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What came first, the depression or the addiction?

Professionals in the addiction and recovery field have a saying: Alcohol and drug addiction can cause mental illness but mental illness does not cause addiction. There is definitely a strong relationship between mental illness, such as depression, anxiety, and bipolar disorder, and substance abuse. When gone undiagnosed and untreated, a mental health disorder can trigger the use of alcohol and drugs, known as self-medicating.

A lot of times, people being treated for substance abuse and addiction and who have been diagnosed with depression or some other mental health disorder will ask, “did my drinking or drugging cause the depression?” And the answer to this is always a resounding… “maybe.” There are ways to determine which came first: the depression or the addiction.

First of all, did you know that any mental health diagnosis made within 6 months of the person’s last use is not necessarily accurate?

I have personal experience with this one. I was in the midst of my active addiction when I landed in the hospital psych ward for a suicide attempt. I am clear that have had experienced depression from an early age – about 11 years old, and therefore before I ever started using alcohol or other drugs. I was medication compliant – meaning that I was good about taking my anti-depressants on a regular basis even while actively using illicit drugs. And this could have been a precipitating factor in my suicide attempt. When using other drugs on top of your prescribed medications, this can yield your medications ineffective or cause them to have a stronger and unwanted effect, such as wanting to kill yourself. Back to the hospital psych ward…so, as the drugs are leaving my system, I start to display the behaviors and characteristics of someone with bipolar disorder. Now that I’m clean and sober, I am positive that I do not, in fact have bipolar disorder although I do still have depression for which I take an anti-depressant.

So, in my case, the depression came before the addiction but, the other mental illness I was diagnosed with, bipolar disorder, was a symptom of my addiction.

A well-trained professional in the field of psychotherapy can locate the source of the depression in order to distinguish whether it existed before the person developed their addiction or is a result of their alcoholism or drug addiction.

Why is it important to know what came first, the depression or the addiction?

Someone who had depression before they began abusing substances will more than likely need treatment, including ongoing medication, as compared to someone whose depression was caused by the abuse of chemicals while in active addiction. Basically, someone whose depression was caused by substance abuse generally will not need the same treatment as someone whose depression started before their substance abuse. In either case, dual diagnosis treatment is ideal for treating both the depression and addiction.

If you or someone you love is struggling with substance abuse or addiction, or are seeking dual-diagnosis treatment, please call toll-free 1-800-951-6135.


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