There is a strong connection between mental health and substance use disorders. Results from the 2019 National Survey on Drug Use and Health revealed that 31.3% of adults with any mental illness were binge drinkers compared to 25.3% of adults with no mental illness. Also, 49.4% of adults with mental illness used illegal drugs, compared to only 15.7% who had no mental illness. When someone struggles with a mental illness, like depression and a substance abuse problem at the same time, they have a co-occurring disorder or dual-diagnosis.

Roughly 9.5 million American adults reported having a dual diagnosis in the 2019 NSDUH survey on Drug Use and Health. The reason is that people with mental health issues like depression turn to alcohol or drugs as they try to cope with sad feelings. On the flip side, depressant drugs and alcohol can increase feelings of fatigue and sadness, and people can experience depression as the effects of drugs wear off or as they face the impact of addiction.

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Which one comes first – addiction or depression?

Whenever addiction and depression are discussed together, the question becomes, which one comes first. The basic addiction disease model dictates that substance misuse changes the brain so that it can’t self-regulate. For many, depression serves as a gateway to addiction. For others, substance abuse can lead to depression. Either way, these two disorders always seem to co-occur.

Depression and substance abuse

Everyone has bad days, whether it’s because of loss, relationships, family, or workplace issues. Most people shake the feelings off and get on with their lives. But for people with depression, the periods of unhappiness don’t go away. They feel sad, helpless, and worthless for days to weeks. Depression is a severe mental health problem that affects about 10% of adults in the US. Data from the Centers for Disease Control indicate the following as risk factors for depression.

People with depression tend to turn to drugs to try to relieve these depressive symptoms. As estimated, one-third of people with major depressive disorder engage in substance abuse as a way to self-medicate to relieve feelings of despair, low self-esteem, and hopelessness. Unfortunately, abusing alcohol and drugs doesn’t resolve these feelings. It only makes them worse. In fact, it can lead to depression symptoms like sadness, hopelessness, lethargy and in some cases, they can turn to acts of self-harm.

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Types of depression

There are many different types of depression. Here are some common examples:

Major depressive disorder (clinical depression)

Major depression is a common type of depression that affects about 7% of people in the US. If untreated, the major depressive disorder can recur throughout the person’s life.

Persistent depressive disorder (dysthymia)

Persistent depressive disorder is a chronic form of depression that lasts for a year or more. Since it's milder, it’s usually easier to cover with drugs or alcohol. However, the condition may eventually lead to major depressive disorder.

Seasonal affective disorder

As the name implies, seasonal affective disorder is seasonal, mostly happening in winter months. The disorder is diagnosed when someone exhibits the symptoms of depression over three consecutive winters.

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Depression as a gateway to addiction

Depression serves as an entry point into alcohol and drug use. As mentioned earlier, those struggling with depressive disorders turn to substances to escape the symptoms of depression. But drugs don’t do much to help them feel better. If anything, one feels worse once the effects of drugs start to wear off. Yet, the person keeps using it to try to forget their problems. It is like a catch 22. Eventually, their bodies become tolerant and need larger doses to attain the same effects.

At this point, they can’t stop using or reduce intake because of withdrawal symptoms like trembling, nervousness, agitation, cold, sweats, or nausea set in. So they may start feeling sad and guilty because they are abusing drugs. Some try to quit cold turkey. But with the withdrawal symptoms and mental disorder, it’s almost impossible.

Besides, quitting leads to an even stickier situation for those with severe depression. People who’ve been abusing substances for years may have a more pronounced depression when they stop using. It is, therefore, a good idea to seek dual diagnosis treatment that addresses both issues in one go.

Why depression leads to addiction

Depression itself isn’t a cause of substance abuse – but it makes one more susceptible to addiction. The inability to cope with hard feelings and life stressors is one of the causes of depression and addiction. Here are some ways depression may lead to addiction.

Feelings of guilt and shame make one scared to ask for help

People struggling with depression are afraid to ask for help. They fear that people will judge them for their condition, so they choose to keep it to themselves. Again, unlike other medical conditions, it is hard to identify the symptoms of depression. So, even if the person gathers the courage to seek help, they may find it hard to explain what they’re going through. So, most people may turn to substances as a way to cope.

Not knowing its depression

One of the hidden risks of drug use is that mental health issues happen gradually. So, a person might not even realize they have depression. So, they’ll take stimulants to keep up with work or a bottle of wine to try to cheer up. When someone doesn’t know they’re dealing with a mental disorder, they’ll keep up with the unhealthy coping mechanism.

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Being scared of psychiatric drugs

Many people are afraid of taking psychiatric medication, not just because of how others will view them but also because of the “damaging effects.” They are scared that the drugs will change their personality or ability to function and that they might not handle the side effects. So they turn to drugs assuming that they are a safer option. Alcohol and drugs offer instant fixes without the hassle of getting a prescription.

There’s hope for co-occurring disorders

Luckily, dual disorders are treatable. If you or someone close to you is struggling with addiction and depression, it’s a good idea to enroll in a rehab that offers holistic treatment. This way, you won’t have to treat depression or addiction separately.

Have you ever wondered why people use more drugs during the holidays than any other time of the year? Well, as it turns out, holidays can be a mixed bag of emotions. Although people look forward to the season, it is not uncommon for loneliness, grief, financial strain, family conflict, and seasonal affective disorder (SAD) to creep in. Many overindulge during the holidays, not just because of the countless opportunities for using substances, but rather the need for extra comfort because of heightened stress.

