A strong connection between substance misuse and mental illness has long been recognized. The National Bureau of Economic Research reports that “people who have ever experienced mental illness consume about 69 percent of all the alcohol, 84 percent of all the cocaine, and 68 percent of all cigarettes.”
The comorbidity of substance use disorders and mental illness is known as a dual diagnosis or co-occurring disorder.
One of those illnesses frequently co-occurring with SUDs is depression. The relationship between the two conditions is bidirectional, meaning that people who misuse substances are more likely to suffer from depression, and vice versa.
One particular form of depression is known as seasonal affective disorder, or SAD for short. SAD is a form of depression that strikes patients during specific seasons—mostly during the winter months when temperatures are cold, daylight hours are fewer, and weather conditions force patients to stay indoors a lot.
The specific cause of seasonal affective disorder remains unknown, but according to Mayoclinic.org, factors that may come into play include reduced levels of sunlight affecting a person’s circadian rhythm, a drop in serotonin (a neurotransmitter that affects mood), and an imbalance of the body’s level of melatonin, which plays a role in sleep patterns and mood.
Unfortunately, people who are affected by seasonal darkness and lack of activity often attempt to self-medicate depressive moods by drinking excessive amounts of alcohol or abusing drugs to overcome their melancholy.
Alcohol use disorder, in particular, seems to be linked to seasonal patterns. A Comprehensive Psychiatry study indicates that alcohol abuse appears to peak during the time of the year corresponding with SAD and—in the United States—the emotionally challenging holiday season.
Self-medicating with substances like alcohol is very dangerous. Ethanol is a depressant, which can exacerbate the symptoms of seasonal affective disorder and other forms of depression. When the feelings of sadness or fatigue intensify, the alcohol intake increases even further and the risk of developing an addiction is elevated. For people in recovery who are responsive to a lack of daylight and susceptible to emotional stress during the holiday season, the relapse risk rises.
It is important to be mindful of the impact seasonal changes can have and counteract any mood swings without the use of drugs and alcohol. Healthy strategies to combat SAD may include maintaining a healthy sleep routine, eating a healthy and balanced diet, and exercising on a regular basis. Some people benefit from mind–body techniques such as meditation, yoga, qigong, taijiquan, or similar practices.
Since lack of sunlight is thought to be a major contributor to the low levels of serotonin, melatonin, and vitamin D during the winter months, light therapy and vitamin D supplements can be used to compensate for this lack.
In light therapy, patients sit a few feet from a special light box so that they are exposed to bright light within the first hour of waking up each day. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood. Activities that help a person get more natural sunlight could be pursued as well.
Lakeview Health in Jacksonville is a dual-diagnosis treatment center providing comprehensive treatment for both depression and substance use disorders. All treatment methods at Lakeview are designed for integrative health, to support the entire patient—mind, body, and spirit. Therapy, group process, and psychodynamic education help heal the mind. Medical supervision combined with fitness and wellness therapy helps heal the body. Mindfulness and spirituality activities help heal the spirit. This integrative approach helps patients lead a completely healthy life.
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