What Is Depression?
Depression is more than just feeling sad or going through a difficult time. Rather, it is a serious mental health disorder that impacts how one thinks and feels and how one interacts with the world.[1] The DSM-5 recognizes several types of depression.[2] Here are the most common among the general population:
- Major Depressive Disorder (MDD): Major depressive disorder is characterized by more than two weeks of consistent sadness, hopelessness, and loss of interest in all activities to the extent that the daily functioning of the person is compromised. MDD is one of the most common mental health disorders in the United States.
- Persistent Depressive Disorder (PDD): PDD is chronic depression in which depressive symptoms are present most of the day, more days than not, for at least two years. The symptoms of chronic depression are generally less severe than MDD; however, the overall impact can seriously diminish a person’s quality of life.
- Bipolar Disorder: Bipolar disorder involves alternating episodes of depression and mania. The depressive episodes are very similar to MDD; however, treating bipolar disorder requires a different approach, which is why accurate diagnosis is critical.
- Postpartum Depression: Postpartum depression is a major depressive disorder experienced after the birth of a child, with persistent feelings of sadness, fatigue, anxiety, and an inability to bond with the new child.
Symptoms of all forms of depression include: persistent feelings of sadness or emptiness, loss of interest in activities, lack of energy, poor or excessive sleep, poor appetite or excessive eating, difficulty concentrating, feelings of worthlessness or guilt, and, in serious situations, suicidal ideation.
The Connection Between Depression and Addiction
Depression and substance abuse have a reciprocal relationship that reinforces itself on a neurobiological level.[3] Many people with depression abuse alcohol, opioids, or other substances to cope with their symptoms.
Often, these people will self-medicate with various substances to numb their emotional pain, get to sleep, or lift their mood. This self-medication has short-term benefits, but ultimately contributes to worsening their depression. For instance, alcohol is a central nervous system depressant, and if used long-term to self-medicate, it exacerbates a person’s depressive symptoms because it negatively impacts the brain’s chemistry.[4]
Conversely, chronic substance abuse negatively affects the brain systems that regulate mood. The neurotransmitters responsible for mood regulation (dopamine, serotonin, and norepinephrine) are directly impacted by long-term use of drugs and alcohol.[5] Because of this, many people who did not have depressive disorders prior to using substances will see new depressive symptoms while they are actively abusing drugs or alcohol and in early recovery.
The bidirectional relationship that exists is the rationale for the importance of dual diagnosis integrated treatment, which means treating depression and addiction simultaneously.
Symptoms of Depression to Watch For
Because depression can develop gradually and is often minimized or normalized by the person experiencing it, recognizing the signs in yourself or a loved one is an important first step.
Symptoms of depression include:
- Persistent feelings of sadness, emptiness, or hopelessness
- Loss of interest or pleasure in activities that were once enjoyable
- Significant changes in appetite or weight
- Sleep disturbances — sleeping too much or too little
- Fatigue and loss of energy even without physical exertion
- Feelings of worthlessness, excessive guilt, or shame
- Difficulty thinking, concentrating, or making decisions
- Withdrawing from relationships and social activities
- Physical symptoms such as unexplained aches, headaches, or digestive problems
- In severe cases, thoughts of death or suicide
When these symptoms occur alongside substance use — whether the depression preceded the substance use or developed as a result of it — dual diagnosis treatment is the most appropriate and effective path forward.
When to Get Help for Anxiety
Anxiety is a normal reaction to stress and uncertainty, and everyone will experience anxiety from time to time. However, there are specific instances in which a person suffering from anxiety will benefit from professional support. These include the following situations:
- Your anxiety feels uncontrollable or out of proportion to the situation
- You are using alcohol, prescription medications, or other substances regularly to manage anxiety symptoms
- Anxiety is causing you to avoid important activities, relationships, or responsibilities
- You have frequent panic attacks
- Anxiety is significantly disrupting your sleep, concentration, or physical health
- You have tried to manage anxiety on your own without lasting success
- Your anxiety and substance use feel locked in a cycle you cannot break
If any of the issues mentioned above resonate with you, please reach out to Meridian Recovery.
How Therapy Can Help Anxiety
Therapy can actually help with reducing anxiety symptoms, not simply manage them. Clinical research that examined multiple evidence-based therapies has shown that therapy leads to long-term reduction in anxiety.[6]
Therapy helps clients recognize their cognitive and behavioral patterns that create their anxiety, as well as allowing them the opportunity to gradually build the skills and self-confidence needed to engage in situations anxiety has caused them to avoid. As part of dual diagnosis treatment, therapy helps to identify ways that your anxiety interacts with substance use in order to end the self-medicating cycle and build a solid recovery foundation.
