America is often portrayed in movies and on television as the land of plenty, where opportunities are everywhere and everyone is happy every day. While it would be wonderful if that image reflected reality, the truth is that many Americans struggle with symptoms of depression for weeks or months at a time. In fact, according to the U.S. Centers for Disease Control and Prevention, 9.1 percent of adults studied in 45 states met the criteria for clinical depression. While it’s hard to know exactly what causes depression in each and every person, and it’s likely that the reasons tend to shift from person to person, some say that addiction to substances like alcohol or drugs play a role in depression. For some, the addiction causes symptoms of depression. For others, the depression causes substance abuse to begin.
Living with both depression and addiction can be a struggle, but there are effective treatments that can be used to help ease symptoms and make life seem worth living once more. At Michael’s House, we specialize in providing care for people who have a Dual Diagnosis, such as a substance abuse issue as well as a mental health issue. If you have any questions about depression after reading this article, or you’d just like more information on the subject of Dual Diagnosis, please call us. We’d love to talk with you about the care we can provide.
No one feels happy and buoyant each and every day of the week. In fact, almost everyone feels a low and sad mood coming on from time to time. It’s part of being human and dealing with the stresses that come and go throughout the day. But for people with depression, a low mood is more than a passing cloud that blocks out the sun. For people with depression, a low mood tends to come on and then stick around for a long period of time with no end in sight.
According to the National Institute of Mental Health, symptoms of depression can vary from person to person, but many people with depression report feeling:
- Extremely tired
- Unable to concentrate or remember small details
- Very hungry, or by contrast, not hungry at all
- Hopeless about life
- Unable to sleep, or able to sleep all day long without feeling refreshed
- Physical pain
Some people develop a major depressive episode, in which they feel completely unable to eat, sleep, work or enjoy their lives for weeks at a time. Other people develop a more mild form of depression in which they still feel significantly altered and unable to cope, but they still force themselves to move forward with the tasks they must accomplish. These people might experience depressive symptoms for years.
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The Link to Addiction
Several studies have demonstrated that people who have substance abuse issues, and who enter facilities that cater to substance abuse problems, also have symptoms of depression. For example, a study published in the journal Psychiatric Hospital found that 33 percent of people seeking care for addiction also had moderate to severe cases of depression. While these studies might be interesting, it’s slightly difficult to determine how to accurately interpret these results. All that these studies demonstrate is that the two conditions tend to go hand in hand. They don’t demonstrate which condition came first. In order to determine whether the addiction caused the depression or the depression caused the addiction, scientists would have to craft long studies involving people who have depression or addiction and then monitor them for years to see whether the other problem popped up in time. These likely wouldn’t be considered humane studies, so it’s no surprise that nothing like this has been done at this time.
There is some evidence that suggests depression and addiction share some of the same genetic markers, and that the two conditions tend to be inherited through the family line. For example, the National Institutes of Health found that a specific gene in a rat is linked to the expression of the chemical serotonin. Rats with this gene, and a lowered expression of serotonin as a result, tend to become depressed at higher levels when exposed to stress, as compared to rats who do not have this gene. Similarly, monkeys with this gene tend to drink more alcohol in a sitting than monkeys who do not have this gene. Therefore, people with this altered gene could be at risk for both depression and addiction.
People are made up of more than just genes, however. Often, depression has a close link to stress and other events in a person’s life. Dealing with the loss of a marriage or the death of a family member puts an enormous amount of stress on a person’s emotional resiliency, and some people aren’t able to hold up under the strain and depression results. If these people have a genetic propensity for depression, their symptoms may be quicker to come on or they may be stronger, but even people without a genetic propensity for depression can still develop the disorder, if placed under an extreme amount of stress. When people feel low and sad, they may turn to drugs and alcohol to shut off the signal and to feel “normal” once more. Addiction can soon follow.
Conversely, some people develop addictions to drugs and alcohol through simple experimentation, and they begin to develop symptoms of depression as the addiction grows stronger. Sometimes, this can be attributed to the brain damage caused by addiction. As a study published in the journal Biological Psychiatry puts it, “…it is possible that early exposure to chronic drugs of abuse might lead to neurobiological changes that increase the risk of depression.” Addiction can damage portions of the brain related to emotional regularity, and that can lead to depression. In addition, being addicted to drugs or alcohol can cause catastrophic life problems, including loss of family, income and home. All of these losses could also cause depression to surface.
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Determining the Significance
While it might be interesting to speculate about addiction and depression, trying to determine which came first and why, it might not matter a great deal when it comes to treatment. What is important is that the depression is adequately diagnosed, and that therapies for depression are provided alongside the therapies provided for addiction. This is the best way to ensure that both problems are dealt with at the same time, and that neither remains behind when the treatment is over. When comprehensive care like this is provided, recovery rates are remarkable. For example, a study in the Journal of Clinical Psychiatry found depressed people needed slightly more intense addiction treatment than people who were not depressed, but at the end of the study, both groups of people recovered at equal measures. Both groups improved in mental health status due to the help they received in treatment.
It is important to stress, however, that both conditions should be treated at the same time in order for true healing to begin. People who only receive care for their depression, for example, might find that their addictions grow stronger as their mental health improves, and they may still face a variety of negative consequences that could push them back into depression. The reverse is also true. Both conditions must be addressed in a Dual Diagnosis treatment program.
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One important treatment that might be provided to depressed people in addiction treatment, that might not be offered to non-depressed people, is medication. There are a variety of medications that can be used to help people struggling with depression that can correct chemical imbalances and make it easier to concentrate, sleep and enjoy life. The medications might take time to work, and sometimes the dosages must be adjusted over time in order to ensure that they’re providing the right kind of relief, but they can make an incredible difference for someone living with depression.
In addition to medications, people with depression and addictions might benefit from targeted therapy sessions with a licensed counselor. This type of therapy is provided to many people who have addiction issues, but therapy for both addiction and depression can be slightly different than therapy for addiction alone. For example, a Dual Diagnosis therapy program might:
- Provide information on symptoms of depression
- Outline how drugs and alcohol make depression worse
- Pinpoint triggers of depression
- Highlight ways a person could deal with depression, without resorting to drugs
According to the American Psychological Association, some people with depression benefit from therapies that help them build strong social connections. When they begin to feel low, they’ll have other people to reach out to for love and support. This might be an incredibly important part of the Dual Diagnosis program for depression, as the addiction may have forced the person to develop relationships centered on substance abuse. Through therapy, the person might learn how to make new connections, while steering clear of those people who represent temptation to use. Some people benefit from family therapies, in which they repair damage done by the addiction. Other people benefit from participating in support groups, where they meet other people who are also learning to live a sober life.
Healing from a Dual Diagnosis of addiction and depression is truly possible. With medications, therapy and help from a supportive group of friends and family, the two problems can be overcome and the person can learn to build an entirely new life. Please contact us today to find out more about our programs, and how we can help you recover.
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