Depression Related to Quitting Smoking

Smoking and mental health

Depression Related to Quitting Smoking

We all know the physical health risks of smoking tobacco, but did you know smoking also affects people's mental health?

*Last updated 9 March 2021

If you’re a smoker, there is now a lot of support available to help you quit. It’s never too late to give up, and you may find that quitting reduces your levels of stress, anxiety and depression.

Why is smoking so addictive?

When a person smokes, nicotine reaches the brain within about ten seconds. At first, nicotine improves mood and concentration, decreases anger and stress, relaxes muscles and reduces appetite.

Regular doses of nicotine lead to changes in the brain, which then lead to nicotine withdrawal symptoms when the supply of nicotine decreases. Smoking temporarily reduces these withdrawal symptoms and can therefore reinforce the habit. This cycle is how most smokers become nicotine dependent.

Smoking and stress

Some people smoke as ‘self-medication’ to ease feelings of stress. However, research has shown that smoking actually increases anxiety and tension.

Nicotine creates an immediate sense of relaxation, so people smoke in the belief it reduces stress and anxiety. This feeling is temporary and soon gives way to withdrawal symptoms and increased cravings.

Smoking reduces the withdrawal symptoms, but doesn’t reduce anxiety or deal with the reasons someone may feel that way.

Smoking and depression

Adults with depression are twice as ly to smoke as adults without depression. Most people start to smoke before showing signs of depression, so it’s unclear whether smoking leads to depression or depression encourages people to start smoking. It’s most ly that there is a complex relationship between the two.

Nicotine stimulates the release of the chemical dopamine in the brain. Dopamine is involved in triggering positive feelings.

It is often found to be low in people with depression, who may then use cigarettes as a way of temporarily increasing their dopamine supply.

However, smoking encourages the brain to switch off its own mechanism for making dopamine so in the long term the supply decreases, which in turn prompts people to smoke more.

People with depression can have particular difficulty when they try to stop smoking and have more severe withdrawal symptoms. Remember there’s lots of support available if you decide to quit, however – you don’t have to go through it alone.

Smoking and schizophrenia

People with schizophrenia are three times more ly to smoke than other people and tend to smoke more heavily. It’s ly this is because people with schizophrenia use smoking to control or manage some of the symptoms associated with their illness and reduce some of the side effects of their medication.

A recent study has shown smoking may increase the risk of developing schizophrenia. However, further research is needed to fully understand how the two are linked.

Ways to help you quit

Stopping smoking suddenly through willpower alone is the least effective way to quit. If you plan ahead, have support and choose the right time to try, you’re more ly to be successful. If you’re feeling unstable, experiencing a crisis or undergoing significant changes in your life, you’re less ly to quit.

If you take antidepressants or antipsychotic medicines, talk to your GP or psychiatrist before you stop smoking. The dosage you take may need to be monitored and the amount you need to take could be reduced. This is because smoking can reduce the levels of some medications in the blood, so you may need a lower dose when you quit.

Prepare for change

Think about your relationship with smoking. Write down what you will gain by not smoking, such as better physical health, fresher breath, improved concentration and more money to spend on other things.

Get support from family and friends

Stopping smoking can be easier with the support of family and friends. If you live with people who smoke, or have friends who smoke, suggest to them that you give up together. If other household members smoke, encourage them not to smoke around you or leave their cigarettes, ashtrays or lighters where you will see them.

Find other ways to cope with stress

If you use smoking to cope with stress, you’ll need to find other ways to deal with it. Some things people find helpful are meditation and breathing exercises, regular exercise, cutting down on alcohol, eating a well-balanced diet, acupuncture and hypnosis. Counselling or simply talking to a supportive friend, family member or religious or spiritual leader can also help.

Find a local stop smoking service

You’re three times as ly to stop smoking successfully if you use a stop smoking service. They offer free one-to-one or group support along with stop smoking medicines. You usually go for a few weeks before you quit, then once a week for four weeks after your last cigarette.

Talk to your GP

Many people don’t realise their GP can help them stop smoking. They may enrol you in a stop smoking clinic, or prescribe nicotine replacement therapy or stop smoking medicine.

