Depression and Addiction

In this comprehensive guide, we delve into the complexities of depression and addiction. When they occur together, the need for support becomes even more crucial. This page is here to help you or your loved ones navigate these tough situations. We’ll share practical insights and simple strategies for self-help, offering a friendly hand in the journey toward healing.

How is depression defined?

Depression is a mental health disorder characterised by persistent feelings of sadness, hopelessness and a lack of interest or pleasure in activities. It can affect a person’s thoughts, emotions, behaviour and overall well-being. Depression is more than just a temporary feeling of sadness; it is a prolonged and pervasive condition that can significantly impact daily functioning.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook used by mental health professionals to diagnose mental health conditions. According to the DSM-5, Major Depressive Disorder (one of the most common forms of depression) is diagnosed when an individual experiences five or more of the below depression symptoms during the same two-week period. This is also coupled with at least one of the depression symptoms being either ‘depressed mood’ or ‘loss of interest or pleasure’:

  • Depressed mood most of the day, nearly every day.
  • Markedly diminished interest or pleasure in all or almost all activities.
  • Weight loss or gain without dieting or changes in appetite.
  • Insomnia or hypersomnia nearly every day.
  • Psychomotor agitation or retardation.
  • Fatigue or loss of energy.
  • Feelings of worthlessness or excessive guilt.
  • Diminished ability to think or concentrate, or indecisiveness.
  • Recurrent thoughts of death, suicidal ideation, or a suicide attempt.

How is addiction defined?

Addiction is a multifaceted condition in which a person persists in using a substance or engaging in a behaviour despite its detrimental effects. It is marked by an overpowering and involuntary desire to consume a substance or partake in a specific activity, frequently resulting in both physical and mental reliance. Two primary categories of addiction exist: substance addiction and behavioural addiction.

Substance addiction

This type of addiction involves dependence on substances such as drugs or alcohol. Individuals with substance addiction often develop a tolerance to the substance, requiring larger amounts to achieve the same effects. Withdrawal symptoms may occur when the substance is not consumed, leading to a cycle of increased use.

Behavioural addiction

Behavioural addiction involves compulsive engagement in certain activities or behaviours.

Common examples include:

  • Gambling addiction
  • Gaming addiction
  • Shopping addiction
  • Sex addiction
  • Internet addiction
  • Below are some of the common signs of addiction:

  • Loss of control
  • Increased tolerance
  • Withdrawal symptoms
  • Neglecting responsibilities
  • Continued use despite consequences
  • Social isolation
  • Loss of interest in hobbies
  • Unsuccessful attempts to quit
  • Preoccupation with substance use
  • Risky behaviours
  • Deceptive behaviour
  • The DSM-V doesn’t officially recognise the vast majority of known behavioural addictions at this current moment in time, but does recognise internet addiction, gambling disorder and internet gaming disorder. Interestingly enough, gambling addiction was moved to Substance Use Disorder in the DSM-V, showing changes in perception of addiction as time progresses.

    Are depression and addiction linked?- A quick look at the evidence

    There is often a complex and bidirectional relationship between depression and addiction. These two conditions can co-occur, exacerbating each other and creating a challenging cycle for those experiencing both. Below, we take a look at some of the strongest evidence that links depression and addiction:

    • Results of a study found significant associations between depression and the use of tobacco and cannabis. Although the study didn’t state whether or not the participants were addicted to either substance, it did show a strong association between the two
    • Up to 40% of patients diagnosed with depression had either a history of substance use disorder or alcohol addiction throughout their lifetime. Shockingly, only 19% of these patients sought medical help.
    • In a study that focused on people with gambling addiction and depression, 69.57% of participants reported to show signs of depression. 73.33% of pathological gamblers showed at least one depressive symptom.
    • According to a meta-analysis, depression was related to future alcohol use, an earlier development of Alcohol Use Disorder and a higher chance of treatment participation. This potentially shows a strong link between depression and alcohol addiction.

    What came first: depression or addiction?

    The relationship between addiction and depression can be complex and varies from person to person. The connection between depression and addiction often involves a bidirectional relationship.

    Depression leading to addiction

    Conversely, substance misuse or addiction can also foster the emergence of depressive signs. The impact of specific substances on the brain, coupled with the repercussions of addiction like strained interpersonal relationships, legal entanglements, and financial hardships, may induce feelings of hopelessness and melancholy.

    Example scenario:
    Mark, a 30-year-old office worker, has been dealing with the weight of depression on his shoulders. One day, an old friend offered Mark cocaine as an escape. Tempted, Mark tried it, briefly escaping the darkness. Yet, as quickly as the darkness returned, Mark wanted to escape it again. As the drug addiction tightened its grip, Mark faced even tougher daily battles, making his struggle with depression more challenging.

    Addiction leading to depression

    On the other hand, substance abuse or addiction can also contribute to the development of depressive symptoms. The effects of certain substances on the brain, as well as the consequences of addiction such as strained relationships, legal issues and financial problems, can lead to feelings of despair and sadness.

