The Link between Depression and Substance Abuse

The relationship between substance abuse and depression is bidirectional. This means that individuals who have depression do experience an increased chance of having a substance abuse problem and those with addiction are at a greater risk of having depression.

Many people who suffer from depression will abuse drugs or drink in order to boost their mood or escape feelings of misery or guilt. However, certain substances, including alcohol, have depressant properties, which escalate feelings of sadness. Using substances to alter any negative feelings can become part of a cycle, which hinders the ability to get treatment for depression.

Does Depression or Substance Abuse Come First?

It can be hard to say which comes first since the results will vary from person to person. Some will develop drug addiction or alcoholism while others develop depression first. A study published in the National Institute of Health’s U.S. Library of Medicine shows that alcohol can actually induce depression. This is because it alters the level of serotonin. When serotonin levels rise, the symptoms of depression can sometimes decrease. Those who have depression can sometimes self medicate in order to treat the problem. Over time, substance abuse will worsen depression. Alcohol dependence and drugs can cause a lot of hardships across every aspect of life and these hardships can make depression worse.

Both alcohol use and mental illness will have a similar underlying cause. Genetics play a role in both substance abuse and depression. Someone who has a sibling or parent with depression can be two to three times more likely to develop it than an average person. Both addiction and mental illness can stem from issues in the brain. When someone is vulnerable to one type of brain disease, they can also be vulnerable to other conditions as well. Both mental health disorders and addiction affect the same chemicals and molecules in the brain. Trauma and childhood stress can put a person at a greater risk for depression and substance abuse. Further research is needed to determine the exact reasons why this can occur. Stress can be triggered by neglect, domestic violence, sexual or emotion abuse, or the death of a parent at a young age. Regardless of a person’s age, stress can be a risk factor for depression. When the body releases the stress hormone cortisol, it stimulates symptoms that are similar to depression.

Can Drug Abuse Be a Cause of Depression?

Drug addiction and alcoholism may be able to cause mental illness because they change the chemical balance in the brain. If a mental health specialist doesn’t diagnose and treat the mental illness quickly, it can also encourage the use of substances. Addiction can be a dangerous cycle once it starts.

How Drug Abuse Can Hinder Depression Treatment

Those who have co-occurring substance abuse disorders and depression usually receive specialized treatment to manage both disorders to be able to improve symptoms and increase the effectiveness of rehab. If someone with depression is getting treatment, such as therapy or medication, and notices that drinking numbs feelings, he or she may still be inclined to continue engaging in that activity and avoid evidence-based treatment. This patient may think that substance use works better than medicine or therapy and stop prescriptions or therapy visits. The substance abuse can then create other symptoms of depression, making it even harder to treat the individual.

Effects of Substance Abuse on Depression

Using drugs or drinking to wind down at the end of the day can lead an individual to think that symptoms are improving. Instead, this can just be creating more health problems. Reaching for alcohol or drugs to help lift spirits can cause depression symptoms to worsen. Depression poses risk such as a suppressed immune system, self-harm, a weakened body, and accidental injury. When a mental illness occurs alongside substance use, risks to emotion and physical health increase.

How Having Both Affects Treatment

When an individual suffers from both depression and substance abuse, this is called a co-occurring disorder. These disorders require a more comprehensive treatment plan that will effectively address both disorders. One shouldn’t be treated without the other since an individual that isn’t treated for both can have a higher rate of relapse.

It can be common for people to be unaware of either condition. If only the substance abuse is treated then a person can go back to abusing substances whenever they feel depressed. When only the depression is treated, an individual can continue using substances, which can lead to more depression symptoms. Drugs that are used to treat depression can be affected by alcohol intake. The person can still feel depressed and even develop anxiety when drinking and taking the medication. Alcohol can also cause an individual to become sedated or feel drowsy. Treatment for both substance abuse and depression will usually involve a combination of therapy and medications.

Self Medicating Depression With Opiates

People are depressed in this day and age. The prevalence of depressive disorder in the United States hovers around 16 million, or about 6.7% of the adult population according to the National Association of Mental Illness. Women are nearly twice as likely to suffer from depression, and young adults have the highest rates of all the age groups, with 11% affected by depressive disorder.

Sadly, a large percentage, about 37%, of individuals who battle depression, do so without getting professional help from a doctor. Barriers to treatment might include feelings of shame or stigma associated with mental health disorders, a sense that it would signify weakness in character to ask for help, and cost constraints for individuals without adequate insurance coverage.

Among those who chose to tough it out, a tendency to self-medicate the debilitating symptoms of depression with drugs or alcohol is common. By using a substance, the individual hopes to numb the difficult feelings that accompany a depressive disorder, such as feelings of despair, sadness, shame, and guilt. Self medicating depression with opiates is one such solution, while others may favor alcohol or another drug.