Nicotine replacement therapy and medication

Nicotine replacement therapy (NRT), anti-depressants and other medication have all been shown to help smokers without mental health problems to stop smoking and they may also be helpful for people with depression or schizophrenia. NRT appears to be more effective when combined with a talking therapy.

You could also consider e-cigarettes. They’re much safer than cigarettes and can help people stop smoking.

Talk to your doctor, a pharmacist or a health visitor about which treatments might be suitable for you.

Talking therapies

Individual, group or telephone counselling can help people to stop smoking. Talking therapies can help people change their behaviour by thinking and acting more positively.

Many counselling programmes use the techniques of cognitive behavioural therapy (CBT) and social skills development.

Research has shown that CBT may be particularly effective in smokers with or without mental health problems.

Avoid triggers linked to smoking

Removing all tobacco products from your home can help lessen some of the cravings of nicotine withdrawal.

Learn to recognise your smoking triggers. Identify when you crave cigarettes, such as at a party or after a meal. Try to avoid those situations where possible, or plan ways to resist triggers you can’t avoid. Most cravings only last a few minutes. If you can ride them out, you’ll be closer to quitting for good.

Be prepared for withdrawal symptoms

You may experience headaches, nausea, irritability, anxiety, craving cigarettes, feeling miserable, difficulty in concentrating, increased appetite and drowsiness. Drinking more fresh fruit juice or water, eating more high fibre foods and reducing caffeine and refined sugar in your diet can all help you cope with withdrawal symptoms.

Don’t give up if you relapse

Many people who quit smoking will relapse at some point. Don’t be put off trying again. Use it as an opportunity to reflect on what went wrong, learn about yourself and figure out what will help you be more successful in future.

Further help and supp0rt

In England, call the National Smokefree Helpline on 0300 123 1044 or visit the NHS website . If English isn’t your first language, you can call the helpline and ask to speak to an interpreter for the language you need.


Depression After Quitting Smoking

Depression Related to Quitting Smoking

Some people report feelings of depression after quitting smoking. Mood changes and irritability are common in the first few weeks after you quit smoking. And so are sadness and depression. 

More severe depression can happen, too. 24% of smokers with a history of depression and 14% of smokers with no history of depression report mild to major depression after quitting smoking.

Most times, these low moods are temporary nicotine withdrawal symptoms and quitting smoking will eventually decrease depression.

And there are many things you can do to speed the process and begin feeling better. 

So if you’re struggling with sadness or depression, or if you’re worried that you will after quitting smoking, keep reading to learn why this happens and how to cope. 

(And if you’re concerned about someone else, there are things you can do to help.)

Remember, You’re not alone! 

What Is Depression?

While experiencing sad feelings and low moods is common after quitting, this is not always depression and it’s not always because you stopped smoking. 

Depression is a mood disorder. It affects how you feel and think, and how well you’re able to cope with life.

Some of the signs of depression are:

• feeling sad or empty

• feeling discouraged or hopeless

• losing interest in things you usually enjoy

• having difficulty concentrating or making decisions

• feeling restless or irritable

• losing your appetite or eating too much

• feeling tired or without energy

• having difficulty sleeping or, for some people, sleeping too much. 

Depression or Sadness?

Feeling sad and being depressed are two different things.

Feeling sad is usually a response to something difficult, disappointing or hurtful. This lasts a day or it can be a longer phase, and there’s a specific cause in most cases.

Feeling depressed isn’t a response to a specific event. It’s a general feeling of unhappiness–usually about everything in one’s life.

Depression is persistent, not a sadness that comes and goes. As a general rule, if a low mood lasts for more than three weeks, it’s probably depression. 

Is quitting smoking to blame if you feel depressed?

Not always. 

Having bad days and going through bad phases is normal.

We all have days or weeks when nothing seems to go right; smokers, ex-smokers and non-smokers a.

The sadness may be in response to something else that’s happened in your life. But this time, you’re going through this challenge as a non-smoker. 

If you feel down shortly after you quit, then it could be because you cut off nicotine and your brain adjusts back to normal health.

But if you feel bad months after you quit, then it probably doesn’t have to do with quitting smoking. 

