Experiences with Quitting Smoking and Depression
June 10, 2015 1:52 PM   Subscribe

Looking for any info, either research or personal stories, about how and why quitting smoking can cause depression in some people.

Husband quit smoking two and half months ago. I've sought advice about dealing with it in a previous Askme, since he was in a state of intense anger/sadness his first week or so. (Thank you for the very helpful answers too, though I guess it's clear that this is an ongoing issue, as you will see below.)

I'm turning to Askme again because I feel he has been going through something that at least LOOKS like clinical depression since then, from my layperson's perspective (lack of energy, irritability, sadness, moodiness, and basically saying/doing things that make him seem like a stranger, and not the man I've known and loved for over a decade). If it gets worse I'm going to ask him to get professional treatment for both his sake and mine.

I've heard of a grieving process that occurs with some heavy smokers after they quit, but it also seems like there might actually be a specific physiological basis for depression after well for people who were used to smoking over a pack a day. I'm looking at this article: http://news.nationalpost.com/health/quitting-smoking-similar-to-clinical-depression-study as well as this article: http://www.medpagetoday.com/Psychiatry/Addictions/27847.

I'm wondering if anybody has any more resources that talk about the link between quitting cigs and depression, and would also appreciate any stories, tips or advice from people who have encountered depression after quitting cigarettes.
posted by neeta to Human Relations (11 answers total) 3 users marked this as a favorite
I don't know exactly this research, but I know some attached research:

Cigarettes/nicotine work primarily on a neurotransmitter in the brain called Acetylcholine. There are receptors in the brain called Nicotinic Acetylcholine receptors because nicotine fits so nicely into them (the brain is playing a big game of perfection with neurotransmitters, binding the right NT into the right receptor).

Since nicotine fits so nicely, the brain thinks it's getting all this extra acetylcholine. So it does more of the stuff that acetylcholine does and - importantly - starts actually making less acetylcholine, because it has this artificial source of it.

So then, when someone quits nicotine, the brain all of a sudden is missing all of this acetylcholine. And while generally there are other NTs associated most strongly with depression (like serotonin, which is what SSRI antidepressants work on), Acetylcholine has often been implicated in depression also.

Note this was written in a very layman sort of way -- but hopefully it will get you started to finding what you need.
posted by brainmouse at 2:03 PM on June 10, 2015 [3 favorites]

Yeah, absolutely. I smoked to self-medicate. And even though I stepped down very slowly and successfully with vaping, I could tell that I was not propped up in the way that I used to be. I waffled for so long about going on medication that I started making my own proper brain-juices again (we're talking 12-18 months), but even now I can look back on that time and think yeah, my body was screwed up. Everything was jacked up - sleep, digestion, mood, physical stamina.

But. But but but. I was never unrecognizable. I think I said on your last post that irritation is one thing and rage is another, and here you are again because he's still not able to control his behavior and you are still concerned. And while you are allowed to walk on eggshells for years if that's what you choose, keep in mind that when someone is frequently enough "seeming like a stranger" to be identifiable as an ongoing pattern, that's sometimes when people get into real trouble - hurt themselves or worse, or take unreasonable risks, or make questionable decisions about operating heavy machinery or social interactions. If it gets any worse, you may not have the option of getting him help anymore.

Serious abrupt personality change is a big deal, and you're associating it with quitting smoking, but a) that's not what quitting smoking does, b) what if the nicotine was masking a serious health condition, c) what if it's a total coincidence that he quit smoking (or had the willpower or urge or whatever sparked his desire to quit) and that was actually when his thyroid started to fail or the tumor got big enough to disrupt his behavior or he hit his head and never mentioned it?

He needs to see a doctor. Quitting smoking should not change someone that drastically.
posted by Lyn Never at 2:30 PM on June 10, 2015 [1 favorite]

When a previous partner quit smoking, it took months for his nervous system to sort itself out. Nicotine stimulates the adrenal glands, so after quitting he experienced extreme energy loss. That energy loss meant he was extra tired after work, going to bed earlier than usual, and spending a lot more time lying on the couch. It definitely affected his mood, including increased sadness and irritability.

In this case my ex-partner started chewing nicotine gum, so he got the nicotine without the smoking. Personally I think it wasn't a great long term solution, even if definitely better than being a 2-pack-a-day smoker.

