Every individual has experienced “bad days” or feeling down. Whether it is our home life, our relationships, something at work, or sometimes we just feel “off.” No one is free of having a bad day. Some individuals can do things that make them happy or makes them feel great and change their mood. But for others who suffer from depression or other mental disorders, it is not so simple to find a cause to be happy. It is the pursuit to be satisfied that leads to 50% of people who suffer from depression and also suffer from substance abuse and vice versa. When a person is diagnosed with depression and substance abuse, it is called Dual Diagnosis. Read on to learn about it and how to help someone with substance abuse and mental health disorder like depression.
What is Depression?
Depression(major depressive disorder) is one of the mental disorders that negatively affects how you feel, the way you think and how you act. Depression is not just being unhappy or having a bad day. We all go through ups and downs. But, major depression is a pervasive and regular depressed mood that badly affects mental health. It is a continuing daily struggle against feeling insignificant and extremely worried, feeling alone, and like the world is closing in.
A person who suffers from Clinical Depression mental illness is far more affected than a person suffering from simple depression mental illness. Clinical Depression is depression that lasts at least two weeks while interfering with your daily life at work and at home.
Signs of Depression
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) some depressive symptoms and signs that someone is suffering from depression include:
- Extreme sadness (mood disorders)
- Trouble concentrating
- Increase in body aches and pains
- Loss of energy
- Change in sexual activities
- Change in appetite
- Change in sleeping habits
- Feeling helpless
- Thoughts of suicide or self-harm
- Feeling like no one loves you
Depression is a mental illness and is more than feeling sad. Depression is not able to see an outcome. Depression influences your mental health which dictates your day-to-day activities, and relationships with family and friends, and more than not, depression leads to misusing alcohol and drugs or a more serious mental health problem.
What is Addiction?
Addiction is a complex mental health disease that is confirmed by chronic substance use regardless of the consequences.
Addiction comes in many forms. A person can be addicted to:
Substance abuse kills thousands of people a year in the US alone and affects millions of people, from the families of users to the strangers affected by the user’s choices. An individual who starts down the road of addiction does not think, “I am going to become a substance abuser.” An individual experiments with drugs or alcohol because of peer pressure or wanting to escape reality and then eventually turn into substance abuse.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA) almost 6.5 million Americans from teens to adults have an addiction to gambling. An addiction to shopping also affects nearly 6 million Americans. Although there are various forms of addiction, they all take the same path from the first time to addiction.
The 5 Stages of Addiction
- Experimenting. People experiment with drugs or alcohol because of peer pressure, while others experiment to mask the pain they feel.
- Regular use or substance abuse. This is when you are starting to indulge daily.
- Tolerance. Tolerance happens when you no longer get the same euphoric feelings as you initially did. So, you have to boost your intake.
- Dependence. This is when you must have what you are addicted to function.
- Addiction. Your brain and body can’t regularly work without being “high.” You are feeling much worse without the substance because you are not feeling the initial feelings of using.
The fifth stage is when a person with substance use disorder starts to go downhill very quickly. It harms not only the user but their friends and family. Families ripped apart and heartbroken that they can not help the user. Friends and family become not as relevant in a user’s life because satisfying their alcohol use disorder or drug abuse addiction is the only thing they exist for.
Signs of Addiction
- Changes in daily behaviors
- Needing an unusual time alone
- New friends
- Money problems
- Poor Personal hygiene
- Lack of interest in hobbies
- Legal problems/criminal charges
- Staying out all hours of the night
- Change in sleeping patterns
- Change in eating patterns
- Mental health problems
It is vital to watch for these symptoms if you think you or a loved one is suffering from addiction.
What is Dual Diagnosis?
When an individual is diagnosed with addiction and depression, it is a Dual Diagnosis or co-occurring disorder. The National Survey on Drug Use and Health, says 45 percent of people with addiction suffer from co-occurring disorder.
Depression is sometimes attributed to being a “gateway” to addiction. Though it can lead to a habit of any type, it most commonly leads to an addiction to drugs and alcohol. Depression can lead to drug abuse and addiction can lead to depression. And 29 percent of individuals with depression suffer a drug and alcohol addiction. In comparison, 50 percent of individuals suffering from a co-occurring addiction and mental health disorder do not seek help.
In the past 6 years, people in drug and alcohol addiction treatment and seeking help with co – occurring depression have grown from 12 to 16 percent. 10 percent of people who are still performing in the everyday workforce are coping with depression. While another 10 percent are struggling with addiction. Of the individuals secretly struggling, approximately 3 percent are fighting both their substance use disorder and mental health conditions.
Only 40 percent of over 3 million working people seek major depression and addiction treatment.
Depression and Addiction: What are the Treatment Options for Dual Diagnosis?
As the number of individuals who suffer co-occurring depression and drug abuse increases, various ways to treat depression and addiction are also growing. Treatment centers like Behavioral Health Centers have treatment options to fit everyone’s requirements. The kinds of treatment alternatives include Inpatient, Outpatient, Intensive Outpatient (IOP), Partial Hospitalization Treatment (PHP), and Therapy in treatment.
Inpatient Treatment for Depression and Addiction
For some, residential treatment is the best way to be successful on their journey. residential treatment provides the security and stability of 24-hour care at a live-in center. Inpatient programs are intense and require a lot of ongoing work from the patient to address both their major depression and substance use disorders.
Inpatient programs help you detox from substances in your body and work with you to start healing yourself. Each second of the day is scheduled and monitored by the staff in the facility. You will work with therapists, psychiatrists, and psychologists in an individual setting as well as in group settings. Treatment can last anywhere from 28 days to 6 months or more.
