抑郁和成瘾

Medically reviewed:06/20/2018
Last updated:04/17/2020
Author:上瘾.com Medical Review

Reading Time:7.minutes

What is Depression?

Depression is a severe mood disorder, characterized by negative emotions, low energy, and difficulty anticipating pleasure or happiness. Many depressed people feel sad, but for some, the dominant feelings are anxiety, irritability, emptiness, or guilt. Some depressed people sleep far too much, while some are restless and have persistent insomnia. Depression can manifest in many different ways in different people, but it always impacts the quality of life and interferes with daily functioning.

Depression is also very common among individuals who suffer from substance abuse disorder, and experiencing both is known as aco-occurring disorder, or dual diagnosis. For some people, depression is the reason they began using drugs or alcohol in the first place, but chronic drug or alcohol use can also cause depression. No matter which problem came first, what’s important is that an individual struggling with both depression and substance use disorder receives dual diagnosis treatment to address both issues.

What are the Signs and Symptoms of Depression?

如果你或你爱的人是抑郁,then at least some of the following signs will have been present nearly every day for most of the day for at least two weeks:

• Persistent “empty,” sad, or anxious mood
• Feelings of worthlessness, guilt, or helplessness
• Irritability
• 悲观情绪或绝望的感觉
• Restlessness or trouble keeping still
• Low energy or fatigue
• 集中，记忆和决策困难
• Feeling “slowed-down.”
• 睡眠困难such as insomnia, waking up too often or too early, or sleeping too late
• Lack of pleasure or loss of interest in activities, hobbies, or social events
• Changes in appetite or weight
• Unexplained aches and pains, cramps, headaches, or digestive problems
• Thoughts of death or suicide

您无需体验列表中的每一个症状被视为沮丧。无论您是患几个或几乎所有这些标志，您都在遇到某种形式的抑郁症，并可以从治疗中受益。

Types of Depression

• Major Depression:严重的抑郁症会影响个人的吃，睡眠，工作，学习，社交，照顾自己，享受生活的能力。主要抑郁症严重损害了几个月或多年的运作，并且往往是慢性的，并且在多次发作中的复发。
• 持续抑郁症：Depression that persists for at least two years, often featuring ups and downs, i.e., some episodes of severe depression alternating with episodes with milder symptoms.
• 产后抑郁症：Severe depression induced by hormonal changes combined with the physical and emotional challenges of giving birth and caring for a newborn.
• 季节性情绪失调：Depression that occurs in the winter months and can sometimes be improved with light therapy.
• 精神病抑郁症：When depression is accompanied by psychotic symptoms such as delusions or hallucinations.

Depression can also include high levels of焦虑and even panic attacks.

While episodes of major depression can make someone temporarily unable to function in daily life, some people suffer from what’s known as “subsyndromal” depression, meaning they experience just a few depressive symptoms that negatively impact their quality of life, but still allow them to continue functioning somewhat normally.

抑郁症的风险

Approximately 16.2 million Americans age 18 and up experienced an episode of major depression in the past year, and 10.3 million of these episodes resulted in significant functional impairments. Some of these Americans will only ever experience a single depressive episode in a lifetime, but for many, depression is a chronic, recurring disorder, with episodes lasting months, or even years.

未经治疗的抑郁症不仅对个人和每个人关心的人的生活质量造成了影响，但它也与许多严重的风险相关。

与抑郁症相关的风险包括：

• Pain or physical illness
• Unhealthy weight gain or loss
• Drug and alcohol misuse
• 家庭和关系问题
• Social phobias
• 焦虑和恐慌症
• Social isolation
• 自残
• 工作或学校的困难

Depression can also lead to premature death or suicide.

英年早逝：Depression impacts physical health in a number of ways. Stress has many proven adverse health effects, and these will naturally be exacerbated by the poor self-care found in most depressed individuals. The fatigue and hopelessness of depression will also keep many individuals from seeking needed medical care or fully following through on treatment regimens or lifestyle changes required to cure or manage any other disease they may have. The misuse of alcohol and drugs associated with depression can contribute to premature death as well, as can obesity, which is another common risk of depression.

Suicide:严重的抑郁症通常导致自杀思想和自杀企图。有时这些尝试是成功的。滥用药物或酒精的人是自杀的六倍，使任何人都患有双重诊断的抑郁和物质使用障碍，以极大的宽松自杀。

How Does Depression Interact with Addiction?

