SUBSTANCE ABUSE & DEPRESSION: WHAT YOU SHOULD KNOW

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1 SUBSTANCE ABUSE & DEPRESSION: WHAT YOU SHOULD KNOW

2 TABLE OF CONTENTS What is Depression? 4 Symptoms of Depression 6 Substance Abuse as a Coping Mechanism 8 Which Occurs First? 10 Substance Abuse and the Brain 12 Treating Addiction and Depression 13 Why Seek Treatment? 14 Sources 15 2

3 INTRODUCTION ROUGHLY FIVE PERCENT OF THE WORLD S POPULATION HAS A SEVERE FORM OF DEPRESSION. According to SAMHSA, approximately 8.9 million adults have co-occurring disorders. Only 7.4 percent of individuals receive treatment for both conditions, with 55.8 percent receiving no treatment at all (1). A co-occurring disorder is described as an individual simultaneously struggling with addiction and depression. Oftentimes, addiction develops as a result of depression as a prior condition. Individuals who have become depressed often refuse to recognize the symptoms of sadness, negativity and loneliness and don t feel that it s necessary to seek help. Roughly 5 percent of the world s population has a severe form of depression (3). Depression is the leading cause of disability worldwide, and it s a major contributor to the global burden of disease (4). Fortunately, there are a number of things that you can do to encourage the recovery process from addiction, depression, or both conditions co-occurring. 3

4 WHAT IS DEPRESSION? IT S NOT NORMAL FOR NEGATIVE EMOTIONS TO PERSIST FOR AN EXTENDED PERIOD OF TIME. At some point in life, everyone feels sad, lonely or melancholy (5). It s normal to experience incredible sadness when you grieve the loss of a loved one or when you feel helpless due to a specific circumstance. It s not normal, however, when negative emotions persist for an extended period of time and affect how you function on a day-to-day basis. For example, if you struggle to get out of bed and go to work in the morning because you feel sad, numb and hopeless for no apparent reason, you may be experiencing the symptoms of clinical depression. 4

5 WHAT IS DEPRESSION? Depression can result from several life circumstances: PHYSIOLOGICAL ASPECTS POOR OVERALL HEALTH GRIEF OR LOSS NEGATIVE LIFE SITUATIONS (LIKE A BREAKUP OR EXTREME STRESS) Depression refers to the medical condition that results from long-term negative emotions. When feelings of depression impact and interfere with your normal daily activities, it s a sign that you need to seek professional help. Some aspects of depression are outside of your control. For example, a genetic predisposition that results in lower levels of natural hormones can be a contributor to depression. In this instance, changing your thought processes and developing healthy coping strategies can reduce the risk of addiction or severe health concerns, and may help the symptoms of depression subside. POOR EMOTIONAL REGULATION AND COPING STRATEGIES PERSONAL PERCEPTIONS AND EXPECTATIONS 5

6 SYMPTOMS OF DEPRESSION Common signs of depression: PERSISTENT FEELINGS OF SADNESS OR EMPTINESS GENERAL PESSIMISM GUILT According to the National Institute of Mental Health, the signs and symptoms of depression vary from person to person (5). Each person s circumstances and health impact the way they experience depression. In some cases, it means that they experience minor symptoms and that they won t face severe complications. In other cases, the problems associated with depression persist and long-term treatment might be necessary to help them recover effectively. LACK OF ENJOYMENT FOR FAVORITE ACTIVITIES OR HOBBIES EXHAUSTION OR FATIGUE ACHES AND PAINS THROUGHOUT THE BODY 6

7 SYMPTOMS OF DEPRESSION Common signs of depression: DIFFICULTY WITH FOCUS & MEMORY Depression manifests itself differently from person to person. For example, one person may sleep thirteen hours a day, while another may struggle with insomnia as a result of depression. Some people may experience a loss in appetite, while others may overeat to cope with their feelings. IRREGULAR SLEEPING HABITS Since the symptoms are not straightforward and are unique for each person, you or a loved one may overlook the signs or ignore the symptoms. POOR APPETITE IRRITABILITY OR GENERAL ANGER SUICIDAL TENDENCIES 7

8 SUBSTANCE ABUSE AS A COPING MECHANISM 1 IN 3 PEOPLE WITH SEVERE DEPRESSION DRINK ALCOHOL IN EXCESSIVE AMOUNTS. About 20 percent of Americans with severe depression or related depressive disorders also abuse drugs or alcohol, and about 20 percent of people with a substance use disorder also show signs of depression or similar depressive disorders after an addiction develops. Almost 1 in 3 individuals with severe depression drink alcohol in excessive amounts (6). Furthermore, women with a history of depression are almost two times more likely to develop an addiction to alcohol when compared to the general population of women (7). Using drugs or alcohol in an attempt to cope with the symptoms of depression increases the risk of addiction and severe health concerns. Self-medicating, or using a substance in an attempt to reduce negative feelings associated with depression make the problem much worse. 8

9 SUBSTANCE ABUSE AS A COPING MECHANISM DRUGS & ALCOHOL HIJACK THE NATURAL WAY THAT YOUR BRAIN COMMUNICATES. Substance abuse impacts the symptoms of depression in a negative way due to the impact on the brain. The National Institute on Drug Abuse says that drugs and alcohol hijack the natural way that your brain communicates and sends messages (8). As a result, abused substances either flood the brain with certain chemicals or tell the brain that a certain reaction should occur. Over time, the brain changes and begins craving the substance. Chemical dependence occurs when an individual needs the drug or alcohol to feel normal and shows withdrawal symptoms without it. 9

