Antidepressants Treatment and Rehab

The danger with antidepressants is that millions of people are prescribed these medications for chronic pain, sleep disorders, depression and anxiety. Opioids and sedatives have enjoyed the spotlight during the prescription crisis, but the dangers of antidepressant dependence still aren’t fully understood. On its own, many researchers argue that dependence on antidepressants isn’t an issue, but when combined with stimulants, alcohol, opioids and sedatives (which is most often the case), you can become emotionally dependent and eventually form addiction.

Depression and addiction can affect each other, as it’s not easy to pinpoint where and when the relationship started. Though not due to a predefined pathology, you’re likely to abuse drugs if you’re depressed – depression itself is a symptom of withdrawal from addiction. If you don’t seek professional help for depression, it grows to result in feelings of low self-esteem, anhedonia, anxiety, suicidal ideation and constant lethargy. In turn, drugs become the easiest route to self-medicate your problem.

Antidepressants: Addiction treatment and rehab

Anti-depressants are a class of medication used to treat mood disorders and anxiety. According to the Royal College of Psychiatrists, 65% of patients taking antidepressants experience a visible reduction in symptoms, three months into treatment. Antidepressants are useful for short-term periods, but should not be the permanent solution to the problem of depression.

Types of antidepressants include:

Serotonin and norepinephrine reuptake inhibitors (SNRIs): These types of antidepressants relieve symptoms such as sadness, irritability, nerve pain and anxiety. They work by impacting neurotransmitter communication between brain cells to reduce symptoms of depression. By reducing norepinephrine and serotonin levels in the brain, they reduce chronic pain and lift mood.

Selective serotonin reuptake inhibitors (SSRIs): These antidepressants are amongst the most commonly prescribed as they generally have fewer side effects than some other types of antidepressant medication. SSRIs work by increasing serotonin levels in the brain.

Tricyclic antidepressants (TCAs): TCA are used when the most common antidepressants aren’t effective. Examples include Imipramine, Doxepin and Amoxapine.

Long-term use of antidepressants can drastically affect your ability to function and can cause weight gain, sleep deprivation and headaches. If you’re experiencing dependence on antidepressants, you should enrol at a drug rehabilitation centre to fully understand the root causes of your addiction and learn coping skills for living a drug-free life.

Antidepressants addiction treatment: What is it?

There are many reasons why you may abuse antidepressants. Even when you follow your doctor’s orders, you can become dependent after taking antidepressants for up to six weeks. You might feel frustrated that the drug isn’t working as quickly as you want and increase the dose to enhance its positive effects. Misuse leads to abuse, which eventually morphs into addiction.

Abuse treatment is necessary if you’ve become dependent on antidepressants. Most side effects should only be managed by a medical professional to prevent unwanted symptoms of withdrawal.

Signs of addiction include failed attempts to quit antidepressants, continued use, even when you know the negative effects of abusing drugs, booking appointments with numerous doctors to source multiple prescriptions (doctor shopping), irritability, loss of interest in activities you previously enjoyed, aggression, seizures, tolerance to your normal dose, hiding drug use from loved ones and experiencing withdrawal symptoms when you quit.

Treatment options include medical detox (to help you detox and withdraw safely from drugs), inpatient recovery programme for comprehensive rehabilitation from drugs, outpatient recovery programmes for those who can’t commit fully to residential treatment, dual diagnosis treatment, aftercare programmes and relapse prevention planning.

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Therapy and specialised treatment options

The goal of treatment is to stop drug use and help you return to full functionality in your home, workplace and community without using drugs to solve problems. Treatment is most effective when you receive an individualised plan, devised from answers you provided during intake. The outcome of treatment depends on the extent of your addiction problems, appropriateness of treatment and your participation in treatment and services utilised to address any problems.

The combination of therapy and medication management is successful in treating addiction. While there are no approved medications for treating Antidepressant Discontinuation Syndrome (ADS), research has shown that two strategies are very effective. The first is to use the tapering method to gradually wean you off antidepressants, while the second method is to use antidepressants with a long half-life to avoid painful withdrawal symptoms. Therapy approaches include:

Family therapy

Addiction is a family disease, as your immediate family suffers when you’re battling addiction. Your family members might not see the need for therapy, since you’re the one with an identifiable problem. However, family therapy is an integral part of treatment that provides support for family members, friends and loved ones and serves to boost your chances of recovery.

A therapist is on hand to ensure no one person feels isolated and so that violence or anger doesn’t escalate during sessions. Their presence also prevents you from being triggered to increase or continue drug use. Your therapists will also engage your family in dialogue for improving problem-solving skills, assigning accountability to family members and to motivate you to adopt positive habits.