    Example scenario:
    Jenny’s life unravelled as the relentless grip of gambling tightened. The once vibrant woman now carried the burden of mounting debts and shattered relationships. Each bet deepened her despair, leading her to exhibit crippling signs of depression.

    In many cases, it can be challenging to determine a clear chronological order, as both depression and addiction can reinforce each other in a vicious cycle. Genetic, environmental and psychological factors also play roles in developing both conditions.

    How are depression and addiction treated in rehab?

    UKAT specialises primarily in addiction rehab treatment, focusing on supporting individuals dealing with addiction rather than targeting depression specifically. However, for those facing a dual diagnosis of depression and addiction, our treatment programme integrates therapeutic approaches that can bring significant benefits.

    Our rehab treatment includes:

    Dialectical Behaviour Therapy (DBT): This approach combines Cognitive Behaviour Therapy (CBT) elements with mindfulness techniques. It provides essential skills for emotional regulation, improving interpersonal relationships and managing both depression and the cravings associated with addiction.

    Group therapy: Through a blend of expert guidance and peer support, our group therapy creates a powerful healing environment for individuals confronting both depression and addiction. This approach promotes a supportive space and reduces the sense of isolation often linked to depression and addiction.

    Individual therapy: Tailored for those with a dual diagnosis, individual therapy addresses both depression and addiction simultaneously. In addition to addiction-focused treatments, holistic therapies play a crucial role in supporting individuals dealing with depression and addiction. Our treatment process incorporates these comprehensive approaches, considering mental and physical well-being.

    Engaging in UKAT’s holistic therapies provides individuals with essential tools and coping strategies to effectively manage depression while progressing toward addiction recovery. Our holistic therapies encompass:

    How to help a loved one with depression and addiction

    Supporting a loved one who is struggling with both addiction and depression can be challenging, but your care and understanding can make a significant difference in their journey towards recovery. Here are some suggestions to help you navigate this situation:

    Educate yourself
    Learn more about depression and addiction to understand better what your loved one is going through. This knowledge can help you approach the situation with empathy and provide more effective support.
    Encourage professional help
    Dealing with depression or addiction on its own is difficult enough, let alone both. Encourage your loved one to seek professional help from mental health professionals, therapists, or addiction specialists, like UKAT. They may benefit from a combination of therapy, counselling and potentially medication.
    Encourage open communication
    Create a safe space for your loved one to open up about their feelings and struggles. Be a good listener and avoid giving unsolicited advice. Sometimes, just having someone to talk to can be immensely helpful.
    Set boundaries
    While being supportive, it’s essential to set boundaries. You cannot control their actions, but you can establish limits to protect yourself emotionally. Make it clear what behaviour is unacceptable and what the consequences are if those boundaries are crossed. This could be relevant if your loved one has an issue with substances or behavioural addictions.
    Be patient
    Recovery is a gradual process, and setbacks may occur. Be patient and continue offering your support. Celebrate small victories and let your loved one know that you believe in their ability to overcome their battle with depression and addiction.
    Take care of yourself
    Supporting someone with depression and addiction can be emotionally draining. Make sure to prioritise your well-being. Seek support from friends, family, or a therapist to help you cope with the challenges you may face.

    What should you do next?

    If you or someone you know is dealing with both depression and addiction, it’s crucial to seek help right away. Handling these problems on your own can be tough. By reaching out for support, you’re giving yourself the best chance to start the journey towards recovering from both depression and addiction. Contact UKAT as soon as you can to take back control of your life.

    Call us now for help

    (Click here to see works cited)

    • Esmaeelzadeh S, Moraros J, Thorpe L, Bird Y. The association between depression, anxiety and substance use among Canadian post-secondary students. Neuropsychiatr Dis Treat. 2018 Nov 23;14:3241-3251. doi: 10.2147/NDT.S187419. PMID: 30538482; PMCID: PMC6260190.
    • Vally Z, Helmy M, Fourie L. The association between depression and addictive social media use during the COVID-19 pandemic: The mediating role of sense of control. PLoS One. 2023 Sep 8;18,9:e0291034. doi: 10.1371/journal.pone.0291034. PMID: 37683017; PMCID: PMC10490948.
    • Alsheikh AM, Elemam MO, El-Bahnasawi M. Treatment of Depression With Alcohol and Substance Dependence: A Systematic Review. Cureus. 2020 Oct 26;12,10:e11168. doi: 10.7759/cureus.11168. PMID: 33133799; PMCID: PMC7592633.
    • Krause K, Bischof A, Lewin S, Guertler D, Rumpf HJ, John U, Meyer C. Explaining the relation between pathological gambling and depression: Rumination as an underlying common cause. J Behav Addict. 2018 Jun 1;7, 2:384-391. doi: 10.1556/2006.7.2018.38. Epub 2018 May 30. PMID: 29846083; PMCID: PMC6174589.
    • Conner KR, Pinquart M, Gamble SA. Meta-analysis of depression and substance use among individuals with alcohol use disorders. J Subst Abuse Treat. 2009 Sep;37, 2:127-37. doi: 10.1016/j.jsat.2008.11.007. Epub 2009 Jan 15. PMID: 19150207; PMCID: PMC4864601.
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