There is a cyclical link between depression and addiction, with each feeding the other in a toxic loop that can be hard to break. For this reason, it is often essential that both depressive disorders and substance abuse disorders are treated at the same time to lessen the likelihood of relapse or continuing depression symptoms.
According to the National Institute on Drug Abuse, roughly one in four people with a serious mental illness also have co-occurring substance use disorder.1 Going even further, the 2019 National Survey on Drug Use and Health (NSDUH) found 1.7% of adolescents (397,000 people ages 12-17) and 3.8% of adults (9.5 million people ages eighteen and older) had both a serious mental illness and substance abuse disorder.2
Although many of us have experienced a day or two where we feel down and out, there is a significant difference between a bad day and clinical depression. Depression is a common mood disorder that can range from mild to severe in intensity, depending on the person and type of depression.
Depressive disorders are typically marked by a pervasive loss of pleasure and enjoyment and a persistent depressed mood that’s accompanied by mood shifts, a sense of hopelessness, loss of energy and motivation, increased fatigue, diet and weight shifts, sleep problems, and thoughts of death and suicide.
Many people think of depression as one disorder, but there are several distinct types of depression.
It should be noted that bipolar disorder is not technically a depressive disorder, but it involves intense swings in mood which, on the low end, can share many of the same features as depression. The other end of bipolar disorder involves mania, which is marked by elevated and euphoric mood, grandiosity, and increased energy.
Depression is one of the most experienced mood disorders, impacting roughly 280 million people worldwide, according to the World Health Organization (WHO).3 In addition, the National Institute of Mental Health found that in the U.S. in 2017, roughly 17.3 million adults over eighteen years old (6.7% of adults) had experienced at least one episode of major depression in the past year.4
Addiction is a complex condition characterized by compulsive behavior towards eliciting a pleasurable or rewarding outcome, regardless of consequences. When it comes to substance use disorders, addiction refers to a compulsion to use a certain substance to achieve the desired state.
Addiction is distinct from dependence in that it is accompanied by a range of negative effects that reduce life satisfaction and impair our ability to function. Dependence, on the other hand, is marked by increasing tolerance and symptoms of withdrawal but does not always include the craving and compulsion like addiction does.
Although depression symptoms will vary from person to person, people experiencing depression may experience symptoms that include:
To receive a clinical diagnosis of depression, most diagnostic criteria require the existence of at least five depression symptoms, including a persistent depressed mood or anhedonia.
Depression is classified with either typical or atypical features. Atypical depression is marked by all the same signs and symptoms of clinical depression, but with temporary periods marked by boosts in mood, increases in appetite and weight, extended sleeping (hypersomnia), and headaches and body pain.
The signs and symptoms of addiction vary depending on the substance, but there are eleven key behavioral signs and diagnostic criteria you can look out for.
Unfortunately, depression and addiction seem to co-occur at fairly regular rates, particularly when it comes to alcohol abuse. This cycle (casually dubbed the DAD effect) is not too difficult to understand. Many struggling with depression may find themselves reaching for the bottle to temporarily escape feelings of emptiness and hopelessness. Temporarily, alcohol and other drugs can help relieve that pervasive melancholy and give a slight boost of enjoyment.
However, once those effects wear off, people with depression may find themselves in a worse spot than before. This issue is because alcohol is a central nervous system depressant, meaning it slows brain activity. In the long run, alcohol and substance use can contribute to depressive symptoms all on their own.
This cycle is referred to as the DAD effect when someone struggles with depression, which causes them to self-medicate ultimately contributing to substance use disorder, which is followed by denial and a continuation of the cycle.
The 2019 NSDUH report found that adolescents and adults who had experienced a major depressive episode were more likely to use substances than their counterparts who hadn’t experienced a major depressive episode.
Another report published by the National Institute on Alcohol Abuse and Alcoholism found that roughly one-third of people with alcohol dependence also had a co-occurring mood disorder like depression.5
Additionally, research suggests one-third of people with a major depressive disorder also have a dual diagnosis of substance use disorder.6
If you or a loved one is experiencing depression symptoms, the best thing to do is talk with a trusted care provider. They will be able to help you determine a clinical diagnosis of depression and work with you to figure out your next steps.
