addiction and depression
Statistics show that there is frequent comorbidity between addiction and depression:
In eating disorders, alcoholism, and drug addiction among young people, 30 to 50% are depressed.
In adults, depression is often about(80%) and suicide attempts prior to the addictive behavior are present in more than 60% of cases.
Discipline and obedience have given way to independence.
with regard to social constraints the individual is now increasingly individualized, alone, and left to his own devices.
The old bourgeois guilt and the struggle to free oneself from the law of the fathers give way to the fear of no longer being up to scratch.
The emptiness and impotence that result from the competition of individuals increase more competitive than cooperative.
The individual, acting yesterday by an external order or by conformity to law, now relies on his own springs and finds himself without a guide: “In the new normality and the new pathology, it is less a question of identification with well-drawn parental images or useful social roles than of asserting one’s identity and self”.
Hence the importance of the current narcissistic pathologies, borderline and depressive states.
Individual asserts himself without recognizing himself in the reflections and masks omnipresent in all strata and classes of society.
“If neurosis is a drama of guilt, depression is a tragedy of inadequacy”, and addiction a problem caomes from disappointment.
But what is the link between these two pathologies: depression and addiction? Are the depressive void and the addictive full the polarities of the same phenomenon? Can one engender the other? Can they interact to reinforce each other? Is addiction a defence against addiction and depression?
Addiction is a means of fighting depression; it abates conflict through compulsive behaviour.
Addictions embody the impossibility of complete self-gripping: the addict is a slave to himself… If depression is the story of a lost subject, addiction is the nostalgia of a lost subject,” according to Ehrenberg.
Depression is the familiar shadow of the man think of the undertaking
Becoming only himself and trying to support himself to the point of compulsion by addictive products or behaviors.
This bipolarity depression-mania present in cyclothymic or manic-depressive illness.
On the other hand, in the case of monopolar mood disorder, and essential depression, the defense mode requires the use of external and artificial products to provide the same effects of forgetfulness, euphoria, and denial of reality…”.
A depressive tendency often underlies drug-addicted behavior: a lack of self-esteem, flaws in the organization of narcissism can lead some subjects to seek in drugs an artificial and rapid means of restoring the self, or even of megalomaniacal triumph”.
Drugs are the object and not the reason for one’s malaise.
- This fight against depressive affects in the terminology of “masked depression”,
- widely used in children and adolescents in agitation, acting out, character disorders, aggressiveness,
- derision, flight, absorption of food, or products of any kind, seeking to mask what lies beneath the surface.
- Addiction is thus only a symptom of a deeper malaise than the object of its repeated and abusive consumption.
We, therefore, find two opposite poles of the same reality in the description of the two syndromes that are bipolarity and depression: sad/gay, inhibition/exaltation, passivity/activity, life/death…
In the depressed and/or addicted person, we often find the same very negative,
pessimistic and tragic images and beliefs of oneself and the world.
is the addicted person a depressed person who ignores himself?
DO DEPRESSION AND ADDICTION EMERGE FROM THE SAME PERSONALITY BACKGROUND?
Psychopathology and psychiatry textbooks describe a depressive vulnerability in a personality that is avoidant, obsessive, dependent, narcissistic or borderline :
- The avoidant personality tends to flee from contact and difficult reality, the escape into addictions.
- Into a different elsewhere, is a possible response when reality becomes too unbearable.
- The obsessive-compulsive personality by haunting ideas and struggles against pervasive compulsive acts such as sexual addiction or alcoholism through rituals of order or cleanliness.
- The dependent personality is sensitive to situations of loneliness and abandonment.
- In the absence of dependence on one person, can become dependent on a product.
- The narcissistic personality with an ideality of itself or of an external object, if this ideality collapses in the form of a depressive fall and disillusionment, the subject can then look for a dream, and elsewhere in the addiction, which this time will not disappoint him/her.
- Because ofThe borderline personality (borderline), seeks to prove that it is alive by taking risks .
- A possible addiction to the search for a strong sensation of adrenaline, dopamine discharge….
The borderline personality is probably the one most prone to mood instability and multiple addictions.
Bergeret also describes a particular form of depression specific to borderline states called essential or borderline depression.
What is at the forefront is the anxiety of losing an object, the lack of a sense of self-worth, a sense of isolation, abandonment anxiety, loss of consciousness, accompanied by physical symptoms, hypochondria and suicidal ideation.
Is depression a consequence of withdrawal?
If addiction can be a way of fighting depression, depression is one of the major risks of decompensation in the sudden and rapid withdrawal from certain addictions such as alcohol, drugs (especially opiates) or bulimia.
After having experienced the fullness, the confrontation with lack and frustration becomes almost unbearable and leads to filling the voids otherwise through agitation, violence, suicide attempts, a frantic search for the missing product or the use of substitutes.
Having finally been able to grieve his relationship with the product, the individual finds himself in a depressive state with the feeling of existential and identity emptiness that he must accept and assume in order to regain a taste for a sober life, Giving up drugs is the price to pay for this nostalgia, which at any moment can turn into melancholy.
For him, there is no time to hope, nor worse to fear than all he has already experienced..
Are there common points between the etiology (the search for causes) of depression and addiction?