Cognitive Behavioural Therapy (CBT)

CBT is a talk therapy approach that helps you identify false thoughts and replace them with more realistic, healthier ones. CBT is based on the premise that a change in attitude leads to a change in behaviour, which eases depression. Instead of telling yourself “Why bother trying?”, you’ll subsequently change this to “I’ll start today by getting out of bed and being productive”.

In sessions, your therapist acts as your teammate and coach to understand and assess the system in place that led to your initial feelings, thoughts and behaviour. You’ll recognise the causes of drug abuse and learn how to change flawed cognitive distortions for positive thoughts that encourage abstinence.

Inpatient and outpatient rehab for antidepressant addiction

Inpatient rehab

A residential recovery programme is a live-in treatment centre. This option is recommended if you’re suffering from severe depression, anxiety, mental health issues or long-term drug use or if you’ve been using antidepressants with other substances such as alcohol. Also, this option is suitable if you’ve tried to quit in the past and failed or are experiencing medical conditions that need treatment alongside addiction.

The length of rehab depends on the severity of your addiction. If you’re a mild user or short-term user, a 30-day rehab stay will usually suffice. Long-term drug users and dual diagnosis patients may benefit from a 90-day rehab stay to adequately address all facets of addiction. Types of inpatient programmes include standard rehab, luxury rehab and executive rehab.

Outpatient rehab

Outpatient rehab is recommended if you’re dealing with mild addiction to antidepressants. It is ideal if you have the motivation to get better, a strong support network and a job where you can’t take time off to attend rehab full time. You’ll attend individual and group therapy sessions every week, meet with your psychiatrists to receive maintenance medication and address mental health issues. Treatment is similar to inpatient rehab, but less intense.

Therapy techniques used in outpatient treatment include the Matrix model, Contingency Management, Multidimensional Family Therapy and Motivational Interviewing. Types of outpatient treatment include:

Intensive outpatient programmes: This type of programme might be recommended if you don’t need medical detox. It enables you to receive treatment whilst meeting your responsibilities at home, work or school. You’ll receive treatment primarily via group therapy and meet with an individual therapist on a weekly basis. Groups do not exceed 10 people to ensure a safe environment.

Day programmes: You’ll attend therapy every day and receive the same treatment as an inpatient. The only difference is that you go home at the end of each day.

Finding an exclusive antidepressant rehab

If you want high-end treatment that offers extra amenities in addition to traditional therapy approaches, luxury rehab (or executive rehab) is ideal. At an executive rehab, you can focus on treatment whilst completing work-related responsibilities. It’s ideal for business executives in top positions. You’ll have access to a workstation, conference room, Wi-Fi and private lodgings.

Amenities at a luxury rehab could include gorgeous settings (sometimes on an isolated beach island), complete privacy, fine dining, horse riding, acupuncture, massage therapy, sauna, gym, swimming pool, five-star rooms and alternative therapies (such as equine and wolf therapy).

Many of these facilities charge up to £10,000 a week and as much as £50,000 a month. The goal of treatment is the same as standard rehab: to help you detox from drugs, understand triggers that lead to drug use and learn coping skills for abstinent living.

What to know about antidepressant clinics

The first thing to know about rehab is that treatment will be difficult in the early days. Remove the notion that there are huge locks on the doors to keep you in and force you to stay until the end of treatment. You are free to leave anytime, even though this goes against medical advice. Treatment only works if you’re willing to commit and participate.

You won’t be allowed on to the rehab programme until you’ve completed detox to rid your body of drugs. Thankfully, most rehab centres have an in-house detox clinic to help you withdraw safely from drugs.

Education is at the core of rehabilitation. It might vary across rehab centres, but the process helps you view addiction from a realistic viewpoint and let go of any ambivalence you might have towards treatment.

Private antidepressant rehabs and confidentiality

All rehabilitation centres protect your identity and treatment files. It is a founding principle that the only person who has permission to share confidential data is you. Medical professionals who view your data are directly involved with your treatment. Admitting that you need treatment makes you vulnerable and exposed. Therefore, for treatment to work, it’s essential you feel safe and protected.

Upon admittance at the rehab facility of your choice, you’ll be given a copy of the confidentiality agreement, specifying your rights as a patient and ensuring your details remain private while you’re in treatment.

Individual and group therapy

Individual therapy involves one-one sessions with your therapist. A trained therapist could be a psychiatrist, family counsellor, social worker or psychologist. You’ll work with your therapist to identify triggers, set treatment goals and learn how to cope with triggers, stressors and emotions, without using antidepressants. Sessions start during detox (when you’ll experience psychological symptoms) and continues throughout rehab and aftercare.

