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Should Depression Be Treated with Opiates? What Alternatives Are Available?

Depression is a serious mental health issue that affects how you feel, think, and act.

Symptoms range in severity from low mood to thoughts of suicide, so addressing the condition early and appropriately is important.
There are different types of depression that each vary in their nature, severity, and duration of presenting symptoms.

Types of depression include:

Types of Depression

  • Persistent depressive disorder
  • Postpartum depression
  • Seasonal affective disorder
  • Psychotic depression
  • Bipolar disorder

To be diagnosed with any of the above forms of depression, your symptoms must have been present for at least two weeks. Common symptoms of depression include:

Symptoms of Depression

  • Feelings of hopelessness, worthlessness, or helplessness
  • Persistent feelings of being sad or anxious
  • Fatigue or decreased energy
  • Difficulty concentrating, remembering things, or making decisions
  • Difficulty sleeping or sleeping too much
  • Changes in appetite and weight
  • Physical aches, pains, headaches, or digestive issues that are not clearly caused by anything else and don’t respond to treatment
  • Suicidal ideation or attempts

Depression is a highly individualized experience, so each individual will be faced with a unique combination of symptoms when struggling with depression. Likewise, there is no one-size-fits-all treatment for depression. Fortunately, there are many treatment options available that people generally respond well to.

Opiates for the Short-Term Treatment of Depression

Opiates were a common method of treatment for depression before antidepressants became a popular and safer alternative. Opiates are effective for improving mood, but they are also habit-forming and run the risk of leading to addiction in many people. For this reason, antidepressants have become a more favorable medication, as their side effects are fewer and people do not generally develop a tolerance or addiction to them.

Despite the risks, opiates remain an effective form of depression treatment as they target opioid systems in the brain that regulate mood-related functions. Opioids have been found to reduce suicidal ideation, physical and mental pain, panic, and grief. Within four weeks, many people experience an improvement in their depressive symptoms.

Long-Term Use of Opioids

While opioids are known to alleviate symptoms of depression, their use is only recommended for the short-term treatment of depression due to the likelihood of developing dependence and addiction. In fact, the U.S. Department of Health and Human Services (HHS) declared the opioid epidemic a public health emergency in 2017.

A high increase in prescriptions being written for opioid medications over the past 20 years has led to significant misuse of opioids, both legally and illicitly. Currently, over 130 people die every day due to opioid-related overdoses.
In 2016, more than 11 million people misused prescription painkillers, and more than 2 million people met the criteria for an opioid use disorder. In 2017, more than 17,000 people died from overdosing on prescription opioids. More than 42,000 people died in 2016 from prescription and non-prescription opioid overdoses.

Because of the risks of misuse, addiction, and overdose, long-term use of opioids is not recommended. Even when obtained legally and used under a doctor’s supervision, prescription misuse is possible.

In addition to the risk of misuse, using medication to treat a mental health issue may never get to the root of the problem. If symptoms persist after taking medication for a few weeks or months, medications may not be the best or most effective form of treatment for you. Finding a type of treatment that addresses the underlying causes of your depression and teaches you healthy and empowering strategies is a productive and long-lasting method for managing depression.

What Doctors Say About Treating Depression

Doctors and mental health experts stress that the earlier treatment for depression begins, the more effective it is likely to be. A combination of treatment methods may be necessary, but recovery is always possible. Medication and therapy, both individually and as a combination, are the two most commonly recommended methods of treatment by doctors.

If you are worried that you are struggling with depression, speak with your doctor. Your doctor may conduct a few brief physical and psychological screenings to gain a better understanding of your presenting symptoms and how long they have been bothering you. Depending on what symptoms you present with, your doctor may diagnose you with a specific form of depression or refer you to a mental health expert.

A combination of therapy and medication is effective for treating depression in most people. Medication can relieve debilitating symptoms of depression enough, so you can access and engage in therapy effectively. Types of medications that are used for treating depression include:

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Types of Depression Medications

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Monoamine oxidase inhibitors (MAOIs)
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • Atypical antidepressants
  • Tricyclic antidepressants
  • Additional medications (mood stabilizers, antipsychotics, anti-anxiety, and stimulants)

Because everyone’s symptoms of depression vary, and everyone will respond slightly differently to the above medications, you may have to try out a couple of medications before you find one, or a combination, that works best for you. Mixing medications should never be done on your own, however, and should only occur under close doctor supervision. Many medications are known to have adverse interactions with one another.

In addition to the medication option, many doctors recommend participating in therapy. Personal therapy can help you gain an understanding of what caused or contributes to your depression, and it will help you build healthy skills for dealing with it in the future. Some doctors even recommend trying therapy first to treat depression, as there is no risk of experiencing adverse side effects like there is with prescription medications.

Alternative Treatment Options

Many other well-recognized options can help to alleviate symptoms of depression. For some people, simple changes to their daily lifestyle habits can be enough to experience some improvement in mood. The National Alliance on Mental Illness (NAMI) explains that there are many complementary and alternative medicines (CAM) that can be useful when combined with therapy and medication.

Alternative Treatment

  • Exercise daily.
  • Eat a healthy diet.
  • Avoid alcohol and other drugs.
  • Take a folate (vitamin B9) supplement.
  • Try St. John’s wort.
  • Consume saffron.
  • Practice yoga.
  • Begin meditating daily.

Because depression is a serious condition that can cause life-threatening thoughts and behaviors, most mental health professionals recommend professional care to treat symptoms of depression. If taking prescription medications does not appeal to you, many natural and safe alternatives may be effective for relieving your symptoms. Your doctor or mental health care provider should be willing to work with you to create a holistic treatment plan that addresses all of your goals and needs.