First introduced in 1961, the Beck Depression Inventory (BDI) is a twenty-one-item self-report questionnaire that helps to identify the severity of depression across a range of depression symptoms. The individual will go through and rate the severity of the symptoms they’ve experienced in the past week from absent to severe.
The 21 items cover a wide range of depression symptoms, including:
According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a clinical diagnosis of depression requires the persistence of five or more symptoms within a two-week timeframe. Symptoms must include either anhedonia (loss of pleasure) or a depressed mood that persists most of the day, every day.
If the individual is experiencing four or more depression symptoms in addition to the loss of pleasure or a depressed mood, appetite or weight changes, restlessness, fatigue, difficulty concentrating, feelings of worthlessness or guilt, and increased thoughts of suicide, they may receive a clinical diagnosis of depression.7
The International Classification of Diseases, Tenth Revision (ICD-10) is a comprehensive list of diseases, signs, symptoms, social contexts, external causes for diseases or injury, and more compiled by the World Health Organization beginning in 1983. The ICD-10 uses relatively similar criteria to the DSM-V in diagnosing depressive disorders but sets the threshold for diagnosis at four depression symptoms rather than five.8
If you or a loved one is struggling with a substance use disorder, the first step to recovery is talking with a trusted care provider to determine the severity and appropriate course of action.
The DSM-5 criteria for substance use disorder cover ten separate classes of drugs and feature the eleven diagnostic criteria addressed in the signs and symptoms of addiction. If an individual indicates two to three symptoms, they’ll likely be given the diagnosis of mild substance use disorder. Four or five symptoms suggest a moderate substance abuse disorder, and six or more symptoms indicate a severe substance use disorder.
According to the ICD-10, the central defining feature of addiction is the desire that compels people to continue taking substances that may otherwise be harmful. The ICD-10’s criteria differ from the DSM-5 in that it lists six diagnostic criteria.8 If a person has experienced three or more of the criteria in the past year, they may receive a diagnosis of substance use disorder.
Other tests you can take to identify SUD include:9
When it comes to treating co-occurring depression and addiction, it is essential to make sure you are engaging in comprehensive programs that target the two disorders separately.
Many people struggling with a dual diagnosis of depression and addiction find therapy to be an invaluable source of support, guidance, and empowerment. Cognitive-behavioral therapy (CBT) is a widely used therapy that helps patients identify and replace faulty negative beliefs with more helpful thoughts and behaviors.
For patients struggling with their emotions without reactivity, dialectical behavior therapy (DBT) may be a better option. A third popular therapy is eye movement desensitization and reprocessing (EMDR) therapy, which helps patients explore challenging memories with less intensity.
Care providers may prescribe SSRIs, SNRIs, antidepressants, anxiolytics, and antipsychotics to treat depression. You may also be prescribed medications to help with withdrawal and curb cravings. However, care providers must be aware of ongoing treatments for SUD when prescribing medications for depression to avoid potentially dangerous drug interactions.
You may find that your environment isn’t conducive to recovery. If that is the case, exploring rehabilitation programs could be beneficial. With inpatient and outpatient options to suit your needs and goals, rehabilitation provides greater access to the tools, support, and professionals to help you on your recovery journey.
We’re committed to fostering unbroken recovery. We provide treatment for addiction and dual diagnosis that is both life-long and life-changing. At Stages of Recovery, our continuum of care helps individuals struggling with addiction become the people they were meant to be.
If you’re looking for a safe recovery program for yourself or someone you know, there is hope. Call us today.