Group therapy is the preferred option for most recovering addicts, as you’ll benefit from shared support. You’ll receive and give support to each other, learn from experiences and share your addiction stories. Unlike individual therapy, sessions involve multiple individuals and some groups have several drug counsellors to ensure sessions run smoothly. Addiction experts recommend that the ideal number of participants is 10-12 clients, although some groups have larger numbers.

Antidepressants: Duration of treatment

Medical Detox: This is the first stage of the treatment process. You’ll access care and emotional support from medical professionals during the process. Withdrawal lasts between five and seven days, but might extend up to two weeks if you’re a long-term drug user.

Inpatient rehab: Inpatient care is recommended for exhaustive treatment of antidepressant addiction. Depending on the severity of your addiction and unique treatment needs, doctors might recommend a 30 day stay for dependence or mild addiction to antidepressants. Longer rehab stays of 90 days might be necessary if co-occurring disorders and polysubstance use disorders were discovered at intake.

Outpatient rehab: There are various types of outpatient treatment. Duration of treatment ranges from 10-16 weeks.

Aftercare: This refers to the addiction treatment received after you’ve completed rehab. Treatment includes relapse prevention planning, therapy appointments and support groups. There is no set duration for treatment. Individual sessions last up to six months, group sessions up to a year and support groups a lifetime.

Ending your antidepressant treatment

Leaving treatment early is never a good idea. It means you’re not ready to re-enter society and undermines all the progress you’ve made during treatment. Discharge Against Medical Advice (DAMA) continues to be a common problem affecting 2% of people in treatment. Predictors include minority groups, lack of insurance to pay for treatment, younger adults, teenagers, men and those with a history of substance abuse.

Patients who have asthma or breathing problems are at risk of readmission within a month and others who leave treatment early are three times more likely to be readmitted within 15 days for the same diagnosis. It’s critical for your recovery journey that you stay in treatment until you’re discharged. You might feel ambivalent towards treatment or think you’ve learned everything about addiction within a few weeks, but treatment solidifies your chances of lifelong abstinence from drugs.

Detoxing from antidepressants: All you need to know

Antidepressants are used to treat major depressive disorder, chronic pain, eating disorders and clinical depression. Most of the evidence shows that the risk is attached to developing physical dependence on antidepressant medications, rather than full-blown addiction. Physical dependence is usually associated with a range of drugs and developing tolerance for antidepressants.

Antidepressant Discontinuation Syndrome (ADS) mostly occurs when you suddenly stop using antidepressant medication that works on balancing serotonin levels, if you’ve used SSRIs for longer than 6-8 weeks, or have abused these drugs in any way.

Early withdrawal symptoms appear within three days after your last drug use and are mostly mild and short-lived. Symptoms peak from days four to seven and even out over a two-week period. Physiological symptoms include nausea and vomiting, dystonia, impaired motor functions, blurry vision, runny nose, tingling sensations, difficulty walking, fever, stomach pain, fatigue and lethargy.

Psychological symptoms usually appear after four days and include mood swings, depression, anxiety, mania, hallucinations, insomnia, vivid dreams, irritability and crying spells.

ADS is not considered life-threatening, but it’s important you detox at a medical facility to prevent unintentional harm due to accidents or poor judgment. Medications will be provided to treat flu-like symptoms such as runny nose, nausea, headache and dizziness. Benzodiazepines will be prescribed for insomnia, alongside medication to treat other symptoms as they emerge.

The tapering process is the safest method for detox. Your regular dose is gradually reduced to avoid ADS and the discomfort associated with withdrawal. If symptoms manifest during tapering, doctors might use an antidepressant with a long half-life to manage symptoms.

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Psychological therapy

Dialectical Behavioural Therapy (DBT)

While DBT was developed for treating borderline personality disorder, it has proven effective in treating psychiatric disorders such as PTSD, anxiety and depression. A 2002 study showed that 71% of people in therapy for treatment showed no symptoms of depression after DBT was completed. In sessions, you’ll learn more about crisis coaching and skills groups. These skills will help you manage life problems and negative emotions during crisis situations.

Motivational Interviewing (MI)

Motivation is often listed as one of the greatest barriers to treatment. You will be aware of the negative consequences of using drugs (including those of a financial, legal and social nature), but treatment is only effective when you voluntarily seek it, admit that addiction is a serious problem and display a desire to get better. When integrated with CBT, Motivational Interviewing is effective in treating anxiety and depression.

