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Cognitive Behavioral Therapy: Help for Co-Morbid Depression and Substance Abuse

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Depression related image Photo: Getty Images

Depression and substance abuse are two serious mental health issues. In the United States, about 14 million adults have major depressive disorder and 3.3 million adults have dysthymic disorder, a mild type of depression that lasts at least two years, according to the National Institute of Mental Health. Results from the US Department of Health and Human Services and the Substance Abuse and Mental Health Services Administration’s 2009 National Survey on Drug Use and Health showed that about 21.8 million people in the United States ages 12 and over had used drugs within the past month; this statistic did not include alcohol or drug use.

Oftentimes, patients can have both depression and substance abuse. Having either condition increases the risk for the other.

Depending on the substance used, people may experience symptoms when they are intoxicated, having withdrawal symptoms, or use the substance chronically. For example, cocaine, a stimulant, can cause low energy and appetite when a person is intoxicated; depressed mood, insomnia and fatigue during withdrawal; and depressed mood from chronic use.

When caring for a patient with both conditions, the health care provider needs an effective intervention. In “Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery: A Treatment Improvement Protocol,” the US Department of Health and Human Services and the Substance Abuse and Mental Health Services Administration noted that different psychological interventions can help patients, which include cognitive behavioral therapy, supportive therapy, motivational interviewing, expressive therapies and behavioral interventions. Research published in the June 6 issue of the Archives of General Psychiatry found that cognitive behavioral therapy can be an effective treatment for co-morbid depression and substance abuse.

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