Understanding Addiction and Depression

Last updated on November 4th, 2019

What came first, the addiction or the depression?

It’s a classic chicken and egg scenario. As a physician, I technically cannot diagnose (at least not accurately) a mood disorder while someone is actively abusing a substance. Yet, it’s common knowledge that many people start abusing alcohol or drugs as a way to self-medicate the distress caused by depression.

In truth, there’s probably a combination of things going on for the person who depends on substances to dampen down intolerable moods. We know from neuroscience that mental illness, whether its addiction or depression, comes from a constellation of factors related to genetics and the environment. 

And in the field of psychiatry, it’s long been understood that addiction is co-morbid with mood and anxiety disorders – meaning that they likely go hand-in-hand.

Self-Medicating and Depression

Most alarming is this fact: According to data from the National Institute of Mental Health (NIMH), it takes the average person suffering with any mental illness over a decade to ask for help.

Rather than shaming, self-medicating, or ignoring those with addictions, I think it’s most important to help people feel comfortable enough to ask for treatment.-Helen FarrellDuring that decade, things can spiral out of control due to worsening moods and escalating addictions. Relationships fall apart, jobs are lost and stability disappears.

According to the World Health Organization (WHO), depression is the leading cause of disability in the world. And given its high association with addictions, substance abuse is rampant for those with untreated depression.

Rather than shaming, self-medicating, or ignoring those with addictions, I think it’s most important to help people feel comfortable enough to ask for treatment. It shouldn’t take ten years to achieve relief from symptoms!

Suffering in Silence

Contrary to what many people wish, a mental illness won’t go away just because you want it to.  Of the 10% of Americans who struggle with depression, many will go untreated and suffer in silence.  This is possible because addiction and depression, like most mental illnesses, are masters of disguise. It can be hard to know if someone around you is struggling because they look just fine.

By capitalizing on that transcendental line – the one where art blends with the practice of medicine – the stigma associated with addiction and depression can be overcome. Whether I am translating poignant patient cases into prose for public education, providing informative commentary on current mental health news to the media, or speaking to students in a lecture hall, the art of medicine takes many forms.

…addiction and depression, like most mental illnesses, are masters of disguise. It can be hard to know if someone around you is struggling because they look just fine.-Helen FarrellIn my recently released animated short-film, What is Depression?, produced by TED-Ed, the difference between feeling depressed and having depression is reviewed. And good thing too, because depression (and all of its manifestations – including substance abuse) is very treatable!

The overwhelming number of views the film received, shortly after its launch, is a testament to the fact that people want to know more about mental illness and how to overcome its negative consequences.

Unfortunately, many people are still confused about what mental illness really looks like. Whether its alcoholism, opioid dependency, or depression – few sufferers look like tattered souls – homeless, loitering on the streets, and incessantly talking to themselves. In fact, they look just like you and me.

From Stigma to Acceptance

Storytelling is an integral part of conveying a message of hope. In my TEDx Talk, Creating Hope for Mental Health, people come to learn that one in four people will find themselves diagnosed with a major mental illness.

As we know, mental illness can wreak havoc on lives and, arguably, its most catastrophic outcome is suicide. And addiction is an independent variable that contributes greatly to a person’s risk for suicide.

Contributing to these dismal statistics is the perpetuation of stigma associated with mental illness. But we as communities have the power to transform stigma into hope and acceptance.

The WHO reports that there is one death by suicide every forty seconds. 

To better put that into perspective, in the time it takes you to watch my TEDx Talk,
Creating Hope for Mental Health, a staggering 27 people will take their own lives.

Embracing Hope

Life is about living. Surviving a major mental illness and achieving success in this world are not dichotomous. 

Doctors and mental health providers encourage patients to maximize health-promoting factors like education, employment, relationships, and hobbies. This, combined with support, lifestyle modification, therapy, and modern medication, can mean the difference between a tortured person and one who prospers.

Whether you’re dealing with addiction or depression or both, there is recovery. There is healing.
And there is hope.



Image Courtesy of iStock

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