Clinical depression is one of the most common co-occurring conditions found alongside a wide variety of mental health issues, however, depression and addictive disorders are particularly common concurrent diagnoses. This occurs for several reasons:
- Addictive disorders typically sustain multiple negative consequences including loss, relationship problems, decline in job performance and poor self-esteem.
- Addictive disorders cause mood instability and vulnerability to depression.
- Individuals with symptoms of depression may seek relief in the use of substances or other compulsive behaviors involving such mood-altering activities as gambling, sex and eating.
Co-occurring Addiction and Depression
Addiction and depression are closely related for many people and the two conditions interact in various ways. One condition may cause or significantly exacerbate the other. Those with the dual diagnosis of addiction and depression develop the co-occurring conditions in various ways as well. For some, depression came first and for others, addiction was the original illness. Despite how addiction and depression came to co-exist, all individuals with these dual conditions require treatment that will address both simultaneously in order to achieve full recovery.
Addiction as an Attempt to Self-Medicate Depression
Individuals with depressive symptoms naturally seek relief from their debilitating effects and many will use addictive behavior in an attempt to cope with depressive symptoms. Any depressive illness–whether endogenous or situational –can be worsened and prolonged by the use of addictive behaviors. Typically, a ‘synergy’ of symptoms occurs. Both depressive symptoms and addictive symptoms begin to build and fuel each other when addictive behaviors are used during depression. Momentary relief found in the use of addictive behaviors will, over the long run, exacerbate and prolong a depressive episode. If addictive behaviors are relied upon to relieve symptoms over a prolonged period, eventually the effects of addictive behaviors themselves become a second and equally significant problem.Ingestive addictions (drugs, alcohol and food) as well as process addictions (such as gambling, sex and shopping) can both be used to ‘self-medicate’ the problematic symptoms of depression.
Anxiety, dysphoria and sleep problems are common depressive symptoms individuals attempt to alleviate with addictive behaviors. The inappropriate use of mood-altering behaviors or substances to cope with such symptoms significantly increases the risk for developing an addictive disorder during an episode of depression. This occurs because of a ‘rebound’ effect: addictions are used to ‘medicate’ depression/depression worsens with addiction and more addictive behaviors are used to ‘medicate’ the worsening depression. A ‘vicious cycle’ of dual disorders begins to feed itself until appropriate dual diagnosis treatment breaks that cycle.