Smoking and Depression

[historyteach]

Smoking and Depression
David Gitlin, MD
Associate Clinical Professor of Psychiatry and Family Medicine, Department of Psychiatry, UMass Memorial Healthcare


By now, you are quite aware that smoking is not in your best interests. Well, here’s just one more reason to strongly consider stopping. To no one’s great surprise, there are some rather strong connections between smoking cigarettes and depression. You may have noticed that many smokers, perhaps even you, are more likely to show signs of depression than people who don’t smoke. So what do we know about this connection?

First of all, we know that people who are at risk in their lives for developing depression are much more likely to become dependent on tobacco. Many of you may have had the experience of being depressed, and know that the tendency is to smoke more when this happens. For people with a history of depression, a greater dependence on smoking seems to happen even when they are not actually experiencing a depression. This means that there is probably some biological connection between depression and tobacco use.

The other part of the connection is that people who smoke are more likely to develop depression. Nicotine has an effect on the brain. Initially, that effect may help decrease depression. A lot of people talk about how smoking a cigarette helps them feel less stressed out. However, when smoking continues for more than a few weeks, it has an opposite effect on the brain and depression may develop or get worse. This may be one of the ways that tobacco exerts its “addictive” effect. Withdrawal from nicotine, which happens when people quit smoking, can actually cause or worsen depression. Because of this, people who are depressed are more likely to fail in their attempts to quit smoking. Failing feels lousy, and may add to the depression.

Now, it is important to know what we mean by depression. Depression is not simply feeling blue. Everybody has bad days here and there, especially if something is not going well in their life. No, serious depression is more than that. It is actually an illness, which doctors call Major Depressive Disorder. In this condition, people have depressed mood for weeks to months, virtually some part of every day. They lose interest in activities, have changes in their appetite, sleeping, and energy, may isolate themselves from others, have problems with concentration, and may feel quite hopeless about life. Occasionally, these feelings may include thoughts of suicide, and people with Major Depression are at much greater risk for committing suicide than people who are not depressed. Major Depression is familial, and people with depressed family members are more likely to develop it themselves.

So, what do you do if you are depressed, or have a history of depression, and want to quit smoking? First of all, remember that wanting to quit is always the first important step, and feel good about making that choice. It is important to tell your doctor about your depressive symptoms and history. In most cases, you should have your depression treated first; some doctors may even treat with medication to prevent depression from starting. Once the depression has been treated, then a good program of quitting smoking can be developed. Luckily, some of the medications for the treatment of depression can also be used to assist in smoking cessation. Addition of nicotine patches or gum may also be important, as nicotine replacement therapy will help to blunt or lessen withdrawal symptoms. Lastly, support groups and/or counseling may be useful in helping to prevent depression from recurring.

Stopping smoking is not easy for anyone; if it was, we probably wouldn’t need to have this website. (www.trytostop.org) For people prone to depression, quitting can feel impossible. A failed attempt to quit may leave us feeling inadequate, which may make depression worse. On the other hand, a successful effort at stopping can really boost our morale and self-esteem, which may help keep depression away. What is most important is to realize that depression won’t prevent your attempt to stop if you follow the right path to quitting.


"To no one’s great surprise, there are some rather strong connections between smoking cigarettes and depression."

Hope this helps!
Shalom!