms and risk factors vary across individuals. For some people, it might be drug addiction first and depression second; for others, vice versa. What we know is that if a person abuses substances such as alcohol, they can develop depression. Over time, the effects of addiction are exhibited in daily life, work and finances; these negative impacts subsequently lead to depression.

When alcohol induces depression, it disrupts serotonin levels, lowering production of natural chemicals and its metabolites. The neurotransmitter serotonin is associated with mood disorders and depression. The transponder is different for those with alcohol use disorder, who will have lower levels of serotonin and metabolites in their cerebrospinal fluid. A study published by the National Institute of Health showed that lower serotonin levels increase depression and when these levels increase, depression decreases in turn.

Sufferers of depression might also use addictive substances to self-medicate for mental health disorders, instead of seeking professional help. However, the relief is temporary and only worsens depression in the long-term.

How Addiction and Depression Are Similar and yet Different

The clear connection between addiction and depression means that both mental health disorders are similar (though of course there are differences too). Both are isolating diseases that make sufferers long for their own company rather than that of loved ones. Isolation enables a person to dwell on depression and to continue taking drugs; this can become a vicious circle of increased isolation, depression and substance abuse.

Depression and drug abuse affect feelings of self-worth. If a person attempts to quit but is unable to, they may become convinced that they’re a lesser person because they can’t kick the addiction. This often leads to further drug use in order to feel confident and happy, however temporary the reprieve.

A major difference between addiction and depression is that substance abuse is reinforced by chemical imbalances in dopamine, serotonin and norepinephrine levels of the brain. Addiction is not an issue when there’s a balance in brain chemical levels. Addiction and depression will be treated as a unit. Antidepressants are prescribed to balance chemical levels and patients will work with a therapist to identify the underlying reasons that led to depression and substance abuse.

Why Depressed People Turn Towards Alcohol/Drugs (and Why the Combination is Dangerous)

Depression is often a gateway to substance abuse. Many people consume alcohol and/or drugs to escape and numb negative emotions. They might drink alcohol, for example, for its sedative effects or to distract them from perpetual feelings of sadness. Although substance abuse can provide temporary relief, it worsens the symptoms of depression in the long run, leading to many negative effects that are felt across all areas of life.

Substance abuse very frequently leads to a breakdown of marital bonds, deteriorating relationships with children and friends, financial and legal woes, job loss and physical health conditions. As these symptoms unfold, depression worsens, often leading to an intensification of substance abuse. If you’re taking antidepressants for alcohol or other substance abuse, it makes them less effective and only worsens depression.

Get Confidential Help Now

Call our admissions line 24 hours a day to get help.

Depression and Addiction: Six Little-Known Facts

Addiction and depression occur together: they are the most common cases of co-occurring disorders. One in three adults with substance use disorder also suffer from depression, according to the Journal of Clinical Psychiatry.

The risk of suicide is higher for dual diagnosis of depression and addiction. Set apart, they are both difficult to overcome and require long-term treatment to properly address all symptoms. Together, they increase the risk of suicide, as alcohol lowers inhibition and makes risky behaviour like suicide attempts more attractive. Statistics show that if someone with a substance use disorder is 10% more likely to commit suicide.

Depression is the major reason someone might relapse as a recovering addict: addiction also derails treatment for depression, as substance abuse interferes with the efficacy of antidepressants.

Long-term treatment is required for addiction and depression: depression is more likely a re-occurring disease and quitting ‘cold turkey’ doesn’t guarantee that a person won’t relapse. Drug rehabilitation gives the best chance of making a full recovery from both substances.

In the beginning, quitting substance use makes depression worse.

Over half of individuals who seek treatment at a rehab centre have mental health disorders, such as depression.

Recovering from Depression and Substance Abuse

Depression has serious consequences on the lives of loved ones and a sufferer’s own wellbeing. The feelings of worthlessness, sadness and despair will reduce via the application of research-based therapies and medications that balance brain chemicals. An integrated treatment programme is required that addresses a person’s mental health needs, detox from alcohol and other substances and rehabilitation for lifelong sobriety.

How to Help a Loved One suffering from Drug Addiction and Depression

Approaching a loved one who is dealing with substance abuse and depression is not easy, but it helps them get their life back on track and prevents both illnesses from causing further damage to their mental and physical health. A few tips include:

Be upfront and honest about the problem: People who are depressed can’t just switch their mood or they would have done this previously. Don’t offer false reassurance, but encourage them that treatment will work.

Be empathetic: Seeing the problem from their viewpoint helps you understand what they’re going through and reduces the frustration you might feel when your first attempt doesn’t work.

Be nonjudgmental: Judgement makes a depressed addict ‘closed off’ and become guarded. Don’t criticise, shout or force them to get treatment.

Offer solutions: Stating the problem is fine, but offering solutions is better. Be prepared to offer treatment solutions when they are ready to get help.

Get Confidential Help Now

Call our admissions line 24 hours a day to get help.

Dual Diagnosis Treatment for Depression and Drug Addiction

Treatment involves dual diagnosis rehab, whereby a combination of medications and therapy are used to treat both disorders. Patients will be prescribed antidepressant medication to help normalise the natural production of serotonin and stabilise moods. Follow doctor’s orders to avoid abuse.

Talk therapy is used alone to treat mild depression and combined with antidepressants to treat severe and moderate depression. Cognitive Behavioural Therapy (CBT) is the most effective technique in treating depression and substance abuse. It helps patients recognise distorted thinking patterns and feelings that fuel drug use and depressive symptoms. Working with a therapist, patients will learn to modify dysfunctional behaviour and thoughts.

Depression Medications and Addiction

Treating depression and addiction can be challenging. Feelings of low-self worth and lack of motivation imitate the effects of withdrawal and chemical intoxication. Common medication includes Selective Serotonin Reuptake Inhibitors (SSRIs) such as Zoloft, Celexa and Prozac. These drugs balance chemical levels by increasing the production of serotonin.


How Does Depression Take Hold?

The warning signs of depression – or the timeline within which it manifests – differs across individuals. However, there are a few signs to look out for when a loved one is starting to feel depressed. They’ll lose interest in daily activities, while getting out of bed in the morning will be harder. They’ll oversleep and experience feelings of hopelessness, anger, irritability, self-loathing, and have difficulty concentrating.

How Is Depression Treated?

Professional treatment of depression involves therapy and medication. A therapist will use various therapy techniques to help a patient understand the causes of their depression, motivate them to take action, provide skills that prevent future depressive moods and treat depression. Medication is provided for those who are suicidal or violent and this helps to ease symptoms, but isn’t a cure in itself.

Can Treatment Cure Depression and Addiction?

Receiving treatment at a rehabilitation centre where dual diagnosis is treated is the best chance of curing depression and addiction. Both are mental health issues that never truly go away, but are treated with a combination of mindfulness-based therapy, dialectical-based therapy and other traditional behavioural therapies that treat addiction and mental disorders.

Get Confidential Help Now

Call our admissions line 24 hours a day to get help.