Major Depressive Disorder, or Clinical Depression, How this Underestimated Mental Illness can Lead to Substance Abuse

Depression is a common word used in our western vocabulary and the idea of depression in our society seems to change from generation to generation. The word may mean different things to different people. Most people feel very decidedly one way or another about about the mental health disorder, depression. In past years, before real research was done around the disorder, sometimes people believed that depression was simply a feeling of unhappiness or self pity. They sometimes thought that it was a choice someone could make, to be sad, depressed, or negative.  Instead, these people often believed someone could, and should, choose to wake up everyday and decide to be cheerful and joyful, optimistic even. They believed that if you only “smile though your heart is aching” you’ll be able to live a content life. It turns out nothing could be further from the truth. There is absolutely nothing simple about this mental illness. It is a scientific fact that depression is caused by, “a combination of genetic, biological, environmental, and psychological factors,” according to the National Institute of Mental Health, depression is by no means a choice of the person struggling with it.

No One Chooses Depression

As stated above, depression, or major depressive disorder, is a result of multiple inputs that include genetic and environmental sources. According to the National Institute of Mental Health,

Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.”

Scientifically speaking, “depression” has a very specific definition that is miles away from the more superficial idea of what depression meant, that has sometimes been embraced by our society in the past. Depression is an actual medical mood disorder that causes dangerous symptoms if it goes untreated. However connotatively – the word “depression” – through consistent colloquial misuse by large swaths of society, continues to mislead some parts of the population to assume the definition of depression is a self indulgent kind of sadness.  


Some Symptoms of Major Depression

Feeling empty or hollowed out – People suffering from major depressive disorder or clinical depression sometimes experience a feeling of emptiness. They may feel like they are completely disconnected from themselves due to this feeling of emptiness.


Persistent sadness – “Sadness” is a word that is often used to mock depression, but the kind of sadness that someone with depression suffers from is not only persistent but pervasive. It can sometimes last for months at a time.


Worthlessness – A consistent feeling of worthlessness often permeates the lives of someone suffering from major depressive disorder


Guilt – Someone suffering from depression may suffer from a heavy guilt complex that can at times feel wholly overwhelming.


Hopelessness – People who are dealing with depression may often feel a sense of hopelessness that can lead to an experience of helplessness or unwillingness to care for oneself. This can feed other difficult symptoms of depression. Like a deviation from good hygiene habits,


Loss of interest in normal life activities – Loss of interest in the things the person is passionate about, the hobbies and favorite activities that might otherwise fill their lives


Restlessness – Someone suffering from depression may find themself fidgeting in an unconscious effort to have a place to put themselves or because they aren’t sure what to do with their body. Many people who suffer from major depressive disorder want to disappear and don’t feel comfortable around a lot of other people. This kind of self consciousness and social discomfort can sometimes manifest in an inability to stay still.


Lethargy – A dragged down feeling sometimes comes with depression. A person suffering from the disorder may move more slowly than usual and talk in a slower cadence. Depression often brings with it a literal and legitimate loss of energy and fatigue.


Insomnia – Sometimes people with depression have a hard time sleeping. They may not be able to get to sleep when they lie down at night, or it is possible that their insomnia may manifest itself by waking them up early in the mornings.


Oversleeping – Conversely, a common symptom of depression is an inability to get out of bed. People suffering from depression may feel like they just cannot sleep enough. This goes back to the lack of energy


Substance Abuse – Major depressive disorder, or clinical depression is one of the most common mental illnesses that co-occur with substance use disorder. A person suffering with depression may develop chemical dependency and addiction to a drug to try and numb some of the shame and hopelessness. However, it is also possible that someone suffering from drug or alcohol abuse and addiction may develop major depressive disorder or clinical depression, triggered as a result of the addiction. It’s often not possible to really pull the two disorders apart. They catalyze each other’s symptoms and can be extremely dangerous if not recognized and treated.


Suicidal Ideation – Tragically, many people who suffer from depression, especially those suffering from dual diagnosis of drug or alcohol addiction, also suffer from suicidal thoughts.  Some of the people suffering from this heartbreaking disorder end up actually go through with a planned suicide. Depression is a disorder that affects the person suffering from it, but often affects their family and wider community as well.


This list is not comprehensive and not every person who suffers from major depressive disorder, or clinical depression, experiences every one of them. The symptoms may ebb and flow over the course of a depressive episode, presenting as moderate to severe in nature. Depending on the type of depression someone suffers from, the depressive episode may last longer for some people than others.

Types of Depression

Persistent depressive disorder: Persistent depressive disorder is also known as dysthymia. This form of depression is the kind of diagnosis someone who suffers from a major depressive episode for a time period of over two years would receive. The depressive symptoms may vary in severity during the lengthy depressive episodes, however the depression will be ever present even when symptoms are less aggressive.


Postpartum depression: Postpartum depression is a type of depressive disorder that happens after a woman gives birth. In the past it has sometimes been referred to as “the baby blues”. The stigma around postpartum depression didn’t begin to crack until Brooke Shields, famous actor, came out as getting treatment and taking medication to treat her postpartum depression. She received great amounts of criticism but it did start the conversation about the disorder and more and more now doctors are legitimizing the disorder by diagnosing and treating women with the disorder.


Psychotic depression: Psychotic depression is a comorbidity. This is when two different disorders come together such as psychosis and the symptoms from that psychosis come through a depression lens. For example, if someone has delusions or hears and sees things that are not real, those hallucinations, that psychosis may show it’s form in delusions that produce feelings of sadness in the person, maybe feelings of inadequacy or shame.


Seasonal affective disorder: Seasonal affective disorder, or SAD occurs usually during the winter months. People complain about a general feeling of malaise  when there is less natural sun. When someone suffers from SAD they usually seclude themselves inside, but then start to re-engage during the spring and summer months. Some people treat SAD by using lights that are meant to mimic the sun.


Bipolar disorder:  Bipolar disorder, while a completely different disease from depression, is most certainly relevant here because people with bipolar disorder, in particular the type of bipolar disorder II, spend plenty of time in a depressive swing. Extreme lows of major depressive symptoms may afflict a person with bipolar II disorder most of the time as their mood swings are lower on the spectrum. A person with bipolar I disorder is higher on the manic side of the spectrum.


Dual Diagnosis and Treatment

Major depressive disorder is a valid disease that can lead to, or be aggravated by substance abuse. When drug or alcohol addiction and a mental health disorder occur in a patient at the same time this is called a co-occurring disorder or a dual diagnosis. This makes treatment for either disorder more tricky because it requires both disorders to be treated simultaneously in order to hope for success in recovery with either one. The two disorders spur each other on in something like sibling rivalry, ratcheting up the symptoms of each other as they intensify.


Luckily, FHE Health offers the best drug rehab in South Florida. Rehab and sober living houses in Florida offer FHE patients quality mental health rehab and excellent medical attention so that they can successfully complete treatment for both afflictions at the same time, providing them a solid foundation for their new way of living.


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