Substance Abuse and Depression: Which Comes First?

Posted: March 23, 2015 by in Hope Recovery Treatment Center


In the recovery community there is widespread acceptance that drug and alcohol addiction can lead to many different forms of mental illness but there is debate about whether mental illness can lead to addiction.

Depressive disorders often cause intensely uncomfortable emotions, for example, overpowering sadness, misery, numbness, isolation, sleep disorders, eating disorders. It is enticing, if prescriptions aren’t being endorsed or used appropriately, for people suffering from depression to self-medicate with drugs or alcohol.

This can intensify the depression and aggravate it far more than it helps. A few drink, a line or two of cocaine may temporarily relieve some symptoms, however the recoil when the substances leaves the body brings the depression to new lows. The ‘withdrawal depression’ happens each time an abused chemical wears off, however many people don’t encounter extreme side effects right away. The withdrawal depression itself can trigger the use of more drugs and alcohol because they will help resolve the awful feelings temporarily.

Another exacerbating issue is that if drugs and alcohol are being used while medication is also being taken, the effects of the alcohol or drugs can be really potent, make the prescribed medications stronger, or deactivate the medications. Either way, this can put the individual in serious risk of health complications.

Because of their own life-shattering experiences with substance abuse, some people in recovery are uncertain of using any drugs, even prescribed ones. They have faced traumatic encounters with addiction and have trouble grappling with the need for drug mediation. Dually-diagnosed patients (those with both mental illness and addiction) should talk with their therapist about the issue, not a friend, regardless of how well-intentioned.

One question often asked by addiction rehabilitation treatment patients who are diagnosed with depression after they are diagnosed with addiction is “did my drinking or drug use cause the depression?” The initial answer is always “perhaps”. A well-trained psychotherapist will frequently be able to draw out the reasons for depression and see whether it existed before the patient came in for addiction rehabilitation treatment. Specialists use a psychosocial evaluation and reports from family members, friends, managers, court and police records and so forth to help figure out which condition materialized first.

It important to know when the depression initially occurred since somebody who had depression before they started to abuse substances will no doubt need addiction rehabilitation treatment, including addiction treatment, for a longer period of time compared to someone whose depression was brought about by the cycle of addiction. Somebody whose depression was brought about by substance abuse for the most part won’t require the same treatment as somebody whose depression preceded his or her substance abuse.

In some cases when somebody comes in for addiction rehabilitation treatment and has a depressive issue that was brought on by addiction, they aren’t ready to precisely report what is going on for them. They may be excessively numb or miserable or unable to focus. In the event that a patient whose depression was caused by substance abuse is sent to treatment for the individuals who were depressed first and  chemically dependent later, within a couple of weeks he or she typically is asking “What’s am I doing here? I don’t have these sorts of issues!’ In these cases this isn’t necessarily a function of denial yet a genuine observation because of unique lack of understanding about whether the depression or the addiction comes first.


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