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Struggling with both a mental health condition such as depression and an alcohol use disorder or alcoholism is referred to as having a dual diagnosis. Dual diagnosis (sometimes also referred to as co-occurring disorders) means you simultaneously struggle with the symptoms of a mental health condition and a substance use disorder. If you are one of the millions of individuals who face this struggle, know that you are not alone. It is estimated that as many as half of those who seek treatment to help manage and recover from the symptoms of a mental health condition also have a substance use disorder.
It is not uncommon for people who struggle with overwhelming symptoms related to a mental health condition such as depression to turn to alcohol as a way to relax or reduce the intensity of their symptoms. Inevitably, chronic, regular drinking can lead to new or worsening mental health symptoms. This means using alcohol to self-medicate or manage your symptoms without seeking mental health treatment may not provide any form of lasting benefit. Conversely, it could make your condition worse. Also, using alcohol to cope with depression may lead to worsening dependence on alcohol or alcohol addiction.
Understanding the best treatment options and how to choose the best treatment facility requires understanding depression and how depression and alcohol addiction are related. When someone struggles with depression, it is more than just being temporarily sad or upset. Ongoing symptoms of depressions require comprehensive, evidence-based treatment to help you learn to manage and cope with symptoms in a safe and healthy way. Unfortunately, many who struggle with depression will never seek or receive the treatment that they need to overcome their symptoms. Some will turn to alcohol to reduce the intensity of their symptoms, increasing their risk for alcohol-related conditions and dependency.
Struggling with both alcohol addiction and depression means you experience symptoms of both conditions simultaneously. It can be challenging for treatment providers to address dual diagnosis conditions because the symptoms of each separate disorder are often significantly intertwined. In the past, it was necessary to address mental health conditions and addiction in separate treatment programs at different treatment centers. This treatment process often meant that many people did not receive the help they needed to thoroughly address their mental and physical health needs. Additionally, one condition would frequently go untreated or undertreated, leading to symptom relapse and the need for further treatment.
Fortunately, the way mental and medical health professionals address dual diagnosis conditions has changed. Today, the unique needs of dual diagnosis patients are better understood. Although research has yet to provide evidence that shows whether one condition "causes the other," it is clearly understood that the symptoms one experiences when they struggle with simultaneously occurring conditions can lead to harmful coping mechanisms.
If you or a loved one struggles with a dual diagnosis condition, the best opportunity to safely and successfully overcome symptoms is choosing treatment at a dual diagnosis treatment center. It is important to remember that not all treatment facilities are equipped to manage the needs of dual diagnosis treatment, and therefore, it is important to do your research before choosing a treatment program.
Feeling blue or “down in the dumps” from time to time is a normal human emotion. Everyone has moments where they don't feel happy, or they feel overwhelmingly upset about a particular situation or event. When this occurs, we usually refer to these emotions as feeling "depressed." For many, these feelings are only temporary. Often, they will resolve within a short window of time after the event or situation resolves. Clinical depression, or simply depression, is different. The emotions you experience when you have depression are for more than temporary feelings of sadness.
In the mental health community, depression is also referred to as major depressive disorder or clinical depression. These conditions are characterized by overwhelming symptoms of emptiness, sadness, or irritability that affect your ability to function in your day-to-day environment. Without treatment, these symptoms can become so overwhelming that they lead to a loss of function at work and home. For someone to meet the clinical diagnostic criteria for depression, these symptoms must last for a minimum of two weeks. Additionally, the symptoms you experience during depressive episodes must be different from your previous level of functioning. In other words, your symptoms must lead to a clinically significant change in mood and ability.
Although not the most common mental illness, depression is believed to affect one out of every fifteen American adults. This averages out to approximately 7% of adults over the age of eighteen each year. Additionally, another 16% will experience depression at some point in their life. Depression is an illness that can occur at any time; however, it generally appears in one’s early teens through mid-20s. Similar to other mental illnesses, depression is more likely to affect women than men. Some studies indicate more than 1/3 of women will experience major depression at some point in their life.
The National Institute of Mental Health defines several different depression forms. Each form is slightly different and may uniquely affect each individual.
Two other types of disorders that are sometimes categorized with depression include bipolar disorder and postpartum depression. Postpartum depression is unique as it only occurs with females who have given birth. Sometimes called the “baby blues,” postpartum depression usually occurs within two weeks after delivery and may evolve into major depression. Bipolar disorder is included as a type of depression because someone with bipolar disorder will naturally experience depressed moods that meet the diagnostic criteria for major depression.
