Types of Depression.

Clinical | Chronic | Manic / Bipolar

Anxiety | Seasonal | Substance Abuse | Pregnancy | Postpartum | Menopause

Substance Abuse.

Substance abuse is the repeated use of alcohol or drugs despite the fact that it creates unpleasant or negative events in the user's life. The rates of substance abuse among adults in the United States has dropped from the levels of twenty and thirty years ago. However, there are some disturbing trends regarding drug use and youth. More children and adolescents are experimenting with drugs. And the drug culture is producing drugs of increasing purity and strength.

Signs of Substance Abuse

Often times an individual with a mental illness or mood disorder (depression) is able to hide their involvement with substance abuse. This is because many of the behavioral changes related to mental illness or mood disorder are similar to behavioral changes related to substance abuse. However, there are some signs of drug abuse that family and health care professional can recognize more easily:

• sudden money problems
• excessive time in the bathroom
• dilated or "pinpoint" eyes
• valuables disappearing from the house
• appearance of new friends
• appearance of drug paraphernalia
• needle marks

Does Substance Abuse cause Depression ?

There is no clear-cut answer to this question. Depression may be caused or precipitated by the use or abuse of substances such as drugs, alcohol or medications. However, the cause and effect relationship is a complex question that needs further study.

What is known is that alcohol or drug abuse may be signs of depression. Some studies state that 30% to 70% of alcoholics are suffer from anxiety and depression and that it is a way for these individuals to self-medicate.

The term that is used by mental health professionals to refer to a patient with both a mental health diagnosis and substance abuse is co-occurring or dual diagnosis.

Substance Abuse in the General Population

In a recent survey more than 16 million Americans ages 12 and older (7.1%) reported using an illicit drug in the past month. More than 12% reported illicit drug use during the past year and 41.7% reported some use of an illicit drug at least once during their lifetimes.

Most researchers agree that as much as 50% of the mentally ill population also has a substance abuse problem. Alcohol is the most commonly used drug, followed by marijuana and cocaine. In addition, prescription drugs such as tranquilizers and sleeping medications are also used with frequency.

Drug use among High School Seniors, 2002
Drug	Ever used	Past year	Past month
Amphetamines	16.8%	11.1%	5.5%
Cocaine	7.8	5.0	2.3
Crack	3.8	2.3	1.2
Hallucinogens	12.0	6.6	2.3
Heroin	1.7	1.0	0.5
Inhalants	11.7	4.5	1.5
LSD	8.4	3.5	0.7
Marijuana/hashish	47.8	36.2	21.5
MDMA (ecstasy)	10.5	7.4	2.4
Methamphetamine	6.7	3.6	1.7
PCP	3.1	1.1	0.4
Steroids	4.0	2.5	1.4
Source: Monitoring the Future Study

Treatment for Substance Abuse

Treating individuals with dual diagnosis of substance abuse and mental illness or mood disorder is complicated. First, these individuals usually resist treatment. Second, a complete and correct diagnosis is difficult because time is needed to unravel the interacting effects of drug abuse and mental illness. Third, housing can be problematic because they are not accepted at home or at community residences. Fourth, they loose their support systems and have frequent relapses. And lastly, they tend to be more violent. However, treatment is possible but it must be intensive, individualized and long term.

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