Depression is a common cause of alcoholism. Many patients who present to Florida Detox are simply self-medicating depression with their Vicodin, Percocet, OxyContin, cocaine, or alcohol.  These drugs, as well as the alcohol give the patient an immediate dopamine surge for temporary treatment of their underlying depression.  The cause of depression in many of these patients is an inherited biochemical deficiency of one or more happy brain chemicals.  When these patients are accurately diagnosed and treated with appropriate medications, they stop craving pain pills, alcohol, or cocaine. 

There are multiple biochemical causes of depression. Interestingly, the incidence or prevalence of depressive disorders in males and females is equal up to age 13.  After females reach puberty and undergo hormonal changes, the incidence of depressive disorders increases 300%.  Hormonal changes can absolutely affect brain chemistry and ultimately lead to addiction problems. 

Clinical research at Florida Detox suggests that many female patients suffer imbalance of both hormonal and brain neurotransmitter chemicals.  Unfortunately, many addiction physicians in this country are unaware that low estrogen levels, specifically low estradiol will decrease serotonin receptivity and activity in the brain. Estrogen dropout either post partum or in mid-life, can create serious depression in female patients with no previous history of depressive disorder. The initial evaluation of new onset depression in a 30-45 year old female should always begin with measurement of estradiol levels.  

The primary focus on serotonin deficiency as the main cause of depression has created treatment failure in many depressed and addicted patients. Other happy (excitatory) neurotransmitters are often ignored and some patients become more depressed when treated with medication. The classic depressive disorder patient who presents to Florida Detox is Susan, a 42-year-old professional female who seeks medical attention for depression from her local physician. Dr. Jones immediately assumes that she would benefit from a serotonin enhancer such as Paxil, Prozac, or Lexapro.  If indeed this patient suffers from low serotonin levels, her depression should respond within 2-4 weeks of treatment with the serotonin enhancer. Typically, prescribed a medication like Paxil (20 mg per day), she returns one month later insisting her depression is worse. Dr. Jones raises the Paxil to 40 mg per day. Frequently these patients are prescribed extremely high doses (60 mg to 80 mg per day) in the physician’s effort to conquer the problem. Unfortunately Dr. Jones disregards the continuous report from the patient that they are not feeling any better and may actually feel more depressed. What is the problem? If serotonin is unilaterally elevated above normal levels with the mediation, the brain will down regulate production of dopamine. This makes the patient with dopamine deficiency even more dopamine deficient. These patients will typically begin to self medicate with dopaminergic drugs like Percocet, Vicodin, or OxyContin to counteract the decreased production. All of these drugs produce increased dopamine activity in the brain’s pleasure center (nucleus accumbens). When these patients are accurately diagnosed with their genetic dopamine/glutamate deficiency and treated with appropriate dopamine/glutamate enhancing medication, they quickly experience cessation of their depression and lose the craving (psychological and biochemical) for drugs and alcohol. Treatment results in better relapse statistics with the application of this scientific approach to addiction and depression. Unilateral elevation of serotonin without dopamine level protection will result in markedly elevated prolactin levels. Prolactin will increase appetite and decrease sex drive.  When dopamine levels are enhanced to normal levels, sex drive will return as will better appetite control.