Many people wonder if drinking alcohol can cause depression or, conversely, can depression cause alcoholism. Some research does indicate a direct link between alcohol use disorders (alcoholism) and depression. Each disease can increase the risk of developing the other. Additionally, struggling with the symptoms of one or the other can worsen symptoms of both. Both conditions rank among the most prevalent mental health conditions and frequently co-occur.
There are a variety of reasons why one may develop a co-occurring alcohol use disorder and depressive disorder. Some may be genetically susceptible to both conditions. Others may experience overwhelming depression symptoms for which they turn to alcohol to manage. It is not uncommon for someone who experiences depression symptoms to turn to alcohol to help reduce the intensity and severity of their symptoms. Unfortunately, this leads to reliance or dependency on alcohol to help relieve symptoms and improve mood. Chronic self-medication through alcohol will eventually lead to an alcohol use disorder.
An article in the Journal of the American Medical Association (JAMA) Psychiatry also points out that there may be a direct link between alcohol use disorders and the development of major depressive disorders in certain individuals. A vast body of research has proven that alcohol can lead to depressive symptoms. Additionally, regular and ongoing alcohol consumption can worsen depressive symptoms in those who already experience depressive disorders or who may be vulnerable to the condition. When someone experiences depression that is linked to drinking alcohol, they may notice the symptoms reduce or stop altogether if they stop drinking. However, research indicates that substance-induced depression (depression resulting from drinking alcohol or using drugs) generally evolves into a clinical or persistent depressive disorder.
Alcohol addiction (also referred to as alcoholism or an alcohol use disorder) is a disease characterized by an overwhelming craving to get and use alcohol despite being aware of the harmful and destructive impacts of ongoing drinking. When someone struggles with alcohol addiction, they experience structural and functional changes to the brain. With ongoing alcohol use, the brain changes how it works to accommodate for alcohol being present. In time, dependency on alcohol develops, and the ability to carry out specific functions or feel certain emotions without the presence of alcohol becomes challenging.
Many people turn to alcohol to help control and reduce symptoms of depression. Ironically, using alcohol to manage depression frequently leads to the exact opposite effect. In some cases, using alcohol as a way to cope with depression can lead to another form of depression known as alcohol-induced depression. Alcohol-induced depression or alcohol-induced depressive disorder is the state of depression that occurs only during or in the time shortly after alcohol intoxication or alcohol withdrawal. In most cases, symptoms of depression specific to alcohol use resolve within three to four weeks of ongoing sobriety. It is important to note that substance-induced depression or alcohol-induced depression is different than traditional depression diagnosis. For diagnosis of alcohol-induced depression to be given, the severe symptoms one experiences after or while drinking must be directly related to intoxication or withdrawal. Symptoms of depression cannot be present prior to the onset of drinking or withdrawal for symptoms to be considered alcohol-induced depression.
At a dual diagnosis treatment facility, you can expect a multifaceted treatment program. Most programs begin with a comprehensive assessment (or intake interview), followed by detox, therapy, and aftercare. The assessment process is a vital first step as it allows your treatment team to learn more about your mental health, depression symptoms, and your relationship with alcohol. It also provides the opportunity for providers to ask questions about your medical and mental health. The intake process helps give a clear understanding of your current physical and psychological health to ensure your treatment plan includes therapy models that focus on your unique treatment needs and goals.
The following step in dual diagnosis treatment is detox. During detox, you will safely and successfully wean off alcohol under the safety of medical supervision. Depending on the severity of your addiction, this process may take several days or several weeks. Throughout detox, a team of skilled medical professionals will monitor your physical and emotional health to ensure your safety and success. Once detox is complete, you will transition into the therapeutic portion of a treatment program. Depending on your specific needs, you will participate in various therapies designed to help you learn more about your symptoms and how to manage them adequately, and how to manage triggering situations after treatment ends. As a 30, 60, or 90-day treatment program comes to a close, members of your therapeutic team will work with you on a comprehensive aftercare plan designed to ensure that you have the ongoing support and guidance you need in the earliest and often most challenging days of recovery.
If you or a loved one struggles with a dual diagnosis like depression and an alcohol use disorder, seeking dual diagnosis treatment is a vital part of your recovery. Although treatment of any kind is an important first step, completing a treatment program that addresses the needs of only one condition increases your potential for relapse in symptoms and a return to using alcohol to cope. Not all treatment programs are designed to treat dual diagnosis conditions, and therefore, it is vital to find one where your treatment needs will be met.