Is Depression An Addiction?
"Although nature commences with reason and ends in experience, it is necessary for us to do the opposite, that is to commence with experience and from this to proceed to investigate the reason."
- Leonardo Da Vinci
As I look back on the circumstances and experiences that make up my life so far, I recently started wondering... Is depression is an addiction?
I didn't believe I was the only person to ask this question, and given I'm not a medical professional, I decided to turn to papers and articles written by the experts. Papers such as "Are You Addicted to Unhappiness," by Dr. David Sack which posits that while most believe happiness is a choice, there is no choice when it comes to depression and anxiety.
In my opinion, this is truth. The only choice we have is to decide to be better, and then decide to get help. Why get help? Because if we could do it on our own, we would have by now.
Another article, "Is it Possible to be 'Addicted' to Depression?" by Jenna Fletcher, concludes that no, depression is not addictive in the same way as drugs or alcohol. Why? Because their research shows that addictions focus on the reward center of the brain, where depression focuses on the punishment center of the brain. Unfortunately, this research doesn't exactly do the best job focusing on non-chemical addiction.
I then found "Why Does Depression Feel Comfortable: Addicted to Depression" by GIA Miami which also concludes that depression is not an addiction. Why? Similarly because "Addiction is a psychological and behavioral state where you compulsively seek a substance or engage in a certain behavior, despite any negative consequences. It is characterized by physical changes to your brain's reward system, an area of the brain that regulates the reinforcement of life-preserving functions."
Um, hello? Read that again... "A psychological and behavioral state where you compulsively seek a substance or engage in a certain behavior, despite any negative consequences." I don't know about other people who have depression, but let's make a small but important shift of perspective while preserving the spirit of that sentence. What if it read:
"A psychological and behavioral state where you act compulsively despite any negative consequences."
Suddenly, and with only a slight perspective shift, the various forms of addiction, depression, and many other co-occurring behavioral disorders fall into the same category... Compulsion.
By the way, I hate that we're still calling them disorders instead of diseases.
On Co-Ocurring Disorders
Co-occurring disorders are also sometimes called dual-diagnoses. It is a critical area of research focusing on the common phenomenon of drug or alcohol addiction, and other mental health disorders. For example, these two recovery centers compiled some incredibly helpful information they asked me to share.
The Recovery Village
Boca Recovery Center https://bocarecoverycenter.com/addiction/depression/
I have not been paid to share their information. I chose to share these two because, wherever you or a loved one may seek treatment, you can let these caring teams serve as a great example that recovery programs should have options and tools that can be tailored to the individual.
Here's the thing, I have no doubt depression and addiction can be co-occurring. That's not what I'm asking. I'm asking if depression is itself an addiction. The research there is much less conclusive, but it turns out the prevailing conclusion is that, no, depression is not an addiction.
I respectfully disagree. Here's why...
On Depression
When researching the topic of depression, I found volumes of information on various forms of depression, their signs and symptoms, and forms of treatment. For example, this information from the National Institutes of Health which helps to characterize depression by such symptoms as:
Persistent sad, anxious, or “empty” mood
Feelings of hopelessness, or pessimism
Feelings of irritability, frustration, or restlessness
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in hobbies and activities
Decreased energy, fatigue, or feeling "slowed down"
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping, early morning awakening, or oversleeping
Changes in appetite or unplanned weight changes
Thoughts of death or suicide, or suicide attempts
Aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not ease even with treatment
Suicide attempts or thoughts of death or suicide
Unfortunately, it falls short of naming the cause of depression, and for good reason. There's still a lot of research being done on external and genetic factors. Research such as a paper titled "Where in the Brain Is Depression?".
Pandya M, Altinay M, Malone DA Jr, Anand A. Where in the brain is depression? Curr Psychiatry Rep. 2012 Dec;14(6):634-42. doi: 10.1007/s11920-012-0322-7. PMID: 23055003; PMCID: PMC3619732.
This paper studies regional brain abnormalities of people with Major Depressive Disorder, and found that while there are abnormalities in various cortical, subcortical, and brain stem regions, the data was still inconclusive in finding a cause.
This is CRITICALLY important.
What we see is impact to the subcortical limbic system which is responsible for emotion, behavior, and other life-preserving functions like fight or flight.
In the both the Jenna Fletcher and GIA Miami articles mentioned earlier, they concluded that no, depression is not an addiction because addictions bring pleasure, but depression brings no 'reward' that could drive addictive behavior.
On Addiction
When researching the topic of addiction, it was unbelievably hard to find any research on addiction that isn't related to drug misuse. The same NIH site only seems to provide education on drug addiction, but chemical addiction is just one form of addiction. The medical world is just now starting to understand the science of addiction that they currently classify as behavioral addictions.
What if all addictions are behavioral, and just manifest in various ways depending on the person? I dug deeper and found this paper from 2012:
When you remove the physical addiction, all that's left are the behavioral ones. And THAT is where the "overlap" between depression and addiction presents as co-occurring disorders.
