Understanding
the Complex Relationship Between Substance Use Disorders and Depression
You might be surprised to
learn that people with depression have a higher risk of developing substance
use problems than those without the illness.
Drug or alcohol use
patterns that are part of substance use disorders might start to affect your
ability to operate normally, your health, and your quality of life. Substance
use disorders, in other words, go beyond casual drug or alcohol use.
Dual diagnosis refers to
the mix of substance use disorders and mental health issues, which occurs so
frequently. Among those with a dual diagnosis, major depression is the mental
health disorder that is most frequently identified.
You may read more about
the link between substance use and depression as well as the special dangers of
having a dual diagnosis down below. Additionally, whether or not you satisfy
the requirements for a dual diagnosis, you can discover advice on how to obtain
help for substance abuse and depression.
·
Is there a link between depression and
substance use disorders?
If you struggle with
depression, you might turn to alcohol and other drugs to lessen or better
control your symptoms. Self-medication is a common term for this.
Evidence indicates that
people with depression are almost twice as likely to self-medicate with alcohol
as with drugs, according to a reliable source.
People may self-medicate
for a variety of causes, including:
o
Managing unpleasant emotions: Constantly
feeling depressed, lonely, or furious can be draining. For some people,
consuming alcohol might help them unwind, take their mind off their suffering,
or "numb" their agony.
o
Increasing mood: Even when positive things
happen in your life, depression can make it difficult to feel joy or happiness.
Some people may believe that drinking alcohol or using other drugs is the only
way to feel happy or any emotion at all.
o
Sleeping: Insomnia and depression are
frequently related. Sedatives are used by some people to fall asleep.
o
Increasing energy: Depression frequently
depletes energy, in part because of lack of sleep. To feel more alert, some
individuals may utilise stimulants.
Indeed, alcohol and drugs
may momentarily hide or lessen your symptoms. However, they are unable to
eliminate those symptoms or heal the underlying problem. In other words, your
depression symptoms will usually return after you stop using them.
Over time you may find
that you need to use more of the substance to have the same effects.
Over time, you can also
develop a dependence on the drug, meaning you require it for your body to
function normally. Addiction risk may be increased by dependence.
More information about the various
addictions
People without access to
mental health services frequently self-medicate. If you have untreated
depression, you may find yourself doing everything it takes to alleviate your
symptoms.
Youth are more prone to
experience the onset of disorders including sadness and anxiety, according to
research from 2018. Quicker detection of these ailments can lessen the
likelihood that they'll also develop a substance use disorder.
·
Do substance use disorders raise the
chance of developing depression?
Depression can influence
substance use, while substance use disorders can influence depression.
Depression is more likely to be exacerbated by more severe substance use
problems.
In four ways, substance
use can aggravate depression:
Inflammation
Numerous chemicals,
especially alcohol, can cause your brain to temporarily release dopamine, which
can result in pleasurable feelings.
However, they may also
make the brain more inflammatory. Your brain has a tougher time producing
mood-enhancing substances like serotonin and dopamine on its own when there is
inflammation.
o
Cortisol
Drugs and alcohol affect
your brain's levels of mood-enhancing chemicals in more ways than one. Levels
of hormones linked to stress can also be significantly raised by them.
A 2014 review of the
literature found that MDMA users have up to four times the amount of the stress
hormone cortisol in their body compared to non-users.
Withdrawal
Regular alcohol or drug
usage might cause your brain to become dependent on those substances to
function.
When you abruptly stop
using those substances, it could take some time for your brain to adjust and
resume producing the normal amounts of serotonin, dopamine, and other vital
neurotransmitters. Meanwhile, depression might also cause you to feel
depressed, numb, or struggle to find enjoyment or interest in your routine and
everyday activities.
As a result, you might
find yourself turning to drugs or alcohol once more to feel like yourself.
Isolation
Regularly abusing drugs
and alcohol might eventually ruin your employment or academic performance, not
to mention how it can impact your relationship.
Being alone might make it
harder to receive support, compassion, and affection. Emotional support can be
quite helpful in managing and coping with mental health issues. This may
contribute to explaining why loneliness raises the risk of acquiring depression.
One need not inevitably lead to the other
Another rationale for
dual diagnosis is possible. Depression and substance use disorders may
occasionally have the same underlying cause.
SUD and depression can
both be brought on by malfunction in specific areas of the brain, including
the:
o
Your sleep-wake cycle is governed by your
circadian clock.
o
Your stress response is controlled by your
hypothalamic-pituitary-adrenal axis, and your reward circuits, which govern
your motivation and satisfaction
A dual diagnosis can also
be influenced by trauma and abuse, particularly if the abuse occurred when the
patient was a child.
In comparison to peers
who did not encounter childhood abuse, those who endured abuse, neglect, or
other forms of maltreatment are up to three times more likely to experience
depression. You have a higher chance of getting a substance use disorder.
Warning signs to watch out for
You might have a positive
relationship with alcohol and other drugs even if you suffer from depression.