When you have bad days, and you probably will, you might think that quitting is to blame and that smoking is the solution.

Remember that smoking put you in this situation in the first place and that if you smoke, a bad day may turn to many bad days of guilt and struggle. 

Instead, focus on your freedom, and know that at the end of a bad day, you won and persevered. And a smoke-free day is a good day after all.

Nicotine and Depression

When you inhale tobacco smoke, nicotine passes into your bloodstream and quickly reaches your brain.

Nicotine hijacks your brain, takes the place of acetylcholine, another neurochemical, and stimulates the release of neurotransmitters dopamine.

Higher dopamine levels improve your mood and your feeling of wellbeing. In fact, it’s sometimes called the “feel-good hormone.”

Why Would Quitting Smoking Make You Depressed?

It has a lot to do with dopamine. 

Dopamine is released when you do something pleasurable, have a nice meal, and also when you expect to feel pleasure. 

Dopamine is also the reason why you use cigarettes as a reward and as a way of managing emotions. 

The problem is that, over time, your brain learns to release most of its dopamine when you smoke. 

So when you stop smoking, the reward–the expected cigarette–doesn’t follow, and your dopamine level drops. So you momentarily feel unhappy or dissatisfied.

Think about it this way.

Nicotine is a stimulant. But after stimulation comes depression.

So you have to keep taking the stimulating drug to avoid the depressive effects.

This creates a vicious cycle of stimulation and depression and the only way to break it is to stop taking the stimulating drug; the nicotine. 

Another Reason Why You May Feel Depression After Quitting Smoking

Some other chemicals in the brain are involved, too. One of them is MAO-A. (That stands for monoamine oxidase A.)

MAO-A levels are higher than usual in people with depression. And they’re very high in the first few days after quitting smoking.

Why does that matter?

Well, high levels of MAO-A reduce the amount of serotonin in your brain.  And low levels of serotonin are linked to depression.

What happens when you stop taking nicotine?

Regular smoking changes your brain chemistry. And when you quit, your brain chemistry changes again. 

Once you stop taking nicotine, your brain will eventually bounce back and stop waiting for nicotine to release dopamine.

Instead, it will release the feel-good chemical when you do something that gives you real pleasure. 

During that transition period is when you’re most ly to feel sad or depressed.

You probably smoked when you did things you enjoyed. Maybe you had a cigarette after a meal, after sex or while talking with friends.

You can learn to enjoy all of these things without smoking, but it may take some time. 

Also, when you stop using cigarettes as a way to manage emotions–whether positive or negative–you may feel your emotions more strongly. You’re not suppressing them, so they may feel more intense. 

This is temporary–you’ll adjust.

You’ll learn other ways of coping, feeling rewarded and managing emotions without cigarettes. And your feelings of sadness or depression will begin to subside. 

It takes a while for your brain chemistry to go back to the way it was before you started smoking.

But if you stay away from nicotine, you’ll go back to normal levels in about a month.

Your brain won’t need that nicotine supply any longer.

How Long Does Quit Smoking Depression Last? 

These feelings can last for up to 4 weeks after you are nicotine free, but it varies from one person to another.

If you’re a heavy smoker, you’ve developed extra nicotine receptors in your brain.

Nicotine binds to these receptors. And withdrawal symptoms develop when the receptors aren’t activated.

The number of nicotine receptors will go back to normal levels and you will start feeling better if you stay away from nicotine.

It usually takes about a month, but that can vary from one person to another.

It’s important to be consistent and remain nicotine-free. If you smoke, you’ll just prolong the quitting process.

Using nicotine patches or chewing nicotine gum or vaping will prolong the process, too.

Nicotine is addictive, whether it’s in a cigarette or in some other form. It will take longer to reduce the number of nicotine receptors in your brain if they’re still being exposed to nicotine.

If you stay away from nicotine completely, you’ll probably find that your mood gradually improves.

There’ll be times when you find yourself feeling more energetic and more excited about something you’ve planned. 

Pay attention to the good feelings and increased energy you feel at times. You can expect more of these positive changes. 

Keep your expectations realistic, though.

It’s not unusual for feelings of sadness to return at times, and for your moods to vary. That’s normal for everyone. 

