This is the second article in our series on Dual Diagnosis.
Sarah is a thirty-five year old mother of two. She works as a nurse at the local hospital. Her husband,Mark is a teacher. Sarah and Mark always support and care for each other and for their kids. Recently, Sarah has been through some difficulties at her workplace. Some of the nurses at the hospital were laid off, and the remaining staff found it hard to deal with the excessive amount of work. So Sarah stayed overtime and sometimes worked double shifts. She couldn’t quit because her family depended on her income as well. Then she started developing depression.
At the beginning, she thought she was just tired. After a while, Sarah, went from being a positive and outgoing person to passive and sad. She started losing weight and interest in her family and skipped all the activities they used to do together. The days when she was feeling happy and willing to go to work suddenly disappeared. She consulted one of the doctors at the hospital and he prescribed her antidepressants. As she wasn’t getting the wanted results, Sarah found consolation in alcohol. The fighting between her and her husband became a daily habit, as her husband and kids often found her unconscious in bed.
The problems also happened at her workplace, where after a few warnings, she got fired. The problem with Sarah was her denial. She thought she had it all together. After she lost her job, her depression and alcohol abuse got even worse. Her husband filed for divorce and she lost her kids and her home.
This working mom often considered herself as a ‘functional addict’. Just like so many others. The graduate student that has an amazing career and abuses cocaine because of past family issues, or the businessman that fights stress and anxiety through heroin. These are just some of the profiles of people fighting an underlying mental illness and substance abuse. The patterns are not always the same and there are many different cases, but in the end, these people have two things in common: they are diagnosed with the double demon of dual diagnosis.
Here are the connections between mental illnesses and addiction:
- People use drugs and alcohol to feel better and relieve the symptoms of depression, PTSD, or anxiety. Instead, they made things worse.
- People start using drugs and alcohol for fun, see the ugly face of depression or mental illness.
- People use drugs or alcohol to relieve physical pain and get addicted to the substance and develop a mental illness.
Regardless of which appeared first, substance abuse makes the symptoms of mental illness worse. In most cases, drug and alcohol abuse go in hand with multiple disorders. Depression and anxiety are the most common.
1. What is Depression?
Depression is a serious illness that affects the person’s feelings, mind, and behavior. People that experience depression have a constant feeling of sadness, low-self esteem, and a persistent low mood followed by loss of interest in activities and inability to feel joy and happiness. Depression is one of the most common disorders, that has many forms. The person can experience mild symptoms, temporary episodes of sadness or a severe form of depression, known as major depression. Fortunately, this condition is treatable, and in some cases curable with regular medication and therapy sessions.
People with depression feel like they’ve entered a dark hole with no way out. They live in despair, isolation, and sadness. Depression is diagnosed if its symptoms are present continually, longer than two weeks. Statistics show that 16 million Americans aged 18 or older had at least one major depressive episode in 2015. There is a connection between mental health disorders and addiction. Researchers haven’t discovered a particular cause for this condition, and point out to a group of risk factors like genetics, environmental triggers, drugs or acute stress.
- A constant feeling of emptiness, hopelessness, and sadness.
- A tearful look, nearly about to cry.
- Show no interest, pleasure, and don’t enjoy any activity.
- Significant weight loss or weight gain.
- Depending on the symptoms, inability to do the most basic tasks, like getting dressed, or take a shower.
- Sleeping too much or experiencing difficulty sleeping.
- Feeling fatigued, tired, without energy.
- Inability to concentrate.
- Suicidal thoughts. At times, suicide attempts.
These symptoms describe the major depressive disorder. Forms and symptoms of this condition vary from person to person. Many people go to work and don’t show typical signs of depression, but deep inside they are about to crash.
2. How are Depression and Addiction Connected?
The term comorbidity describes a condition when two disorders or illnesses occur in the same person, simultaneously or sequentially. It often happens for a depressed person to get addicted to substances, such as alcohol or drugs and develop depression. When a person has both addiction and depression, it’s called dual diagnosis. Some people use drugs or alcohol to deal with negative thoughts or lift their spirits. Others use alcohol to deal with everyday life, become addicted and develop depression because alcohol is a central nervous system depressant. Depression and addiction feed each other and worsen the symptoms of one another, by intensifying them.
