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Drug and Depression Rehab
How Dual Diagnosis Treatment Works

Given the intricate ways that drug addiction and co-occurring depression can impact your daily life and complicate the recovery process, it is vital to receive professional help at a drug and depression rehab that can provide comprehensive treatment for both conditions. Only those programmes equipped to handle depression as well as drug addiction will be able to assist with an accurate diagnosis, detoxification process, professional counselling services, and aftercare planning.
In this article, you’ll learn more about:

What is depression?

Depression is a mental health disorder characterised by a persistent feeling of sadness and loss of interest that lasts for a long period of time. It’s okay to feel sad and overwhelmed sometimes, but if those negative emotions persist over a long period and start impacting your mental and physical health, as well as relationships and work life, it may be time to get help.
According to The American Psychiatric Association (APA), the most common signs and symptoms of depression include:
  • Feeling sad, depressed, or irritated 
  • Reduction of physical movements
  • Lack of joy and interest in hobbies and activities 
  • Thoughts of suicide and death
  • Problems concentrating and inability to make decisions
  • Feeling hopeless, worthless, and guilty
  • Lack of motivation and energy
  • Insomnia / hypersomnia
  • Loss of appetite / increased appetite
If you have experienced five or more of these symptoms nearly every day within a two-week period, you may be diagnosed with having depression.
Student suffering for depression in young age

Common types of depression

Gaining a better understaning of depression, and of its different types, can be the first step in getting help and feeling better. The most common types of depression are:

Also known as Manic Depression, Bipolar Disorder leads to severe mood swings. Often the affected individual will go through periods when they feel overly elated and joyful, followed by very dark moods that leave them feeling hopeless.

This is a condition that results in continual feelings of hopelessness and sadness. Major Depressive Disorder is usually diagnosed when symptoms have continued for more than two weeks.
Mostly in relation to people who live in colder countries where there are long periods of darkness in winter months, this type of depression can often pass when the weather warms up. Symptoms include weight gain, heaviness in limbs, feeling sad, and oversleeping. SAD symptoms must persist for at least two consecutive years for a person to be given a formal diagnosis.
This condition causes individuals to suffer from delusions, paranoia or hallucinations. It can cause sleepless nights and for the person to feel as if someone or something is trying to harm them. Psychotic Depression often leads to affected individuals losing interest in personal grooming and self-care.
Also known as dysthymia, this condition relates to regular symptoms of depression that persist for more than two years. Unlike Major Depressive Disorder, these symptoms are not regular. Sometimes the person will experience minor depression, while other times they will be crippled by severe symptoms such as suicidal thoughts, insomnia and anxiety.

Co-occurring depression and drugs abuse

There are many ways that drug abuse can affect or contribute to depression. It’s often difficult to determine whether a person starts abusing drugs due to feeling depressed, or whether their substance abuse causes depression, or whether an underlying third factor causes both of the above issues.
This complexity comes from the fact that many drugs – both illicit and over-the-counter – when used for long periods of time can cause symptoms that are similar to depression. Drugs change the balance of dopamine and serotonin in the brain – creating feelings of highs and lows that can lead to someone believing they need to take more of a drug to feel ‘better’. Likewise, depression itself also drives many people to self-medicate with drugs, thereby perpetuating this harmful cycle.
Other types of challenges may increase risk factors for both drug abuse and depression. Underlying brain abnormalities or chemical imbalances, genetic issues, previous experience of trauma, and high stress levels may contribute to either or both of these conditions.

Drugs that are often linked to depression

The most common types of drugs that may cause exacerbate depressive symptoms include:

Marijuana abuse and depression

Cannabis or marijuana is known as a drug that relaxes and causes positive feelings – but research shows that heavy use of this drug can lead to anxiety and depression, particularly for those who have a family history of mental illness or are otherwise pre-disposed to mental health issues. While cannabis can temporarily ease the symptoms of depression, most people will experience negative emotions again once they have come down from their high.

Stimulants and depression

The most commonly used stimulants taken by those suffering from depression include: cocaine, prescriptions stimulants like Adderall, methamphetamines, MDMA, and amphetamines. These drugs, which cause a short-term boost of energy and happiness, are often taken to ease the symptoms of depression. Once the high fades, users will feel depression again and reach for the drug to make them feel better. A professional rehab for drugs and depression may be necessary in order to determine the cause and effect, and deliver the appropriate treatment.

Criteria for Substance Use Disorders

The four groups of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnostic criteria for Substance Use Disorders are listed below. People with six or more of the following conditions (across all categories) are considered to have a severe disorder, meaning that rehab is likely necessary.

