People who use recreational drugs such as cannabis, ecstasy and heroin often notice changes in their mood. At times these changes may be so severe that they are frightening, and could be part of a depressive illness.
Depression and recreational drug use are both common and can occur together purely by chance as individual problems. More often, however, there is an interaction between the two and this can take several forms:
- a person may be suffering from depressive symptoms and take drugs in the hope of gaining some relief
- depressive symptoms may develop as a direct result of taking drugs, or as part of withdrawal symptoms when drug-taking stops. (Low mood in withdrawal may be brief and self-limiting, but sometimes it can lead to a serious, prolonged depressive illness.)
- a person may take drugs to ‘escape’ from a problem during a particularly stressful time in their life; this stress may also be the trigger for an episode of depression
- heavy drug use can lead to major financial problems, difficulties with relationships or trouble with the law. A person taking recreational drugs is likely to have more of these pressures, which may trigger depression
- people who are depressed may use recreational drugs in an attempt to end their life
- drug use is particularly common in other psychiatric illnesses (such as post-traumatic stress disorder or some anxiety disorders and phobias) that can also have depressive symptoms, even if the main problem is not depression itself.
Why do recreational drugs have these effects when people take them to feel good?
There are certain chemicals in the brain (called neurotransmitters) that are key to the way we feel – in other words they control our emotions. It is the levels of these chemicals that are altered in depression. Recreational drugs also affect these chemicals. This is why drugs alter the way we feel.
Neurotransmitters are affected by different drugs:
- dopamine is affected by cocaine, amphetamines and ecstasy
- serotonin (or 5-HT) is affected by ecstasy and LSD
- noradrenaline (Norepinephrine) is affected by amphetamines, opiates (heroin, morphine etc)
It is largely these three chemicals (dopamine, serotonin and noradrenaline) on which antidepressant medicines work.
So what does all this mean for someone who feels depressed and who is using drugs?
It means that to be able to help them effectively, doctors have to sort out what role the drugs play in the depression. If the feelings of depression are simply part of the withdrawal from a drug and are temporary, it is unlikely that antidepressant treatment will be of benefit; antidepressants take an absolute minimum of two or three weeks to start working. The best help in this case is to try to help the person to get their drug use under control or stopped.
Both taking drugs and the withdrawal process can produce depressive symptoms, so it is very difficult to know exactly what is going on, even if it seems that the depression led to drug taking in the first place. As a result, it is vital to sort out the drug problem so it is possible to judge whether antidepressants or other treatments for depression are needed.
This doesn’t mean it is impossible to treat the depression when someone is still taking drugs, but it does make it more difficult.
Getting some help if you feel depressed:
Your family doctor will be able to advise you and, if necessary, arrange for you to see a general psychiatrist or a specialist in drug problems (often a psychiatrist, nurse or psychologist). See below for organisations that can help you seek help, or if you live in Calderdale, contact us.
It is important that you are honest about your drug use with any doctor, nurse or other professional you are seeing, otherwise they will find it very difficult to work out how best to help you.
The Depression Alliance is a leading UK charity for people with depression. Click Here to visit the web site.
Rethink, is a national mental health membership charity, that works to help everyone affected by severe mental illness recover a better quality of life. Click Here to visit their help and advice on depression.