Consider this research published by the National Library of Medicine in 2012. In addition to many other credible sources (citations intact), the authors of this paper further reference research published in 1979 by Dr. Stanton Peele and Archie Brodsky called Love and Addiction:
"The idea that true addictions can exist even in the absence of psychotropic drugs (behavioral addictions) was popularized by Peele.[4] According to Peele, addicted individuals are dependent on a particular set of experiences, of which the reactions to a specific chemical substance is only one example.
Building on Peele's notion, some authors have developed the idea that addiction does not necessarily have to involve the abuse of a chemical intoxicant or substance.[5,6]
For example, the term “addiction” has been used to refer to a range of excessive behaviors, such as gambling,[7] video game playing,[8,9] eating disorders,[10] sports and physical exercise,[11] media use,[12,13] sex addiction, pathological working,[14] and compulsive criminal behavior. Although such behavioral addictions do not involve a chemical intoxicant or substance, a group of researchers have posed that some core indicators of behavioral addiction are similar to those of chemical or substance addiction.[15] At present, researchers emphasize that in order to make a diagnosis of behavioral addiction, functional impairments must be present at work, in social relationships, or in other social situations.[16]
A number of experts believe that behavioral addictions can be passive (e.g. television) or active (e.g. computer games), and usually contain inducing and reinforcing features which may contribute to the promotion of addictive tendencies.[16]"
The Tie That Binds
“Having wandered some distance among gloomy rocks, I came to the entrance of a great cavern ... Two contrary emotions arose in me: fear and desire--fear of the threatening dark cavern, desire to see whether there were any marvelous things in it.”
- Leonardo Da Vinci
I believe addiction is about survival of the self. Without <INSERT ADDICTION HERE>, I cannot survive. I view depression as being about survival of the group. Without ME, <INSERT GROUP HERE> would be better off.
What unites depression and addiction is really choice. Or rather, the lack thereof.
I don't believe we choose depression, just like I don't believe we choose addiction. When we lose our ability to chose, and instead are driven by compulsion, that means our experiences have become driven by the limbic system of our brains. What does the limbic system control? Reward and pleasure; punishment and pain. Fight or flight, fawn or freeze.
That's when I realized the point-of-compulsion is when addicts turn from feeling "rewarded" to feeling their addiction is needed for survival, and therefore more instinctual in its expression. That is when depressives enter the stage where we believe that punishing yourself is deserved, a form of self-flagellation, and really only echoes of what was once a "reward." Both seek escape from the pains of the external.
Amazingly, another defining characteristic that unites depression and addiction is recovery. Why is that amazing? Because on one hand, we have disease (compulsion), and on the other hand we have cure. I know the word "cure" is wrought with debate, but I ask you to take it with my intent - a path to wellness.
This concept of compulsion on one end and recovery on the other made me start visualizing the amygdala as less of a squishy part of our brain, and more as a level - you know, the kind you use to hang pictures on your wall.
Now when I hit that point-of-compulsion, for example, I do a pattern interrupt. I picture a level with my depression on the left side, and gratitude on the right. My ego on the left, and my higher self on the right. I then ask myself what's causing the level to tip to the left, and think about what I need to do to tip it back to the right. To "level off" as they say.
That has helped me stop fearing my depression, because I now accept it as a part of me. I focus on those things that tip the scales to the right. I try to practice accountability as a core value; have enlisted the help of my doctors and therapist to guide me; cut myself off from things things I know will bring me down (especially medical dramas and nihilism). I found a spiritual belief system I resonate with. When I feel like I need to be lifted up, I ask for help and patience from those around me. I don't ask source to make me feel better, but for the opportunity to help someone, knowing that in doing so I get a rush like nothing else. Is that a little selfish? Sure, but I see it as a win-win.
In Conclusion
I guess what I'm trying to say is that the brain is a complex organism, still not fully understood. Many of us may require different treatments based on our specific biology and traumas. I'm not saying there is a cure-all. But I do believe that when we surrender ourselves, we are actually re-empowering ourselves with the ability to choose. Moving from instinct and surviving, to consciousness and thriving. We're not saying we can't get well, we're saying we can't do it alone. We're not saying we give up, we're saying that we recognize there is nowhere to go but up, and we're shedding our dead weight to start making the climb.
We're taught from an early age that the ability to choose or assert our independence is wrong. That eating fruit from the tree of knowledge of good and evil is a sin. That Prometheus' punishment for bringing us fire from the Gods was justified. Did you know that the word "heresy" actually means "choice"? We are taught to be subservient to leaders who only have their own interests at heart, and are made to ingest news and programming that makes us live in fear (ego/left side of the level). We need to remember that choosing to be of service to each other is what helps make the world a better place (higher self/right side of the level).
So you see, the ability to choose is not what makes us human, it's what makes us divine.
When I chose to surrender, I didn't forfeit my ability to choose. I surrendered my misguided ego to my higher self. Our higher selves are our connection to Source, and provide us better guidance than our egos ever could. It's when I made this shift that I believe I went from coping with depression to conquering it.