Cocaine is a highly addictive stimulant drug that is derived from the coca plant that grows naturally in regions such as South America. Cocaine gives users a burst of energy and floods the pleasure centers in the brain, creating a temporary euphoric or happy feeling.
The drug is usually snorted, injected or smoked. It acts as a central nervous system stimulant, increasing the production of the neurotransmitter dopamine, which gives users the high feeling. Over time, a tolerance develops, and users require more and more cocaine to feel the same effects.
Cocaine abuse eventually leads to a drop in natural dopamine productions, changing brain chemistry and causing users to crave the drug to replace those levels. According to SAHMSA, as of 2012, 14.5 percent of Americans over age 12 had tried cocaine in their lifetime.
One of the most common mental health disorders in America is major depression. The National Survey on Drug Use and Health in 2012 reported that in the past year over 16 million American adults over age 18 had experienced at least one major depressive episode. Depression causes overwhelming sadness, feelings of isolation and numbness. A major depressive episode is defined as a loss of pleasure or interest, a depressed mood and a change in levels of functioning including trouble sleeping, eating, concentrating, low energy and lowered self-image for a period lasting at least two weeks.
While there are many potential causes for depression, biology and brain chemistry are thought to at least play a role.
In fact, many antidepressant medications essentially work to boost neurotransmitter production to elevate mood. It is no surprise that some seek to self-medicate in order feel better, with many turning to illicit drugs such as cocaine for an instant mood enhancer.
Co-occurring Disorders
“Co-occurring” refers to the presence of two or more illnesses or disorders in the same individual. For example, someone suffering from depression who also has a cocaine addiction is considered to have co-occurring disorders: addiction and depression. According to the National Institute on Drug Abuse, those suffering from anxiety and mood disorders are twice as likely as the general population to also suffer from addiction and vice versa.
It’s long been thought that depression and cocaine addiction are linked at some level. In fact, one of the greatest minds in the history of psychiatry, Sigmund Freud, was actually thought to have used cocaine on himself to treat depression. It was originally touted as a wonder drug with uses as an anesthetic, antidepressant and stimulant.
It was several years before cocaine’s addictive nature and nasty side effects warranted a retraction of its medicinal purposes and subsequent banning in America. The DEA now defines cocaine as a Schedule II substance, meaning it is a dangerous, illegal drug with a high potential for abuse, which can easily lead to physical and psychological dependence.
It is unclear which comes first, depression or addiction. Cocaine changes the brain circuitry and pleasure centers, and whether it kills brain cells or simply impairs them is still unclear. This drop in reward-pleasure center neurons by as much as 10 or 20 percent, according to Dr. Little, the author of a study published in the American Journal of Psychiatry, is bad news for cocaine addicts and may indicate why the rates of depression are so high in cocaine users.
Cocaine enhances pleasure centers by chemically stimulating neurotransmitters and altering brain chemistry, and it is unclear whether or not this process is reversible.
Depression seems to indicate a lack of neurotransmitters in the pleasure centers of the brain or at least a lowered level of them. Cocaine users may develop depression by suppressing their body’s natural production of these brain chemicals, while those suffering from depression may seek relief from the chemicals in drugs like cocaine. Cocaine withdrawal can also create intense feelings of depression.
Risk Factors
Much research has been done on brain chemistry, biology, addiction and depression. Exactly what causes addiction and depression is still largely unclear; however, there have been several factors identified that may increase the risks for these co-occurring disorders. Some of these factors include:
- Environmental triggers that can lead a person to abuse drugs and also feel depressed, such as a trauma or childhood abuse
- Genetic factors that may indicate a predisposition for addiction and/or depression
- Exposure to drugs or acute stress during developmental stages like teen years can alter brain chemistry, producing depressive episodes or substance abuse
- Brain chemistry in which the same regions of the brain are affected by both depression and cocaine abuse
While it is unclear if one causes the other or which one comes first, it is clear that each disorder can magnify the other and often makes the situation worse. Cocaine abuse can lead to compounded feelings of depression, and depression can lead to increased cocaine abuse in an attempt to self-medicate and feel better.
Warning Signs
Cocaine abuse is serious and can lead to extreme effects including overdose and death. Cocaine alters brain chemistry and also affects the heart. A study published in the Journal of Substance Abuse Treatment found that a survey of cocaine addicts admitted to treatment had a 5.1 percent higher fatality rate than that of the general population.
Depression is also not something to be taken lightly. One of the most extreme effects of depression is suicide, which according to the American Psychological Association, accounts for two percent of all deaths in the United States.
Some of the warning signs for cocaine abuse and/or depression are:
- Extreme mood swings; being excitable and high when on the drug, experiencing low energy and irritability when not on the drug
- Difficulty concentrating or focusing
- Changes in sleep pattern
- Loss of interest in things formerly enjoyed
- Withdrawal from family and friends
- Weight fluctuations
Both depression and cocaine abuse carry their own side effects and warning signs as well. Cocaine users may have dilated pupils and evidence of white powder around the nose or track marks from injection. Depressed individuals often suffer from prolonged feelings of hopelessness, numbness and sadness.
Healing Process
For those suffering from co-occurring disorders like depression and addiction, specialized treatment can help them regain control of their lives. If only one or the other is treated, then in the end neither is likely to improve. Dual diagnosis treatment works on each disorder simultaneously, producing better long-term results.
Cognitive Behavioral Therapy can be a highly effective part of treatment in many cases of substance abuse and addiction as it can help individuals change their ways of thinking, define emotional and environmental triggers, and create a more well-balanced individual.
Since both depression and cocaine alter the brain, it takes specialized treatment in order to correct those pathways and start the healing process. The process requires patience and endurance as well as compassion and understanding.
With depression, individuals are often treated with medication in the form of antidepressants. If they also suffer from cocaine abuse or addiction, medication therapy needs to be carefully monitored by a consulting physician.
At FRN, we strive to assess each individual and create a specialized treatment plan. Individuals with co-occurring disorders have higher success rates and lower chances of relapse when their disorders are treated properly and concurrently. Call 844-675-1221 today to speak with one of our admissions coordinator about how dual diagnosis care can help you or your loved one start a new life in recovery.
Further Reading About Cocaine Use and Depression
David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton