Addiction and Depression: Dueling Demons

Despite what some people may think, drug and alcohol addiction doesn’t simply appear suddenly. People who abuse drugs and alcohol often do so because of the deeper underlying reason that has not be addressed and resolved. One of the most common reasons of drug and alcohol addiction are underlying mental health issues. One of the most common mental illnesses that co-occurs with substance abuse is depression

Everybody will go through short periods where they feel down in the dumps. In most cases, people learn to work through those issues and move forward. For those who suffer from depression, it goes deeper than “just having a bad day”. Depression is an often-crippling condition which makes people feel hopeless, worthless and trapped with no way out of what they are feeling and thinking. According to statistics provided by Dual Diagnosis, around 10 percent of Americans suffer from depression.

According to the Diagnostic and Statistical Manual of Disorders, true depression is a chronic condition that lasts for at least two weeks and can include the following symptoms:

Anybody can suffer from the effects of depression. However, it is commonly seen among those who are middle-aged, female, and among those who are chronically underemployed or unemployed.

For people who suffer from depression, there are many reputable treatment programs that are available that can help them overcome this debilitating condition. While there are many treatment options, resources, and support available to help people from all walks of life combat depression, many are reluctant to seek help. The main reason why many don’t seek help for their mental health issues is the prevailing stigma attached to mental illness. They simply fear that people will unfairly judge them or view them as undesirable and broken people.

As a result, these people will turn to drugs and alcohol to help cope with their depression. While substances help them feel better, it is a short-term blanket solution at its very best. If people who suffer from depression fail to seek professional help to thoroughly address the issues cause their condition, they will continue to suffer. Substance use only compounds their problems, and over casual use of substances eventually leads to dependency then addiction. If this occurs, people have what is known as dual diagnosis which is very difficult to treat.

For those who suffer from a dual diagnosis such as depression and drug addiction, they must find specialized treatment options to effectively deal with both issues. Because of the complex nature of a dual diagnosis, a traditionally structured drug treatment program will not adequately help the addict in need. Therefore, it is absolutely essential that people suffering from depression and addiction seek professional help from a treatment center that features specifically designed programs that can deal with psychiatric issues as well as addiction issues.

Dual diagnosis treatment features expert psychological programs that help dual diagnosis patients tackle the issues that lie at the root of their depression. Expert treatment staff will utilize medication-assisted treatment (MAT), therapy and other therapeutic interventions that will give patients the tools and support they need to overcome depression. Additionally, they are able to receive a specialized and unique drug treatment plan that will address their addiction issues

Hawaii Island Recovery is a dual diagnosis addiction treatment center specializing in the treatment of substance abuse, behavioral addictions, and co-occurring mental health disorders.The world was shocked, saddened and confused to learn last week that Robin Williams, a phenomenally gifted entertainer and, by all accounts, a sensitive, generous and loving man, had taken his life.

Mr. Williams was always candid about his struggles and proactive in his treatments. But his dignity and integrity remained intact in part because of his honesty, but also because of his hopefulness.  The hopefulness that he tragically lost at the end.

Research shows that substance abuse and mental disorders are a dangerous combination.

Addiction and depression are tough enough to deal with alone. Together their negative effects multiply. For example, those with depression and those with a substance abuse disorder have about a 10 percent lifetime suicide risk. When combined, the suicide risk skyrockets to about 1 in 4.

Depression also acts as a relapse trigger. In fact, studies have found that it’s the single biggest predictor of alcohol relapse. Drugs and alcohol also appear to interfere with the effectiveness of depression treatment.

The good news is that treatment that working on both issues can lead to good outcomes. Treatment that focuses on one without also dealing with the other, however, is a virtual guarantee of relapse.

When an individual has both depression and an addiction, it is called a Dual Diagnosis. A Dual Diagnosis can be made up of any combination of a mental disorder (anxiety, depression, bipolar disorder) and addiction (drugs, alcohol, sex, gambling). Dual Diagnoses that include depressive disorders are among the most common forms of the problem; in fact, the Journal of Clinical Psychiatryreports that one in three adults who struggle with alcohol or drug abuse also suffers from depression.

