“Which came first — my depression or my substance abuse?”
You may have asked yourself this question many times if you’ve been using drugs and alcohol to manage feelings of hopelessness, sadness or despair. Many people who have clinical or situational depression take drugs or drink to control depressive symptoms like:
- Weight gain
- Social isolation
- Suicidal thoughts
But because many of these symptoms are also common side effects of substance abuse, it may be difficult to tell where your depression ends and your drug or alcohol abuse begins. Clinical depression is a serious condition that can affect your physical health, your emotional well-being, your family life, your work and your hopes for the future.
Using illicit drugs or alcohol to manage this illness is no more effective than drinking or using street drugs to control cancer. In fact, using depressants like alcohol, prescription painkillers or tranquilizers can make you feel even more tired, anxious and emotionally drained. Rehabilitation programs for depression can address both your mental illness and your addiction, so that you can find your way out of the fog of hopelessness and despair.
Seeking Help for Depression: Critical Steps to Recovery
- See your health care provider for a complete medical evaluation. If you have a physical condition that’s causing depression-like symptoms, your doctor may help you determine the underlying causes for your fatigue, weight gain or sadness.
- Schedule an appointment with a mental health professional. In addition to having a medical evaluation, you should also see a mental health expert for a depression screening. A therapist, psychologist or psychiatrist can help you find out whether your depression is caused by your life circumstances or by a clinical disorder.
- See an addiction specialist who also specializes in mental health disorders. An addiction counselor can gauge the severity of your drug or alcohol abuse and help you find treatment that addresses both your depression and your addiction.
- Make a commitment to recovery. Abstaining from illicit drugs and alcohol is especially important for people who suffer from depression — but abstinence can also be more challenging if you have a dual diagnosis. If you have a strong commitment to getting better, you’re more likely to make a successful recovery.
- Build a support system. In addition to your doctor, therapist and addiction counselor, you can seek help from dual diagnosis support groups, 12-step programs, trusted friends and family members. Both depression and substance abuse can isolate you from others, but when you’re in recovery, it’s critical to reach out for help.
Signs and Symptoms of Depression
Everyone feels sad, blue or lonely sometimes. These feelings are part of the natural spectrum of emotions that we all experience. But clinical depression lasts much longer and is much more pervasive. The cause of major depression is unknown, but according to the Mayo Clinic, the disorder may be related to an inadequate production of certain neurotransmitters, or chemical messengers in your brain.
Neurotransmitters like serotonin keep your moods stable and provide emotional balance. When your brain doesn’t process these chemicals correctly, you may experience symptoms of depression. Hormonal influences, stressful life experiences, trauma and heredity can also play roles in depression. If you’ve experienced these signs of depression for two weeks or more, it’s important to seek help from a mental health professional:
- Loss of interest in work, family, romantic partners or hobbies
- Changes in your weight
- Sleeping too much or suffering from insomnia
- Irritability or anger
- Constant worrying or anxiety
- Difficulty focusing your attention on your activities
- A lack of energy
- Tearfulness and emotional instability
- Feelings of low self-worth
- Thoughts of self-injury or suicide
Drinking more heavily than usual, abusing prescription painkillers or sedatives and experimenting with illegal drugs are common symptoms of depression. The American Journal of Psychiatry notes that these substances can also trigger depressive episodes, creating a vicious cycle in which the “cure” for depression only worsens the symptoms of this serious medical disorder.
Depression doesn’t always manifest itself as sadness. Some people — especially younger males — express depression as anger, frustration or irritability rather than despair and tearfulness. They may engage in risk-taking behaviors like using illegal drugs, driving under the influence and stealing. When you’re depressed, you may be attracted to dangerous drugs for self-destructive reasons. You may turn to alcohol or pain relievers to numb feelings of guilt, anger or despair.
Depression and Substance Abuse
It’s not uncommon for people who suffer from depression to show signs of drug addiction or alcoholism — and vice versa. In a study published in Psychopathology, researchers at the University of Porto Medical School in Portugal evaluated 285 study participants for drug addiction and depression. The scientists found that there was a strong correlation between drug abuse and depression, and that the severity of the addiction corresponded to the severity of depressive episodes.
Why is substance abuse especially harmful to people who suffer from depression? Drug or alcohol abuse can interfere with the brain’s production of neurotransmitters, causing chemical changes that can exacerbate feelings of worthlessness and despair. If you’re taking antidepressants or anti-anxiety meds under a doctor’s supervision, illicit drugs and alcohol can interfere with the effectiveness of your medication and may cause unpleasant or dangerous interactions.
Substance Abuse, Depression and Suicide
The combination of substance abuse and depression is a deadly mix, increasing the risk of self-injury and suicide. The American Foundation for Suicide Prevention (AFSP) reports that:
- Depression affects more than 24 million people in the US each year — more than heart disease or AIDS.
- Major depression affects more than 60 percent of people who commit suicide.
- Alcohol use is involved in approximately 30 percent of suicides.
- About 7 percent of people who suffer from alcoholism will die by suicide.
On a more hopeful note, the AFSP reports that depression is a preventable illness. Up to 90 percent of people who receive treatment for depression show improvement in their symptoms.
Dual Diagnosis Rehabilitation
How is rehab for depression different from rehabilitation for people who don’t suffer from this medical disorder? Dual diagnosis rehab focuses on treating your depression and your substance abuse as separate but closely related issues. In addition to medical detox, you may receive psychotherapy that targets your depression or anxiety.
These strategies help you identify the harmful behaviors and negative thought patterns that perpetuate the cycle of depression and substance abuse. In addition to psychotherapy, you may need antidepressant medications to restore balance in your brain chemistry and promote stable moods.
With 24-hour medical supervision, you can get the help you need to feel positive and hopeful again. Individual psychotherapy, couples or family counseling, and group therapy will help you understand the reasons for your depression and provide a support system that can help you fight addiction.
For those who struggle with depression and addiction, recovery can be twice as challenging. With the guidance and encouragement of compassionate addiction professionals, you’ll begin to experience hope again. Solutions and support are available when you take that first important step.