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Cari has worn a variety of hats before coming to Stages of Recovery – in a past life, she was in advertising sales, association management, corporate event planning and property management. Hailing from West Texas, Cari grew up in Midland before attending Texas Tech University. Always creative and an over-achiever, she graduated magna cum laude with a BA in Advertising before moving to Florida for the next seven years. A true Texan at heart, Cari returned to the Lone Star State and pursued a career in property management where she earned national designations in leasing, apartment management and obtained her real estate license. In 2015, she met Stages of Recovery owner Stephen Medley by chance. Recognizing her style and resourcefulness, he challenged Cari to head up the renovation of the men’s Transitional Housing properties in Lubbock and Waco (check them out – they look pretty great if we say so ourselves!). Given her knack for organization and execution, the Stages family officially welcomed Cari in 2020 to assist behind the scenes in administration, operations and marketing – she’s here to make us look good! In her spare time, Cari’s pastimes include cooking, interior design and doting on her Scottish Folds – Birdie and Apollo.
Words to Live by:
“Why cope when you can eliminate?”
J. E. Buddy Bowman whose journey into the treatment field marks an inspiring second career. Buddy’s passion for recovery is deeply rooted in his personal journey, having experienced both therapeutic community and 12-step recovery since 1984. This profound understanding of the recovery process allows him to approach his counseling with empathy, compassion, and an unwavering belief in the transformative power of rehabilitation.
Buddy also comes to us as a “Train the Trainer” in Texas, and has specialized in working with clients involved in the Criminal Justice system. This unique background has earned him a well-deserved reputation as an empathetic and effective counselor.
Buddy finds immense joy in his family, is an avid nature enthusiast and enjoys exploring the breathtaking landscapes of the western United States. One constant companion on his journeys is his beloved dog, Bandit.
Check back soon to learn more about Tony!
Matt obtained his bachelor’s degree in Addiction Counseling in 2017 and his master’s in 2020 in the same area of study. In 2020 Stages of Recovery welcomed him as an intern which quickly turned into a part-time then full-time position, assisting with groups and transitional housing at the men’s properties in Lubbock. Matt began his journey in counseling because he wanted to help people struggling with the disease of addiction, by being a role model and helping them realize the potential they have in recovery.
Seeing people succeed in recovery and change their lives for the better fuels Matt to continually offer support and leadership to the recovery community here at Stages.
“I have experienced the joy and peace that comes with sobriety and want to share that and show others that there is a way out of the darkness that is addiction.”
Favorite quotes:
“Pain is certain, Suffering is optional.” Gautama Buddha
“Don’t compare yourself with other people; compare yourself with who you were yesterday.” Jordan Peterson
Dustin is in long-term recovery and has been sober since May of 2011. He is from San Antonio, TX and is married to his lovely wife, Emma. They moved to Lubbock, TX where Dustin attended The Center for Collegiate Recovery Communities at Texas Tech University. Upon Emma’s graduation from Texas Tech in May of 2018, they relocated to Moore, OK, where Dustin graduated in 2020 with his bachelor’s degree in Social Work and recently achieved his master’s degree in Social Work from The University of Oklahoma. Dustin is also the recipient of the National Collegiate Recovery Student of the year award in 2019 for his tireless work building a recovery space on campus for students. Dustin was also the BSW student of the year in 2019 as well as a two-time recipient of the Anne and Henry Zarrow Social Justice Award for 2020-2021. Dustin has sat on numerous boards of directors in the Oklahoma community. His passion, education and ability to help others gain a life of purpose and meaning are just a few reasons why we are excited to have him on our team!
Mechie went through Stages of Recovery 10 years ago with the dream of one day obtaining a degree and providing for his daughter. He had his daughter at five months sober and started working as a janitor at Texas Tech University in 2011. After discharging from Stages of Recovery, Mechie received a scholarship at Texas Tech and The Center for the Study of Addiction and Recovery. Not only did he receive his Bachelor’s degree from Texas Tech, he pursued his Masters in 2014. Mechie has committed his life to helping others and lives by the motto that he doesn’t care about their feelings, he cares about their lives. His humble roots, passion to help others, and commitment to being his best self is what we at Stages of Recovery embody! We are ready to make shock waves in recovery with this guy!