Aside from alcohol, cocaine and heroin are known for their connection with depression. Cocaine affects the pleasure centers in the brain and creates and euphoric and happy feeling. People suffering from depression would sometimes do everything to get away from the negative feelings and reach for the drug. However, after the short-term effect is over, the depressive symptoms intensify, the person takes a higher dose and that creates the circle of addiction. People who abuse cocaine feel depressive after the short euphoria, and increase their dose to feel good again.
Heroin is a strong opiate that also affects the brain pleasure centers and alters the opioid receptors, dopamine, and endorphins. After heroine’s ‘rush’, the person’s depressive symptoms worsen. And it’s really hard to get out of the cycle and feel better without shooting more. Marijuana also triggers depressive and anxious feelings that get worse after the effect of drug ends.
It’s important to recognize the symptoms of depression and addiction. This condition leads to the development of suicidal thoughts. If the person has nobody by their side to help, they are unlikely to seek help by themselves.
The only way of curing these conditions is to enter a dual diagnosis treatment program. Curing addiction and depression separately never works. Before treatment, the person undergoes a carefully conducted evaluation, where a conversation with an addiction specialist, can diagnose someone with dual diagnosis.
Depending on the severity of the situation, a combination of the right treatment approaches lead to a successful recovery:
- Detox. With dual diagnosis, detox must take place at a supervised facility. The withdrawal symptoms of drugs, and especially alcohol may be lethal.
- Medication. People with depression are prescribed antidepressants, combined with therapy.
- Inpatient Rehab. For severe cases of addiction and depression, inpatient rehab is the best approach.
- Outpatient Rehab. People that experience mild symptoms of depression but can still function in society, can go through outpatient rehab.
- Family counseling. Families play a huge part of the addict’s life. Support and encouragement of their family help people with dual diagnosis get better. It gives them hope for a better future.
- Group and individual therapy. At individual therapy, depressed people talk about their feelings and the possible causes that triggered their depression. Or the possible causes they started doing drugs which later lead to depression. The important thing is to find the underlying issue and work towards improvement. To find the meaning of their life, and relieve them from their suicidal thoughts. It’s hard for a depressed person to open up. But over time, and with the right approach, love, and support, one will work towards recovery. Group therapy is important for the depressed person to feel supported and see that there are people struggling with the same condition as them.
- Cognitive Behavioral Therapy.
- Activities. A depressed person struggling with the disease of addiction needs to feel the beauty of life. Through various activities, including the ones they used to enjoy, the person should start showing interest and heal. Activities clear their mind and help them forget about their struggles.
4. How Can You Help?
Sometimes it’s hard to recognize the symptoms of depression in a person that abuses drugs and alcohol, as some of the substances cause the same symptoms. When you discover someone you know is using drugs, you’ll probably panic. In this situation, it’s justified.
When dealing with a dual diagnosis, your loved one faces two difficulties: addiction and depression. Which makes it harder for you to handle the situation. How should you approach a depressed person? How can you help them? What if your approach affects them negatively? And even if you sometimes think it’s a dead end situation, there are always ways that you can help:
- Inform yourself. Even though there is little chance you recognize dual diagnosis, knowing the patterns of addiction and its connection with mental illness will help you understand the potential causes of these conditions.
- Talk to an addiction counselor. You need someone knowledgeable to will guide you through the difficulties. Talk to a therapist if there is something that affects you deeply.
- Advise your loved one to get treatment. Discuss entering into inpatient rehab if you see the situation isn’t getting better, or outpatient rehab if your loved one can function without environmental triggers affecting them.
- Organize an intervention. If your loved one refuses treatment, organize an intervention. Show them how much you care. However, do it in the presence of an addiction counselor. You’re dealing with a sensitive situation.
- Patience. Even when a person goes through every possible treatment, their symptoms may still persist. Therefore, you need a lot of patience to get through the years of fighting against these conditions.
For more information please call our Addiction Treatment Helpline at (844) 439-4765. This is a Free and completely confidential call. We are available 24/7. In many cases, your health insurance company will cover 100% of the treatment cost. So please call now.