Dual Diagnosis: Depression Treatment

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Dual Diagnosis: Depression Treatment 2017-07-05T21:55:17+00:00

Dual Diagnosis: Depression

Depression is one of the most common mental health concerns of modern times. While depression rates are high for substance users and non-users alike, the lifetime prevalence of depression for substance users is approximately 24% higher than in the general population. Worldwide, depression has risen to unprecedented proportions and the World Health Organization now predicts epidemic levels of depression by the year 2020. In clinical terms, depression is sometimes referred to as Depressive Disorders or Mood Disorders.

Below you find some general information on depression, its symptoms, causes, triggers, and the treatment we offer at Hope Rehab. Please feel free to reach out to us for a free consultation or if you should have any questions.

What is Depression?

Many people use the term depression to describe sad mood or feeling ‘blue’. This, however, is far from the experience of clinical depression which can take on different forms, including:

  • A Major Depressive Episode, which lasts at least two weeks during which we experience symptoms such as

    Profound lack of energy

    Changes in eating and sleeping patterns

    Difficulties in all areas of cognitive functioning

    A significant loss in previous interests or loss of ability to experience pleasure

    Intrusive thoughts of suicide

    Persistent feelings of worthlessness and guilt

    Depressed mood most of the time

    These symptoms are so severe that they greatly impact individuals’ ability to work or study, and/or be able to maintain meaningful relationships.

  • Persistent Depressive Disorder (Dysthymia): This is considered a milder form of depression, with some of the same symptoms as described above, but lasting for at least 2 years. Individuals experiencing dysthymia have a tendency to look at the glass half empty, and typically cannot recall a time in their lives when they have ever been truly happy or even content. In the past, this type of depression was referred to as Depressive Personality Disorder.

  • Bipolar Illness (formerly called manic depressive illness): Individuals experience extremes in mood, alternating between periods of extreme depression and mania. The hallmark of the latter are excessive energy and a decreased need for sleep, typically accompanied by a sense of grandiosity and high risk behaviours such as drug use, promiscuity or gambling. Unlike major depressive illness which may be recurrent but is very much treatable, bipolar illness is chronic in nature and requires skilled intervention that includes medication. Not surprisingly, Bipolar illness is the most frequently misdiagnosed mental illness in the context of substance use, given that the ups and downs in moods caused by substance use can easily be mistaken as depression and mania to the untrained eye. Bipolar illness can take on various forms such as bipolar I or II, rapid cycling bipolar, all of which causing individuals difficulties in functioning to at least some degree.

Types of Depression

  • Clinical/Major Reactive Episodes

  • Premenstrual – Periods – Postnatal

  • Psychotic – Break with Reality

  • Persistent Depressive Disorder/Dysthymia

  • Mild Depression: Discouraged about the future

  • Moderate Depression: Dismal future

  • Severe Depression: No future

How is Depression Linked to Substance Use?

In the context of substance use and recovery from addiction, depression can show up in various ways, including but not limited to:

  • A depressed mood is a common consequence of coming down from a substance induced ‘high’. For example, stimulant users often report experiencing depressed mood, profound lack of energy and disabling physical fatigue at the tail end of heavy use, during withdrawal and early abstinence.

  • Individuals suffering from depression may use alcohol or other substances to cope with difficult symptoms, especially when these become chronic. For example, research shows that depression precedes methamphetamine use.

  • Post-acute withdrawal symptoms are similar to symptoms of depression, including decreased motivation, lack of physical energy, difficulties concentrating and insomnia.

  • The overlap of bipolar illness and substance abuse is 60%.

  • Individuals suffering from depression are twice as likely to develop substance abuse problems as compared to the general population.

  • Marijuana use is shown to impact cognitive abilities and motivation, and chronic use may cause depression in some individuals.

  • Depression is common in illicit opiate users and symptom severity increases with heavier substance use; symptoms typically improve or subside during treatment.

