Dual Diagnosis & Anti-Depressants

When an individual suffers from both a substance abuse problem as well as a mental health disorder, such as depression, anxiety, or bipolar disorder, it is referred to as a co-occurring disorder or a dual diagnosis. As these are two separate conditions, they require two separate treatment plans. It is however inevitable that the recovery process of one will affect the recovery process of the other.

What comes first?
A natural question to ask is whether the substance abuse causes the mental disorder or vice versa. There are several possibilities: the substance abuse could bring to the fore underlying mental disorders, substance abuse could worsen the symptoms of a mental disorder or the mental disorder could have led to self-medicating and eventual dependency on substances such as drugs or alcohol. Whatever the cause, these two factors are closely linked and should both be addressed in the treatment protocol. If only one condition is treated, the condition left untreated will continue to trigger the other one. Thus, if one suffers from depression and is simultaneously addicted to alcohol but only seeks treatment for the former, the alcohol will render the anti-depressants useless. Likewise, if one only seeks treatment for alcoholism, the depression in itself will continue leading to cravings for alcohol.

The role of anti-depressants
It has been estimated that up to a third of individuals suffering from addictions suffer from some type of depressive disorder. It has also been established that recovering addicts are far more likely to relapse if they are depressed. As such, the use of anti-depressants along with therapy for addiction is often prescribed for dual diagnosis. Despite this, recovering addicts are often wary to try anti-depressants and prefer to engage in a life of complete sobriety. This is also often advocated in the twelve-step recovery program in Alcoholics Anonymous. This is however a misconception.

Anti-depressants, although intended to lift your mood, do not produce the same high that one normally experiences from drugs such as opioids. Opioids produce an immediate high, which eventually becomes less and less intense, leading the user to take increased dosages to produce the same effect.

Anti-depressants, on the other hand, can take months to alter the mood of the individual. It is a moderate and progressive lifting of the mood, which is not abused by the increasing of dosages. It is thus often stated that anti-depressants do not pose a risk to recovering addicts. In fact, it is essential that substance abusers that suffer from depression treat their dual diagnosis effectively and at the same time.

The danger of anti-depressants
Despite the necessary role of anti-depressants in dual diagnosis, it is important to keep in mind that any long-term medication is to be approached with caution. In order to keep on the safe side, it is important to only get anti-depressants from a qualified practitioner and to consult with him or her regularly about your use and dosage.