When it comes to self medicating depression with opiates, or any drug, it can be a two way street. Some individuals may have become addicted to opiates, such as OxyContin or Vicodin, following an injury or surgery where these prescription pain medications were used long enough to create a dependence on them. In other cases, the individual may have become addicted to an illicit type of opiates, such as heroin. Addiction to opiates can lead to depression, especially for individuals who use opiates for chronic pain for a certain duration of time. In fact, a study published in the Annals of Family Medicine reported that about 12% of patients who used opioid pain medications for 30 days or more developed depression. As for heroin use, the life-altering consequences of the drug can result in major depression.

Effects of Self Medicating Depression With Opiates

For those who have existing depression but seek the use of a substance to help hide the highly unpleasant symptoms of depression, they may lean on opiates. The reason for choosing an opiate, either a synthetic opioid or heroin, is due to the deep relaxation and sense of euphoria that the opiate provides. The individual virtually escapes from reality, meaning they escape from their depression symptoms.

Sadly, the effects of self medicating depression with opiates are short-lived. As the individual develops a higher tolerance to the drug, their need for more of it increases. Over time, opiate addiction can develop, creating long-term effects that are much worse than the initial struggle with depression alone.

Signs of Opiate Addiction

When someone begins self medicating depression with opiates they may initially enjoy the effects of the drug on their mental health. Opiates can alleviate pain, anxiety, and enhance relaxation in addition to masking the depression. However, once the brain’s neurotransmitters are impacted, and brain chemistry shifts to accommodate the influx of the drug’s dopamine response, the individual will begin to experience negative symptoms.

Signs and symptoms of opiate addiction include:

  • Needing to take higher or more frequent doses
  • Constipation
  • Impaired vision
  • Slowed thinking, cognitive issues
  • Ignoring obligations and responsibilities
  • Insomnia
  • Drug cravings
  • Memory impairment
  • Anoxia
  • Dry mouth
  • Difficulty concentrating
  • Doctor shopping
  • Obtaining the opiates off the street or Internet
  • When attempting to quit using the opiate withdrawal symptoms commence

These symptoms of the opiate abuse or addiction only compound the distress caused by the depression, creating a complex dual diagnosis.

Dual Diagnosis Treatment for Depression and Opiate Addiction

When someone has been self-medicating depression by using opiates, or any substance, that has resulted in a substance addiction, they will need expert dual diagnosis treatment. Successfully treating someone with co-occurring disorders requires a specialized program with both psychiatric and addiction professionals available to treat both disorders simultaneously.

Depression treatment follows a conventional protocol of combining antidepressants with psychotherapy. The antidepressants aim to regulate brain chemistry, namely serotonin, dopamine, and norepinephrine, but the effects take about a month to be noticeable. Many times, the initial prescription, selected from about 25 types of antidepressants, may need to be adjusted or switched to another antidepressant if the individual doesn’t experience relief by the 6-week point.

Psychotherapy is useful in treating both the depression and the addiction. Psychotherapy is a core treatment element for both disorders, helping individuals communicate their underlying emotional issues, past traumas, or difficult life circumstances with an objective therapist. In addition to assisting the client in processing these sources of pain, a psychotherapist can also point out a client’s distorted thought patterns—“I can’t function without Oxy, I can’t handle life without it—that lead to a reflexive behavioral response to reach for the drug. Using cognitive behavioral therapy (CBT) the therapist can suggest replacement thoughts—“I am feeling sad today so I will take a brisk walk and feel better”—leading to positive and more constructive behavioral results.

To further treat the addiction piece of the dual diagnosis, there are various additional treatment elements provided in a dual diagnosis program. These might include:

  • Addiction education. Classes that teach clients how addiction develops in the first place can be effective in deterring future use of drugs, as well as assisting in relapse prevention planning.
  • Experiential activities. Because a dual diagnosis impacts all aspects of one’s being it is helpful to augment therapy with holistic therapies such as mindfulness meditation, journaling, art therapy, music therapy, equine therapy, yoga, and acupuncture.
  • Medication-assisted treatment. Some individuals may benefit from a drug that is designed to reduce cravings and improve recovery outcomes. For opiate recovery, this might include buprenorphine, Suboxone, or methadone.

Individuals struggling with both depression and opiate addiction can greatly benefit from dual diagnosis treatment, going on to enjoy a fulfilling and productive life.

Quest 2 Recovery Offers Dual Diagnosis Treatment in Los Angeles

Quest 2 Recovery is unique among addiction treatment providers. At Quest 2 Recovery, we have created a comfortable, intimate home setting for individuals struggling with depression and a co-occurring substance use disorder, including opiate addiction. Our dual diagnosis program is holistic in scope, treating all aspects of the client—mind, body, and spirit. Situated in a serene location, Quest 2 Recovery offers new hope to those who need a quiet respite from the stressors of daily life in which to heal and restore overall wellness. For more information about the program, please contact Quest 2 Recovery today at (888) 453-9396.