Understanding Depression and how it interacts with Addiction

Depression is one of the most common psychiatric illnesses. It involves the body, mind, and thought process, affecting the way people eat and sleep, the way they feel about themselves, and the way they think. A depressive disorder is not the same as occasional sadness; it tends to be more prolonged and more severe. Like chemical dependency, depression is a disease. It is not a sign of personal weakness or a condition that can be willed or wished away. People with depression cannot simply pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or even years.

Many recovering addicts have experienced depression. Research suggests that the rate of major depression is two to four times higher among substance abusers than in the general population, affecting about 30 to 40 percent of people seeking help for alcohol and other drug problems. If your loved one is among them, mental health treatment may be needed as well as chemical dependency treatment.


Symptoms of depression may include:

  • Ongoing sad, anxious, or “empty” moods
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Fatigue, low energy, or feeling “slowed down”
  • Difficulty concentrating, remembering, or making decisions
  • Insomnia, early morning awakening, or oversleeping
  • Changes in appetite and/or weight
  • Restlessness and/or irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, or even chronic pain
  • Thoughts of death or suicide, or suicide attempts


How do depression and addiction interact?

Due to prolonged addiction problems, addicts face variety of emotional, social and physiological problems such as job loss, broken relations, and discontinuation in studies, financial bankruptcy, legal problems and many others, which lead to recurrent episodes of depression. So in one way or other, depression and addiction is highly correlated with each other, especially considering the consequences of addiction.”
– Mental Health Matters


A drink or two, a line of cocaine or two, might temporarily relieve some symptoms, but the backlash when the chemical leaves the body brings the depression to new lows. This withdrawal depression” happens each time an abused chemical leaves the body, though many people dont experience severe symptoms at first. The withdrawal depression itself can trigger the use of more alcohol or drugs because they will help get rid of the
bad feelings.

– Psych Central


In the first few weeks of recovery, depression is common and should be expected. It usually lifts, however, after a few weeks of treatment. If your loved one has lingering symptoms beyond the first weeks and months of sobriety, there may be an underlying depression that needs to be treated.


One question I get asked frequently from addiction-treatment patients who are diagnosed with depression after they are diagnosed with an addiction is “did my drinking or drugging cause the depression?” The initial answer is always a resounding maybe.” A well-trained psychotherapist will often be able to tease out the source of the depression and find out if it existed before the patient came in for addiction treatment. Therapists use a psychosocial evaluation and reports from family, friends, employers, court and police records, and the like to help determine which condition occurred first.

Why is it important to know when the depression first occurred? Because someone who had depression before they began to abuse substances will most likely need treatment, including medication intervention, for a longer period of time compared to someone whose depression was caused by the cycle of addiction. Someone whose depression was caused by substance abuse generally will not need the same treatment as someone whose depression preceded his or her substance abuse.”
– Richard Zwolinski

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