Addiction is a complex and deadly illness that affects millions of people around the world. Many people who struggle with addiction also have underlying mental health issues, such as depression, anxiety, or bipolar disorder.
This makes treatment even more difficult as both the addiction and the mental health condition need to be addressed simultaneously. In some cases, the mental health condition has nothing to do with the addiction, while in others they’re closely linked.
While every situation is unique and needs to be evaluated by a trained medical professional, it’s possible that antidepressants can help with either your underlying depression, depression caused by your addiction, or some of the symptoms of addiction, like cravings.
Addiction is a chronic disease that affects the brain's reward, motivation, and memory systems. When we engage in pleasurable activities, such as eating, exercising, or socializing, our brain releases a chemical called dopamine, which creates a sense of pleasure and reward.
Drugs and alcohol can also trigger the release of dopamine, leading to feelings of euphoria and pleasure. Over time, repeated drug use and abuse can change the way the brain functions, making it harder to experience pleasure from everyday activities — this is called anhedonia.
When your brain function is changed this much, staying sober can be much harder because you’re not enjoying life the way you did before drugs and alcohol. A sober life can feel boring and dull when all the things that used to make you happy don’t anymore.
This by itself can lead to depression and is a reason many people go back to using — it can seem like life just isn’t worth living without substances. The reality is that this is untrue: your brain just needs time to heal.
Antidepressants may be able to speed up that process, helping your brain get back to the way it used to function.
People with depression may turn to drugs or alcohol as a way to self-medicate, temporarily relieving their symptoms. However, this can quickly spiral into addiction as the brain becomes dependent on the substance to feel good.
On the other hand, people with addiction may develop depression as a result of the toll that addiction takes on their life, relationships, and overall well-being. This can create a vicious cycle where depression leads to addiction and addiction leads to depression.
While they can certainly help, antidepressants are not necessarily the only answer to this problem. If you’ve caused wreckage in your life during your addiction, you may need something like the 12 steps to fix that wreckage, which can in turn help you feel better about yourself and your life.
If your depression is coming mostly from a place of guilt, shame, and regret, that might be all you need to treat it.
However, if you were suffering from depression before you ever took a drink or used a drug, it’s not likely that your depression will just go away because you got sober or worked the 12 steps.
While the brain can certainly heal itself over time, a lot depends on the extent of the damage you caused.
The type of drugs you were using, how much you used, how often you used, how often you overdosed, if you hit your head when drinking or using — all of these things play a huge role in how much your brain can actually heal.
If your brain chemistry is fundamentally damaged, you might need more than some time sober to fix it.
Antidepressants work by balancing the levels of certain chemicals in the brain — such as serotonin, norepinephrine, and dopamine — which can become imbalanced in people with depression and addiction.
While antidepressants are not typically used as a standalone treatment for addiction, they can be a useful tool in conjunction with other therapies, such as counseling, support groups, and behavioral interventions.
By alleviating the symptoms of your depression, you may be less likely to turn to drugs or alcohol as a way to cope.
Additionally, some antidepressants, like Wellbutrin, have been shown to reduce cravings for drugs and alcohol, which can make it easier for you to resist the urge to use.
In fact, it’s been known for decades that Wellbutrin may help with addiction. From cocaine and methamphetamine to nicotine and even video game addiction, Wellbutrin seems to be effective at reducing cravings for a wide variety of addictions.
However, this single drug isn’t right for everyone. What’s most important is that you talk with a psychiatrist who can decide which medication is most likely to help you given your unique situation.
There are several types of antidepressants that are commonly used in addiction treatment. Selective serotonin reuptake inhibitors (SSRIs) are one of the most widely prescribed types of antidepressants.
They work by increasing the levels of serotonin in the brain, which can improve mood and reduce anxiety. Other types of antidepressants include serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs).
Your psychiatrist will work with you to determine which type of antidepressant is best suited for your needs. It’s critical that you talk to a psychiatrist before you start any of these medications as not every type is appropriate for everyone.
For example, SSRIs and some other antidepressants carry a risk of inducing mania in people with bipolar. It’s also recently been found that antidepressants will affect people differently based on their genetics. For example, an SNRI might work better for you than an SSRI based on your genetic profile.
Many people are getting genetic testing done before starting these drugs to avoid trying antidepressants that might not work or might have serious side effects.
While antidepressants can be a useful tool in addiction recovery, they are not without potential side effects. Common side effects of antidepressants include nausea, dizziness, headache, dry mouth, and sometimes weight gain or weight loss.
More serious side effects, such as suicidal thoughts or behavior, can also occur in some individuals, particularly in children and young adults. It’s critical that you talk to your psychiatrist about any potential side effects and report any unusual symptoms right away.
Despite the potential side effects, there are many potential benefits to incorporating antidepressants into your recovery plan. By addressing your depression directly, antidepressants can help to improve overall well-being and quality of life.
They can also make it easier to stick to other aspects of your treatment plan, such as counseling or support groups. After all, if you’re so depressed you can’t get out of bed in the morning, it’s not likely you’ll make it to IOP or a session with your therapist that day.
What’s most important is that you work closely with a psychiatrist when trying to choose the right medications to take and the right dosages to take them in. Sometimes you just need to try a different medication. Sometimes you just need to increase or decrease the dosage.
The unfortunate reality is that, even with genetic testing, it’s not always clear which medications are going to be best, or even why. It can be frustrating and overwhelming to try one medication after the next with no benefits and only side effects, but when you find the right medication at the right dosage, it becomes far more likely that you’ll stay sober long-term.
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