When someone struggles with both addiction and depression, it is called a co-occurring or dual diagnosis. It represents two major challenges at once and is a regularly occurring malady. The numbers are staggering: 15 million American adults – almost 6.7% of the population currently suffer from Major Depressive Disorder. The Substance Abuse and Mental Health Services Administration (SAMHSA) found in a 2014 survey that 7.9 million adults suffer from a co-occurring disorder.
Most of us experience times when we feel depressed. It is normal to feel down once in a while, especially during difficult or challenging life experiences and times of increased stress. However, for many people, symptoms of depression take hold and turn into a persistent mental disorder. This kind of depression is actually very common. As stated above, persons in long-term recovery are no strangers to depression. Sometimes, those who develop an addiction are seeking relief from the pain of depression through alcohol and drug use. At other times, abusing alcohol and drugs may lead to symptoms of depression.
People with mental health disorders are more likely than people without mental health disorders to experience an alcohol or substance use disorder. Co-occurring disorders can be difficult to diagnose due to the complexity of symptoms, as both may vary in severity.
The National Institute of Mental Health lists the following symptoms to help people determine whether or not they are experiencing depression:
• Persistent sad, anxious or “empty” mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities
• Decreased energy, fatigue, being “slowed down”
• Difficulty concentrating, remembering, making decisions
• Difficulty sleeping, early-morning awakening or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, suicide attempts
• Restlessness, irritability
• Persistent physical symptoms
If you are experiencing any of these symptoms, consult with a physician. Remember, these symptoms can become critical as they persist and get worse over time. Depression lasting for an extended period—two or three weeks with more bad days than good—is a sign of major/clinical depression requiring professional assistance. If you are having persistent thoughts of death/suicide or have attempted suicide, you are certainly suffering from depression and should reach out for help immediately.
Depression is much like a parasite: it attacks the host and consumes life-sustaining nutrients for its own benefit. Over time, the negative impact of the parasite on the host may get worse. Major depression has a profound impact on a person’s daily recovery. In my work with those who suffer, I often hear it described as being “covered by a wet blanket,” unable to see any hopeful view of the future and feeling weighed down by everyday life. This uncertain future creates feelings of sadness, guilt and/or irritability. Others have often described depression as trying to “run in Jell-O,” working hard to get somewhere but unable to make any progress. This lack of progress despite expending tremendous energy may lead to loss of interest, difficulty concentrating and fatigue. It is also common for those who struggle with depression to experience feelings of anxiety.
Because co-occurring disorders are complicated, people often do not reach out for meaningful help or they only get help for a part of the disorder from which they are having difficulties.
In many cases, people receive treatment for one disorder while the other disorder remains untreated. This may occur because both mental and substance use disorders can have biological, psychological and social components. Other reasons may be inadequate provider training or screening, an overlap of symptoms or that other health issues need to be addressed first. In any case, the consequences of undiagnosed, untreated or undertreated co-occurring disorders can lead to a higher likelihood of experiencing homelessness, incarceration, medical illnesses, suicide or even early death.
That is the bad news. The good news is that co-occurring addiction and depression are treatable. The best form of recovery from co-occurring disorders integrates meaningful treatment and resources while paying attention to the biological, psychological and social components of healing and wellness. If you have a co-occurring disorder, don’t be afraid or hesitate to reach out for help. You must find the courage to discuss your current situation with those around you. Reaching out to a healthcare provider, counselor, psychiatrist, your recovery community, family and friends is essential and can be life-changing.
There are so many who can relate to what you are experiencing, and you will quickly learn you are not alone. With just a step or a phone call, you can receive meaningful direction as you continue your journey of wellness and recovery.
References Provided Upon Request
Dr. Kimball serves as the Director of the Center for Collegiate Re-covery Community and holds the George C. Miller Family Regents Professorship at Texas Tech University. He is co-author of the book, Six Essentials to Achieve Lasting Recovery, Hazelden Press. He is also a consultant with MAP.