Depression and Substance Abuse
The Dangerous Link Between Depression and Substance Abuse
Depression is a serious and common mental health condition. By itself, depression can cause significant impairment in a person’s day-to-day functioning. Unfortunately, though, depression often co-occurs with substance abuse disorder. Together, these two conditions can fuel each other in a deadly cycle of abuse, self-harm, and suicidal ideation and attempts. The following article will explore the link between substance abuse and depression and who is most at-risk of experiencing these co-occurring disorders.
What is substance abuse?
Substance abuse is the harmful or hazardous use of psychoactive substances. People can abuse legal and illegal drugs, and also alcohol. Abusing psychoactive substances can lead a vulnerable person to dependence syndrome. Substance abuse disorder is a harmful cluster of cognitive, behavioral, and physiological symptoms, including but not limited to the following:
- Intense cravings to use the substance.
- Problems controlling the use of the substance.
- Continuing to use the substance despite the consequences.
- Prioritizing the use of the substance over other important activities.
- Experiencing increasing tolerance for the substance.
In some cases, experiencing painful, dangerous withdrawal symptoms upon cessation.
What is depression?
Depression symptoms can vary by individual, but the most common are the following:
- Sadness
- Anger and irritability
- Emotional numbness or emotional lability
- Decreased ability to concentrate
- Problems sleeping and eating
- Changes in weight
- Significant impairment in functioning
- Extreme, pervasive feelings of guilt, shame, or worthlessness
- Sluggish movements
- Fatigue
- Suicidal thoughts and attempts
- Self-harm
These symptoms or cluster of symptoms must be present for at least two weeks for an official diagnosis of clinical depression.
How can someone experience substance abuse and depression at the same time?
20% of US adults with depression or another mood disorder struggle with substance abuse disorder too. It’s possible for someone to experience depression and a substance abuse disorder at different times. But when the two conditions happen simultaneously, leaving both issues untreated can have devastating consequences for the person afflicted.
For clinicians, co-occurring disorders are challenging to diagnose and treat appropriately, but treatment is not impossible. The symptoms of depression can make substance abuse disorder symptoms worse, and vice versa. In some cases, one disorder can lead a person to develop the other disorder. Depression symptoms can cause people to abuse drugs or alcohol to relieve their symptoms. Likewise, abusing substances can lead to feelings of shame, guilt, or depressed mood. An at-risk person who abuses substances can quickly spiral into a major depressive episode.
A recent report from the Agency for Healthcare Research and Quality found that one in eight hospital ER visits in the US is due to a mental health disorder and substance abuse problem. Depression is the most commonly cited mental health condition in the report, and alcohol is more likely to be a problem for people than illegal drugs.
Is substance abuse and co-occurring depression dangerous, and why?
Co-occurring disorders are extremely dangerous. Alcohol abuse puts a depressed patient at high-risk of attempting suicide. Depressed patients may abuse drugs to lift their mood or decrease feelings of self-loathing. But alcohol is a depressant that increases low mood and feelings of fatigue. For a depressed patient with an alcohol abuse disorder, continuing to abuse alcohol makes the depression worse. Without treatment, the risk of suicide is incredibly high.
Also, drugs and alcohol can significantly lower a person’s inhibitions. In vulnerable people who are already having thoughts of suicide, taking drugs can lower their defenses and lead them to attempt suicide.
What substances are most likely to cause or worsen a depressive episode?
Alcohol is the most dangerous substance a person can take if they are already depressed or are at-risk for experiencing a depressive episode. One-third of people with depression also struggle with alcohol abuse and dependence.
Who is most at-risk for co-occurring depression and substance abuse disorder?
- People who are between the ages of 45 and 64.
- People who are chronically unemployed.
- African Americans and Hispanics are most at-risk.
- People who are too disabled to work.
- People who lack medical insurance.
What are the treatment options for depression and a co-occurring substance abuse disorder?
For patients with co-occurring disorders, it’s crucial to treat both conditions at the same time. If only depression is treated, the patient will continue to abuse drugs or alcohol and suffer severe consequences as a result. By only addressing substance abuse, depression can worsen, and the patient is at risk of suicide, self-harm, and significant functional impairment.
The severity of the illness and the type of drugs or substances a person is addicted to will all determine what kind of treatment methods will be most effective. For example, a person who has been addicted to alcohol for many years will benefit from inpatient medical detox.
Individuals who abuse multiple drugs may also need medical detox and several months long inpatient rehab to safely withdraw from the substances.
For both depression and substance abuse disorder, ongoing maintenance plans must be put in place. Depression and addiction often recur, and individuals are at high-risk for relapse. By participating in an inpatient program that utilizes integrated care for co-occurring disorders. Patients can have access to effective treatment methods in the event of a relapse or recurrence of symptoms.
Most people with depression respond well to a combination of medications and therapy. CBT and DBT can effectively alleviate both symptoms of depression and substance abuse. SNRIs and SSRIs are the most commonly prescribed medications for clinical depression.
For those who are unable to respond favorably to medication, electroconvulsive therapy and transcranial magnetic stimulation can treat depression and alleviate stubborn symptoms. Transcranial magnetic stimulation is one of the least invasive treatment methods for depression. After a session, patients can quickly resume their normal activities.
Depression and co-occurring substance abuse disorder can prove fatal if left untreated. Fortunately, there are many different safe and effective treatment methods for these disorders. Don’t hesitate to reach out to an experienced counselor to find relief from the painful symptoms of depression and substance abuse.