But with time, any sadness or depression that was linked to quitting smoking should end. 

Ex-smokers who have gone for a year or more without a cigarette report being happier than smokers.

And they report being much happier than they were when they were smoking.

So don’t let a short period of adjustment keep you from your goal of becoming a non-smoker.

What If You Were Already Depressed Before You Quit Smoking?

A lot of smokers suffer from depression. In fact, smokers are more ly to experience depression than non-smokers. Scientists aren’t sure why.

And smokers with depression or anxiety disorders often smoke very heavily. People experiencing depression or anxiety are more ly to reach for a cigarette whenever they feel uncomfortable.

You might be pleasantly surprised to find that quitting smoking makes you feel less depressed. For some people, quitting smoking is as effective as taking antidepressants!

Several studies have reported a decrease in depression and an improvement in “psychological quality of life” in people who quit smoking. And this is true whether or not they suffered from depression or anxiety.

So don’t worry that quitting smoking will make you even more depressed in the long run. That’s not ly to happen.

How to Cope with Sadness and Depression after Quitting Smoking

There are a number of things you can do to help yourself feel better. 

  • One of the most important is to go easy on yourself. This isn’t the time to make a major life decision or start a big project. Give your body and your mind time to adjust to being free of nicotine first.
  • Talking to someone can help. 
  • Take care of yourself. Make a point of eating regular meals. Focus on healthy foods, lean meats, fresh fruits, and vegetables.
  • Reduce alcohol. Don’t rely on alcohol to improve your mood. Drinking may help you feel better for a little while, but it makes depression worse in the long run. And having a drink can reduce your motivation to quit smoking.
  • Pay attention to your grooming. Take a shower, even when it seems a lot of work. 
  • Try to stay active. Exercise releases endorphins into the bloodstream. Endorphins create a sense of calm and relaxation and improve our mood. The feeling they create is so good that it’s often called a “runner’s high.”

So go for a run, take a walk, ride your bike, go to the gym. Do what you can.

You could also invite someone to exercise with you. Spending time with other people can help you feel more connected and motivated. 

  • Socialize. Call a friend or family member. Meet someone for coffee or a meal. Make plans to go to a concert or see a movie. 
  • Be sure to get outside and get some sunlight. If you can’t get outside, open the blinds and let more light into your home. Sunlight helps boost serotonin levels. It’s a neurotransmitter that influences mood. It isn’t clear why, but it’s usually lower in people with depression.
  • Walk your dog. If you don’t have one, walk someone else’s dog. Animal shelters are usually glad to have volunteers come in and take a dog out for a walk. Even a brief time spent with an animal can ease depression. And walking a dog can help you connect with other people in a relaxed way.
  • Do something that you usually enjoy, even if it doesn’t appeal to you right now. It’s hard to take action and get moving when you’re depressed, but you’ll almost always feel better once you do.
  • It’s a good idea to make plans for your day. Be sure to include something enjoyable in your plans, to give yourself something to look forward to. 
  • Keeping a gratitude journal can also help. It’s a list of things you’re thankful for. They can be as simple as seeing a beautiful sunset, or as basic as having a safe place to live and food to eat. And of course, friends and family can go on your gratitude list, too.
  • This too shall pass. Remember that your low feelings won’t last forever. You’ll adjust–physically and mentally–to being nicotine free. And the odds are that you’ll be much happier once you do.

You’ll be healthier, too. And more energetic. So there’s a lot to look forward to.

  • You’re working towards the goal of being smoke-free. You may want to try working towards another goal, too. It can be in any area of your life–financial, health, career.

Any steps you take towards reaching your goal can focus your energy on something productive, bolster your self-esteem and help improve your mood.

Sometimes depression is so severe that self-help measures exercise and socializing with others aren’t enough.

If that’s the case for you, seek professional help. It’s especially important if you find yourself thinking about suicide or otherwise harming yourself.

Cognitive behavioral therapy (CBT) can be very helpful, and so can other forms of psychotherapy. You talk with a counselor about your thoughts and feelings. Together, you work to try to understand them better. And your counselor helps you learn new ways of coping.

Just remember: help is available. You don’t need to cope with depression alone.


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