A report released by the National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA) showed a strong correlation between alcohol and drug use and depressive disorders.
The report released in May 2023, showed the rise in use of alcohol among Kenyans with the age of initiation being as low as six.
According to Dr. Janbibi Yusuf, Head Consultant Psychiatrist at City Health Mombasa, chronic use of substances may cause neurobiological changes that increases the risk of an individual developing a depressive disorder.
“Neurobiologically, we know that substance abuse has an adverse effect on the developing brain. Certain substances affect the connections between different neurons and contribute to either an increase or decrease in the transmission of certain signals in the brain.” She explained
“For example, alcohol reduces the size of the part of the brain where reward function is processed. It therefore leads to a loss in the ability to experience pleasure, a key symptom in depression. Others like khat increases the risk of chronic insomnia (inability to initiate and sustain sleep) which again is also associated with depression.”
The NACADA report, which represents the latest national survey on drug and alcohol abuse in the country notes that one in every five youths aged 25 – 35 years were currently using at least one substance, with the most abused drugs being alcohol, tobacco, khat, cannabis followed by prescription drugs.
The report shows a significant link between depressive disorders and drug and substance use (DSU), emphasizing the growing challenge faced by addiction professionals in addressing co-occurring substance use and mental health disorders.
According to the report, one in every eight Kenyans aged 15 – 65 years (3,199,119) are said to be alcoholic with the Western region having the highest prevalence at 23.8 per cent followed by Coast at 3.9 per cent and Central at 12.8 per cent.
“Alcohol continues to be the most widely used substance of abuse in Kenya with findings pointing towards increasing demand for cheaper and readily available alcoholic products especially chang’aa, traditional brews, and potable spirits” the report read.
According to NACADA 2022 Report, risk of depression was higher in alcohol and cannabis users. This is due to the fact that alcohol is legal, socio-culturally acceptable and there are cheaper traditional brews available.
“Use of cannabis was higher for males 4.7 per cent than females 0.2 per cent. There was a higher prevalence in the use of cannabis in the urban areas 3.0 per cent than in rural areas 1.5 per cent. Nairobi region had the highest prevalence of past-month use of cannabis at 5.0 per cent,” the report read in part.
Contrary to the perception of cannabis as harmless, Dr. Janbibi explained that there is a global rise in the concentration of delta-tetrahydrocannabinol (THC) found in street cannabis.
“Globally, it has been noted that the concentration of THC in cannabis has been steadily increasing. THC has a well-documented addictive potential and is associated with an increased risk of developing mental illnesses like depression and psychotic disorders, especially in younger abusers,” she said.
Dr. Janbibi went further to explain that with chronic cannabis users, especially those who start using from an early age tend to have a less favorable prognosis in treating depression and schizophrenia when compared to individuals who abstain from cannabis use.
“Cannabinol and cannabidiol are the other prominent cannabinoids, not thought to have psychoactive properties are safer for use, that is they don’t make people “high” but may be useful in reducing pain and inflammation, controlling epileptic seizures. However, the cannabis that is available to Kenyan youths contains high concentrations of THC, because the addictive potential is what sustains the market for drug peddlers.” she explained.
Due to the overlap in symptoms of drug use and depression, diagnosis can be a nightmare. Symptoms like excessive sleeping, mood disorders and reduced appetite could apply to either a mental disorder or drug use.
The report suggests that comprehensive assessments should be conducted to evaluate individuals seeking addiction treatment for the presence of depressive disorders.
Such assessments would enable addiction professionals to develop personalized treatment plans that consider both the substance use and mental health aspects of a patient’s condition.
By addressing both disorders concurrently, addiction professionals can provide more effective and holistic care to individuals struggling with addiction and depression.
Treatments have to adequately target both disorders because inadequate treatment of one will interfere with recovery. Multiple treatments, however, could lead to undesirable drug interactions and side effects.
Dr. Janbibi warns against self-medication especially among those struggling with addiction noting that, “those with depression may use substances to self-medicate against depressive symptoms. Eventually, this becomes habitual and an ineffective coping strategy which causes more harm than good, the depression thus occurring first and being the cause for substance use.”
She went on further to insist on the importance of seeking proper treatment while also acknowledging the existing gap in the country when it comes to mental illness diagnosis and treatment.
“It is a known fact that mental health services in Kenya are overwhelmed with patients given the few centers that can provide such services. There are few youth- centered services that are available. Stigma, financial constraints, lack of awareness, and limited availability of integrated treatment services can hinder their ability to receive the appropriate care.”
