Living Mindfully: Addiction and Depression

Depression and AddictionWhen we work with recovering addicts, we emphasize the importance of creating a new lifestyle where it’s easier to not use drugs and alcohol rather than to keep using. Creating a new lifestyle means more than eliminating substances. Working toward a sober lifestyle requires a holistic approach, assessing all the factors in someone’s environment that can trigger relapse and planning ways to manage those triggers. Obvious factors tend to be external, such as living situation or ongoing exposure to substances. But internal factors, such as emotional trauma or mood disorders, are just as critical to address in the healing process.

Throughout our Living Mindfully series, we are discussing mental health disorders that may coexist with addiction. The use of substances may result in symptoms of depression, anxiety, and other mood instability. Addiction magnifies issues for people with pre-existing mood disorders. The following discussion begins our first mental health topic: Depression.

Mixing depression with substance abuse

Every drug has some type of impact on the body, including alcohol, caffeine, and nicotine. Depending on your mood, consuming one of these substances will amplify that mood. For example, if you’re feeling excited and take a stimulant, that intake will amplify your excitement.

Alcohol and opiates act as depressants to the central nervous system, meaning they tend to lower vital activity and function of the organs. Depressants can reduce stimulation to parts of the brain, causing someone to feel “down” or low. One of the consequences of using drugs and alcohol can be feelings of depression. However, it’s important to not quickly label a person with depression in addition to addiction because general mood instability can last up to 18 months after abstinence begins.

When we study recovering addicts, specifically those who have been sober for years, research shows that alcohol did not drive their depression, but rather worsened the symptoms of the disorder they were already facing. If someone is struggling with depression or suicidal thoughts, alcohol intensifies the darkness they are experiencing. About 1 in 3 people have neurological maladaptation, and resolving that issue can take up to 18 months following cessation of drugs and alcohol. For example, if someone is drinking while they grieve the loss of a loved one, that alcohol consumption will deepen and darken their state of mind. Anyone who is chronically depressed will continue experiencing worse symptoms from abusing alcohol or illicit substances.

Treating an addict with depression

When we bring someone into residential treatment, we take into account as much of the person’s drug habits and medical history as available. If someone has been previously diagnosed with depression, we look for ways to help the person work toward sobriety and get help to treat the chemical imbalance in their brain. Thoughts, feelings and behaviors drive a person’s negative thinking. Cognitive Behavioral Therapy is critical to making life-long changes to how a person thinks.

If someone has never been diagnosed with depression, we work with that person to identify their thoughts and feelings as withdrawal progresses to help them gain awareness of what they are thinking and feeling. We closely monitor that person to watch their moods and behaviors as any remaining drugs exit their system. Sometimes a person may think they have depression, but most of their symptoms are normal for anyone going through withdrawals. Regardless of outlying mental health issues, an addict in withdrawal management (also referred to as detoxification) is likely to experience difficulty sleeping, loss of appetite, and feeling sad or overwhelmed. We avoid labeling a person with a diagnosis of depression, as these are normal feelings and thoughts that may resolve through withdrawal management. Other times someone may think they are depressed because of the pain and chaos in their world, but those feelings are more so a result of their environment and substance abuse—not necessarily driven by depression.

Throughout the treatment process, our clinical staff assess how any symptoms have improved or worsened. We evaluate sleep and eating patterns, helping people get in the practice of healthier routines, including exercise, regular eating patterns, and connections to others. When a person adapts to a healthier, daily schedule, we may re-evaluate and consider possible medication if depressive symptoms persist.

Battling lack of energy

One of the toughest parts of living with addiction and depression is finding the motivation to get treatment. No matter who you are, choosing to become sober requires energy. If someone already has depression, the initiative to say, “I deserve to change,” takes that much more courage and energy than someone living without depression. Positive thoughts like “I deserve to change” and knowing a place to get help can shift someone to find the first step toward a recovery process.

When a depressed person is battling feelings of hopelessness, they can also feel disappointed at their slow pace of progress or the continued challenges of withdrawal symptoms. In order to get on the right track, that person needs to shift their thinking to focus on making little changes rather than expecting dramatic changes in their mood or cravings.

To continue the conversation about mental health, check out Part II of our Living Mindfully series: Addiction and Anxiety.