Signs of Depression – Treating A Co-Occurring Disorder


Signs of Depression – Treating A Co-Occurring Disorder

Understanding Depression and the Signs of Depression

Everyone gets sad from time to time. We all experience periods of sorrow, from a loved one passing away, a relationship breakup, losing a job, or failing an important test. It’s normal to feel grief, but for many, the painful emotions don’t go away. They may have a clinical disorder known as depression – the prolonged sadness and apathy that continues for at least two weeks and significantly disrupts normal life.

Depression is a common co-occurring disorder in victims of substance abuse. Many people choose a life of drugs and alcohol to dull the feelings of depression. Others try very earnestly to quit but feel defeated and worthless when they fail. The chemical effects of various drugs further complicate their imbalance with feelings of psychological dependence. Drug addicts easily feel depressed, anxious, and even contemplate suicide after not taking the drug regularly. As their heart rate slows down and they become increasingly tired, drug addicts can lose the will to fight depression.

Therefore, it’s important to treat drug addiction as more than just the physical withdrawal from the substances. Substance abuse as a co-occurring disorder (COD) deals with the complete care of the person’s mental, emotional, and spiritual well being to also treat their independent psychological disorder. A rehabilitation center that just detoxed drugs and managed withdrawal may not prevent some people with a COD from later becoming homeless, incarcerating, dropping out of school, or commit suicide.

The debilitating effects of drugs can mask the symptoms of depression and make it difficult to treat separately. It’s important that any care center have a thorough screening and evaluation process to ensure their patients receive the right care. That being said, no single test can identify someone as suffering from a form of depression. Feelings of sadness can be subjective and difficult to measure. A quality rehab center must have a wide range of professionals to give a complete diagnostic, especially mental health therapists.

Types of Depression

For you to recognize and treat the disorder, it’s important to understand that there are many different forms of depression, including:

  • Major Depression Disorder – also known as unipolar depression, this form includes 2 weeks or more of feelings of low moods and is often accompanied by feelings of low self-worth, lack of energy, weight loss, and lack of interest in hobbies. If someone consistently exhibits at least 5 of the major symptoms, their doctor may diagnose them with major depression.
  • Persistent Depressive Disorder – also known in the medical field as dysthymia, this form describes someone with symptoms of depression that last 2 years or longer. Though normally not as severe as major depression, this kind significantly affects the person’s livelihood for years by making it difficult to manage relationships, work, and school.
  • Bipolar Disorder – also known as manic depression, someone suffering from bipolar disorder will have episodes that range from extreme “high” moods and self-esteem to dangerously “low” periods of depressive periods. During the low mood swings, they experience all the characteristics of major depression disorder.
  • Seasonal Affective Disorder – simply abbreviated SAD, this form of depression is associated with the winter seasons when the days are shorter. Doctors aren’t sure exactly what causes, but the lack of sunlight may impact someone’s sleep pattern and serotonin levels. Almost 10% of Alaskans experience SAD where it is night for most of 10 months of the year.

Warning Signs of Depression

Depression can vary in its duration with different forms, but, generally, depression cripples a person’s self-image. They can exhibit this outwardly by staying in bed all day, refusing to communicate, self-harm, and lose their appetite and interest in things they once loved. Many people suffering from depression may feel shame or guilt and try to hide their true feelings.

You should always be genuinely hospitable and give intentional love and attention. Maintaining a strong bond of trust is key to understanding the person’s struggles and helping them get the right treatment. At the same time, don’t be too invasive or give the person more reason to feel guilt or shame.

Please don’t take it personally if the individual losses of interest or communication with you. Someone suffering from grief may just need space for a time, yet their depression cannot be left untreated. Be very careful in approaching the situation in offering treatment, like counseling or medication.

When you have a genuine connection to the person, you may notice certain signs that they are suffering from a form of depression, from physical, emotional, and cognitive issues. Warning signs that persist and control their lives are an indication the person suffers from depression. Watch for things such as:


  • Insomnia or excessive sleeping
  • Losing their appetite or overeating
  • Significant weight changes
  • Having unexplained pain or weakness
  • Headaches
  • Excessively tired


  • Having a short temper
  • Being unfocused and confused
  • Having poor hygiene or not caring about their appearance
  • Loss of interest in activities they once loved, including sex
  • Obsessing over thoughts and constantly rethinking situations
  • Isolating themselves from loved ones
  • Crying excessively


  • Feelings of hopelessness, guilt, and shame
  • Feelings of nothingness, like having a blank mind
  • “Feeling down”
  • Feeling as if they are alone and no one cares about them

Depression and Suicide

About 50% of people who suffer from major depression commit suicide. In total, about 121 people tragically commit suicide a day in the United States. Prolonged feelings of hopelessness can drive someone over the edge. Drug addiction only makes the struggle worse as depressed people can unintentionally die from an overdose. If someone talks about suicide, even in a light joking manner, be very vigilant and seek help immediately. Pay close attention if the person:

  • Says things like “things would be better if I wasn’t around” or “no one would miss me anyway”.
  • Suddenly switches from appearing very sad to extremely happy
  • “Tempting fate” by taking risky actions like running red lights, leaving the stove on, taking too much medication.
  • Getting things in order, like changing a will or selling property randomly
  • Drawing or writing scenes of death or other similarly disturbing things
  • Committing self-harm

Abusing drugs and alcohol puts someone at a high risk of suicide, even if they do not show signs of depression a COD. Studies show that men who abuse substances are about twice as likely to commit suicide and women are over six times likely.

Do you know someone depressed with a substance abuse? Riverside Recovery offers a holistic approach to care to give them the best chance of getting their life back! No one is beyond recovery! Give us a quick call today!


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