For some individuals who have depression and a substance use disorder, giving up drugs or alcohol can actually make depression worse. If you’ve been using alcohol for years to bury your depressive symptoms, you may find that your depression rises to the surface in sobriety. That’s why it’s so important to receive integrated treatment for both depression and substance abuse at the same time.

Without treating the depression that drives your addiction, or vice versa, you’re likely to go back to your addictive behaviors or to experience a return of your depressive symptoms as soon as you finish rehabilitation. In many cases, people who have depression and substance abuse drop out of conventional rehab programs because sobriety is too much to handle without the right level of therapeutic support.

Support, encouragement and motivation are essential tools in the battle against depression and substance abuse. Clinical depression can drain your energy and make you feel that rehab is a hopeless cause. Individual counseling, peer group support and family counseling can give you the strength you need to continue your recovery journey in spite of the challenges you face.

It’s tempting in situations such as these to write off attempts at treatment. Why bother, some ask, when this is the outcome?

It’s important to remember that although mental health and substance abuse treatments may not always result in continuous remission, they can drastically improve quality of life and lead to stretches of highly productive living. In Williams’ case, his early alcohol and drug use was followed by 20 years of sobriety before a return to drinking in 2003. This was followed by treatment and a return to sobriety in 2006. Just before his death, suffering from severe depression, he checked himself back in to treatment for “fine-tuning,” not because he had again relapsed, he said, but because he felt he needed the support. That he ultimately succumbed to his depression says more about the power of the illness than about any treatment shortcomings.

The reality is, there is no simple cure for depression or for addiction. The best we have is treatment that can be lifesaving for many – but sadly, not for all.

One of the biggest failings of modern treatment for depression and addiction is that people aren’t educated about the need for ongoing treatment. Instead, there is a mythology that we will take a few weeks of antidepressant pills or go to rehab for 30 days and come home cured. It doesn’t work that way.

The reality is that after an initial treatment period, only about 1 out of 3 people with depression is in remission, 1 out of 3 people is improved but not in remission, and 1 out of 3 is no better than when they started. The greatest success is seen when therapy and medication are combined in long-term treatment. For those with recurrent depression who don’t receive ongoing care, the likelihood of relapse within two years is close to 100 percent.

With substance use disorders, treatment should be delivered and success measured over the long-term. A substantial group will maintain continuous abstinence but a larger group will be able only to change their behaviors in ways that significantly reduce the impact of drugs and alcohol on their lives. This may mean sobriety comes in spurts, but each period should be counted as a victory. It may not be the best outcome, but it does mean a life changed for the better.

I’m always startled by the misunderstandings of the nature of depression that seem to rise to the forefront in tragedies such as these. So it bears repeating: depression is a brain disorder that is most likely caused by a combination of genetic, biological, environmental and psychological factors. It is not something you snap out of any more than you snap out of cancer. It’s not a refusal to be grateful for all of the blessings of life. It’s not a character flaw. And it’s not something that wealth, fame, international acclaim or even respect and love can protect you against.

With each bout of depression, the sufferer may feel a type of emotional blunting or, worse, find his mind crowded with all the old bad feelings – hopelessness, anxiety, preoccupation, dread, fear, self-loathing – often leading to sleep and appetite issues and spurring a turn to alcohol or other drugs for relief.

Williams, who had sought treatment for depression in the period leading up to his death, also “Fresh Air” (link below) and told Terry Gross and discussed his mood swings.

“Do I get sad? Oh yeah,” Williams admitted. “Does it hit me hard? Oh yeah.”

In Robin Williams’ case, we are again reminded of the strength of this foe. Treatment, therapy and medication for depression can help most and save many.  But sometimes, despite mighty efforts, there is no Hollywood ending.

If you or a loved one are struggling with depression and anxiety, there is no doubt you feel a tremendous since of hopelessness and despair. You may feel completely overwhelmed with what you or a loved one is going though, and you fear that help is out of your reach. Fortunately, help is just a phone call away. With one phone call to the treatment professionals at Hawaii Island Recovery, you will get the help you need to become truly happy and healthy.

Our staff fully understands the unique needs of dual diagnosis patients. Our programs are effective, proven to work, and will help you or a loved one break free from mental illness and addiction for good. Contact Hawaii Island Recovery today and finally achieve peace of mind, body and soul.