  • Alcohol is a central nervous depressant, and chronic alcohol misuse been shown to cause symptoms of depression.

On that note: Addiction can have serious repercussions on a person’s life. Not only can it lead to financial and legal troubles, impaired thinking and judgment but it can also be the reason for failing relationships. All the above-mentioned things cause stress and might make you lose all hope for a better future. Therefore you’re more likely to feel depressed.

Symptoms of Depression

  • Hopelessness

  • Feeling Down

  • Withdrawn

  • Isolation

  • Reduced Libido

  • Low Self-Esteem

  • Hypercondroia

  • Appetite Loss

  • Weight Loss

  • Fatigue

  • Suicidal Thinking

  • Excessive Sleeping

  • Empty

  • Feelings

  • Pessimism

  • Worthlessness

  • Helplessness

  • Neglect

  • Procrastination

  • Making Decisions

  • Pleasure Loss

  • Self-Pity

How is Depression Treated?

Drug-induced symptoms of depression often clear with prolonged abstinence and may not need any specialised treatment. Additionally, many therapeutic interventions helpful for the treatment of addiction are equally helpful in the treatment of depression, such as cognitive behavioural therapy (CBT). If symptoms persist, treatment is readily available, and the choice of treatment strongly depends on type, severity and chronicity of symptoms, as well as individual preferences.

Some Types of Depression Require Medication & Long-Term Therapy

For example, mild to moderate depression can be treated with short-term cognitive behavioural therapy (CBT) and changes in lifestyle. This type of treatment includes a focus on challenging and changing negative thoughts, setting small behavioural goals to achieve healthy routines as they pertain to physical exercise, diet and sleep. Severe depression and Persistent Depressive Disorders on the other hand typically require a combination antidepressant medication and psychotherapy for best and lasting results. Bipolar disorder I is one of the most debilitating mental health disorders and typically requires long-term and multi-faceted interventions that include medication, community support and specialised forms of therapy, such as Interpersonal and Social Rhythm Therapy.

Triggers for Depression

  • Substance Abuse

  • Abuse

  • Trauma

  • Medications

  • Grief

  • Losing Job

  • Economic

  • Divorce

  • Isolation

Depression and Alcohol Addiction

Repercussions that come with addiction make it more likely to feel depressed

Alcohol is a depressant and has a sedative effect on the brain. Therefore, it exaggerates depression because of it’s direct neurotoxic effects. A drink or two, smoking cannabis, a line of cocaine, might temporarily relieve some symptoms, but each time a chemical leaves the body, it usually brings the depression to new lows known as “withdrawal depression”.

If you suffer from depression it is difficult to imagine not being depressed in the future

When people suffer from depression, it is difficult to imagine not being depressed in the future. You can’t always think your way out of depression and if you can’t say anything positive to yourself, it’s best to think nothing at all.

Looking at the world through the glasses of depression distorts things in a negative way

The expression “looking at the world through rose-colored glasses” means everything seems wonderful. It is a distortion of reality. Just as “looking at the world through depression glasses” always distorts things in a negative way.

Depression: Common Negative Self-Talk

  • I don’t like the way I look

  • I am not smart enough – I am a loser

  • Nothing ever goes my way

  • I should not be depressed

  • I’m weak – pain will never end

  • I’m incompetent – I can’t do anything right

  • I am trapped – there is no way out

  • I can’t change – I feel hopeless

  • I find socializing hard

  • I’m a failure – I lack confidence

  • I’m different – I feel lonely

  • I am confused

  • It is easier to avoid facing difficulties

  • I have to do everything myself

  • Losing pleasure in things I used to enjoy

  • Feeling like a burden to others

  • Lack of self-esteem and self-loathing

  • Being very critical of yourself

  • Feeling numb, emotionless and empty

What Hope Rehab Offers for those Suffering from Depression:

Hope Rehab Center draws on multiple therapeutic interventions helpful in addressing not only the symptoms of depression, but also contributory and causal factors. These interventions include:

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