It is not uncommon for individuals to experience depressive thoughts and feelings while being active substance abusers or recovering from addiction, but what happens if those feelings become dangerous and a person requires professional help? And how can you tell if a person you love is potentially suicidal?
Suicide was the 10th leading cause of death in the United States in 2016, according to the Centers for Disease Control and Prevention (CDC). Nearly 45,000 persons took their own lives that year, which was double the number of individuals killed by homicides. The National Institute of Mental Health (NIMH) also states that persons between ages 18-25 have the highest rate of severe suicidal feelings and tendencies.
Suicidal Ideations and Behaviors Among Adult Americans
The fatality rates due to suicide only include the number of deaths and not the attempts. The Substance Abuse and Mental Health Services Administration (SAMHSA) found that two-thirds of those who considered suicide in 2014 did not enact an actual plan to end their lives. Also, most individuals (8 out of 9) who had suicidal thoughts did not attempt it.
This means the number of adults in the United States who are at risk for suicide is significantly higher than the deaths that occur each year. One of the primary factors that contribute to an individual becoming suicidal is major depression. The likelihood of this condition occurring is 2-4 times higher among persons who struggle with substance abuse.
Substance Abuse and Suicide
According to a 2014 article in Psychology Today, 1 in 3 individuals who die due to suicide is under the influence of alcohol, drugs, or both. The most common substances associated with suicide attempts are heroin, oxycodone, and alcohol. These are all depressants that have effects that lower inhibitions, and hypothetically, this experience could drive an individual who has considered suicide to go through with it.
The report goes on to say that the suicide rate among individuals with untreated substance use disorders may be as high as 45 percent—and only about 1 in 10 people with addictions receive treatment. So, when considering how substance abuse affects the risk of suicide, we should also note how the stigma, guilt, and shame that comes with addiction prevent many people from feeling comfortable seeking help.
Feeling hopeless and helpless, many people may consider suicide to be a logical solution to the problem. Substance abuse, depression, and the risk of suicide are all intimately connected. The National Institute of Mental Health (NIMH) reports that approximately 90 percent of the people who take their own lives in the United States suffer from depression, a substance abuse disorder, or a combination of these problems.
Intentional vs. Unintentional Overdoses
Overdose is roughly defined as using too much of a substance(s) regardless of whether it’s prescription, over-the-counter, legal, or illicit. Due to the often complicated nature of overdose, it’s often difficult to determine if a death was deliberate or accidental. Medical examiners can only consider the evidence and document an educated guess.
There’s also a grey area between deliberate and accidental—it’s called “apathy.” Feelings of apathy are prevalent among those who are depressed and abuse substances. The feeling of “I don’t care if I live or die,” or throwing caution to the wind when using potentially lethal substances is more common than many would like to think.
Moreover, a mother who refuses to believe that her deceased daughter would intentionally kill herself by overdose or deliberately commit suicide may only be half right. It could very well be that her daughter didn’t set out to cause her own death but also really didn’t care if she lived or died, either, and therefore, was particularly reckless regarding her substance abuse.
According to the National Institute on Drug Abuse (NIDA), accidental overdoses are those in which a drug, an excessive amount of a drug, or the wrong drug was inadvertently ingested. This can occur either by a person’s own actions or during a medical procedure. Incidents of deliberate overdoses are associated with evidence of the desire to commit self-harm and suicide.
Depression Increases the Risk of Substance Abuse
The National Bureau of Economic Research (NBER) reports that individuals who have been diagnosed with a mental health condition at some point in their life consume more than two-thirds (69 percent) of the alcohol in the United States and 84 percent of the cocaine. The connection between depression, anxiety, and other mental and emotional problems has been well-established in studies.
People with a mental health condition that do not receive the appropriate treatment may be more likely to resort to substance abuse as a means to escape negative thoughts and feelings and self-medicate. Often, this attempt to alleviate symptoms fails, however, and only exacerbates problems and perpetuates a downward spiral of addiction and misery.
Addiction Recovery and Suicide
Although completing an addiction treatment program is an amazing accomplishment, people transitioning from rehab back into the real world are often plagued by intense feelings of depression and anxiety.
Even after months or years of sobriety, a moment of tragedy or desperation could compel an individual to relapse and reignite the belief that their only destiny is death or a life of neverending substance abuse and addiction. While being treated as a long-term resident, patients have nearly constant support. When left to their own devices following treatment, feelings of depression can quickly progress into suicidal ideations.
What You Can Do
Suicide prevention often requires a comprehensive approach, which is best managed under the guidance of health professionals. Common signs and symptoms of suicide include the following:
- Expressing feelings about wishing to die or to kill themselves
- Looking for ways to commit suicide
- Talking about feeling hopeless or having a lack of purpose
- Talking about feeling trapped or feeling intolerable pain
- Talking about being a burden to other people
- Increasing the abuse of alcohol or drugs
- Acting anxious, irritable, or reckless
- Sleeping too little or too much
- Withdrawing and isolating oneself from others
- Exhibiting anger and rage
- Reacting with severe mood swings
If you believe you or your loved one is at imminent risk of overdose or suicide, you should call 911 immediately or visit the nearest emergency department. If you suspect your loved one is regularly abusing drugs or alcohol and is at high risk for self-harm, you should begin to plan an intervention to stop their downward spiral before it gets any worse.
Getting Treatment for Suicidal Depression and Addiction
When a person suffers from a substance abuse problem and a mental illness such as major depression, this combination of symptoms is called a dual diagnosis or comorbid or co-occurring disorder. Treatment for a dual diagnosis requires thoughtful planning and an integrated approach, ensuring that both diseases are being addressed simultaneously.
For instance, a treatment plan may include antidepressants to relieve depressive symptoms and medication to treat opioid or alcohol abuse disorders. Furthermore, studies have shown that medication is most effective when an individual concurrently receives counseling and behavioral support. Many individuals find that undergoing intensive treatment is necessary to overcome addiction and learn healthy coping strategies for depression.
Just Believe Detox and Just Believe Recovery centers employ a caring team of medical professionals trained to deliver these therapeutic services, such as psychotherapy, group counseling, and mindfulness therapy, with compassion and expertise. We are committed to helping each individual we treat by providing them with the tools, education, and support they direly need to achieve abstinence, prevent relapse, and experience a long, fulfilling life.