Tommy was raised in Tulia, Texas and is married to his first love, Rosalind. They are volunteers for the state of Texas’ program called “Twogether in Texas”, where engaged couples undergo an eight hour workshop. They dedicate their time as a couple to marriage ministry and outreach in the community. Together they have six children and twelve grandchildren. Tommy has been with Stages of Recovery since 2018. He has a Master’s in Addictions Counseling. He is currently in the process of obtaining his LPC Associate and LCDC licenses. Tommy began his recovery in December 2001. He’s driven to give back to the recovery community after seeing so many friends and family who suffered from addiction lose their lives. His journey hasn’t been easy and if he can help the next man, woman, boy or girl choose a different path than he did, it fills his heart with joy.
Favorite Quote
“The true test of a man’s character is what he does when no one is watching.” John Wooden
Check back soon to learn more about Ayla!
Steve Richardson is a husband, father, and grandfather. He is also a man in long-term recovery and has a son in recovery as well. Through this journey, few would find it difficult to relate to Steve, making him especially adept at developing relationships with clients and their families. Recovery is so central to his life, that at the age of 52, Steve closed a successful consulting firm and returned to school to become a licensed clinical social worker, as well as a licensed chemical dependency counselor. His education includes a BA in Literature from Texas Tech University, a BS in Psychology at Tarleton State University and a MA in Social Work at the University of Southern California. Along with his extensive education, degrees and training, he brings 50+ years of life experience to every individual, family and group session. Steve believes that no one’s illness should dictate the quality of their future and that their pain and struggle are real. Every addict’s life matters and there is always hope. In other words, no one’s future is carved in stone. His certainly wasn’t.
Favorite Quote
“There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.” Albert Einstein
Stephanie moved from her hometown of San Antonio to Lubbock, TX in 2011 to begin a long journey toward self-growth and healing. She graduated from Texas Tech University with Bachelor degrees in Psychology, and Science in Human Development and Family Studies. After a year of work in the chemical dependency field, Stephanie went on to graduate with a Masters in Couple, Marriage and Family Therapy (with a focus in Addiction in the Family) in 2018. After receiving support from countless loving individuals during her struggle with mental illness, it has been Stephanie’s mission to extend the same level of compassion and care to her clients. She believes counseling is a way for individuals, couples and families to share their experiences and pain, and find ways to transform their darkness into light. Stephanie is especially interested in working with adolescents and adults struggling with addiction and substance abuse, at-risk populations, and couples/families. She works from a systemic perspective with all clients; meaning she gathers information about all areas of an individual’s life to assess needs and the effects that each area may have on the others. Looking through a systemic lens offers the ability for individuals to create lasting transformations through self-awareness about their unmet needs in multiple areas. In her personal life, Stephanie spends most of her time with my husband and their five goofball dogs. She’s a PokemonGo, Disney, and Taylor Swift enthusiast and she enjoys creative outlets including make-up artistry, painting and interior design.
“Mel” is originally from Angeles City, Philippines. He graduated from Lubbock Christian University with a degree in Social Work. One of the newest clinicians to join Stages in 2020. Mel has over 20 years in Residential inpatient services and is known for his willingness to go above and beyond for others. He is skilled in Mindfulness and serves with a true heart of service. Like many, Mel has had many experiences and challenges in his life that have equipped him to keep pushing forward. These experiences allow him to make deep and meaningful connections with those he helps. When working with clients, he champions the mindset that every human needs three things: TO BE HEARD, TO BE SEEN, AND TO HAVE A SENSE OF PURPOSE. Mel’s motto in life is simply to “Be you” and to not allow anyone or anything to deter you from this.