Impaired control

  • A substance is often taken in larger amounts or over a longer period of time than was intended
  • There is a persistent desire or unsuccessful effort to cut down or control substance use
  • A great deal of time is spent on activities necessary to obtain the substance, use the substance, or recover from its impact
  • Cravings or a strong desire or urge to use the substance

Social impairment

  • Recurrent substance use resulting in a failure to fulfill responsibilities at work, school or home
  • Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance
  • Important social, occupation, or recreational activities are given up or reduced because of substance use

Risky use of substance

  • Recurrent substance use in situations which it is physically hazardous
  • Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is to have been caused or exacerbated by the substance

Pharmacological criteria

  • Tolerance, as defined by either a need for markedly increased amounts of the substance to achieve intoxication or desired effect, or markedly diminished effect with continued use of the same amount of the substance
  • Withdrawal, as manifested by either: the characteristic withdrawal syndrome for the substance; or the substance (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.

When to seek help for addiction and depression

Although it’s common for someone with a mental health condition to also be dealing with a drug addiction, admitting that you need help is a challenging first step. You might think that your drug use is under control, or that your feelings of sadness are just ‘part of life’ – but if they are affecting your everyday activities, you should consider treatment at a drug and depression rehab.
If you’re not sure whether you need help, ask yourself the following questions:
  • Is my depression and addiction stopping me from doing things that I want to do such as sport, dating, or pursuing career goals?
  • Have my attempts at trying to pull myself out of depression and cutting back on my drug of choice been unsuccessful?
  • Have my loved ones expressed fear and concern about my drug usage and changes in my behaviour?
  • Have I become accustomed to the effects of the drugs and needing to consume larger amounts to achieve the same high?
  • Have I experienced physical withdrawal symptoms, such as irritation, agitation, measure, or cold sweats?
  • Have I experienced psychiatric symptoms such as depressive episodes, flashback or panic attacks?
  • Have I used drugs to cope with feeling down or depressive moods?
  • Have I used emergency services for acute intoxication, self-harm or suicide attempts?
  • Have I engaged in dangerous behaviours and/or put myself in legal difficulties?

If you answered ‘yes’ to one or all of the above, an integrated dual diagnosis rehab programme can help you take the first step towards getting your life back on track.

Drug and depression rehab

Drug and depression rehab is a multi-stage service that begins with diagnosis and then a period of detox if necessary. These are followed by various forms of behavioural therapy (delivered in one-on-one as well as group settings), to provide you with the mental tools and positive mindset you need to move past drug addiction as well as depression. 

Residential treatment centres allow you to focus on your recovery goals, while removing most external pressures and stresses that drug addiction can bring. All the while, rehab centres provide additional support both during and after your main period of care, to maintain your progress and prevent a relapse.

How rehab treats depression & drug abuse

The first element of rehab for drugs and depression is the likely need to embark on a period of detoxification. Depending on the type of drugs you have been using, your withdrawal symptoms may be intense. In such cases, it is essential that you detox and stabilise before commencing the next phase of the treatment process.
Once the detoxication process is complete, your will embark on a treatment plan that involves both conditions being treated simultaneously. If you stay in an inpatient rehab centre, constant support and advice will be made available so that you can be guided to recovery by experienced counsellors.
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The complex symptoms of both depression and substance use require a comprehensive and integrated treatment programme in order to achieve long-term recovery. Your treatment plan should include elements of the following:

Detox and withdrawal management

  • Detoxification is defined as a set of interventions aimed at managing acute intoxication and withdrawal.
  • A key aim of this stage is to cleanse your body of drugs, help you resist the physical urge to self-medicate, and preparing you for successful treatment of each condition
  • Detoxification is an important part of addiction treatment, but should form only the first stage of a continuum of care

Medication for depression

There are many different types of medications available to treat depression. These include:
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • Atypical antidepressants
  • Tricyclic antidepressants (TCAs)
  • Monoamine oxidase inhibitors (MAOIs)
  • Other medications or combinations of antidepressants
A full list of options will be discussed between the client and their medical team
Psychological therapies
A number of evidence based therapies can be effective in treating both drug addiction and depression, such as:

Cognitive Behavioural Therapy (CBT): A widely used approach, CBT centres around one-on-one conversational interactions with a trained counsellor. The method is used to build clients’ cognitive and emotional toolkit, helping them learn new ways to manage and direct their thought processes toward positive ends.

