The Centers for Disease Control and Prevention (CDC) estimated that 10 percent of Americans suffer from depression. According to the reports published in the Journal of the American Medical Association, around 50 percent of individuals with severe mental disorders also struggle with substance abuse, whereas 37 percent of alcohol abusers and 53 percent of drug abusers have at least one serious mental illness.
The struggle is worse for a person who is dealing with both depression and addiction, otherwise known as dual diagnosis. Mental illnesses and substance abuse are the most common co-occurring morbidities. The Journal of Clinical Psychiatry reports that one in three adults who struggle with substance abuse also suffers from depression.
Some may raise the question that because both substance abuse and alcohol co-occur, is it really necessary to know which one is the cause and which one is the effect. It is one of the most important questions when it comes to substance abuse treatment and therapy. If people assume that depression is the cause of substance abuse in a certain case, then treating substance abuse as an independent entity will only cause the individual to relapse over and over again, as depression will keep bringing the addiction back.
When depression precedes substance abuse, those individuals will most likely need treatment, including medication intervention, for a longer duration than compared to someone whose depression was caused by addiction. The treatments differ for someone whose depression was caused by substance abuse than those who initiated substance abuse due to depression.
In case of a dual diagnosis, both the mental health issue and substance abuse have their own particular symptoms that further compound the ability to function, manage daily life issues and interact with others. The situation gets further complicated as the co-occurring disorders also influence each other and interact. When a mental health problem is ignored, the substance abuse problem normally gets worse as well. On the other hand, when alcohol or drug abuse becomes worse, mental health problems usually become more provoked as a result.
According to a report by the National Survey on Drug Use and Health (NSDUH), there is a significant relationship between mental health and substance abuse. Based on the largest national survey on substance use and health, this report determined a higher risk of the initiation of substance abuse by teenagers and young adults who suffer from depression. The statistics gathered indicated that young adults often began smoking within the first year of their depression diagnosis. Moreover, the occurrence of depression among young adults was discovered to be 9.4 percent of the population aged 18 to 25, which is approximately 3 million young adults in the United States per year.
Interviewing nearly 135,000 individuals aged 12 and older, the study discovered that around 35 percent were more likely to have started consuming alcohol and twice were more inclined to initiate abuse of illicit drugs and prescribed drugs within the first year of being diagnosed with depression, when compared to the population that was not struggling with depression.
Terry Cline, Ph.D., an administrator for the Substance Abuse and Mental Health Services Administration (SAMHSA) said, “This study clearly reveals that too often people turn to cigarettes or other substances to try to deal with depression, creating a double jeopardy for their health and well-being.”
Research published by Cell Press in the journal Neuron suggested that despite the common knowledge that depression can increase an individual’s chances of substance abuse, there exists a converse relationship between depression and substance abuse as well.
The researchers examined the involvement of histone H3 lysine 9 dimethylation (H3K9me2), a prominent type of chromosomal modification, in the resulting effects of repeated cocaine use on the susceptibility of depression. Using a mouse study model, the researchers found that cocaine increases the susceptibility to stress in mice, as a decreased level of H3K9me2 in a major reward center in the brain linked cocaine with stress vulnerability. The researchers further demonstrated that key areas of the brain were vulnerable to stress or cocaine that promoted both depression and addictive behaviors.
“Together, our results provide fundamentally novel insight into how prior exposure to a drug of abuse enhances vulnerability to depression and other stress-related disorders,” said senior study author Dr. Eric Nestler from Mount Sinai School of Medicine. “Identifying such common regulatory mechanisms may aid in the development of new therapies for addiction and depression.”
Dual diagnosis involves a high level of complexity in treatment. It is evident that patients struggling with dual diagnosis cannot receive the care they require in a conventional, one-dimensional rehab program. Only programs suitably equipped to manage psychiatric problems alongside drug and alcohol addiction can assist effectively with treatment.
An integrated treatment plan should include effective counseling that involves making the patients understand and come to terms with the dynamics of their illness and addiction. This includes motivating them and empowering them to make the necessary changes in their lifestyle. Medication therapy is a vital component of recovery for most dual diagnosis patients struggling with depression. Antidepressant drugs have helped many individuals who struggle with this disorder to deal with their symptoms and lead an empowered life. Individual counseling, peer group support and family counseling will strengthen patients to pursue their journey of recovery despite the challenges.
The Dual Diagnosis Helpline is available 24/7 to help you deal with the challenges that come with dual diagnosis. We can connect you to the best treatment programs built to help with your specific situation. Call us at any time to get started.