Outpatient Treatment for Depression and Addiction
Outpatient treatment offers you the flexibility to keep working or going to school. On average Outpatient treatment requires 16 hours of therapy a week. Outpatient programs focus on drug abuse education, individual and group counseling. It works with you on how to cope with life’s obstacles without relapsing.
Outpatient treatment can be a safe option for someone with a mild addiction. Some recovering addicts continue to an outpatient program to continue their addiction treatment. Outpatient treatment can last up to six months, and sometimes, it lasts up to a year.
Intensive Outpatient Treatment (IOP) for Depression and Addiction
Intensive Outpatient Treatment allows a person to still go to work or school and participate in daily life activities. Still, it requires more intensive work than a regular Outpatient program. IOP expects the patient to do individual as well as group therapy sessions. IOP’s focus on stress management, conflict resolution, successful socialization, sobriety, and how to change negative behaviors and thoughts.
IOP also teaches the user how to set and achieve goals and how to monitor themselves. Every session is to help the user look deep into themselves and fix the root problem. In turn, it will help the user lead a life of sobriety. IOP’s last 12 to 16 weeks before reaching the maintenance phase, which can last months.
Services offered in Intensive Inpatient programs:
- Some detoxification- If there is no risk of severe withdrawal symptoms
- Individual Counseling- Focus on changing behaviors learned during the road to addiction
- Group Counseling- Intensive Inpatient treatment’s primary focus is on group therapy. This builds sober behaviors, positive communication skills, structure, and provides guidance.
- Family Counseling- Works with patients and their families to rebuild the relationships addiction and depression tore apart.
- Medication Management- Medication, along with therapy, can help patients fight the battle against depression and addiction.
Partial Hospitalization Program for Depression and Addiction
Partial Hospitalization Program (PHP) offers the most intensive non-inpatient care. This program is very beneficial for patients with a co-occurring disorder who need a more structured step-down program. It is for individuals who do not meet the criteria for the intense inpatient programs. Individuals can go to work, school, and stay in their own homes at night. But they are required to attend 4 to 6 hours a day of treatment sessions.
While in treatment, patients will participate in:
- Individual Counseling
- Group Counseling
- Family Counseling
- Medical appointments/ Medication regimens
- Nutritional Counseling
- Relapse prevention education
- Exercise and recreational therapy
- Sober life skills
PHP is not the first step in substance abuse treatment, but a middle program when a substance abuser has completed an inpatient program and needs continued guidance to reduce depressive symptoms and continue with their addiction recovery. Partial Hospitalization Programs focus on healing the inside and teaching you to live a sober and mentally stable life. Counseling sessions help build self-confidence, decision-making skills, and how to express yourself adequately.
People that complete a PHP program have an increased chance of lifetime sobriety and mental stability.
Therapy in Treatment
Therapy in treatment is a necessary step in reaching victory. To live a healthy and prosperous life, you have to be given the right tools. Therapy is created to help the patient get to the root of the problems and find healthy ways to cope with those issues.
A patient with a co-occurring disorder benefits considerably with alternative therapy. People are given a plan and guidance on how to handle all aspects of both diseases. Patients go through Behavioral Modification, Cognitive Therapy, and Alternative treatments.
Behavioral Modification Therapy for Depression and Substance Abuse
Behavior modification is a therapeutic program built to change unwanted negative behavior. Patients and therapists work together to recognize what triggers an adverse reaction and the various effective ways to encourage positive behaviors. Behavior Modification therapy rewards positive decisions and removes a reward when an adverse decision is made.
Removing an award is not a penalty for making a patient think of more useful ways to cope with a problem. Patients who have a Dual Diagnosis lived a life performing and feeling a particular way to survive. People have to relearn healthy ways to think and live.
Behavioral modification commonly uses some of the following methods:
- Modeling- Teaching positive behaviors through impersonating scenarios and showing them a suitable way to do things.
- Cueing- Helps individuals learn what their triggers are and how to change their environment to promote positive responses.
- Avoidance- Teaching individuals how to avoid people and places that trigger negative behavior.
- Fear Management- Building skills and techniques to handle the issues thrown at you daily
Cognitive-Behavioral Therapy (CBT) for Depression and Substance Abuse
Cognitive Behavioral Therapy believes that when you alter a person’s perception of themself, it will alter their behavior. People who suffer from a dual diagnosis also suffer from very low self-worth and self-esteem. Cognitive Behavioral Therapy concentrates on a hands-on method for problem-solving. CBT helps identify what damaged a person’s self-esteem and how to repair it.
This form of therapy requires a patient to dig into their emotional baggage without falling back to their addiction. When an individual starts to heal emotionally, it also promotes positive choices. It increases the chance of a life free of addiction and depression.
Cognitive-Behavioral Therapy helps people with the following issues:
- Mood swings
- Anger issues
- Childhood traumas
- Eating disorders
- Sleep problems
- Relationship problems
As more is discovered about treating a Dual Diagnosis, treatment programs continue to evolve to help their patients find success. Alternative therapies focus on four main elements,
It is a lifestyle change and demands a high level of engagement from the patient.
Alternative therapies also expect a patient to be completely open and willing to look at the good, bad, and the ugly of their life. This is not a fast process, but with hard work, it can be extremely beneficial to a life of sobriety.
Alternative Therapies may include:
- Breathing exercises
- Guided imagery
Behavioral Health is Here for You
It is frightening when you finally admit that you need help. Let our caring medical staff and mental health professionals guide you every step of the way.
Our team at Behavioral Health Centers are experts in dual diagnosis treatment. It’s important to treat both substance use disorder and mental illness simultaneously to prevent further adverse effects and ensure your recovery.