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Depression And Addiction: Co-Occurring Disorders

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Depression is one of the most common mental health disorders across the globe, affecting millions of people each year in the United States alone.

Classified as a mood disorder, depression is a condition that affects a person’s emotions, behavior, and can have an impact on physical health as well. In its severe forms, depression can be debilitating, affecting a person’s ability to work, go to school, and carry out other routine tasks.

About 20 percent of people that struggle with depression also experience substance use or addiction at some point in their lives. Depression can often precede substance use, and in other cases may develop as a symptom or response to heavy drug or alcohol use.

The most effective treatment method for people struggling with depression and substance use is dual-diagnosis, an integrative treatment that treats both conditions at the same time.

What Causes Depression?

There is no one single cause of depression that applies for every person who develops the disorder. Depression often develops as a result of several factors, including environmental, genetic, biological, and psychological factors.

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Depression is common among people experiencing significant life stress, as well as survivors of trauma or other personal difficulties. These experiences can trigger symptoms typically linked to depression, such as low mood and low self-worth. It can also cause changes in a person’s behavior and lead to several physical problems.

Common symptoms of depression include:

  • persistent low mood
  • feelings of emptiness
  • irritability
  • fatigue
  • hopelessness
  • loss of energy
  • changes in appetite
  • weight loss or gain
  • changes in sleep (increased or decreased sleep)
  • difficulty concentrating
  • social isolation
  • feelings of guilt or worthlessness
  • loss of interest in previously-enjoyed activities
  • headaches or digestive problems (in the absence of a medication explanation)
  • recurring thoughts of death or suicide

According to the Diagnostic Statistical Manual of Mental Disorders (DSM-V), a person must experience at least five or six of these symptoms nearly every day for more than two weeks to receive a diagnosis of depression.

Types Of Depression

Clinical depression, or major depression, is the condition most people think of when they come across the word ‘depression.’ In addition to this, there are several other forms of depression that can vary in their severity and co-occur with drug and alcohol use.

The most common types of depression include:

  • Major Depression: Major depression, or major depressive disorder, is the most common type of depression, affecting more than 16 million adults in the U.S. in a given year. Many people with major depression struggle to function in their daily lives, and may have difficulty in both their personal and professional lives. This type of depression is currently the leading cause of disability for people ages 15 to 44 nationwide.
  • Persistent Depressive Disorder (Dysthymia): Persistent depressive disorder, also known as dysthymia, is a chronic form of depression. The primary feature of PDD is experiencing a low or dark mood on most days for at least two years.
  • Bipolar Depression: Although bipolar disorder is considered its own mood disorder, one of the primary features of bipolar 2 disorder is depression. These periods of depression occur in stark contrast to episodes of mania and may last for weeks at a time. People with a bipolar 1 diagnosis may or may not experience depressive episodes.
  • Postpartum Depression: Postpartum depression is a specific form of depression that can arise following childbirth. Mild depression and anxiety following childbirth is common. Postpartum depression, however, differs from mild changes in mood as a condition that can feature severe depression, anxiety, and fatigue.
  • Premenstrual Dysphoric Disorder (PMDD): Premenstrual dysphoric disorder (PMDD) is a condition that involves severe mood changes seven to ten days before a person’s period. One of the most common symptoms is severe depression, as well as fatigue, anxiety, anger, and other physical symptoms typical of premenstrual syndrome (PMS). Unlike milder physical and emotional changes before a person’s period, the depression experienced from PMDD can be debilitating and disrupt a person’s ability to function in their normal routine.
  • Seasonal Affective Disorder (SAD): Seasonal affective disorder (SAD) is a form of depression that affects people at specific times of the year. SAD is most common during winter and is largely attributed to less natural sunlight. Those affected by SAD typically feel their depression lift during the spring and summer months.

In addition, depression is also a common symptom experienced during psychotic episodes. People with schizophrenia, for instance, may experience extreme lows in mood that can cause them to behave in ways similar to those with other forms of depression.

How Often Do Depression Disorders And Addiction Co-Occur?

Drug and alcohol addiction commonly co-occur with depression. According to the National Institute on Drug Abuse, people with a mood or anxiety disorder are two times more likely to use substances than the general population.

Similarly, people with a drug or alcohol problem are also two times as likely to struggle with a mood disorder like depression.

The mechanisms behind the high prevalence of co-occurring depression and drug use are complex, but may be linked to a few shared risk factors.

Causes Of Co-Occurring Depression And Substance Use

Researchers that study addiction and mental health disorders have found several possible reasons to explain why depression and drug use co-occur so often. Some of these causes are linked back to shared risk factors for both conditions, including family history, genetics, and the effects of depression and substance use on the brain.

Similar Effects On The Brain

Drugs and alcohol affect many of the same areas of the brain linked to depression, including chemicals like dopamine that regulate mood and behavior. Substance use can cause changes to brain structure that can make a person more susceptible to developing a mental illness.

The effects of depression on brain activity can also alter the experience of taking drugs, enhancing their positive effects. This can make a person more likely to use and become addicted to substances.

Many drugs can also cause symptoms of depression, especially when taken in high doses or on a frequent basis. This can occur while a person is under the influence, after the effects of the drug have worn off, and as a symptom of withdrawal.

Stress And Trauma

Stress and experiences of trauma are a shared risk factor for substance use and depression. This can include, but is not limited to:

  • job stress
  • unemployment
  • divorce
  • relationship problems
  • loss of a loved one
  • financial stress
  • childhood use or neglect
  • domestic use
  • rape and sexual assault
  • gender dysphoria
  • confusion about one’s sexuality

Physical and mental health are significantly shaped by environmental, social, and economic factors impacting people’s everyday lives. When a person is experiencing significant stress as a result of physical surroundings, financial stress, or other challenges, there is a higher risk of developing depression and turning to substances for relief.

Abusing Substances To Self-Medicate

Substances like drugs and alcohol may also be used to relieve symptoms of depression – a behavior commonly known as self-medication. This can occur both in those who have or have not sought previous treatment for their depression.

Feelings of happiness and sense of well-being are common symptoms of many addictive substances. In the moment, taking a drug or drinking can feel good and provide relief. Over time, however, drug and alcohol use can make depression even worse, and lead to severe dependence and addiction.

Treatment Centers For Depression And Addiction Dual Diagnosis

Recovery from co-occurring depression and addiction requires treatment that takes into account the whole person, and not just the physical effects of a person’s struggles.

Our inpatient and residential treatment programs at Vertava Health provide personalized treatment plans for patients to help them achieve successful addiction recovery. Patients who have co-occurring disorders receive a dual-diagnosis treatment plan designed to treat both addiction and mental health struggles.

Our dual diagnosis programs offer an integrated treatment plan that involves behavioral therapy, medication, and other treatment services based on each patient’s needs.

Treatment services offered at Vertava Health include:

  • medically-assisted detox
  • cognitive behavioral therapy (CBT)
  • dialectical behavior therapy (DBT)
  • group counseling
  • family counseling
  • medication-assisted treatment (MAT)
  • experiential and adventure therapy
  • trauma therapy
  • aftercare support

Contact one of our treatment specialists at Vertava Health today to learn more about our dual diagnosis treatment programs for yourself or a loved one.