Do former addicts experience depression differently? What I am trying to say clinical depression is absence of self hygiene, forgetting to eat, staying at home most of the time, suicidal thoughts. But can he still be depressed and I might not know about it? For ex. still go to the gym, shopping, working normal hrs, etc.
Do former addicts experience depression differently?
ashleykm3
#3
Hey @Maya, great question! The research I do in school is primarily on the causes and treatment of depression, and this is a topic that has been encountered a lot among the younger population!
The whole āexperienceā of depression depends on a lot of factors, including genetics, sex (women are at much higher risk for depression than men), age (depression is more common in younger than older adults), negative life events, interpersonal relations . . . the list goes on.
A lot of the symptoms you mentioned, such as decreased attention to self-hygiene and not going outside much, are common manifestations of the symptoms of Major Depressive Disorder, or clinical depression. However, symptoms vary from person to person and can manifest in several ways, depending on the severity of the depression and the personās lifestyle, for example.
The answer to your question is yesā your son can still be depressed and you might not know about itā this is what many people have termed high-functioning depressionābecause the person is still able to keep the better part of a daily routine in work or going to the gym, etc, but still experiences enough of the symptoms of Major Depressive Disorder (MDD) to have the diagnosis. For example, an individual may be experiencing certain symptoms of MDD, such as fatigue, depressed mood, or insomnia, but may not be experiencing one or a few of the other symptoms of MDD, such as decreased ability to concentrateā making this person able to seem like they can pull off a high-functioning life. Several of my classmates have been diagnosed with depression, yet they are still able to pull off 12 hour days of class, homework, and a job. It can be pretty scary to realize how depression can āhideā in these high-functioning individuals because it may make us think nothing is wrong.
So itās important to remember here that even though it might seem like everythingās fine, that things might not actually be fine. No matter what, our loved ones can always use a little love <3
erica
#4
Hey there, @Maya! Itās difficult to say definitively whether people who are abstaining from substance use experience depression differently (because the entire experience of recovery is different for everyone). Yes, clinical depression can include the things you have listed, however, itās not all or nothing. @ashleykm3 really hit the nail on the head with her response!
To add a bit, substance use impacts the brain and the levels of two specific neurotransmitters:
Serotonin: this is also known as the āhappy chemicalā, because it appears to play an important role in regulating mood. Low levels of serotonin in the brain have been associated with depression, as well as other mental health issues such as anxiety disorders, phobias, etc.
Dopamine: this helps regulate movement, attention, learning, and emotional responses. It also enables us not only to see rewards, but to take action to move toward them. All substances release dopamine in the pleasure areas of the brain, certain behaviors do as well.
Depending on the drug of choice, the amount taken, and the length of time our loved one used this substance, brain healing times can vary. Generally, recovery from the nervous system damage can take anywhere from 6 months to 24 months with the help of a healthy recovery program.
When our loved ones first get sober, they may go through a period of stabilization from acute withdrawal from their drug of choice. Something called Post Acute Withdrawal Symptoms (PAWS) is a group of symptoms that occur after acute withdrawal - symptoms that may appear seven to fourteen days into abstinence. PAWS results from a combination of damage to their nervous system from years of substance abuse as well as the stress faced when coping with life without drugs or alcohol. PAWS can peak in intensity over three to six months after abstinence begins. This amount of time can be overwhelming, but Iām sharing it in order to normalize that we may see our loved ones struggle a bit more than anticipated in recovery. PAWS can also look like clinical depression, or other mental health diagnoses.
The most identifiable trait of PAWS is an inability to solve usually simple problems (this can lead to diminished self-esteem). There are six major categories that contribute to this:
1. Difficulty in thinking clearly (difficulty concentrating, impairment of abstract thinking, thoughts going around and around in head without the ability to break the circular thinking and put thoughts together in an orderly way)
2. Difficulty in managing feelings and emotions (feeing numb aka: anhedonic, strong feelings for no reason, mood swings, depression, fear/anxiety, and strong anger/resentment)
3. Difficulty remembering things (forgetting things within a short amount of time as well as new skills, not remember important childhood/adulthood events)
4. Difficulty with physical coordination (dizziness, trouble with balance, hand-eye coordination, slow reflexes, clumsiness, prone to accidents)
5. Difficulty in sleeping restfully (difficulty falling asleep, unusual or disturbing dreams, waking during the night, not feeling rested/always feeling tired, sleeping for very long periods of time)
6. Difficulty managing stress (canāt recognize minor signs of stress, inability to relax when stress is recognized, overwhelming impact of stress on self physically and mentally)
Keep in mind that in time the brain does heal! As someone supporting a loved one, it may be helpful to look into ways you can learn to be patient and cope during this period of behavioral change.
Please ācommentā below so we can continue this dialogue, @Maya. Iām here & happy to help!
Mona
#5
Thank you @erica for explaining what depression looks like to our loved ones after drug abuse. I guess inability to cop with life without drugs is a big trigger for relapse.
We should be well educated to better support. Iāve experienced this with my boyfriend few days after detox, he had these sever mood swings and unreasonable fear. At that time i was completely in sea about how to deal with what ever he is under ,that eventually led to his relapse. If i only can go back to that time with the knowledge and support that i have now , things could have been different.
Yes depression can be lying beneath the surface.
