Double Whammy: How Addiction Impacts Depression

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For many people, addiction and depression occur at the same time. Living with these conditions or caring for a loved one who is struggling with depression and addiction can be difficult and confusing.

The more you learn about how addiction affects depression, the better equipped you’ll be to seek help — for yourself or a family member — and manage your own feelings when a loved one is depressed.

Research shows that medicines and therapy can help patients feel better and find alternatives to their addictive behaviors, says Dr. Liptak.

Addiction is a chronic condition that creates a constant internal drive to experience pleasurable activities. This stimulates the reward center of your brain.

Depression is a mood disorder that causes feelings of sadness and a loss of interest in your normal activities. Depression affects how you think, feel, and act.

Addictions can be chemical (drugs and alcohol, or sugar), or activity-based (overeating, shopping, gaming, or social media), says Stephen Liptak, PsyD.

“Anything that activates the pleasure centers in the brain can be every bit as intense and powerful as a chemical,” Dr. Liptak says.

Shared Triggers

Either addiction or depression can develop first, says the National Alliance on Mental Illness (NAMI). Someone with depression may use drugs and alcohol as a way to cope. Substance abuse can lead to depression because of the way drugs and alcohol change our moods, thoughts, brain chemistry, and behavior.

“Many individuals who become depressed will use substances to self-medicate in order to feel better,” Dr. Liptak says. “A lot of us do this. What person when feeling down, hasn’t reached for a piece of chocolate or had a drink at the end of a long day?”

When someone is depressed, using addictive substances such as drugs or alcohol can lead to further problems. That’s because drugs and alcohol are depressive agents that act on the central nervous system, says Dr. Liptak.

“So you end up chasing your tail,” he says.

Which comes first — addiction or depression — may vary between women and men, says Dr. Liptak.

In men, addictive behaviors tend to develop first, followed by depression. In women, it is the opposite. Women are more likely to experience depression first, followed by an addiction. Shopping addictions and eating disorders also are more common in women than in men, Dr. Liptak says.

“We see a lot of women developing eating disorders after a depressive episode.”

Addiction Makes Depression Worse

Drugs and alcohol upset the chemical balance in the brain. This can lead to depression or make depression worse.

Drinking or taking drugs while taking medicine for depression “makes the medicine have to work harder,” says Dr. Liptak. “You are putting a depressant into your system on top of being depressed. You could be increasing your depression over time and making it worse.”

Addiction can also cause sleep problems, which is an important variable that often gets overlooked, Dr. Liptak says. The link between sleep and mental health is a strong one that should not be ignored.

Many people who struggle with addiction and depression often experience disrupted sleep. They might drink alcohol or use substances to help them fall asleep. Such substance use often causes you to wake in the middle of the night and not be able to fall back to sleep.

Poor sleep or lack of quality sleep can make you feel depressed or irritable and unable to shrug things off.

Know the Signs

When addiction and depression mix, you may notice changes in yourself or a loved one when it comes to behavior, physical appearance, and social interactions.

The most common symptoms of addiction and depression that occur together are:

  • Changes in appetite and sleep
  • Withdrawing from regular activities
  • Withdrawing from friends and family
  • Changes in personality
  • Weight gain or loss
  • Bloodshot eyes
  • Deterioration in physical appearance
  • Engaging in risky behavior when drunk or high
  • Loss of control
  • Doing things you wouldn’t normally do to maintain the habit
  • Needing the drug to function

If you are experiencing these symptoms or know someone who is, be sure to talk with your doctor right away about how you’re feeling.

Addiction And Depression Often Go Together

It is quite common for people to experience addiction and depression at the same time. Statistics from NAMI show that among people with mental illness, 33 percent also experience addiction. The figure jumps to 50 percent among people living with severe mental illness.

At the same time, a third of alcohol abusers and more than half of those addicted to drugs also report a mental illness.

Addiction and depression share common underlying causes, says the U.S. Department of Health and Human Services’ website. This may explain why people often experience both conditions at the same time. The National Institute on Drug Abuse says those shared traits include:

  • Brain composition. Addiction and depression both affect the parts of the brain that handle stress responses.
  • Genetics. Your DNA may make you more likely to experience depression or addiction.
  • Developmental issues. Early exposure to stress or trauma can harm brain development and make someone more likely to experience depression and/or increase the chance of substance abuse.

While substance abuse commonly occurs with depression, it’s also frequently present with other mental health conditions such as anxiety disorders, schizophrenia, and other personality disorders.

Recovering From Addiction And Depression

Treatments for addiction and depression vary, but the best outcomes can be achieved when both conditions are addressed using a combination of methods, including medicines, psychotherapy, detoxification, and inpatient rehabilitation.

The most common treatments combine medicines and psychotherapy, says Dr. Liptak.

Patients often think of medicine as a last resort because there is still a lot of misinformation and cultural shame about taking medicines for depression. That feeling is beginning to change as people become more open to talking about it, says Dr. Liptak.

“Many times the talk therapy won’t even work until we get a patient on a medicine to lift their depression enough so they are energized and moving,” he says. “That needs to happen before someone can make lifestyle changes and changes in their thinking patterns.”

Research shows that medicines and therapy can help patients feel better and find alternatives to their addictive behaviors, says Dr. Liptak. He makes a point to ask patients what they get out of their substance use or other addictive behavior.

“Good therapy helps you explore why you chose it and what it does for you,” Dr. Liptak says.

Someone might find that drugs or alcohol helps them feel normal or allows them to tolerate the boredom of being at work or sitting in class all day.

“When you understand the motivation,” says Dr. Liptak, “you can find ways to cope without creating other problems in your life.”

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