It is common to find people who suffer simultaneously from both addiction and depression while others may suffer from one of these conditions before or after they develop the other.
People with varying degrees of depression – sometimes diagnosed and sometimes not – may turn to addictive substances or behaviours to bring relief from their depressive symptoms, such as a persistent and heavy low mood, loss of interest, appetite and energy. The use of substances or behaviours to alleviate these symptoms is generally termed self-medication. As is often the case, this “remedy” can end up making the depression worse, especially if substances with depressant effects like alcohol or benzodiazepines are consumed.
Other people who may not have previously been depressed may develop the condition as a direct consequence of their addiction, whether that is related to substance use or to behaviours like gambling. In any event, one condition is likely to compound the other, leaving the person understandably feeling hopeless about life. In such a state there is an increased risk of suicide and other forms of self-harm.
People who present with a dual diagnosis (addiction and a mental illness such as depression together) need help for both conditions. They need to be given the positive message that they can be helped and that recovery is possible; an encouragement which needs to be repeated.
Unfortunately many people who seek help for depression are never asked about their use of substances or other potentially addictive behaviours. Conversely when people seek help for an addiction they may not be asked whether they are also depressed. Subsequent treatment will inevitably fall short. A holistic approach to assessment is called for. People seeking help would be advised to reveal symptoms that might relate to both conditions.
In a residential treatment centre where medical facilities including expert psychiatric support are on hand 24 hours a day, careful assessment, continuous reassessment and close monitoring can be undertaken. It may be difficult to determine whether the depression is an underlying, pre-existing problem until detoxification has been safely completed.
A person’s state of mind and mood can change quite markedly for the better once the system is clear of addictive substances. In other cases, the withdrawal from some drugs such as stimulants like cocaine and methamphetamine may bring on depressive symptoms. Anti-depressant medication may be called for as a temporary aid to recovery in this instance or when an underlying depression is diagnosed.
Another advantage of a residential treatment centre for patients with both depression and addiction is the ready access to psychotherapeutic interventions and to emotional support from fellow patients. The availability of physical therapies is also important as evidence grows as to the value of exercise when it comes to reducing symptoms of depression. A virtuous circle can be created as people begin to improve their general health which in turn brings psychological benefits.
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