Maya
#6
Thank you for explaining these I feel like such a jerk nowš most of these I considered lasiness - not paying attention, being ignorant. I see some of these are plain side effects. I am at the point where my grace and mercy has run out and find myself just as mean and angry and resentful as he is. Weird transformationā¦ I thought the term co-dependent is only related to those who knew the person while they were using drugs (not the case with me, since we got married when he was already sober 2 yrs). The more I dig into this the more I realize doesnāt matter if you knew the person or not, they still influence the way you react, etc. Was just reading the post about āwhat is that one kind thing you did to your loved oneā. And the first thing that came to mind - kind thing is the fact that I am still is this relationship. But really truthfully, I think I am just slowly but steadily giving up on working on it. And I love him with all my heart but I feel like I am a well and all the water has been drank and the cup is just plainly scrubbing the bottom trying to get more while there is nothing left not even one drop. Self-care is my motto for this year.
Jane
#7
@Mona great to know thank you for verbalizing that - weāre always seeking more ways to get you the knowledge that will be game-changing for you (because I remember the times I learned pivotal truths too!)
@Maya from the sounds of it with your self-care motto for this year I think youāre right where you need to be. We canāt support others when we are depleted, now is the time to put your well-being first and reassess from there. Sending love and support for your noble objective <3
Please keep us posted on how thatās going!
erica
#8
@Mona, my pleasure! Yes the emotional swings experienced in recovery can potentially be triggers for relapse. However, if our loved oneās learn how to manage their new emotions, and we help them by educating ourselves (like you said) then the road will be a lot less bumpy!
@Maya donāt feel like a jerk, weāve all been there because we werenāt born with a manual in our hands on how to deal with a loved oneās substance use and/or recovery! The important thing is you know now, and the knowledge can help inform your decisions from a new perspective! Also, love self-care as a motto!
katie
#9
@Maya Thank you for this. 
That must be a painful feeling, and so important. You canāt pour from an empty cup - it doesnāt serve anyone. Iām so glad youāre here now, looking after you. Sending lots of love.
And I love him with all my heart but I feel like I am a well and all the water has been drank and the cup is just plainly scrubbing the bottom trying to get more while there is nothing left not even one drop.
Alair
#11
@erica, This entry about Serotonin and Dopamine, followed by the explanation about the acronym PAWS was so helpful. In fact, even as I am responding, I am realizing that this describes many behaviors. I have learned about the brain damage, and the lack of dopamine. The problem solving skills is a big aha. And I kind of feel sick to my stomach. My son needs to sign up for unemployment because he lost his job. But he keeps telling me he canāt figure out how to do it.
Because I have now learned that we should not do anything for our loved one who is struggling with addiction, that they can do for themself, and because I know in his life before addiction he used to do this kind of work, I havenāt helped him. And tonight, I realize his problem solving skills are weak. So, do I help him now or not? He needs some income coming in. I know he isnāt ready to get a job right now. Signing up for unemployment would solve some of our money issues.
This is the conflict that is so hard for me. I thought that I was doing the right thing by protecting him in the past. Now I know that it enabled him. So I have lost all confidence in my parenting instincts.
I appreciate all that Iām learning, but I am also confused.
sammiesame
#15
@erica
Thank you for sharing how drugs affect neurotransmitters in the brain. That sure helps with understanding an addictās struggle.
My daughter has had Absence Seizure disorder since she was 6-7 years old. Many children are affected with āabsenceā moments we call day dreaming. However, most grow out of that tendency near age 16. However, my daughter did not which further complicates everything as relates to her getting back to a ānormalā brain state. Honestly, she has enough brain issues going on without the use of drugs which certainly affects her overall ability to stay in recovery.
@erica can you offer any details of Sublocade and how it affects the brain?
Today and everyday I intend to help my daughter, and everyone in our family and friends circle, understand SUD. I intend to spread the word so everyone can better support someone they love that has become lost in the depths of addiction!ā¦and so it is! Amen! 
Jacqui
#10
This conversation is an oldie but a goodie! Commenting here to bring it back to the top of the Village Community, especially as the topic of PAWS has recently come up.
Alair
#12
@Jacqui, This information about PAWS is amazing and I hope that we can continue the conversation.
momentsandlight
#13
@Alair - Iām glad youāre learning new ways of seeing and approaching addiction. One of the biggest things Iāve learned is that nothing is black and white, completely right or completely wrong. We canāt fit things that are āenablingā and ānot enablingā into two separate lists. There is a big gray area.
For me, anything that makes it easier for my husband to use, continue bad habits, isolate, or not take responsibility would be āenabling.ā (I really donāt like that word, BTW! It makes us question even simple acts of kindness!) Anything that removes barriers to a sustainable recovery would be support. Helping your son apply for a job? Thatās supporting his recovery.
In the end, trust your gut. How do you feel about your actions?
You are doing great, @Alair. You are human. Youāre here, youāre learning, youāre moving forward by looking inward. Thatās the best thing you can do for your son right now. Keep going! 
Am I enabling by letting my addicted young adult daughter live in my home?
Alair
#14
Thank you, @momentsandlight, this makes sense to me.
I think that Iām figuring it out, and the more I learn, the more I consider how I will respond to a situation, instead of just reacting out of frustration or fear. I think that I had to come to a certain level of acceptance. This is the journey we are on right now. Not only did I not expect it, certainly didnāt ask for it, but also had very little preparation for it. I wanted it to go away. Instead of wasting my energy on resistance and self disgust about the ways I messed up, Iām using my energy to put in to practice what I am learning.
When I told my son that if he wanted me to, I could help him fill out the forms. I told him that I realized that he was capable of doing it, but had recently learned that the task might seem overwhelming to him. He visibly relaxed his body, and said that it just makes him feel so anxious. I asked if it helped him feel less anxious if we worked on it together. He said that it was a big relief for him. As it turns out, we ran in to some glitches and will have to continue tomorrow when we can call the department for help. I think that it was reassuring for him to realize that glitches are normal and while frustrating, that putting it aside until we can take further action was calming. We got some filled out today and will get more completed tomorrow.
It seemed very clear to me that this was supporting his recovery and a positive way to help.