Self-Medicating: The Link between Depression & Substance Abuse

Self-Medicating: The Link between Depression & Substance Abuse
By Premier Forensic Dream Team Member, Anthony Botrus LMFT, with Dr. Alex Avila

 Originally published in OFFICES OF DR. AVILA: PREMIER FORENSIC PSYCHOLOGY EZINE, # 103  on 4/1/17

When faced with a psychological trauma, injury, or stress, our clients often face some form of depression.  A serious form of depression is known as Major Depressive Disorder (MDD), in which a client has a period of at least 2 weeks in which they have a depressed mood or the loss of interest or pleasure in nearly all activities.  When evaluating a client, it is important to determine the extent of his/her depression, and if there are any co-morbid (additional) mental health issues.

One of the most common co-occurring disorders for someone who has MDD is Substance Abuse. Research has shown that many of the factors that cause depression may also play a role in the development of addiction. A nationwide study of 43,093 adults found that for those suffering from a current alcohol addiction, over 20% also met the criteria for Major Depressive Disorder (Penatti & Dundon, 2011). Over their lifetimes, patients who were diagnosed with Major Depressive Disorder have an over 40% risk of developing an alcohol use disorder, and an over 17% risk of abusing other drugs (Penatti, O’brien, & Dundon, 2013).

Additionally, substance abuse co-occurring with depression is often difficult to diagnose, and ultimately treat—doctors have a harder time determining the cause of symptoms, as well as the type of medications to prescribe (Penatti et al., 2013). Sadly, depressed patients who engage in substance abuse also have greater risk of suicide, social and personal impairment, and other psychiatric conditions. In the case of depression and alcohol dependence, it is recognized that alcohol use is linked to a prolonged course of depression (Davis, Uezato, Newell, & Frazier, 2008).

Ultimately, it is important to realize that untreated depression can both lead to, and become further complicated, by substance abuse. It is imperative that clients who are victims of trauma or psychological injury (or mental adjustment issues) seek professional help if they are experiencing symptoms of depression since the risk of serious impairments increases with self-medication in the form of substance abuse.

References
Davis L., Uezato A., Newell J.M., & Frazier E. (2008). Major depression and comorbid substance use
disorders. Current Opinion in Psychiatry. 21 (1) 14-18.
Penatti, H.M., & Dundon, W.D. (2011). Comorbid Depression and Alcohol Dependence. Psychiatric
Times.  Retrieved on 3/30/17 from http://www.psychiatrictimes.com/major-depressive-disorder/comorbid-depression-and-alcohol-dependence/page/0/2
Pettinati, H. M., O’Brien, C. P., & Dundon, W. D. (2013). Current Status of Co-Occurring Mood and
Substance Use Disorders: A New Therapeutic Target. The American Journal of Psychiatry, 170(1), 23–30. http://doi.org/10.1176/appi.ajp.2012.12010112
World Health Organization (2017). Depression Fact Sheet. Retrieved on 3/30/17 from
http://www.who.int/mediacentre/factsheets/fs369/en/

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