The concept of regression can link these two experiences:
- Regression constitutes a more or less organized and transitory return to previous modes of expression of thought
- behaviours or object relationships, in the face of internal or external danger,
- likely to provoke an excess of anguish or frustration.
Can this definition be not suitable to depression and addiction?
- In depression, there is a return to a slowed-down way of thinking , difficulty in remembering, dreaming and creating, difficult speech,
- confrontation with emptiness, invasion or cutting off of affects, important and often painful somatizations or anaesthesia of physical sensations. The body speaks when the thought can no longer express itself. Everything seems to stop; it is the loss of vitality.
- Moreover In addition, it is the passage to the impulsive act that signs the regression to an archaic mode of expression.
- It is the very image of regression by fleeing from reality, abandoning oneself to hallucinatory daydreams
- searching for a lost and outdated paradise.
Moreover, the relationship is pre-objective for both. The depressive is in search of a lost and loved object; either the other is to fill the void in the melancholy, or the relationship is an anaclitic one, being there only to lean on it and try to come to the surface (in the borderline depression).
furthermore, the addicted person incorporates a product that he or she idealizes to fill an emotional void, to seek physical sensations of completeness to replace a missing or failing person; addiction makes separation and individuation impossible.
Can Gestalt therapy teach us about the common functioning of depressed and addicted people?
In the contact-withdrawal cycle, observing the early stages of grief informs us about what is at play in the depression. The characteristic of depression is the fixation on withdrawal:
in withdrawal, there is disintegration, a desire for death and the impossibility of forming a new figure; sensations of nothing, blurred and foggy emerge, blocking any process of transformation. It is a sterile emptiness…
In addictive behaviours, we are rather in the emergence phase of the beginning of the cycle.
In order to avoid remaining in a vacuum, the experience in a chaotic and rapid way reflects a passage to an impulsive act that puts an end to the death anguish underlying the depressive affect.
This emergency mechanism dichotomizes the unfolding of the cycle and takes us directly to the stage of full-contact by provoking relief.
On the other hand, withdrawal is almost impossible, hence the eager search for new completeness.
The emptiness appears as space to fill, and if, by chance, it is conscious and felt,
It becomes intolerable and leads to the insatiable search for the object to fill the gap, incorporate massive response”.
Depressives main problem is emptiness and addicts mask the void with the full
Ideas to help in depression
- Helping them to contact the emptiness,
- the desire for nothing, death is a necessary passage to approach and tame this anguish, and give it a form, a representation.
- After regression comes confrontation.
- The work on aggressiveness is particularly important with a depressive and/or addicted person:
- defrosting the sadness affects, which is already not easy but allowing to contact the anger for a depressed person,
- who is often afraid of destroying the other and wants to repair it, is even more perilous.
- In the same way, the addicted person masks his aggressiveness by force-feeding and drowns out the anger with an overflow of excitement that makes the aggressiveness turn against oneself (guilt mechanism).
- Learning to say, write, shout, mobilize oneself corporally, work on one’s energetic and creative capacities (sublimation of one’s impulses) while everything at the service of inhibition, retroreflection and incorporation, takes time.
- Bergeret speaks of archaic violence in the borderline depressive, which is “a brutal instinctive manifestation in front of the still blurring of image of others, in the anguish that there is no room for two in the sun”, it’s you or me, so it will be me.
- The narcissistic dynamics of the borderline case will put it before the other, who will be denied despite a willingness or discourse of benevolence, but an inevitable loneliness will follow, leading to depression or addiction.
It is a question of putting in place support and backing to get through the depressive crisis together and encourage the transition to depressiveness, consisting of the ability to confront reality, in a renunciation of omnipotence, and through the creation of meaning through words and the acceptance of bringing to the surface all the frustrations and painful memories that are buried.
Are antidepressants a legal addiction?
The United States, are the world’s leading consumers of psychotropic drugs, particularly antidepressants.
They are prescribed by treating doctors or psychiatrists for a period upto a year in order to avoid relapses; they do not, in principle, lead to physical dependence but, on the other hand, to psychological dependence. While they are useful and complementary to psychotherapy for proven depressions, they are sometimes prescribed for false depressions which are in reality soft blows or moments of mourning to go through. Aren’t antidepressants legal addictions? Frequent self-medication leads to all kinds of drifts and abuses up to suicide attempts. This is called pharmacodependence.
Phil Pignare speaks out against these abuses: “The risk of medication is that it allows the institution to avoid questioning itself, it puts the evil to sleep and does not treat social and relational ills, loss of identity and value”. This is a major lack of philosophy and ethics. It calls into question the lobby of the pharmaceutical laboratories which sometimes claim to compete with psychotherapies and overvalue pragmatism: it is the drug that defines depression.
It is the trial-and-error method: modify the molecules and try.
pharmaceutical lobbies against the antidepressants Added new psychic illnesses to be treated with new miracle drugs.
Ehrenberg confirms this contention: “Anti-depressant medications are likely to create real addictions fairly quickly, recreating a surface euphoria and no happiness”. And Jhone Lima adds: “The remedicalisation of depression, through an excessive use of antidepressants, is the culmination of a slow abrasion of the tragic human experience. There is an over-inflation of the pharmaceutical industry to the detriment of speech spaces”. The pill of happiness, contrary to popular belief, does not exist!