Depression is a risk factor for substance use and subsequent addiction and therefore is a mood disorder that commonly co-occurs and sometimes worsens with such addiction. Since depression is so intricately linked with addiction, it is also important to manage it when recovering from addiction. Find out more about how the two are linked and how to manage depression in recovery.
What are Depression and Addiction?
Depression, sometimes known as clinical depression, is a mental health disorder that is characterized by persistent low mood. While it is normal to feel sad at times, depression is much more than this. It can be a debilitating disease, affecting your daily life. Depression is the main cause of disability across the world. According to the Anxiety and Depression Association of America, when surveyed in 2020, 14.8 million adults in the US had had at least one major depressive episode with severe impairment in the last year.
Addiction is a brain disorder that causes you to compulsively seek out and take the substance to which you are addicted. It is a progressive disease which means that it develops gradually the more you take a substance. Despite some people’s belief you are not born addicted to drugs or alcohol. There are however risk factors that make you more likely to develop an addiction which is discussed later.
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Common Depression Symptoms
Depressive symptoms can be both physical and psychological. The following are common depression symptoms, though you may not experience all of them:
Psychological Symptoms
- Persistently feeling low
- Mood swings
- Lack of interest in things you used to enjoy
- Agitation or anger
- Withdrawing from loved ones
- Decreased libido
Physical Symptoms
- Difficulty sleeping
- Irregular eating
- Self-harm
- Substance abuse
The Relationship Between Depression and Addiction
There is a two-way relationship between depression and addiction which means they can compound each other making it difficult to stop the cyclical relationship between the two.
How Depression Can Lead to Substance Abuse
As mentioned, there are risk factors for addiction. One of these is mental illness, including depression. Some people will use drugs or alcohol to manage depression. Alcohol increases the activity of dopamine and naturally occurring opioids in the rewards pathways of the brain which causes feelings of happiness and relaxation. Similarly, there are different drugs, such as heroin or methamphetamine, that cause feelings of euphoria. Such substances can provide a temporary escape from unpleasant feelings of depression.
However, while substances can ease symptoms of depression in the short term, in the long term they only make them worse. For example, depressants such as alcohol and opioids have a sedating effect. You may also be aware of the feeling of depression or anxiety when you have a hangover. Stimulants also worsen the symptoms of depression, for example, MDMA leads to an increased release of serotonin which makes you feel euphoric when you are taking it. However, after this, you crash as you have a depleted resource of serotonin, and it can take up to three months to restore these to their natural levels.
In addition, substance use can affect your physical health, for example, increasing your risk of heart and liver disease, cancer, and strokes. There is a link between physical health conditions and depression so if you develop physical health problems due to substance use it is likely to cause you to experience depression or make existing depression worse. It is also common for those with an active addiction to stop taking care of themselves which can in turn mean that your physical and mental health deteriorates even more.
What Causes Depression in Recovery?
Your brain is clever, and when it experiences changes that cause its balance to be disrupted, it will adapt to this to reach a new balance. This means that substance use can become a part of a new balance. When you stop taking substances, your brain needs to adapt again, as it is not receiving what it feels it needs to function normally. It’s common to experience a crash in early recovery whilst your brain re-balances itself.
Unfortunately, this can have compounding effects: you cannot quit because your depression will get worse when you first quit, but the longer you use substances the worse your symptoms will become. It is therefore necessary to understand how depression interferes with your recovery and, importantly, how you can manage it.
How Depression Interferes with Sobriety
As we have discussed, you may have experienced depression as part of your substance use and addiction. Even if you haven’t, it is likely you will experience a crash when you stop taking a substance. It can make it very difficult not to relapse as you think that by taking the substance you can stop the way you are feeling. You may experience post-acute withdrawal which causes you to experience depression for much longer but it is important that you resist a relapse for this short term relief.
If you have used substances as part of overcoming depression, then recovery is more complicated. You may be experiencing things that you would not if you were suffering from either disorder alone. It is, therefore important to consider specialized treatment.
Help for Depression During Recovery
Overcoming depression in recovery may seem impossible, but it is not and there are many ways that you can alleviate symptoms.
Self-Care
Self-care is important in recovery as it helps you to learn about, and care for, yourself.
First and foremost, build a daily routine. When you are suffering from depression it can be difficult to even get up in the morning. If you have a routine, it can help you to start the day. It is also important to incorporate a healthy diet and exercise into this routine, as physical health is important for mental health. Nutritious and balanced meals and the endorphins released from exercise can really help relieve depression.
There are many other ways you can show self-care – it may be as simple as enjoying going to the cinema or taking a bubble bath or by some more specific techniques that have been shown to help depression, such as yoga, meditation, and mindfulness – including learning deep breathing exercises.
Getting Help from Your Support Network
Feeling isolated and alone can make depression worse. Having a strong supportive group of family and/or friends around you during recovery can be very helpful. Make sure they are people that support your recovery and do not encourage the use of substances again. Another way you can build a support network is by attending 12-step support groups. Many people find that these are extremely helpful during recovery and will choose to continue for years or even indefinitely. Such groups can make sure that you feel less alone in your journey and allow you to learn and develop through peer learning.
Professional Help
Sometimes it is not possible to overcome depression by changing your habits and looking after yourself. Sometimes even if you know that exercise and speaking to friends will help you feel better it is impossible to do anything about it. If this is the case, or if you have been suffering from depression for a long time, you should seek professional help.
Typically, you will first be offered talk therapies such as cognitive behavioral therapy. This is based on the idea that the way you think and behave affects the way you feel. It aims to break unhealthy thought patterns and behaviors to improve your mental health. You may also be offered medication for treating depression. Most people will be offered selective serotonin reuptake inhibitors which increase the activity of serotonin in your brain, thereby boosting your mood.
Warning Signs of Suicide
Most people who suffer from depression will not attempt suicide. But it is important to understand the warning signs as it can be a risk. Common symptoms include:
- Self-destructive behavior
- Expressing hopelessness and worthlessness
- Neglecting personal appearance
- Suddenly contacting or visiting people they care about
- Seeming calm or happy after being depressed
- Speaking about death
- Increased substance use
You can get support by calling the National Suicide Prevention Lifeline (Lifeline) at 1-800-273-TALK (8255) or texting the Crisis Text Line (text HELLO to 741741).
Getting Support at Cornerstone
Addiction recovery can be very difficult, but with the right support, it becomes much easier. At Cornerstone, we provide compassionate support that focuses on long-term recovery. As mentioned, it is important to include self-care in recovery. We offer traditional medical techniques while also helping to heal from within. We also offer specialized care for those suffering from co-occurring disorders. Our treatment options include:
- Medication-assisted treatment
- Individual therapy
- Group therapy
- Acceptance and Commitment therapy
- Well-being activities such as mindfulness, meditation, and yoga
- Exercise and nutritious meals
If you are ready to seek support and take steps to deal with your addiction and you are interested in our addiction recovery program, please get in touch with us now on (714) 547-5375, or find out more on our website.