Women are more prone to depression, among other things due to hormonal fluctuations in key periods of their reproductive lives, a biological factor to which other social ones should be added, such as the stress of combining the working world with the domestic world. The coexistence of major depression with substance use is also more frequent in women than in men (although men are more addicted to substances in general), something that, however, is invisible because women secretly carry their addiction -and with her depression– out of fear, among other issues, "of losing her children", that social services will withdraw them (at least temporarily) due to inability to raise them.
“More depressive symptoms occur in women than in men, despite consuming at the same level. Women feel more stigmatized when they go to seek therapeutic help, which is an obvious barrier for these patients. Social guilt and fear of being judged leads to delay in treatment and diagnosis.
This is stated by Adrián Neyra, a psychiatrist from the Dual Pathology and Psychosis Program at the Doctor Negrín hospital in Gran Canaria and associate professor at the University of Las Palmas de Gran Canaria, in the Lundbeck seminary. "Depression, is it born or is it made?"
The prevalence of substance use disorders in people with depression stands at 25%. The greatest comorbidity occurs with alcohol (20.8%), followed at a distance by opioids (11.8%) and cannabis (11.7%). In last place is the consumption of stimulants –cocaine and amphetamines– (4.8%).
"Both diseases are closely related, since, in general, the risk of suffering from an addiction is multiplied by two if you have depression, and vice versa, if you suffer from an addictive disorder, the risk of suffering from depression doubles," says Neyra. .
What is clear, as numerous studies have shown, is that people with depression continue to consume more than those without depression. In turn, the consumption of substances such as alcohol increases the symptoms of depression and the probability of suicide. "The high level of people addicted to opioids who suffer from depression is also worrying, since this substance is the most common in overdose deaths, both accidental and suicidal," says the psychiatrist from the Canary Islands.
In addition, those with dual depression also have more severe functional impairment, worse recovery rates, higher morbidity and mortality, and higher hospitalization rates than those with a single diagnosis of depression.
Given this evidence, mental health experts call for an integrated treatment of dual pathology, where the same therapeutic team treats depression and addiction at the same time, as recommended by various international societies.
However, “it is estimated that in 80% of the Spanish territory addictions are treated in a network other than mental health. And we have an obvious paradox: the most serious patients are not fully accepted in the mental health network, due to the fact that they consume. This is the great problem of dual pathology in Spain, where we continue with the sequential or parallel model, which causes patients to drop out of follow-up and there is rarely real coordination between the two therapeutic teams," says Neyra.