People who are depressed may find it extremely difficult to explain their condition to outsiders.
Finding the right words to express inner pain takes creativity and energy, and people with depression may find that these two attributes are in remarkably short supply while their disorder is in place. Just getting out of bed is hard enough. Explaining the fact that all of the color has gone out of the world and that happiness seems like a distant memory that will never return seems to be too much to bear. People might also worry about the stigma associated with depression. They may believe they should “snap out of” the pain they’re feeling, or that admitting to depression will lead to an immediate stint in the hospital.
As a result, studies suggest that people with depression spend an average of eight years trying to handle the problem on their own, struggling with their symptoms and coming up with their own methods to mitigate the damage. Sometimes those self-help methods lead directly to drug abuse and/or addiction.
Types of Depression
Depression is one of the most common mental illnesses experienced by adults within the United States, with the U.S. Centers for Disease Control and Prevention reporting that 9.1 percent of adults meet the criteria for a depression diagnosis. Each person who has depression is likely to experience slightly different symptoms at slightly differing levels of severity, but in general, depression is a mental illness that’s associated with persistent low, sad or angry feelings that interfere with everyday life.
- Agitation or irritability
- Inability to concentrate or stay on task
- Social isolation or withdrawal
- Lack of interest in activities once considered pleasurable
- Changes in sleep quality, or length of time spent sleeping
- Hopeless or helpless feelings
- Suicidal thoughts
- Weight gain or loss
Major depression, in which symptoms listed above last for two weeks or more, can be triggered by a major life change, such as the death of a loved one or a diagnosis of a life-threatening illness. Many people who have an episode of major depression will experience another episode later in life, although they may have periods of relative happiness between episodes. This is the form of depression most people are familiar with, as the symptoms are dramatic and the suffering involved can be severe. There are other forms of depression, however, and these depression issues can be just as troubling.
Dysthymia is a chronic form of depression in which a person feels some of the symptoms of major depression, but the severity of those symptoms doesn’t match the severity found in major depression. The condition can still cause significant distress, however, as people with dysthymia don’t experience a break in their low moods. They feel persistently low and sad without pause for years.
Seasonal affective disorder, also known by the acronym SAD, can cause people to experience the symptoms of major depression during the cold and dark months of the winter. When the spring returns, and natural light is available once more, the symptoms seem to ease. Cycling depression like this seems like a relatively mild problem, and it would be reasonable to assume that people with SAD don’t struggle as much as people with major depression.
However, people with SAD may have an extreme amount of difficulty with socialization and happiness during the holiday season, which is the time at which people are expected to be happy and social. The dysfunction can be severe. According to an article produced by Medline, about half of people with SAD can improve with light therapy. However, the other half will continue to struggle, even if they install light therapy boxes and use them properly.
When a new baby comes into the world, mothers are expected to feel overwhelmed with joy and love. New moms are also flooded with hormonal changes, however, and these swirling chemicals can cause some women to feel persistently low and sad in the months following the birth.
Some mothers even fear that they will harm themselves or their new babies, due to the discomfort caused by this mental illness.
Depression and Addiction
For people who are depressed, addictive drugs might seem like the silver bullet that can solve their problems and make their discomfort disappear. Addictive drugs can cause the brain to release dopamine, which is often referred to as the “feel good chemical,” and this chemical is often lacking when people are struggling with depression. While addictive drugs might provide some relief on a short-term basis, people who keep taking addictive drugs month after month and year after year can cause long-term damage to brain cells, and this can make depression worse. In time, their brain cells won’t produce dopamine at all, unless drugs are present. A minor deficiency in dopamine can turn into a complete lack of the chemical. Depression can deepen and strengthen as a result.
People who abuse alcohol can also develop symptoms of depression. In fact, a study in the journal Addiction found that having either alcoholism or depression doubled the likelihood that the other disorder would appear. It’s unclear what pharmacologic changes caused by either disorder could influence the other, but it’s clear that the link is both strong and persistent.
It can be difficult for experts to spot depression in people who are addicted. Researchers writing in the journal Psychiatric Quarterly make this point quite plain. In this study, researchers found that heroin addicts had “strong depressed feelings,” as found in surveys, but they showed very few overt signs of depression, in the reviewer’s opinion. The people might have seemed simply sedated on drugs, not depressed. This could keep people from getting the help they need, as their depression is hiding behind a mask of drugs.
The Impact of Both Conditions
People who have both depression and addiction could face more severe levels of distress than people who have only one problem. The chemical changes caused by addictions could make symptoms of depression seem to linger or deepen, and the symptoms of depression can make taking drugs seem like a reasonable way to cope with stress and pain. People with depression have difficulty planning for the future and weighing the consequences of their actions, which could allow them to take drugs even when those drugs have a good chance of ruining their future opportunities.
In a study of the issue, published in the journal Drug and Alcohol Dependence, researchers found that people who had both cocaine addiction and depression had higher levels of distress and poorer levels of psychological functioning, when compared to people who had cocaine addictions alone. Depressed people also had higher levels of drug cravings and lowered abilities to resist those cravings.
People with addictions and depression might also be more likely to attempt suicide, when compared to people who don’t have addictions. In a study in the journal Trends in Pharmacological Sciences, researchers suggest that changes in the brain due to drug use are to blame, making it difficult for people to control their impulses and make good decisions. This sort of damage could make a suicidal impulse almost too difficult to resist. Additionally, people with addictions have the tools they’d need for a suicide available, almost all of the time. By taking one more pill or a slightly higher dosage of drugs, they can end their lives quite quickly. Where people with depression might need to hunt about to find a method with which to end their lives, people with depression and addiction are surrounded by that temptation almost all of the time. Sometimes, the temptation is just too hard to resist.
There are many different medications that can be used in the fight against depression, including:
The Agency for Healthcare Research and Quality reports that only three in five people experience significant improvement in their depression symptoms the first time they start taking medications. Most people need to try multiple different types of medications before they settle on just one that provides relief, and even then, some people need to switch medications after a time in order to gain complete control.
Not everyone who has depression needs management with medications, however. Some people benefit from talk-therapy sessions in which they learn more about how depression and addiction interact, and they develop skills they can use to keep both conditions under control. These sessions can be remarkably helpful, and the sessions can be incredibly empowering as people learn more about how to steer their thoughts into positive territory and transform depression into action.
At La Paloma, we focus on helping people who have both addictions and mental illnesses.
We utilize medication management, when needed, but we also emphasize the power and control that can be gained through therapy sessions. We encourage our clients to participate in support group meetings too, so they can break free of their self-imposed isolation and learn from others who have the same background and the same kinds of struggles. We’d like to invite you to participate. Please call our toll-free line to speak to a counselor today.