29 June 2019

Addiction – the Elephant in the Room with Depression and Anxiety

depression-as-as-cause-for-alcohol-drug-addiction
Over the last decade, successful campaigns in Britain have encouraged people to talk about their mental health. From taxi drivers to teachers, athletes to actors, plumbers to politicians, we’re finding our voice as a nation – particularly about depression and anxiety, the most common mental illnesses.

In conversations with friends, at work and community events, in TV debates and soap operas and social media posts, we are collectively bringing mental illness out of the shadows. With one in four people affected each year by mental health disorders, this is excellent progress for individuals and society.

However, there’s a piece of the puzzle that is still too often missing from the national debate about mental health – addiction. It’s time to talk openly about the dual diagnosis of mental illness and addiction, as part of the same conversation – because when they co-occur, they are never isolated issues.

In this post, we’ll discuss the importance of a person-centred approach to treating addiction, depression and anxiety. With holistic care, the lives of patients, carers and their families will improve.

UKAT provide assessments and treatment programmes for addiction and mental illness. Please contact us today for specialist help with a dual diagnosis.

Why It’s Vital to Talk about Addiction, Depression and Anxiety Together

As campaigners break through the stigma around mental illness, more people are feeling confident to go to their GP with mental health concerns. But many still feel pressure to hide or play down addiction. Sometimes patients lack insight or awareness around the mental health impacts of addiction. Others feel ashamed to ask for help due to negative stereotypes. Sometimes patients with legitimate prescriptions from their GP take other drugs purchased in pharmacies or online.

A two-way change is needed. It starts with healthcare professionals asking good questions about current or past addictions – particularly when new patients present with symptoms of anxiety or depression and if their mental illness gets worse. Addiction awareness will encourage more patients with a dual diagnosis to ask for the right help.

Too often, however, when GPs diagnose depression or anxiety, they don’t carry out thorough addiction assessments. Ten-minute appointments don’t allow the level of investigation that is needed. Important medical advice can be overlooked, such as:

  • Alcohol and drug use can cause or worsen depression and anxiety
  • Process addictions – such as gambling, food disorders or workaholism – can trigger, or be a reaction to, mental ill health
  • There are significant risks of excessive drinking or drug use, whilst taking many anti-depressant or anti-anxiety medications
  • Mental health medication could be ineffective if you’re suffering from undiagnosed bulimia or anorexia
  • Prescription drugs including anti-depressants can be addictive – coming off them can cause withdrawal symptoms that feel similar to a mental health relapse
  • Prescription drugs should only be tapered and stopped with close medical supervision.

Dual Diagnosis – 4 Reasons We Need Better Awareness and Treatment

It doesn’t matter whether the addiction came first or another mental illness like depression or anxiety disorder. Where they co-occur, they need to be assessed, treated and monitored together. Here’s why:

1. You can’t ‘snap out of’ addiction

Firstly, addiction is a mental illness, which often has physical health consequences. People who understand or have experienced addiction know this – but still there’s damaging narrative in society that addiction is a choice.

In the last decade, this unhelpful stigma has been challenged with depression and anxiety. It’s far less acceptable now to tell a person with depression to ‘snap out of it’ or an anxiety sufferer to ‘pull himself together’. The same attitude is needed towards all addictive disorders.

Driving every addictive pattern, there are mental processes that trigger cravings for drugs or drink, gambling or overspending, eating too much or too little food. Of course, alcohol and drugs can become physically addictive too – but there are always psychological factors underpinning the disease.

Therefore, the most effective addiction treatment helps people to detoxify or stop safely, whilst also offering psychological treatments to change the underlying thinking.

Talking therapies such as cognitive behavioural therapy, dialectical behavioural therapy, trauma therapy and psychodynamic counselling are used as much in addiction treatment programmes as they are for depression and anxiety disorder.

Alternative treatments including mindfulness, meditation, art therapy, music therapy and nutrition planning can be equally beneficial for people with addiction, as for depression and anxiety.

2. Addiction and mental illness symptoms can overlap

Addiction, depression and anxiety have many similar symptoms – for example, cycles of destructive thinking, low self-worth, unmanageable fears, extreme anger or sadness, self-harming thoughts or actions, a racing mind, lack of motivation and loss of hope for the future. These are all feelings and experiences reported as much by people with addiction, as with depression and anxiety.

In treating dual diagnosis, therefore, it’s essential that professionals have the knowledge and skills to understand the interplay between the conditions. Addiction can mirror, intensify or mask symptoms of depression or anxiety, and vice versa.

3. Relapse prevention

Depression and anxiety can become locked into a vicious cycle with addiction – leading to chronic relapse.

anxiety-concept
Take alcohol and anxiety, for example. Alcohol is a central nervous system depressant, so you might feel less anxious after a drink or two. However, the more alcohol you have in one session, the greater the withdrawal symptoms will be when you stop drinking. As your brain tries to rebalance after alcohol, you are likely to feel higher levels of anxiety than usual, triggering cravings for more alcohol.

For this reason, treating anxiety in isolation – without considering the mental health effects of excessive drinking – would be less likely to result in sustainable recovery.

4. Better healthcare services for people with a dual diagnosis

The more we bring the conversation about co-existing addiction, depression and anxiety into the open, the more healthcare services will have to adapt to patients’ needs.

Honest public debate helps patients to ask for what they really need. It also helps campaigners to persuade politicians to make a change. This includes fair funding for addiction treatment and mental health services, opening up referral pathways to organisations with the skills to treat dual diagnosis.

Please contact UKAT to talk about treatment for addiction with co-occurring depression or anxiety. You can recover. With the right support, there is always hope for a happier life.

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