Is Depression Normal After Quitting Smoking?

Johanna Parkin/Getty Images

Question:  Is depression normal after quitting smoking?

Answer:  According to the Centers for Disease Control and Prevention, it is quite common to experience depression symptoms following the cessation of a regular smoking habit. 

Generally these symptoms are not that serious and will resolve fairly quickly, in a week or two; but, if they linger for a longer period of time or are particularly disruptive to your life, they could require assistance from a mental health professional.

 

Among the symptoms that may be indicative of depression are the following:

  • Feeling sad, empty or depressed
  • Losing interest in things that used to give you pleasure
  • Feeling irritable or restless
  • Having problems with sleep
  • Experiencing changes in appetite or weight
  • Having problems thinking, making decisions or remembering things
  • Feeling tired
  • Feeling worthless, guilty or hopeless
  • Thinking about dying or suicide

If you require depression treatment, your doctor may recommend an antidepressant and perhaps counseling or psychotherapy.

    It is not clear why many people become depressed following smoking cessation, however, it is known that people who smoke are more likely to suffer from depression than non-smokers.  Although it is not understood why this link exists, it has been speculated that perhaps depressed people use smoking as a way to self-medicate.  It may be, experts suggest, that nicotine has an antidepressant effect and the removal of nicotine causes the person's depression to return.

      Yet others have suggested that perhaps some effect of smoking itself might make people more prone to becoming depressed.

    There is some evidence to suggest that the use of certain antidepressants may aid in smoking cessation and your doctor may prescribe these.  This is believed to be helpful for three reasons:

    1. Antidepressants may be helpful in relieving the depression often associated with quitting.
    2. It is possible that nicotine is providing some sort of antidepressant effect and an antidepressant medication can replace the depression relief that was being provided by the nicotine.
    3. Some antidepressants may exert an effect on the neural pathways underlying nicotine addiction.

    Two antidepressants are often used to help people stop smoking:  bupropion (Zyban) and nortriptyline.  According to a 2014 Cochrane Review, there is "high quality" evidence that bupropion increases the likelihood of success in quitting after at least six months of use.  In addition, there is "moderate quality" evidence that nortiptyline increases quit rates.  Clinical trials have not provided any evidence, however, that selective serotonin reuptake inhibitors (for example, fluoxetine), monoamine oxidase inhibitors (for example, selegiline) or venlafaxine help people quit smoking.  In addition, over-the-counter remedies like St.

    John's wort and S-Adenosyl-L-Methionine (SAMe) do not appear to be helpful.

    Sources:

    Jaret, Peter.  "10 Ways to Reduce Stress While You Quit Smoking."  WebMD.  WebMD, LLC.  Reviewed by Louise Chang, MD:  January 20, 2011.   Accessed:  July 29, 2015.

    Hughes, J.R., LF Stead, J. Hartmann-Boyce, K. Cahill and T. Lancaster.  "Antidepressants for smoking cessation."  The Cochrane Database of Systemic Reviews.  Published online:  January 8, 2014.  Accessed:  July 29, 2014.

    Taylor, Gemma, Ann McNeill, Alan Girling, Amanda Farley, Nicola Lindson-Hawley, Paul Aveyard et al. "Change in mental health after smoking cessation: systematic review and meta-analysis."  348 (2014) :g1151.

    "Tips From Former Smokers:  I'm Ready to Quit:  Quit Guide."  Centers for Disease Control and Prevention.  U.S. Department of Health and Human Services.  Last updated:  March 15, 2015.  Accessed:  July 29, 2015.

    Continue Reading