Struggling With Depression in Opioid Addiction Recovery

MastHead Outline
April 17, 2018
Girl sitting down on the steps in front of he house looking down depressed and struggling

The link between mental illness and addiction is more common than you may think.  

Depression and Opioid Withdrawal Symptoms

If you’ve gone through drug withdrawal or have watched someone go through the process, you know how difficult it can be and how the body and mind can be at odds with each other. Aside from the physical pain and discomfort, people can sometimes experience debilitating depression. This can make recovery much more difficult to achieve in the long term. Dealing with depression and opioid addiction isn’t easy, but thanks to developments in modern medicine, there are several ways to tackle the problem. One question we can ask ourselves is, why does it occur in the first place? 

Coping with Depression During Opioid Addiction Recovery

Depression in opioid addiction recovery occurs when there is a malalignment of dopamine and serotonin in the brain. It becomes an even more volatile chemical imbalance that worsens when someone suffering from opioid use disorder stops using an opioid substance. This offsets the brain chemistry in your head because opioid addiction alters the reward pathway of the brain. Because of this symptoms of depression are more intricate and difficult to manage without medical intervention.  

The two main chemicals that affect mood, dopamine, and serotonin, take time to reach normal levels again in recovery. Until then, they won’t be released at the same levels as they once were before the drug was withdrawn. This causes the low mood or “blues” that many people suffer from, especially when first beginning treatment.  

Link Between Depression and Opioid Misuse 

Depression and opioid use are often interlinked. Opioids not only lead to withdrawal and depression but also serve as a coping mechanism for untreated symptoms.

Recently, people with pre-existing depression received opioids for pain management, reporting increased happiness from the drug’s euphoric effects, often when misused. Before current guidelines, medical professionals overlooked the connection between prescription opioid misuse and depression.

With new emerging information, researchers have found that depression can predispose people to develop chronic pain conditions. Studies have reported that people with depression experience altered pain sensations and can be more sensitive to pain in general. In other words, depression heightens pain and opioid misuse, spiraling into an addiction and depression cycle.

Lady sitting on the bed looking like she is battling depression or going through opioid withdrawal.

Mental health challenges in opioid withdrawal

Contrary to popular belief, depression isn’t just a persistent low mood. Although this can be present, it is best described as a feeling of total apathy and a loss of positive emotions. People suffering from this condition frequently report problems like: 

  • Anhedonia (loss of pleasure in previously pleasurable activities) 
  • Apathy 
  • General weakness 
  • Chronic pain 
  • Disturbed sleep patterns 
  • Mood swings 
  • Feelings of hopelessness 
  • Anxiety 
  • Suicidal ideation 

Some people who suffer from depression can suffer so much that they relapse to self-medicate. A study in the International Journal of High-Risk Behaviors and Addiction studied two groups of people. One group of people relapsed and the other group are non-relapsed individuals recovering from substance use disorder. According to the study results, people who suffered from extreme depression were twice as likely to relapse than those who didn’t suffer from severe depression. 

Post-acute Withdrawal Syndrome and Depression 

Depression after opioid addiction is sometimes part of post-acute withdrawal syndrome (PAWS). This is a debilitating condition that can cause tremors, seizures and a high heart rate, among other symptoms. Even in the weeks to months that follow drug withdrawal, people can start to feel mood problems like depression.  

PAWS can show in people who are attempting recovery on their own or someone who is undergoing medication-assisted treatment (MAT). Thankfully, MAT individuals benefit from opioid maintenance, easing painful withdrawal symptoms and the effects of sudden changes in brain chemistry.  

Still, PAWS can occur later into treatment, with delayed symptoms that manifest once a patient has been on their medication for quite some time. This can certainly become frustrating for those who are working hard in recovery, but there are solutions to overcome PAWS-related depression while sticking with a MAT program.   

Methods of Treating Depression in Opioid Addiction Recovery

Dealing with depression is difficult for anyone, but the effects described above show just how important it is to find ways to cope, especially for those who are working hard in their recovery. 

Counseling: Substance use counseling is an integral part of any effective, comprehensive medication-assisted treatment program. The counselors who oversee individual and group counseling sessions understand that patients often need a positive and encouraging support system. This support helps them to overcome the many ups and downs of the recovery journey. 

Exercise: Physical activity stimulates dopamine and serotonin release in the brain, helping to boost mood and overall health. Even just 30 minutes of moderate exercise a day can make a big difference for many.  

Healthy diet: Healthy diets, primarily those high in essential vitamins and minerals, work to heal the body and correct a broken gut biome. There is scientific evidence that the gut and brain connection plays a significant role in maintaining prosperous mental health.  

Support system: Developing friendships and reconnecting with loved ones is a crucial part of the recovery process that can garner motivation and a sense of belonging that is often eroded by the spiral of addiction. 

Medication: Overseeing medical providers that treat MAT patients are frequently looking out for comorbidities that include mental illness, such as depression. They can prescribe anti-depressants to patients who may need help overcoming their struggles while maintaining their sobriety.  

Advanced psychotherapy: Additional behavioral therapy is sometimes required for patients in MAT who struggle with persistent anxiety and depression symptoms.  

Depression and opioid addiction can be difficult to manage at the same time, but you don’t have to do it alone. Finding the proper treatment and help can give you the fighting chance you need to keep you steady on your recovery journey. To learn more about medication-assisted treatment (MAT) at AppleGate Recovery and the many benefits of office-based outpatient treatment for addiction, message or call the nearest location today.