Favorite Quote
“Be like water making its way through cracks. Do not be assertive, but adjust to the object, and you shall find a way around or through it. If nothing within you stays rigid, outward things will disclose themselves. Empty your mind, be formless. shapeless, like water. If you put water into a cup, it becomes the cup. You put water into a bottle and it becomes the bottle. You put it in a teapot, it becomes the teapot. Now, water can flow or it can crash. Be water, my friend.” Bruce Lee
Averie is a graduate from Texas Tech University with her Bachelors of Social Work in 2018 then in 2020 with her Masters of Social Work. Averie has been working within the area of addiction and recovery since August of 2018 when she started her Bachelor of Social Work field practicum with Stages of Recovery. Averie decided to work with addiction and recovery because of her passion for seeing people better themselves. Averie believes everyone can change, and she shows a clear love for being part of the process and empowering individuals along the way. Averie has been in recovery herself since October of 2017. She has two adorable dogs, Rockie and Chewie. In Averie’s free moments, you can catch her spending time with her partner, watching reality TV, or playing video games.
“I love to get in the trenches with the people that I work with, fight with them for their change. I believe anyone, no matter what they have been through, has the ability to overcome.”
Ashley Loveless, Licensed Master Social Worker, earned her Bachelor of Arts and Sciences in Social Work and Spanish from Texas Tech University in 2014. Ashley proceeded to obtain a Master of Social Work from Our Lady of the Lake University in 2017. Ashley has been a licensed and practicing LMSW since 2014 and has worked in many private and non-profit sectors including administrative roles, hospice roles, sexual assault counseling, sex-trafficking rescue/counseling, and mental health. She began her career as a Correctional Mental Health Social Worker at Montford State Psychiatric Prison/Hospital in Lubbock, TX in 2014. She has been employed part-time with Stages of Recovery since February 2019 as a Mental Health Counselor, co-leading early recovery groups and taking on individual clients. Ashley works full-time at Hospice of Lubbock as a medical social worker. Ashley and her husband Paul, have four daughters, Sophie, Harper, Sawyer, and Bowen and a dog named Lincoln. Ashley enjoys traveling, yoga, baking, and adventure.
Lynn has been an LPC for nearly eight years. By volunteering at the Greater Dallas Council on Alcohol and Drug Abuse, she became interested in addiction and recovery. Her practicum in graduate school included working with veterans and women in recovery through art therapy techniques. Lynn is a member of the National Association of Alcoholism and Drug Abuse Counselors and the West Texas Counseling Association. Along with her Marriage and Family Master’s degree, she holds a Master’s degree in art therapy. Lynn’s unique background allows Stage’s clients to introduce and foster creativity throughout their personal recovery. Lynn is a former classroom teacher, grades 1-8. She is certified in all-level art and counseling.
Favorite Quote
“Imagination rules the world.” Napoleon.
Melissa currently works as a Licensed Chemical Dependency Counselor-Intern and as the Administrative Director at Stages of Recovery. Along with working at Stages of Recovery, she works with adolescents in the Parent Empowerment Project. She has worked in the recovery field since 2015, with a focus on substance use disorder and helping families heal. She pursued work in addiction because of her academic, professional, and community involvement, as well as her personal experiences. Melissa’s work has allowed her to dive deeper into the field of addiction and recovery and to expose her genuine love for the betterment of other’s lives. Currently, she is a doctoral student at Northcentral University and pursues her degree as a Doctor of Philosophy in Marriage and Family Therapy. Melissa received her bachelor’s degree in Community, Family, and Addiction Sciences at Texas Tech University and her master’s degree in Couple, Marriage, and Family Therapy at Texas Tech Tech. She was a member of The Center for Collegiate Recovery Communities at Texas Tech University.
“It takes one person to believe in you.”
A Pennsylvania native, Anthony left home when he was 21 during an active addiction – he thought he had it all figured out. Anthony moved from Wyoming to Montana to Colorado. His addiction progressed, causing him to neglect priorities like relationships, rent, and job opportunities. Eventually, Anthony found himself homeless and broken spiritually, emotionally, and physically. Anthony researched a treatment center in the Dallas area that was able to fly him down to Texas. He was a client there for 57 days. While at treatment, Anthony heard of The Door Sober Living and the recovery that Lubbock had to offer. Anthony took a greyhound to Lubbock and in 2012, Anthony stayed at The Door for six months before moving out. Without The Door’s accountability and structure, he fell back into addictive behavior for several months. Anthony checked into the Ranch at Dove Tree, where he stayed for 30 days. Upon successful completion, Anthony returned to The Door Sober Living on May 19, 2013. This time, Anthony signed a one-year agreement and expressed great willingness to maintain sobriety. In July 2014, when a previous house manager moved in with his fiancé, Anthony was asked to step up and take on his duties. This then, Anthony has grown into the Client Relations House Manager. His continued dedication to recovery and belief in the Stages of Recovery program as a whole led to an opportunity in 2017 to become the fourth owner of Stages.
