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Depression and Substance Abuse

Depression and substance abuse go together more often than not.  Depression and other psychological disorders have such a relationship with each other that doctors have coined a technical term for it called dual diagnosis.  This means that the two disorders of depression and substance abuse are equally involved in the overall problem, not that depression is the primary problem and substance abuse is a behavioral result.  In a dual diagnosis the two feed each other instead of one feeding the other.

Depression and Substance Abuse – Info

There are all kinds of correlation between depression and substance abuse.  Now take care because correlation does not imply causation, but only some form of relationship.  People who have recently suffered from episodes of major depression experience higher rates of substance abuse and addiction compared to the population as a whole.  People in general end up with around 8 percent having engaged in substance abuse in a year, as opposed to the 21 percent reported by the U.S. Department of Health and Human Services to have suffered depression and substance abuse together in the same year.  This is in adults and teenagers.  In a dual diagnosis its not clear which issue came first.  So what’s the relationship?  That is what we can find out.

Depression and Substance Abuse – Relationship

An individual dealing with depression and substance abuse may have begun using in order to self-medicate for the depression.  Or the substance abuse may have thrown off their neurotransmitter equilibrium and caused depression.  Unfortunately self-medicating in this fashion will only increase depression in the long run.  Depression and substance abuse both have some of the same external triggers.  They can come from the same source.  Research has developed a list of triggers, that are not limited to the following:

  • Genetics – There are genetic factors that can make a person predisposed to addiction and mental disorders.  Genetics can affect the levels of dopamine which definitely contribute to depression and substance abuse, as can serotonin.
  • Brain Development – Early brain development issues can cause recurring episodes of major depression and lead to future and current substance abuse issues.
  • Environment – There are environmental factors such as stress, trauma, peer pressure, etc., that can cause both depression and substance abuse.
  • Brain Regions – Depression and substance abuse are both affected by and share certain brain regions.

Depression and Substance Abuse – One Treatment

For a patient who has a dual diagnosis, both depression and substance abuse should be simultaneously treated for a complete recovery.  If either one lingers, the patient may be drawn back into addiction or melancholy.  This always begins with detoxification.  It is a must and allows for the patient to manage his or her withdrawal symptoms so that the person can think clearly and not resist treatment.  This is a must for recovery.  Then psychological treatment including individual and group therapies, inpatient or outpatient treatments, and recovery groups will help with substance abuse.  Medication, such as antidepressants like selective serotonin reuptake inhibitors, and cognitive behavioral therapy are some options for depression.  Treat both comorbid syndromes simultaneously for the best chance at full recovery.

Symptoms of Depression

As a substance abuse counselor, and after reading this site, we should all be comfortable with the symptoms of substance abuse.  However, it is probably beneficial to quickly discuss some of the symptoms of depression.  There can be a persistence in sadness, anxiety, and anhedonia.  There can be a loss of interest in ordinary activities with a decreased energy altogether.  There can be sleep problems such as oversleeping, waking too early, and insomnia.  Eating problems can arise such as eating too much or not enough.  Concentration, attention, and memory can be affected.  Hopelessness, pessimism, and negativity become the normal culture.  Feelings of guilt and worthlessness can arise from feeling depressed.  The person can become preoccupied by death and suicide.  A consistent irritability and episodes of crying will occur.  Psychosomatic symptoms like physical pain and aches can occur.  Understanding depression and substance abuse both is key in helping those with a dual diagnosis.

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