Young Adults’ Experiences of Depression in the U.S.

Depression, substance use and abuse

Many studies show a strong association between substance use and mental health conditions. Although the reasons for this connection are still are being researched, there is recognition that these conditions share risk factors such as genetic vulnerability and environmental triggers like stress or trauma*. Several people in our study talked about current or past use of alcohol, alcohol in combination with over-the-counter or prescription medication, marijuana, or opioids. 

Using substances to cope with the experience or symptoms of depression

Some people we talked to struggled to describe specifically how substance use and their depression were connected. Others, though, stated it was used to self-medicate, in order to “avoid feelings” or to “feel normal”. Whitney said, “it just made me happy for that little bit and, um, I kind of clung to that. Like I felt normal.” Sierra Rose noted she never learned to properly cope, and turned to substances to help herself. Others said it served to “numb myself” or made it easier to fall asleep. Elizabeth said, “I was interested in taking anything that would make me fall asleep, because it was the only relief that I really got.”
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About 5% of the U.S. population experiences seasonal affective disorder, a type of depression that is triggered by seasonal changes, often in late fall and winter*1. Jeremy, who has seasonal depression, described how during winter he is less physically active and more prone to use drugs and alcohol.
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Starting to use substances

People first became involved with substances in a few different ways. Many reported turning to them when life was particularly difficult. For some, this occurred in the context of a major change such as when a family member died. Leanna started self-medicating by using marijuana when her father won custody over her. She “went from foster care to living with a complete stranger.” She continues to think that marijuana keeps her “happy and calm and I can’t be angry.” She also uses aromatherapy, such as lavender, for the same effect. 

One man we interviewed said he turned to heroin when he could not afford medication for his depression. Tia started taking prescription Tylenol with hydrocodone for menstrual cramps, and realized how mellow it made her feel. Many who used substances said they were first introduced to them by new friends. Using substances helped them to bond with the group and served a social need.
The unintended consequences of substance use 

People we talked with described that when they first started using substances, they were not thinking about the potential impact this use would have on their thinking, relationships and functioning. Elizabeth says the alcohol, sedatives, and cigarettes she used “really impacts your capacity to think properly, accurately, clearly.” Some people spoke about how their substance use threatened to end or actually did end relationships with friends and family. Drugs and alcohol also impacted some people’s ability to hold a job. Ben describes how his drinking “before the clock” led him to arguing with a customer and getting suspended from work. Some people were incarcerated because of their substance abuse. Others named their “constant struggle” with substance abuse as the reason they have trouble keeping a job. Ryan describes how his substance use prevented him from getting a medication that he found helpful for his panic attacks.
Relapsing with drugs/alcohol

A few people we interviewed discussed starting up again with drugs and alcohol after stopping. Emerging research indicates complex changes in brain circuitry and chemistry are related to substance use cravings and relapse*2. For people we interviewed, sometimes, this relapse was due to being around others that also took part in substance use. Others wanted again to feel the happiness that they initially felt from using drugs and alcohol. Whitney says, “And I was having issues with my boyfriend at the time so, it, he kind of played on that. And that’s how I got my happiness there for a little bit but I started feeling the effects from the drugs again and I’m like oh not this again. I went right back to where I was. I noticed it.” 

Others experienced stressors that again triggered their substance use. These could be everyday life stressors or one time stressful experiences. James says the stresses of everyday life and depression lead him to continuously turn to marijuana. He describes, “every day I get up and smoke because I think it make[s] me happy because I know I get, I messed up in… life.” In contrast, Julia started using alcohol again after a particular school assignment that triggered her depression.
Deciding to no longer use substances and getting help for addiction 

Tia says stories at Alcoholics Anonymous about others that used substances inspired her to quit alcohol. She described, “this guy was a lawyer and he had a beautiful house and car, and family and [then he became] addicted to drugs and is homeless and doesn’t have his family and probably never, [will] get it back.… it was sort of a reminder to help me not engage in that activity anymore.”

Whitney received help from a formal dual diagnosis program after prison. She describes learning “how my depression and my other, other things that I, you know, had been diagnosed with kind of coincide with one another and how drugs and alcohol are a huge factor and it’s impacted me more.” Myra realized there were alternatives to alcohol that could help her feel better. She now realizes that taking care of herself, checking in with her fiancée, and reading or listening to music are other options. 

For more information see ‘Depression and strategies for everyday life’ and ‘Depression and healing’.





References
*”DrugFacts: Comorbidity: Addiction and Other Mental Disorders.” National Institute on Drug Abuse, March 2011, Web. 7 February 2016. 

*1 Kurlansik, Stuart L., and Annamarie D. Ibay. "Seasonal affective disorder." American family physician 86.11 (2012): 1037-41. 

*2 Volkow, Nora D., et al. "Unbalanced neuronal circuits in addiction." Current opinion in neurobiology 23.4 (2013): 639-648. 

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