The rate of substance abuse throughout the United States has soared in the past few years, and the number of people reporting depression and opioid use has soared to levels we’ve never seen before. If you’ve ever wondered how heroin use relates to depression, much of it concerns people self-medicating to manage their symptoms.
Unfortunately, it turns into a cycle of potentially deadly consequences. A person feeling depressed might turn to drugs to cope. In the short term, they feel better, causing them to use more heroin. However, the longer they use it, the substance doesn’t produce the same effect, so they’re constantly chasing that high only to avoid withdrawal symptoms, not even because they like it anymore. This is a significant sign they’ve developed a substance use disorder (SUD), or they’re close to it. We’ll examine all of this below.
What Is Depression?
Depression is one of the most common health disorders affecting American children and adults yearly. According to the American Psychiatric Association (APA), major depressive disorder (MDD) affects one in 15 adults in a given year, equating to 6.7 percent of the population.
The principal authority for psychiatric diagnoses, as defined by the APA’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), defines major depressive disorder as a “serious medical illness affecting how you behave and think and causes persistent feelings of sadness and loss in previously enjoyed activities. Depression can also appear as an array of physical and emotional issues that disrupt your ability to function at home and work.
In order for your doctor to declare a depression diagnosis, the DSM-5 mentions the following criteria must be met – you must experience five or more symptoms during the same two-week period, and one of the symptoms should include a depressed mood or a loss of interest or pleasure.
- You experience a depressed mood most of the day, almost every day.
- There is a diminished interest or pleasure in all activities most of the day, almost every day.
- The individual experiences significant weight loss or weight gain even if they aren’t dieting – they’ll also experience an increase or decrease in their appetite each day.
- They’ll have a noticeable slowing of thoughts and reduced physical movement, which others notice.
- Loss of energy or fatigue that occurs daily
- Feelings of excessive guilt or worthlessness regularly
- An inability to concentrate, think, or be decisive nearly every day
- Recurrent and overwhelming thoughts of death, suicidal ideation without a specific plan, or suicide attempts
In order to receive a depression diagnosis, the symptoms must cause someone significant distress and impair their work, social life, and other areas of routine human activity. The symptoms must also not be the result of substance abuse or other medical conditions.
When Substance Misuse Is Present
According to the World Health Organization (WHO), the misuse of illicit drugs like heroin is considered substance abuse. However, before someone develops a substance use disorder (SUD), they first must become tolerant of the substance they’re abusing. In this, it’d be heroin, which means they no longer experience the same effects from a specific dose, and they’re forced to take more to achieve their desired result.
The following stage is dependence, meaning the individual needs the drug to avoid withdrawal. At this point, it’s unlikely they even get high off heroin – it’s merely consumed to prevent getting sick. Lastly, a substance use disorder is characterized as compulsive-seeking of heroin no matter the consequences.
The DSM-5 has outlined 10 of 11 criteria, dependent on the substance of abuse, marking what it considers a substance use disorder. Individuals who meet two or three of the criteria are considered to be mild, whereas four or five are moderate, and those meeting six or more are rated as having a severe disorder. The following must all occur in a 12-month period.
- The substance is taken longer than intended or in larger amounts.
- There is a persistent urge to cut down or control the use of the substance, but you constantly fail at these attempts.
- Most of your time is consumed trying to obtain the substance, using the substance, or recovering from the effects of the substance.
- You have an overwhelming, persistent urge to use the substance.
- The need to obtain, use, or recover from the substance begins to interfere with work, home, or family obligations.
- Using the substance causes recurrent social or interpersonal issues.
- You’ve given up important social, recreational, or occupational activities to chase getting high.
- You continue using the substance despite knowing that it’s causing physical or psychological damage.
- You’re using the drug even though you know it’s hazardous. For example, you know the heroin you’re buying is laced with fentanyl, but you use it anyway.
- You’ve become tolerant of the substance, meaning you often need more of it to become intoxicated.
- You experience withdrawal symptoms if you take less or run out.
Heroin Use and Depression: What’s the Relation?
Heroin is an incredibly potent and dangerous opioid drug derived from morphine. It’s existed for centuries and is naturally extracted from the seed pot of opium poppies. The drug can be snorted, injected, or smoked, and it has an unparalleled ability to hijack your brain.
It does this by attaching to naturally occurring opioid receptors throughout our body and brain and stimulating the release of dopamine, our body’s natural feel-good chemical. When you ingest heroin, it produces intense feelings of euphoria and causes your brain to associate heroin with rewards. Unfortunately, people can become addicted after the first time they use it.
You might hear that and think – well, how does that relate to depression? Heroin is a central nervous system (CNS) depressant. Not only does it restrict breathing, but it also slows down your functioning. When you’re diagnosed with depression, a heroin use disorder, or vice versa, your mental health issues will rapidly decline as a result of heroin misuse or abuse. Unfortunately, this can significantly increase the odds of a lethal outcome.
If both disorders go untreated, suicide becomes a terrifying but likely scenario. According to Dr. David Sack from Verywell Mind, “those who use substances are already at greater risk of taking their own life. When substance use is combined with depression, a leading cause of suicide, the risk of self-inflicted death grows exponentially.” Those with depression have around a ten percent lifetime suicide risk. Individuals with a substance use disorder are about the same, but when combined, those odds rise dramatically to 25 percent.
For those reasons, seeking treatment for both conditions is vital. If you go to professional addiction treatment for heroin abuse and don’t disclose that you’re dealing with depression, you’ll likely relapse once treatment concludes. This happens because you’ll still battle the root causes of what pushed you to use drugs, which is likely depression. Not only is this a waste of your time and money, but it can be dangerous. One of the leading causes of drug overdose deaths is when a person relapses and has no tolerance to the substance they were abusing, so they use the same dose they took during active addiction and lose their life.
Treating Heroin Addiction and Depression
When a person is struggling with heroin addiction and depression, it’s known as a co-occurring mental health condition. When it comes to heroin and depression, it’s a bit of a chicken or egg effect, meaning that someone who’s depressed and becomes addicted to heroin will need to stay in treatment longer than someone whose depression stems from heroin use. Either way, if you have an addiction and depression, dual diagnosis treatment is vital as it simultaneously treats your heroin use and depression.
Dual diagnosis treatment will help save your life and better understand the causes of your heroin addiction by getting to the root of the cause – depression. You’ll work with a therapist to determine what’s causing your depression. For example, is it environmental? Or is it a chemical imbalance that requires medication to remedy? You’ll finally have answers to the questions you’ve been wondering about for so many years up until this point. A life of addiction is no life lived at all. It’s time to get the help you deserve and bring a ray of hope back into a life that may have otherwise been filled with darkness. Don’t wait a minute longer.