Depression is the collective name for a group of mental health conditions that cause significant mood disturbances and interfere with the ability to lead a productive daily routine or feel a sense of emotional well-being. People who drink excessively or abuse a range of recreational drugs generally have higher depression risks than the rest of the population. In a study published in August 2014 in the journal Substance Abuse, researchers from several U.S. institutions explored the ways that depression impacts the overall health and preparedness of people seeking treatment for substance problems.
In the U.S., all diagnosable forms of depression belong to a group of conditions known as depressive disorders. The best known of these conditions – major depression (major depressive disorder) – is a severe, frequently debilitating illness that can occur in single episodes or appear repeatedly over time. Another form of depression, persistent depressive disorder (once known as dysthymia), may appear in a less intense form than major depression but continues to trigger symptoms for a minimum of two years. Variants of major depression include postpartum depression, which appears in the aftermath of childbirth; psychotic depression, which includes hallucinations and/or delusional thought patterns; and seasonal affective disorder (SAD), which typically occurs in winter when natural sunlight levels taper off. Additional depressive disorders recognized by the American Psychiatric Association include premenstrual dysphoric disorder, disruptive mood dysregulation disorder, substance/medication-induced depressive disorder and unspecified depressive disorder.
Depression, substance abuse and diagnosable substance use disorder (substance abuse/substance addiction) are interwoven in complex ways. Specific types of substance abuse linked with increased depression risks include heavy alcohol intake, cannabis/marijuana intake (especially in large amounts or relatively early in life), opioid drug or medication intake (especially in large amounts), stimulant intake and inhalant intake.
When diagnosable depression symptoms and diagnosable substance problems appear together, they commonly have a negative impact that’s greater than the impact produced just by depression or just by substance use disorder. Addiction specialists and mental health experts refer to conditions that trigger bigger problems when they appear in combination as comorbid conditions. Unfortunately, comorbid cases of depression and substance use disorder are relatively common. Specific problems found in these cases include unusually severe depression symptoms, unusually frequent depression symptoms and an unusually steep decline in functional ability. Some substance abusers live in physical and social conditions that increase their chances of developing diagnosable depression. Conversely, some people with diagnosable depression live in physical and social conditions that increase their chances of getting involved in substance abuse.
Impact on Treatment Seekers
In the study published in Substance Abuse, researchers from the University of Texas at Arlington, Columbia University and two other institutions used an examination of 507 people enrolled in outpatient treatment for substance problems to explore the impact depression has on treatment seekers. All of these individuals took a mental health screening tool called the Patient Health Questionnaire. In addition, they submitted information on a range of topics that included their typical substance use habits, their ability to function socially, their general physical well-being and their ability to cope with problems and changing circumstances.
The researchers found that 21 percent of the study participants had symptoms that would qualify them for a depression diagnosis. These depression-affected individuals also had unusually high chances of being affected by diagnosable symptoms of post-traumatic stress disorder (PTSD) or some form of anxiety disorder. Separate from any issues with anxiety disorder or PTSD, the participants with depression frequently had two problems that could potentially interfere with the success of substance treatment: a substantially reduced ability to function socially and a substantially reduced ability to cope with problems and changing circumstances. However, the depression-affected individuals did not typically abuse substances more often than their counterparts unaffected by depression.
The study’s authors note that effective coping skills, in particular, are an indicator of the odds of success in substance addiction treatment. This means that people who lack these skills commonly have higher chances of dropping out of treatment or otherwise failing to establish a pattern of substance abstinence. They believe that substance treatment programs may be able to substantially improve the outcomes for people with comorbid depression symptoms by assessing each individual’s coping abilities and taking steps to improve the coping abilities (and social function skills) of those people with a notable deficiency.