10 WHICH OCCURS FIRST? A CO-OCCURRING DISORDER IS WHEN AN INDIVIDUAL EXPERIENCES ADDICTION AND DEPRESSSION AT THE SAME TIME. A co-occurring disorder is when an individual experiences addiction and depression at the same time. Determining when the depression developed helps therapists create a realistic and appropriate treatment program (3). Unfortunately, it s not always easy to identify when the depression first developed in relation to the substance abuse. If a person shows signs and symptoms of depression as well as substance abuse, then a treatment program needs to consist of a personalized plan of action that includes treatment for the mental health disorder. Co-occurring disorders complicate the treatment process because they require more treatment for a longer period of time. 10

11 WHICH OCCURS FIRST? THE BEST TREATMENT PROGRAM FOR CO-OCCURRING DISORDERS IS TAILORED TO YOUR NEEDS. In many cases, a history of depression suggests that the depressive disorder occurred before the substance abuse. In that situation, the drug or alcohol is a form of self-medication that only worsens the situation. For example, alcohol aggravates depression because it s a depressant, causing impulsive behaviors that a person may regret later on. That behavior leads to more negative feelings and emotions, causing a downward spiral over time. When substance abuse occurs before symptoms of depression, the treatment options that help with recovery focus on healing the physical body as well as focusing on counseling. Many symptoms of depression fade as the body and mind heal, and an optimal treatment plan will adjust to changes based on each individual s situation. 11

12 SUBSTANCE ABUSE AND THE BRAIN SOME DRUGS INCREASE THE RISK OF DEPRESSION. The way in which substance abuse impacts depression is shaped by several factors, including the specific drug and the individual s overall well-being. Some drugs increase the risk of developing depression by flooding the system with dopamine and changing the way that the body reacts to the substance. The National Institute on Drug Abuse says that amphetamine drugs or cocaine cause the body to flood the system with pleasure hormones (9). In turn, the brain and body develop a tolerance to those hormones and ultimately stop responding to their natural levels. In other situations, the neurons send false messages to the brain, which causes confusion. The National Institute on Drug Abuse says that marijuana and heroin do not directly cause a flood of dopamine, but they send inaccurate messages to the brain (9). As a result, the drug disrupts the chemical signals in the brain and causes symptoms of depression or related disorders. 12

13 TREATING ADDICTION AND DEPRESSION Treatment options that help with recovery: HEALTHY NUTRITION EDUCATION APPROPRIATE MEDICAL TREATMENTS ALTERNATIVE TREATMENTS & COUNSELING EXERCISE PROGRAMS COGNITIVE AND BEHAVIORAL TREATMENTS An effective treatment plan addresses both addiction and depression simultaneously. Treatment should focus on creating a personalized plan, and should recognize that no single treatment works well for each person (10). A personalized plan allows an individual to focus on his or her specific recovery goals, as well as allowing them to avoid complications. When searching for a treatment program, it s important that you find a treatment center that will partner with you and nurture your individual needs and nuances though your recovery process. The more tailored your program is to your needs, the higher your chance of successful sobriety will be. ADJUSTMENTS TO THE TREATMENT PROGRAM TREATMENTS FOR DEPRESSION 13

14 WHY SEEK TREATMENT? TREATMENT TEACHES YOU HOW TO COPE WITH SYMPTOMS & HANDLE LIFE CHALLANGES HEALTHY AS THEY ARISE. Specialized treatment programs that offer tools to help with addiction and depression provide a chance to start fresh and regain personal health and well-being. They allow you to identify the causes of your substance abuse and address the problem in a healthy and effective manner. When depression complicates the recovery process, treatment is necessary. Treatment enables the individual to learn better ways to cope with symptoms, and provides them with easier ways to handle life challenges that arise. It also offers training for life skills for a holistic approach to the recovery process. 14

15 SOURCES (1) Co-Occurring Disorders. Substance Abuse and Mental Health Services Administration. (2) Richard Zwolinski, C.R. Zwolinski, Depression and Substance Abuse: Chicken or the Egg?. Psych Central, January 30, 2013, (3) Mental Health By the Numbers. National Alliance on Mental Illness. April 2, https://www.nami.org/getattachment/ Learn-More/Mental-Health-By-the-Numbers/General-MH-Facts pdf (4) Nick Nauert, Ph.D., Depression s Chemical Imbalance Explained. Psych Central, November 10, 2006, com/news/2006/11/09/depressions-chemical-imbalance-explained/398.html (5) What is Depression?. Web MD, May 11, (6) Todd B. Kashdan, Ph.D., What Causes Depression? Myths About Chemical Imbalances. Psychology Today, March 13, 2014, https://www.psychologytoday.com/blog/curious/201403/what-causes-depression-myths-about-chemical-imbalances (7) Signs and Symptoms of Depression. The National Institute of Mental Health, depression/men-and-depression/signs-and-symptoms-of-depression/index.shtml (8) Substance Abuse. The Anxiety and Depression Association of America, related-illnesses/substance-abuse (9) Alcohol and Depression. Web MD, September 16, 2014, (10) Drugs and the Brain. The National Institute on Drug Abuse, July 2014, (11) DrugFacts: Treatment Approaches for Drug Addiction. The National Institute on Drug Abuse, September 2009, drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction 15

16 Addiction and depression often occur hand-in-hand and cause health concerns for many men and women around the world. When you or a loved one abuses a substance, identifying the underlying cause of substance abuse and addressing the depression makes it easier to reach recovery and accomplish your personal goals. With professional treatment, each individual has the tools to regain his or her health and start improving their lifestyle and relationships. Call Greenway Recovery Center for more information on depression, substance abuse, treatment and recovery. 1 (866)

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