Dialectical Behaviour Therapy (DBT): DBT utilises both individual and group therapy to encourage an outlook based around acceptance and change. This evidence-based method uses mindfulness, emotion regulation, and other related approaches to promote internal improvement and self-control.

Assertive Community Therapy (ACT): ACT helps clients accept their feelings and emotions without judgment, as a way of coping with and embracing the complexity of life. This method allows clients to look forward rather than backward, and prepares them to meet the coming challenges with maturity.

Contingency Management (CM): CM uses a rewards-based system to encourage constructive behaviour, and maintain motivation toward continuous improvement.

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12 Steps methods

Many rehab centres use the 12-step method popularised by Alcoholics Anonymous as the foundation for their treatment model. 12-step programmes provide a popular and in many cases effective framework for drug addiction and recovery. Clients at a 12-Step-based rehab receive a variety of interventions and will work through the steps during their treatment programme. These rehabs may host NA meetings on-site, or take clients to off-site 12-step meetings.

Ongoing recovery plan

To help avoid relapse, post-treatment support is often provided by drug and depression rehab centres. This support may involve helping you to join a 12-step group such as Narcotics Anonymous, connecting you with a local therapist, or providing ongoing counselling on an outpatient basis.

Drug and depression facts

  • Depression and drug addiction commonly occur together
  • Individuals with depression and drug addiction are a higher suicide risk
  • Depression is the biggest cause of relapse
  • Quitting drugs will usually make depression worse initially
  • Over half the people who go to rehab for drug addiction also suffer from a mental illness
  • Long-term treatment for both conditions is the most effective way to recover

Why choose inpatient drug and depression rehab

Most outpatient rehabs and smaller clinics are not equipped to handle complex cases such as a dual diagnosis, which is more difficult to treat than a single condition. Clients often require support from different treatment providers in different segments of the healthcare system, which can lead to poor communication, fragmented services, medical errors, and insufficient continuity of care.
The best place for dual diagnosis treatment is at a residential drug rehab facility where the stressors and distractions of daily life are removed. As an inpatient in a drug rehab centre you will be able to focus all your attention on building better coping mechanisms and new, positive, thought patterns.
Research shows that the most common cause of drug relapse is an untreated underlying psychological condition. Similarly, the most common cause of psychiatric relapse is drug abuse. Residential rehab gives you the chance to gain treatment for both conditions at the same time, reducing this risk.

The following are reasons why integrated care lends itself to a residential rehab approach:

  • Access to medications such as antidepressants, mood stabilisers and antipsychotic agents to ease withdrawal and mental health symptoms 
  • A range of psychological treatments available, including individual and group therapy, as well as therapy and support for loved ones
  • Removal from stressors and triggers from your home environment
  • A range of resources that provide support for clients’ psychological, medical, and psychosocial needs 
  • Integrated treatment plans that encompass detoxification, addiction, and mental health needs
  • Clients will learn coping skills and strategies to deal with everyday life triggers and prevent relapse
  • A chance to explore the relationship between your alcohol use and depression, and develop personal recovery goals
  • Strong peer support, providing social interaction and connection among clients
Get help for depression and drug abuse
As the third most popular country in the world for medical tourism, Thailand is the perfect place to consider seeking treatment for drug addiction and depression. With its world-class facilities and drug addiction and depression programmes, Thailand offers considerable cost savings for treatment when compared to comparable levels of care in the UK, Canada, and Australia.
Thailand’s medical professionals and rehab centres meet recognised international standards, with Western counsellors who have a great deal of training and experience providing treatment for drug abuse and depression.
Rehab in Thailand can help you break away from the habits and temptations of your current day-to-day life. You will also have the opportunity to participate in fascinating cultural and social exchanges that you would never have experienced at home.
Are you ready to kick your drug addiction and emerge from depression? Take the first steps to recovery by contacting us for a free consultation with one of our clinical specialists.
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Author
Cameron Brown
Psychologist
About the Author
  • “What Is Depression?” Edited by Ranna Parekh, Psychiatry, The American Psychiatric Association (APA), www.psychiatry.org/patients-families/depression/what-is-depression.
  • Godier-McBard, Lauren & Park, Rebecca. (2015). Does compulsive behavior in Anorexia Nervosa resemble an addiction? A qualitative investigation. Frontiers in Psychology. 6. 10.3389/fpsyg.2015.01608.
  • Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006.
  • NIDA. “Common Comorbidities with Substance Use Disorders.” National Institute on Drug Abuse, 27 Feb. 2018, https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders. Accessed 25 Feb. 2020.

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