Addiction and depression are, unfortunately, commonly intertwined. One may often lead to the other, and while the relationship between the two may seem straightforward at first, there are several unexpected and interlinking factors. To understand why the two are common, it’s important to understand what depression is, what addiction is, and how one relates to the other.
What Is a Depression?
Depression is characterized by a period of a consistently low mood and melancholy. If a person is sad or down every day for at least two weeks, they may be diagnosed with a depressive issue. This does not make someone ‘crazy’, and it does not necessarily mean their depression is caused by hereditary problems or neurobiology.
A long depressive period following the loss of a loved one is known as complex or complicated grief, and is an issue tackled separately from depression. Depression usually comes out of nowhere, and periods or episodes of sadness often do not have to be ‘triggered’ to occur.
Ethnic minorities, adults between the ages of 45 and 64, women, members of the LGBTQ community and people who are chronically unemployed and/or unable to afford medical insurance are more likely to be depressed, and share some of the highest risk of depression, according to current data. The truth is that only a fraction of people who are diagnosed with a depression go on to get the help they need, and among them only a percentage ever finish a treatment course – and there are many more who may be struggling with a depressive episode or a set of depressive symptoms without ever speaking out about these issues. As such, depression is likely more common than a lot of data may suggest.
What Is an Addiction?
While an addiction can colloquially mean several different things, the American Psychiatric Association refers to addiction as a complex brain disease characterized by compulsive drug use despite certain harmful consequences. While using drugs is not a form of addiction, using them excessively without the ability to stop, and continuing to use them even after you’ve tried to stop, is addiction.
An addiction may be physical, in the sense that the person is unable to stop due to the onset of strong cravings and physical symptoms of withdrawal, but it can also manifest emotionally, in the sense that the primary reason drug use is continued is because the person is relying on drugs as a way to cope with external and internal stressors, including abuse, feelings of anxiety, poverty, and more.
One Then the Other
There are different reasons why an addict may find themselves struggling with depression, and different reasons why someone with depression may turn to drugs. Drug use, especially drugs that are easier to access and generally cheaper than others such as alcohol, are a highly effective way to cope with feelings of depression and anxiety in the short term because these drugs offer a powerful jolt of positive emotions and chemically-induced happiness.
However, they also cause a crash afterwards, and generally lead to higher levels of anxiety and depression, further fueling a destructive and vicious cycle of drug use as a way to stave off unapproachable pain and negativity.
On the other hand, drug use can also heavily contribute to the development of a depression to begin with. While there are more drug users with mental health issues than in the general public, only a portion of these turned to drugs as a way to cope with existing issues. Others developed mental health problems due to their drug use. While drugs like heroin and methamphetamine release a powerful high, they also desensitize you to many other forms of joy. Methamphetamine in particular can potentially damage the serotonergic pathways and can cause anhedonia, or the inability to feel pleasure. This can lead to the development of depression and other issues as well.
In many cases, a depression is more likely to fuel relapses because it becomes harder to maintain sobriety and continue working on your recovery while still depressed. This is why it becomes critical to approach both depression and addiction simultaneously – treatment has to consider both together and the ways they interact.
Treatment Must Be Holistic
A holistic treatment is one that examines the whole, rather than the parts. Addiction treatment should, ideally, consider each individual’s unique challenges and circumstances. Someone from a specific background with a challenging upbringing and a history of traumatic experiences is going to require a different approach in treatment than someone who found themselves living a more sheltered life, as a general example.
To be more specific, certain conditions and disorders can heavily complicate the treatment process, requiring an approach that sees a person as more than a collection of symptoms.
To treat depression and anxiety, both have to be addressed concurrently. A psychiatric professional with experience in addiction medicine can help someone with a dual diagnosis through a better understanding of how two diagnoses can play into each other, and the common complications that arise when trying to treat addiction with depression. For example, it’s harder to prevent relapses and help someone remain consistently sober when the additional pressure of depression weighs down on the already challenging aspects of recovery. Therapy must be guided to consider all symptoms, and medication – such as antidepressants – may come into strong consideration.
Patience is key, as is preparing a patient’s expectations. Addiction recovery can be frustrating, and an additional diagnosis does not make things any easier. Rather than place great importance on perfect behavior, it’s more important to accept that mishaps and speed bumps are a part of the recovery journey. The person undergoing treatment and their friends and family must understand the possible challenges that may lay ahead, depending on the circumstances at hand.
Treating a dual diagnosis is tough, but by no means impossible. People have been known to overcome addiction and depression – but there is no one set treatment. Some people recover and improve faster than others, and it’s important to seek support to help maintain a hopeful outlook. No matter how dark things may get, having friends and family around can save your life.