It addresses your ambivalence towards taking the required actions for positive change and helps you build a positive attitude towards treatment. Principles of MI include:

  • Counsellor guides you to recognise and address ambivalence
  • You are responsible for any ambivalence, not your therapist
  • Relationship with your counsellor should resemble a partnership
  • Motivation doesn’t come from outside, but from within you
  • Contingency Management

Substance use is influenced by environmental, social and biological factors. If you work towards desirable behaviour and maintain expectations, your chances of reward grow. This therapy approach uses motivational incentives to reward good behaviour and punish negative actions. It is based on the premise that behaviour that is punished or rewarded will be repeated in the future. Principles of Contingency Management include:

  • Target behaviour – either to reduce negative behaviour or increase positive behaviour
  • Target clients with poor rate of past success
  • Reinforce or reward must be something of value to you
  • Work towards finding a balance in reward (this should be practical and engage you)

Risks of treatment

The risks of treatment are mostly associated with detox and withdrawal, whereby you’ll require medical supervision to rid your body of harmful toxins. While withdrawal symptoms of antidepressant abuse are mild compared to other more powerful prescription pills, they are amplified by any mental health disorders and polydrug use.

Doctors also have to be extremely cautious when prescribing medication to ensure you don’t switch an addiction to antidepressants for one to withdrawal medication. Do not quit antidepressants on your own or detox ‘cold turkey’. Medical detox is the only way to remain safe during treatment.

Paying for antidepressant addiction treatment

Millions of drug addicts around the globe who need addiction treatment won’t access rehabilitation services because they fear the cost of treatment. Money shouldn’t be a stumbling block to living a stable, healthy life. Options when considering rehab payment options include:

Medical insurance: As a mental health disorder, addiction is sometimes covered under your private medical insurance. Depending on your type of policy, your insurer might cover the full or partial cost of rehab. Some could attach conditions – such as attending rehabs in their network – if you require full coverage. Contact your insurer to determine what’s covered in your plan. Other options include:

  • Crowdfunding
  • Reaching out to friends and loved ones for financial support
  • Paying with your credit card or personal funds
  • Taking out a home equity loan to fund treatment
  • Applying for an NHS grant
  • Attending a government-run rehab centre

What to expect from treatment

When you first arrive at a rehab centre, you’ll sit down with a clinician to discuss your family history, type of substance abuse, medical history and other variables related to your addiction. A doctor performs a physical checkup, while a behavioural therapist conducts a psychiatric evaluation to check for co-occurring disorders that will be addressed during treatment.

The next stage is detox to remove toxins from your body and physically stabilise you for rehab treatment. In rehab, programmes include behavioural therapies and psychotherapy to identify the root causes of your addiction, treat dual diagnosis disorders and learn new coping skills that don’t involve using antidepressants as you navigate through life.

During rehab, you’ll also work with your therapist on developing a relapse prevention plan and choosing an aftercare plan that aids your recovery journey. This treatment continues after rehab and is constantly refined to align with your treatment progression.

Benefits of holistic rehab

Stress management: Stress is a part of everyday life, but some people deal with it differently than others. Holistic rehab equips you with the tools for managing stress without negative behaviour or attitude.

Provision of alternative behavioural techniques: To properly address both the physical and psychological aspects of addiction, holistic rehab goes beyond conventional approaches to models such as massage therapy, bodywork, breathing control, health touch and acupressure.

Treating you as a whole: The biggest benefit of holistic rehab is that it treats you as a whole – that is, more than just your symptoms. There are emotional, social, psychological, mental and physical elements of addiction and holistic rehab addresses all these areas.

Nutrition therapy: Eating healthy, nutritious food is a major part of your recovery journey. A healthy lifestyle leads you to spend more time exercising and maintaining a healthy state of mind. This leads to happiness and increased positive energy.

Restoring your balance: Treatment is based on the belief that addiction puts you off balance, preventing you from enjoying all the good things life has to offer. Holistic rehab helps to restore that balance – firstly via detox, medication and therapy, helping you break free from substance abuse.

Post-rehabilitation support

Aftercare is the follow-up treatment you’ll receive once you’ve completed the recommended length of rehab stay. There is no ‘one size fits all’ for aftercare programmes. You’ll work with your therapist whilst in treatment to design a programme that meets your individual needs. Aftercare has proved useful in helping addicts stay on track and reducing relapse rates. The duration of treatment ranges from three months to a year – and for some, a lifetime.