Has your husband looked into taking Wellbutrin for a few months? It not only helps with the quitting process by reducing the urge to smoke, but it also has a mild stimulant which will make the reduced adrenaline production less bothersome.
posted by jess at 2:34 PM on June 10, 2015 [2 favorites]

I definitely had some nasty depressive spells (I quit about 6 weeks ago) but more troublesome was insomnia.
posted by thelonius at 5:09 PM on June 10, 2015

David Foster Wallace recounted some troubling symptoms of tobacco withdrawal in this Believer interview (conducted by David Eggers I believe). It's a long interview but you can do a ctrl-f for "tobacco" and find it pretty quickly.
posted by sudo intellectual at 6:45 PM on June 10, 2015

Ages ago I was trying to quit smoking with nicotine patches - I was having some decent success and had gotten down to the smallest size patch, and it was around that time that I started being approached by friends concerned about my obvious depression - I hadn't noticed it coming on - or at least hadn't considered it to be anything other than part of quitting smoking. Stepping back up to a bigger patch noticeably improved my outlook, and going back to cigarettes made me want to go out and do stuff again. (It took me another three years of off-again on-again to finally quit.)
Aside from that anecdotal bit - it's worth noting that Zyban, which is prescribed to help people quit smoking, is also sold as Wellbutrin, an antidepressant. (wikipedia tells me they're both trade names for Bupropion)
I guess a big question is how aware he is of the changes in his behavior, and if it's getting better or worse. If nicotine withdrawal has effectively rendered him chemically depressed, then a prescription for Zyban could be just the thing to help him through this bit. Since it needs a prescription, that'll also get him to a doctor as Lyn suggests.
posted by ersatzjef at 9:31 PM on June 10, 2015

Allen Carr portrays quitting smoking as being akin to the grieving process. He writes a compelling comparison between quitting smoking and losing a dear friendship or even a relation in his famous book, The Only Way to Stop Smoking Permanently.

(As a side note, the book definitely works but once and only once - you do not get a second chance.)
posted by digitalprimate at 2:38 AM on June 11, 2015

I went through this same kind of thing, and I was lucky enough to believe/recognize that the depressive feelings were artificial and not necessarily 'real' in the greater sense of who I was. I had two revelations along the way which helped tremendously:

1) Exercise was fun again. I actually felt good when I was exercising, and knowing that I only smelled of sweat and not sweat and smoke (which is toxic, in my opinion) was a nice thing.

2) This was the biggie, and what really motivated me - sexytimes with the wife were WAAAAAY better for both of us. The better bloodflow and oxygen levels did wonders not only for my performance, but for our shared enjoyment. Seriously - if I had known that ahead of time I would have stopped smoking years before.

I know this is anecdotal, but basically, doing things that make you feel good - both of which happen to help you fight depression - work better than they do while smoking. Basically felt better/happier because of all this. Make sense?

If you guys make some extra efforts along both those lines, I'd be interested to know if your experience was congruent.
posted by Thistledown at 6:15 AM on June 11, 2015 [1 favorite]

When I quit smoking, I fell into a major depression for close to six months. I'm talking about "what is the point of working/amassing stuff/having fun when in the end we're all going to die" kind of thoughts. Quitting was so, so hard for me - in fact one of the reasons I never started up again was because I knew I couldn't go through that again.

Unfortunately what I did to get through was eat & drink everything in sight, and I was a miserable bitch. Plus I did a lot of crossword puzzles and frequented quitnet.com.

If I knew then what I know now I would have definitely gone to the doctor for some anti-depressants.
posted by lyssabee at 6:18 AM on June 11, 2015

Jigsaw puzzles. Not crossword puzzles. The pieces gave me something to fidget with.
posted by lyssabee at 6:18 AM on June 11, 2015

This question is so perplexing to me because I had never felt better than when I quit cigarettes. I also read Allan Carr's book and I can tell you that pretty much immediately, I was done smoking and obviously it took some time to actually feel a change in myself, but I was acutely aware of how much HAPPIER I was once the smoking was out of my life.

So yeah, I totally agree that your spouse should see a Doctor. At least his experience is wildly different than what I went through.
posted by JenThePro at 8:29 AM on June 11, 2015

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