By Vivek Singh Chauhan
Far from offering any long-term solution to the problem of depression, abusing substances such as alcohol, opioids, and drugs like cocaine and heroin will only worsen it, health experts have warned.
People suffering from depression reach for drugs as a way to lift their spirits or to numb painful thoughts. But depression and substance abuse actually feed into each other and one condition often makes the other worse.
“Substances worsen the depression and cause dependence. It may also increase the risk of suicide and self-harm in people suffering from depression. Such people do not respond to the standard treatment procedures and their recovery gets delayed,” Mrinmay Kumar Das, Senior Consultant, Behavioural Medicine Department, Jaypee Hospital, Noida, told IANS.
Substance abuse also covers up the underlying depression, making it difficult for the clinician or therapist to address the root cause of the problem.
“Our body contains naturally occurring chemicals called neurotransmitters (dopamine) that bind to receptors throughout the brain and body to regulate pain, hormone release and feelings of well-being. This can be externally triggered with substance abuse,” Sandeep Govil, Consultant, mental health and behavioural sciences at Saroj Super Speciality Hospital, New Delhi, said.
“When substances are used for over a period of time, the brain gets used to the system of secreting the chemical, thereby increasing the levels. High levels of dopamine are said to worsen depression and may lash out with aggressive behaviour,” Govil explained.
A recent report by the World Health Organisation titled “Depression and Other Common Mental Disorders - Global Health Estimates” said the total number of people living with depression in the world is 322 million.
The estimated prevalence of depressive disorders in India is 4.5 per cent of the country’s total population, according to the report.
Usually, the symptoms of depression include a predominantly low mood on most days. Depressed individuals may feel a lack of interest in their favourite activities, feel physically exhausted, and sleep too much or too little.
They also tend to lose appetite and hence unwanted weight loss is often observed. There is also a feeling of guilt, hopelessness and worthlessness which may lead them to take extreme steps like committing suicide or self-harm.
For some individuals who have depression and a substance-use disorder, giving up on drugs or alcohol may be even more challenging. Those using alcohol for years to bury depressive symptoms find that depression rises to the surface in sobriety.
That is why it is so important to receive integrated treatment for both depression and substance abuse at the same time.
Without treating depression that drives addiction or vice versa, patients are likely to go back to their addictive behaviours or to experience a return of depressive symptoms as soon as they finish rehabilitation, the experts said, adding that earlier the people come out of their shell and talk about their mental health problems, the better.
Discussing depressive disorders and other mental disorders can help in identifying, managing and treating the problem at an early stage.
“People should come out and talk about their problems. Treatment at an early stage is easy, doesn’t need medication and can be managed through simple counselling techniques, and by using coping strategies that can be adapted individually or through help at home,” said Pallab Maulik, Deputy Director and Head of Research at The George Institute for Global Health India.
Research shows that only one in every 27 people with mental disorders receive any care in countries like India.
“Depression, unlike physical illnesses, requires much more than medical support -- like support of family, friends, and motivation to get well by talking about it,” Prashant Goyal, Consultant Psychiatrist at Sri Balaji Action Medical Institute in New Delhi, added.