Aftercare generally involves the following programmes:

  • Attending group counselling sessions and appointments with an addiction specialist for individual sessions
  • Participating in 12-step programmes or alternatives
  • Continuous education on new coping strategies and skills

Sober Living Support

Sometimes, rehab isn’t deemed long enough to allow you to practice coping strategies learnt in therapy sessions. Sober living homes are group dwellings, mostly inhabited by people who’ve completed rehab treatment. Living in a sober home, you’ll have to follow rules such as no drugs in the house, return in time for curfew, complete your house chores, attend support group meetings and stay drug-free throughout the entirety of your stay.

It’s a great way to spread out the transition process whilst maintaining sobriety. You’ll likely have to hold down a job or volunteer and will be subject to random drug testing to ensure you stay drug-free. A sober home is like living in a rented apartment, as you pay rent and cook your own meals, just like in your regular home.

Seek help

The National Institute on Drug Abuse estimates that 52 million people have abused drugs at least once in their lifetime.

Addiction is a severe mental health issue that requires rehabilitation – not just to rid your body of drugs, but to provide counselling that helps you understand addiction and the consequences of abusing drugs while learning to live an abstinent life. Call a drug addiction helpline and a counsellor will help you get started on your recovery journey.

Reach out today

Many people have the false opinion that reaching out for help makes you look weak. You can’t get better unless you admit you have a problem and seek help for it. There is no shame in asking for help from family, friends, doctors and rehab clinics. Millions of people suffering from various addictions never reach out, only worsening addiction symptoms and destroying families with the negative effects. By asking for help, you’re refusing to be a victim and regaining control of your life.


FAQs

What are the dangers of antidepressant addiction?

Long-term use of antidepressants affects your ability to function normally. It affects your ability to achieve orgasms during sex, leads to sleep deprivation and migraines. If you combine alcohol with antidepressants, it amplifies the effect of both substances, leading to a rapid increase in blood pressure, accelerated heart rate and impaired motor functions.

Can abuse and addiction to antidepressants be treated?

Addiction can be treated with a combination of medication management and behavioural therapy approaches.

Do I need addiction treatment?

You need addiction treatment if you’ve abused antidepressants in any way. Don’t wait until you hit rock bottom. Once you notice the signs of addiction, seek substance abuse treatment immediately. The signs include an inability to quit drug use, despite knowing the consequences and dangers of abusing drugs, failing relationships with your immediate family, loved ones and colleagues at work, hiding drug use, obsessing over next drug use, becoming antisocial, spending all your money on drugs and experiencing legal/financial woes because of drug use.

Which type of antidepressant addiction treatment is right for you?

The type of treatment you choose depends on your addiction needs and which treatment best caters to them. Inpatient rehab is ideal if you’re a long-term addict, have tried to quit in the past and failed, are experiencing physical health problems caused by drug abuse, or have been diagnosed for mental health or abusing other substances, alongside antidepressants.

Outpatient rehab is designed for highly-functioning addicts with a desire to quit (and a strong support system in place), who need to attend work or school while receiving treatment.

Should you go to residential rehabilitation?

The only way to receive comprehensive, holistic treatment is by enrolling as an inpatient. Inpatient drug rehabilitation is needed if you combined antidepressants with alcohol or other substances, have a mental or physical health conditions and if you’re a long-term drug user. Residential treatment ensures you have 24/7 access to support, addiction treatment and a therapeutic community that enhances healing.

What should I expect in rehab?

The first few days in treatment are the hardest, as you’re still adjusting. When you enter, you’ll be assessed and interviewed, with the answers you provide being used to create an individualised treatment plan for you. The next stage is detox, where your body rids itself of antidepressants and other drug toxins. After detox, you’ll enter rehab, where psychotherapists help you understand triggers that fuelled drug use and teach you to cope with future triggers without resorting to taking drugs.

How much does the programme cost?

The cost depends on several factors, such as the size of the programme, location of the rehab centre, number of therapy techniques used in treatment, patient to staff ratio, type of rehab and expertise of staff. In the UK, standard rehab costs around £5,000 a month and £1,000 a week, while luxury rehab programmes cost up to £10,000 a week.

What support is available after you leave the programme?

After you leave rehab, support may include transitioning to a sober living home, where you’ll live with other recovering addicts in a less structured environment, peer counselling and community-based support groups such as Narcotics Anonymous and other 12-step programme alternatives, as well as attending therapy sessions and continued doctor appointments.

Which recovery centre is right for your teen?

It’s crucial to monitor your teen when they’re taking antidepressants. Some teens go to great lengths to experience the ‘high’ of antidepressants, leading them to abuse their medication. Your teenager will benefit more from specialised teen rehab centres with  paediatric doctors, child counsellors and care professionals, licensed and equipped to work with teenagers and adolescents.

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