Mental health professionals and researchers are well aware that depression and substance problems often appear together and cause worse problems for the individual than when they appear on their own. In a study published in January 2015 in the journal Drug and Alcohol Dependence, researchers from two American universities explored the connection between depression and a relatively low tolerance for stress in women affected by serious substance problems. These researchers concluded that low stress tolerance is an important contributor to the severity of substance abuse/addiction in depressed women.
Depression and Substance Problems
Depression is associated with the excessive or abusive intake of a range of mind-altering substances, including alcohol, opioid drugs, opioid medications, cocaine, amphetamine, methamphetamine, solvents and other makeshift inhalants, and marijuana and other forms of cannabis (i.e. hashish and hashish oil). Alcohol withdrawal is also associated with increased depression risks. In addition, the use of sedative-hypnotic medications (including tranquilizers) can worsen an existing case of major depression or any other form of depressive illness.
Diagnosable depressive illness and diagnosable substance use disorder (substance abuse/addiction) are comorbid conditions. This means that the presence of depression alters the course of substance use disorder (or vice versa) and produces worse outcomes than would otherwise typically occur. Specific indications of comorbidity or worsened outcomes in a depressed person with serious substance problems include a higher number of depression symptoms, more intense depression symptoms and bouts of depression that recur with unusual frequency. Specific aspects of an ongoing pattern of dysfunctional substance use that may add to or trigger depression symptoms include the social damage associated with being identified as a substance abuser or addict, the isolation that often accompanies a damaged social reputation and a chronic lack of adequate financial resources.
Stress tolerance is a term psychologists and psychiatrists use to describe any given person’s ability to withstand the mental/emotional impact of everyday or extraordinary stress without experiencing significant adverse effects. Some people have a fairly well-developed ability to withstand or tolerate stress, while others do not. However, stress tolerance is not a fixed or permanent characteristic, and you can learn to increase your mental/emotional durability. Specific factors associated with a relatively high level of stress tolerance include access to a strong social support network, the ability to view problems in positive terms, the ability to focus on long-term outcomes rather than short-term setbacks, the ability to assess and monitor your current emotional state, the ability to assess and monitor your body’s reactions to stress and the ability to set effective and reasonable priorities.
Impact on Women
In the study published in Drug and Alcohol Dependence, researchers from the University of Maryland and the University of North Carolina, Chapel Hill used data gathered from 189 participants in residential substance treatment to assess the impact that gender has on the overlapping effects of depression and stress tolerance in cases of substance use disorder. Each of these participants had his or her substance problem severity measured with a screening tool called the Short Inventory of Problems-Alcohol and Drugs. Depression symptoms were measured with a widely used screening tool called the Beck Depression Inventory; the researchers used a third screening tool, called the Computerized Paced Auditory Serial Addiction Task, to gauge each participant’s stress tolerance.
After analyzing their results, the researchers concluded that, when it comes to the severity of substance abuse/addiction, there is a triangular relationship between gender, stress tolerance and depression. Specifically, for women, they concluded that heightened symptoms of depression are linked to more serious forms of substance problems in individuals who have relatively low stress durability.
The study’s authors defined stress tolerance (distress tolerance) as the ability to continue to pursue goals and plans even when setbacks lead to significant, negative changes in normal mood. This definition fits well with more generalized notions of the ability to successfully endure stress. Men enrolled in the study did not experience the same connection between substance problem severity, depression symptoms and low stress tolerance. This may be an important finding since, compared to American men, American women have a roughly 70 percent higher lifetime rate of exposure to diagnosable depression. The authors believe that women in treatment for substance problems may benefit from gender-specific approaches to improving stress tolerance.