However, since substance use disorders and depression can reinforce one other,
it never hurts to exercise some caution.
Several indicators of
possibly concerning substance use include:
o
You ponder a lot about when you'll get
another chance to consume alcohol or take drugs.
o
You are aware that your drug usage has
hurt your relationships and work, but you find it difficult to care or give up
the drug.
o
You become even more worn out and
pessimistic about life as the effects of the drugs or alcohol wear off.
o
To maintain a constant level of energy and
mood, you need more and more of the drug.
o
You struggle to stop using drugs despite
feeling guilty or ashamed about it.
o
The potential long-term ramifications of
substance use don't seem to matter all that much in comparison since you feel
so gloomy about the future.
If you've observed any of
the aforementioned symptoms, a mental health expert can provide additional
assistance and advice on what to do next.
Dual diagnosis risks
If you have both
depression and a drug use disorder, it could be more difficult for you to
control your symptoms than if you just had one of them.
People with dual
diagnoses are more likely to: Compared to those with a single condition at a
time
o
More profound depression symptoms
o
Relapse after trying to stop using drugs
o
A lesser standard of living
o
Suicide attempt
The order in which the
diagnoses occur may have an impact on the likelihood of suicide, according to a
2013 longitudinal study trusted Source on 816 participants. The study tracked
people from the ages of 16 to 30 to determine how many went on to develop
alcohol use disorder, depression, or both conditions simultaneously.
Most persons who
experienced both diseases concurrently first experienced depression. More than
a third of this group disclosed having attempted suicide at least once.
The rates of attempted
suicide in this cohort were as follows:
o
Twice as high as they were for those who
first experienced depression before alcohol use disorder
o
Three times higher than they were for
individuals who simply experienced depression
o
When compared to persons who merely had
alcohol use disorder, they were nine times higher.
The authors of the study
speculate that this group may have had more severe and persistent forms of
depression than the other participants, but they were unable to determine why
this group had a greater prevalence of suicide attempts.
·
Getting assistance for two diagnoses
Typically, dual diagnosis
treatment simultaneously tackles both mental health issues.
Or, to put it another
way, you don't have to stop using drugs to get treatment for depression.
Similarly, you don't have to wait for your depression to get better before
seeking help for your drug use.
A treatment plan that
incorporates medication, therapy, and support groups may be suggested by a
therapist or other qualified professional.
Medication
The physiological causes
of depression and substance use disorders can be treated with medication.
The neurotransmitters
implicated in depression can be balanced by antidepressants. Although they
don't directly address symptoms of a substance use disorder, they may
nonetheless indirectly assist by easing the depressive symptoms that fuel the
urge to use drugs.
The cravings and
withdrawal symptoms you experience if you have an alcohol use disorder or an
opioid use disorder can be lessened with medication.
Alcohol use disorder
medications include:
o
Naltrexone
o
Acamprosate
o
Disulfiram
Some examples of drugs for opioid use
disorder.
o
Buprenorphine
o
Methadonene
o
Snaltrexone
While it is feasible to
take antidepressants together with these medications, it is important to
remember that some medications should not be used at the same time. Sertraline,
an antidepressant, and methadone, for example, can both increase serotonin
levels. Your serotonin levels could rise dangerously high and cause serotonin
syndrome if you take them both at once.
You can learn more about
your pharmaceutical treatment options from a doctor or psychiatrist.
Psychotherapy
Some of our mental health
disorders' social and emotional foundations can be addressed through
psychotherapy.
Some dual diagnosis
strategies include:
o
With the use of cognitive behavioural
therapy (CBT), you can address the false beliefs and harmful actions that
contribute to both depression and substance abuse.
o
Motivational interviewing: This strategy
can assist you in resolving ambivalent emotions related to substance use or
self-destructive behaviours.
o
Dialectical behavioural therapy (DBT):
This method can assist you in discovering and putting into practice new
techniques for controlling emotional distress as well as for more effectively
managing depressive symptoms, cravings, and withdrawal symptoms.
Support Groups
Consider joining a
support group if therapy is out of your current financial reach or if you don't
feel ready to engage with a professional just yet. A support group can be
joined in addition to individual therapy.
Support groups provide a
venue for individuals with comparable issues and mental health symptoms to get
together and assist one another on an equal footing. Members can commiserate,
offer consolation, and celebrate victories.
If you have two
diagnoses, you might look into:
o
Dedicated dual diagnosis support group
called Double Trouble in Recovery
o
Alcoholics Anonymous SMART Recovery
The Conclusion
Drug use and depression
frequently coexist. Substance abuse can sometimes cause depression, although
depression can also be exacerbated by substance abuse.
The gold standard for
dual diagnosis treatment addresses all of your symptoms and concerns at once,
regardless of whether the ailment manifested itself first. Medication,
counselling, support groups, or a combination of them all may be a part of your
healing process.
The most crucial thing to
keep in mind is that both substance use disorders and depression can go better
with treatment. Once you feel ready to ask for help, professional support can
significantly reduce your symptoms.