The fact is that holidays aren’t holidays for those who find themselves burdened with other additional obligations and tasks while their everyday lives must go on as usual. So they tend to be more vulnerable and so inclined to succumb to drug use because stress sources multiply. This, at least, may be one reason why people use more drugs during holidays. But there are more reasons, as you will notice in this article.

Using drugs during the holidays

A holiday season isn’t entirely to blame for drug use issues, but it contributes, of course. It’s the time of year when people are more inclined to participate in different social events where drugs and alcohol are the glue that holds everything together.

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Alcohol is sometimes the focal point of holiday celebrations.

Again, many people base expectations about holidays on unrealistic displays of healthy, affluent families from TV ads and shows. But this only fuels anxiety during the holiday season. When someone tries to live up to what they see on TV, yet it is not realistic, they may become anxious and try to numb their feelings with drugs.

Seasonal pressures arise from various sources, including financial obligations, increased demands on time and energy, and even final exam and grade reports. There’s usually a ton of extra demands. People want to do it right, so they end up becoming exhausted.

Seasonal affective disorder or winter depression is also pretty common around this time of year. SAD is a type of depression linked to low-light conditions that occur during long, dark winter months.

Here are the reasons why people use more drugs during the holidays:

Family problems tied to using drugs

Holidays evoke images of family bliss: loved ones gathering around a fireplace, lots of music and dancing, gift exchanges and catching up, etc. But for many, this dreamy image is usually nothing more than that – a dream.

For some people, a holiday is a time of loneliness because they live far from family or have lost their loved ones. For this group, holidays can be a time of sad memories and additional stress because it reminds them of relationships they don’t have. Some may turn to drugs and alcohol to blow off some steam or disconnect with the world.

The same applies to people who dread holidays because of family drama and strained relationships. The thought of a perfect holiday gathering can make a normal social tension unbearable.

Financial stress

Lack of finances is a common reason for seasonal sadness. One survey by the American Addiction Centers revealed that finances and gift-giving were the leading cause of holiday stress. An average person spends about $750 on gifts. And this figure can go even higher for those with more children, friends, co-workers and so on.

While gifting may not seem like a problem, it can be a major depressor among those who are strained financially. The effects of this stress can be detrimental on many levels and may lead to an increase in drug use during the holiday seasons. Studies show a strong connection between substance abuse and depression. For some, this stress becomes too much to bear and many with deep mental health issues can succumb to suicide.

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Stress around the holidays can come from a variety of sources. Loneliness, anxiety, financial worries can all lead a person to using drugs or alcohol to cope with their pain.

Holiday anxiety

Large gatherings, tense family relationships, and all the preparations can be overwhelming to some people. This is because of the constant worry that something might go wrong or that people will judge. Social anxiety is also pretty common around holidays, considering many events involving groups of peers, friends, and families. People with anxiety issues turn to drugs to help lessen the anxiety – though this only worsens the situation.

A study by the American Psychological Association and Greenberg Research tried to find out those who suffered from elevated stress levels during holidays, and the findings were surprising. Of the respondents in the study:

A sad, anxious, stressed, or angry person might lose sleep and be unable to focus on the celebrations and events happening around them. And as it turns out, these mental disorders often travel in the company or drug abuse. Drugs may help one feel less inhibited and more comfortable in social settings. But anxiety robs one the ability to know when enough is enough, or that drugs in any amount can be dangerous, or that they need therapy and treatment and not drugs for their disorder.

Personality

Impulsivity, a personality trait, is a risk factor for substance misuse. Those who are struggling with addiction assign higher values to immediate values than the delayed ones. And with lots of events, parties, and the general craze going on, the impulsivity only tends to heighten during holidays.  

Nostalgia

Nostalgia, a sentimental yearning or longing for the past, is a big part of the holiday season. Like birthdays and anniversaries, holidays trigger nostalgia because they act as temporary landmarks. Nostalgic depression is a holiday syndrome and may be accompanied by feelings of bitterness, helplessness, anxiety, and depression. It is common among loners with a history of family disruption.

Nostalgia is beneficial as it helps people cope with boredom, grief, and loneliness. It also strengthens social connectedness and reinforces a sense of identity. But to some extent, nostalgia can be toxic. Toxic nostalgia is especially harmful to recovering addicts, as it can make them believe that the time they spend using drugs is worth returning to. It may also make them forget all about the negative impacts and stresses of addiction that made them quit in the first place.

Seasonal binge-drinking

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Traditions can be hard to break. For many, drinking to excess has been a normal part of their holiday experience, for most of their lives.

It doesn’t come as a surprise that people indulge in seasonal binge-drinking during the holiday season. In fact, the Distilled Spirits Council of the US says that a quarter of the $49 billion-a-year profits in the distilled spirits industry come from late November through to New Year. So whether it’s peer pressure or excitement or the desire to unwind, people – including the moderate drug or alcohol users – tend to increase their consumption rates. Moderation is rarely taken seriously during holidays – with many believing that they’ll compensate for all their bad consumption in January. So, they keep overindulging in drugs, alcohol, and even food.

When all these things come together, one is likely to experience symptoms like:

Unfortunately, these symptoms can have far-reaching effects, especially for those with no support systems. In addition to using drugs, the symptoms can increase the risk of suicide, personal injury, violence, and relapse. That is why it’s essential for those who experience such symptoms to get professional help. It also helps to have friends to talk to whenever sad memories or feelings of loneliness come up.

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