In 2016, approximately 19 million American adults had a substance use disorder, and 43.3% of those individuals experienced a co-occurring mental illness that same year. Misuse of addictive substances makes people far more vulnerable to mental health problems. Thirteen-point-eight percent of American adults with a substance use disorder also had a severe mental illness in 2016, compared to only 3.4% of adults without a substance use disorder.

美国在美国有超过两百五十万人的成年人对物质使用障碍和共同发生的精神疾病进行了双重诊断。超过30％的成年人，他滥用物质滥用也与抑郁症斗争。这些问题之间的相当大的重叠表明，大规模需要同时针对这两个问题的协调治疗计划。

Consider the example of someone who struggles with酒精和抑郁症. If they are treated for alcohol use disorder but not depression, their depressive disorder will make them likely to start drinking again. Conversely, if they are treated for depression but not alcohol use disorder, any improvements in mood and functioning will be short-lived, as excessive drinking will cause their depression to return.

What Causes Depression?

抑郁症最常是由不同因素的组合引起的，这些因素可以是生物，遗传，心理或环境的。

People facing serious illnesses such as cancer, diabetes, or Parkinson’s disease often deal with depression. Sometimes this is psychological, due to the severity of the disease, but sometimes depression is a side effect of medications or treatments prescribed to treat the disease. As was stated earlier, misuse of drugs or alcohol also often leads to depression.

Other risk factors for depression include:

• A family history of depression
• Trauma
• 睡眠剥夺
• Major life changes
• 慢性应力

It should be noted that all the factors with the potential to cause depression also have the potential to lead to substance use disorder. This is because difficulties in life can lead some individuals to self-medicate, trying to soothe negative mental and physical states with addictive substances. These common factors are also why a dual diagnosis of depression and addiction must be treated comprehensively, with careful attention paid to all aspects of each problem.

How are Depression and Addiction Treated?

There is a significant treatment gap in the United States today, with far too many people struggling from substance use disorders not getting treatment. In 2016, some of the most significant treatment gaps were seen for individuals suffering from both addiction and mental illness. Of the approximately 8.2 million Americans in need of dual diagnosis treatment, 51.9% did not receive any form of treatment, 38.2% received only mental health treatment, and 2.9% received only substance use treatment. Only 6.9% of these 8.2 million received the dual diagnosis treatment that they needed.

The combination of alcohol and depression is a significant problem in the United States, especially when it comes to treatment, or the lack thereof. Fifty-six-point-three percent of people with depression go untreated, 78.1% of people with alcohol use disorder go untreated—and the overlap between these two groups is considerable.

好消息是,抑郁和substance use disorder can be effectively treated if an individual allows themselves to receive professional help. Furthermore, many of the same treatments that work for depression also work for substance use disorder, as long as the counselors, therapists, and patients tailor the approach to address the various issues unique to both sides of the dual diagnosis.

People suffering depression and addiction will get the necessary comprehensive treatment at arehabilitation facilitythat specializes in dual diagnosis. This may be an inpatient program, where the patient lives full-time at the treatment facility, or an outpatient program that allows the patient to continue living at home while receiving treatment. The ideal recovery plan should take a “step-down” approach to dual diagnosis recovery that starts with inpatient care, then moves to outpatient care, and then to aftercare.

Aftercare通过在他们的治疗中心参加校友活动，帮助恢复人们保持健康，定期与辅导员一起检查，或参加同行支持小组会议。帮助患者找到稳定的住房，职业培训或就业的服务也是一个很大的帮助，让人们恢复变得更加独立。只有在自我意识，自力更生和自我照顾中才能实现成功的长期恢复。

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy或者是CBT，是抑郁和成瘾的最有效治疗之一。CBT用于抑郁症通常通过帮助患者确定延长抑郁症状的消极思维模式和虚假信仰。然后治疗师与患者替换与更健康，更现实的想法的消极情绪和虚假。随着时间的推移，从消极的思想转向一个积极的思想，从故意努力变为一种习惯，令人抑制的症状逐渐改善。CBT有助于患者学习健康的应对机制，使他们能够有效地应对生命压力源和冲突，以便抑郁发作不会重复。它还引导患者在感知的转变中，使他们能够更积极地解释生命事件和环境。

成瘾的CBT通常始于帮助患者识别触发物质使用的思想，情况，情感和环境。然后，患者了解如何避免可以避免的触发器，并且对无法避免的那些触发器的更健康的反应。像抑郁症的CBT一样，成瘾的CBT还教导了日常应对技术，帮助患者有效地应对寿命的起伏，而不会转向物质，以及感知的变化，使得曾经标记为消极的事情可以重新解释在更积极的光线下。