Stephen “Medley” is the founding owner of Stages of Recovery, Inc. and The Door Sober Living Community. A visionary with a passion to help those in recovery, he saw a need in the community and decided to take matters into his own hands. Medley has over twenty years of recovery time. After getting clean at the age of nineteen, he knows firsthand how to show many of our younger clients that it is still possible to have fun in recovery. Medley graduated from Texas Tech University as a member of the Collegiate Recovery Community at the Center for the Study of Addiction and Recovery with a bachelor’s degree in Business Administration. Medley is the leader of the company and an inspiration to all staff members. Medley understands the power of knowing why; why we made poor decisions and the importance of knowing and remembering why we don’t want to make them again.
“I’m passionate about helping individuals realize and reach their dreams by focusing on their WHY.”
Stephen O’Dell has been with Stages of Recovery for over 12 years. He has served in many roles as the company has continued to grow. He is currently one of the owners and the CFO. He also does direct business development and admissions for those in need of services. Stephen’s time with Stages began when he was a client learning how to live his new life in Recovery. He began his journey at the young age of 18 with big dreams and goals. Stages of Recovery provided him with the tools, guidance, and community needed to build a life worth living. Stephen later achieved his bachelor’s and master’s degree in Personal Financial Planning in 2016 and 2017 from Texas Tech University, with the help of a scholarship from the Center for Collegiate Recovery Communities (CRC). He went on to get his CFP® Mark (Certified Financial Planner) in 2018. Stephen’s unique personal and his extensive professional experience makes him a great fit to help you and your family navigate the complicated process of finding help for your loved one in need.
Many people think of Wealth as a monetary value. O’Dell defines Wealth as “The relentless pursuit of a desired lifestyle, and the strategic maintenance of that lifestyle”- Stephen O’Dell. With the help of Stages you and your family can begin to define what your goals are and begin the process of healing together.
Cole and Medley founded The Door Sober Living Community together. Cole is the details behind the program. As Program Director, he conceived and implemented The Door concept and has written multiple grants for this program and others. He is talented at blending the nature of business practices into the field of social services. Cole was born and raised in Lubbock and has been in recovery for over ten years, proving that you can get clean in the same town you live in. He is a proud graduate of the Lubbock County Drug Court program and advocates that Drug Courts work. He holds a Bachelor’s and Master’s Degrees in social work from Texas Tech University. Cole has an inspirational wife, Veronica, and two beautiful children, Eliana and Wyatt. His focus in the company is to make sure that the activities stay true to the spirit of recovery and the mission and vision of the company.
“I’m passionate about guiding people out of their mental sense of lack and into freedom.”
Stephen “Medley” is the founding owner of Stages of Recovery, Inc. and The Door Sober Living Community. A visionary with a passion to help those in recovery, he saw a need in the community and decided to take matters into his own hands. Medley has over twenty years of recovery time. After getting clean at the age of nineteen, he knows firsthand how to show many of our younger clients that it is still possible to have fun in recovery. Medley graduated from Texas Tech University as a member of the Collegiate Recovery Community at the Center for the Study of Addiction and Recovery with a bachelor’s degree in Business Administration. Medley is the leader of the company and an inspiration to all staff members. Medley understands the power of knowing why; why we made poor decisions and the importance of knowing and remembering why we don’t want to make them again.
“I’m passionate about helping individuals realize and reach their dreams by focusing on their WHY.”
