It is reported that about one-third of people with psychiatric disorders experience substance abuse and that about one-half of substance abuse clients have the diagnostic criteria for a psychiatric disorder. The most common mental health issues for substance abusing clients are anxiety and mood disorders, especially depression.
As we look at the neuropsychology of depression, recent research (Neuropsychology of Depression, edited by McClintoch & Choi 2022) shows that executive function and memory can be affected by depression including limiting the entry of information into working memory, particularly that which is irrelevant and negative. Core executive functions are impaired in depression, specifically when emotions (negative vs positive or neutral) are presented as stimuli or as a specific functional reaction to an occurrence.
Joormann & Vanderlind (2014) define emotional regulation as the strategic and automatic processes that influence the occurrence, magnitude, and expression of emotional responses. In individual with depression or remitted depression, research has shown an increased tendency to use maladaptive emotion regulation strategies including cognitive distortions or the use of alcohol and drugs. There is also a tendency for people with depression to respond to negative life events and/or negative mood states with ruminating thinking. These people tend to ruminate on negative information and have difficulty distracting themselves from negative thoughts. The combination of these two things plays a role in maintaining depressed moods.
Analysis of ruminating thinking and core executive functioning suggest that through rumination, depressed people have too much irrelevant information making its way into working memory and may face difficulty switching between mental states, negatively affecting their ability to complete necessary tasks or goals. They note that strategies to regulate emotional states depends on working memory and executive function.
The relationship between emotional regulation, rumination, executive functioning and working memory are affected by depression. This is furtherly impacted by one’s use of alcohol and or drugs as a coping mechanism or to regulate emotion or emotional responses. In Substance abuse and mental health treatment, it is imperative to recognize these issues and incorporate this knowledge into how we treat depression, substance use disorders, and co-occurring disorders.
At Desert Star, we are aware of these reciprocal relationships. That knowledge and insight is incorporated in our treatment approaches in all of our programs.
Oasis Program: a treatment program designed specifically for the treatment of substance use disorders.
Mental Health Matters: a treatment program designed especially for the treatment of depression, anxiety, bipolar disorder, PTSD, and other mental health disorders.
Sojourners Program: a treatment program designed for young adults between the ages of 18 – 25 with co-occurring mental disorders.
Joormann, J., & Vanderlind, W. M. (2014). Emotion Regulation in Depression: The Role of Biased Cognition and Reduced Cognitive Control. Clinical Psychological Science, 2(4), 402–421. https://doi.org/10.1177/2167702614536163
McClintock, Shawn M., and Jimmy Choi, editors. Neuropsychology of Depression. The Guilford Press, 2022.