Cocaine and depression

Cocaine abuse and addiction often go hand in hand with depression. Taking this powerful class A stimulant when suffering depression, can even cause an individual to want to take their own life, AND give them the false sense of courage and impulsiveness to carry it out.

Most people who take cocaine do so as it makes them feel good. They enjoy the instant euphoric high that cocaine can produce. Others take it because they are self-medicating an addiction or an underlying mental health illness.

Cocaine’s effects temporarily counteract the symptoms of depression. However, the cocaine ‘high’ only lasts as long as the drug. The comedown period from cocaine intensifies depressive symptoms.

If you suffer from depression, or cocaine is causing you to feel depressed, taking cocaine really is the worst thing you can do.

Here we explain how taking cocaine can cause depression and, why, if you already suffer from depression taking cocaine can make your condition much, much worse.

Can cocaine cause depression?

Yes, there is clear evidence to support that cocaine abuse can cause depression. The more chronic the cocaine use, the higher the risk of developing depression and long term brain damage.

Depression is common in cocaine addicts. The rate of depression recorded in chronic and long term cocaine users is significantly higher than in the rest of the general population (1)

Cocaine causes a huge amount of dopamine to flood the brain. The dopamine increase is what users experience as a powerful euphoric high.

Prolonged and chronic abuse of cocaine causes substantial changes and damage to the brain’s pleasure reward system, neurotransmitters and brain cells; tolerance to cocaine builds and less dopamine is produced as a result.

With a cocaine addict, eventually the only way they can feel pleasure is to take increasing amounts of cocaine. When they are not taking cocaine they are likely to feel severely depressed, unmotivated and suffer mood swings.

Eventually they feel little or no pleasure at all – even when taking cocaine. They only suffer the adverse effects associated with cocaine use, including: depression, anxiety and paranoia. At this point the brain has become damaged, it is unable to produce dopamine either naturally or through artificial stimulus (2)

When a cocaine addict reaches this point, they feel trapped and hopeless. This is when a cocaine related suicide becomes very high risk if professional treatment is not promptly sought.

Dopamine’s role in cocaine related depression and dual diagnosis

One of the main symptoms of depression is the inability to feel pleasure anymore (Anhedonia). Dopamine, a reward chemical organically produced by the brain, plays a key role in our ability to feel good, regulate emotions and provide motivation.

The DSM (Diagnostic Users Manual) defines Anhedonia (a hallmark symptom of depression) as the diminished interest or pleasure in response to stimuli that were previously once perceived as rewarding before the development of the disorder (3)

Sound familiar? Going by this definition, it is easy to see why cocaine use and depression can often become a ‘chicken or egg’ scenario.

In chronic long term cocaine users it can be impossible to determine if it is only the cocaine diminishing the brain’s dopamine levels, thus resulting in depressive symptoms, or if an underlying depressive disorder is exacerbating the individuals cocaine use.

One of the two major symptoms of major depressive disorders (MDD) in addition to depressive mood symptoms, is poor response to antidepressant medications (4).

In cases where cocaine is being abused, the cocaine will counteract any benefits of prescription antidepressants. This is why it is vital that the cocaine is stopped before medical and psychiatric treatment can be of any real benefit.

If I stop cocaine will my depression get better or worse?

All evidence indicates that ANY depressive illnesses will improve with the cessation of cocaine use. During cocaine withdrawal, symptoms of depression may well become temporarily worse. This is why a medical cocaine detox is vital for those that suffer from both cocaine addiction and depression.

A medical cocaine detox should be carried out within an inpatient rehab for the safest and most effective results

Once the cocaine has been safely removed from the equation, a correct diagnosis can then be made once cocaine withdrawal symptoms have subsided.

Delamere rehab ensures that all of our cocaine detox patients are medically monitored and therapeutically supported 24/7 during the detoxification process. Prior to undergoing detox, a full psychiatric and medical assessment will be conducted.

Delamere continually review all of our patients during and after detox. If a dual diagnosis illness such as depression is identified, treatment for this will be factored into the patients comprehensive treatment plan.

What cocaine does to an already depressed person

Whilst many individuals who suffer from depression do seek the correct professional help, some turn to self-medicating using drugs and alcohol

Cocaine’s effects can temporarily relieve the symptoms of depression. However, when the depressive symptoms return during the comedown or withdrawal period, they are often amplified. This can lead an individual who is self medicating with cocaine to continue spiralling downwards into a deadly cocaine addiction.
Cocaine withdrawal symptoms similar to symptoms of depression include:

• Feelings of sadness
• Dissatisfaction with life in general
• Dysphoria
• Loneliness
• Demotivation
• Loss of interest in anything
• Increased anxiety
• Disturbed sleep pattern
• Poor appetite
• Loss of libido
• Paranoia (feeling that everyone and everything is against them)
• Suicidal thoughts or ideation

Treating cocaine and depression effectively

In an individual that suffers both a problem with cocaine and depression, the first step for a full recovery from both conditions is to treat the cocaine problem.

If the person suffers from a cocaine addiction or dependence, a full medical cocaine detox is strongly recommended. Cocaine withdrawal can be brutal and even life threatening without medical intervention.

One overriding cocaine withdrawal symptom is depression. In a patient that is already exhibiting symptoms of depression prior to detox, it is extremely important that they are continually medically monitored and therapeutically supported.

Treatment for depression and cocaine addiction should ideally be delivered within the same treatment episode for maximum effectiveness. Delamere treat all of our dual diagnosis patients for all conditions presenting simultaneously.

Failing to treat any condition that is presenting in a dual diagnosis patient will inevitably lead to relapse of all conditions, including the addiction. This is why at Delamere we take dual diagnosis so seriously. We have the medical and therapeutic means to treat co occurring illnesses and addiction all under one roof and within the same treatment episode.

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