Depression & Drug or Alcohol Addiction

Many people who have a substance use disorder also suffer with another mental health condition like depression, anxiety, and personality disorders.¹ A 2020 national survey found that 17 million Americans ages 18 and older (6.7%) had co-existing substance use disorders and mental illness.²

 Among patients who present for treatment of substance use disorders, the most common co-occurring psychiatric disorder is major depressive disorder.³

This article will discuss the link between depression and addiction, risk factors for both conditions, and how to get help if you or someone you love is battling depression alongside a substance use disorder.

The Connection Between Depression and Substance Abuse

When a person experiences a substance use disorder and depression at the same time, it is called a co-occurring disorder, or dual diagnosis.⁴

The relationship between substance use disorders and co-occurring disorders like depression is complex and bidirectional, meaning that one disorder can influence the development and course of the other. Stress can also worsen one or both disorders.⁵

It’s often difficult to know which disorder developed first because both disorders can be inconsistent and nuanced, with symptoms that wax and wane over time.⁵

What Are the Symptoms of Depression?

Depression is a mood disorder characterized by prolonged periods of excessive sadness, emptiness, and irritability that significantly affect a person’s ability to function.⁶

Many people experience sadness from time to time, but people with depression experience chronic sadness that does not go away on its own.

Common symptoms of depression include:⁶

• Feeling overwhelmed with negative feelings like sadness, worry, frustration, hopelessness, guilt, and worthlessness.
• Loss of desire to engage in most daily activities or hobbies that were once pleasurable.
• Low energy and fatigue.
• Poor concentration, memory, and difficulty making decisions.
• Changes in amount or quality of sleep.
• Changes in appetite or weight.
• Physical symptoms, such as headaches or digestive problems, that do not have a physical cause.
• Recurrent thoughts of death, suicidal thoughts, planning, or attempts.

There are several different types of depression, including:

• Major depressive disorder (moderate to severe depression that lasts for more than two weeks)
• Persistent depressive disorder (mild depression that lasts at least two years)
• Seasonal affective disorder (depression that occurs during the winter months)
• Perinatal or postpartum depression (depression that begins during pregnancy or within a year of giving birth).⁶

In all cases of depressive disorders, episodes must not be attributable to the effects of substance use or another medical condition.³ It can be difficult to diagnose depressive disorders in people using drugs or alcohol, as both substance use and withdrawal can be associated with depressive symptoms.⁵

What Are the Symptoms of Addiction?

When someone has an addiction (or substance use disorder), they have difficulty controlling their drug or alcohol use, even though it causes significant problems in their life.⁵

Some symptoms of addiction include:⁸

• Cravings or strong urges to use drugs or alcohol.
• Continuing to use substances even though they have negative effects on a person’s relationships, physical and mental health, and functioning.
• Using substances in situations that are dangerous.
• Exhibiting tolerance, or requiring more of a substance over time to feel the same effects.
• Experiencing withdrawal symptoms when not taking the substance.

Can Depression Cause Addiction?

In most cases, depression does not cause addiction, and addiction does not cause depression.¹ There is typically no single cause of either depression or addiction, and because depression can influence substance use and vice versa, each condition often impacts the development and course of the other.

People with depression may use drugs and alcohol to cope with their symptoms.¹ This is commonly referred to as “self-medication.” While drugs and alcohol can, in some cases, relieve or mask the symptoms of depression, over time substance use often becomes a maladaptive coping mechanism that tends to worsen symptoms of both disorders.^1,5

Continued drug use or drinking as a response to symptoms of mental illness may also lead to a substance use disorder.⁵

It should be noted, however, that mood symptoms, such as sadness, apathy, irritability, pessimism, hopelessness, fatigue, anxiety, hyperactivity, and changes in appetite or sleep patterns are all common in people who have substance use disorders. They are often associated with intoxication as well as withdrawal.³

If these symptoms are resolved with abstinence, then it is unlikely a person needs to be treated for a depressive or other mood disorder.³

Risk Factors for Co-Occurring Addiction and Depression

Addiction and depression share many of the same risk factors, which increase a person’s likelihood of developing certain conditions.^1,9

Some of the biological and environmental risk factors for co-occurring depression and addiction include:¹

• Stress.
• Trauma, especially during childhood.
• Having a family member with an addiction or depression increases a person’s risk of also having an addiction or depression. Researchers believe genetics affect around 40%–60% of a person’s risk for developing a substance use disorder.

Addiction and other mental illnesses, such as depression, also affect similar areas of the brain, including areas that control motivation and the reinforcement of behavior, which can also increase a person’s risk of developing either or both conditions.¹

Teens who use and misuse drugs are at greater risk of developing an addiction and co-occurring mental health condition like depression as they get older.¹

Depression & Alcoholism

Depression and alcohol use disorders co-occur at high rates. In fact, depression is the most common mental health condition experienced by people with alcohol use disorders (AUDs).⁷

 One study showed that among individuals with lifetime major depression, 16.5% also had an alcohol use disorder.¹⁰

 When these two disorders present together at the same time, the symptoms associated with each condition are likely to be more severe. In general, depressive disorders and AUD are associated with worse prognosis than either disorder alone, and there is an increased risk of suicidal behavior.⁷

Depression & Drug Abuse

Depression also co-occurs at high rates with drug use disorders, including prescription medications, opioids, marijuana, and stimulants.^11,12 This is true for adults and teens.

Research indicates that, among individuals with lifetime major depression, 18% also have a drug use disorder.¹⁰

A recent study found that marijuana use among patients with depression may delay the improvement of depressive symptoms as well as reduce the chances of a person seeking treatment for depression.¹³

Additionally, a lifetime diagnosis of major depressive disorder is more likely to occur in individuals with a history of substance use disorders (51%) and alcohol use disorder (41%) than in people with a history of any anxiety disorder (37%) or personality disorder (32%).⁵

How to Help Someone With Depression and Drug or Alcohol Addiction

It can be difficult to see someone you care about struggle with depression, alcohol or drug use, or co-occurring disorders. As a family member or friend of someone with depression and addiction, you can play a key role in helping them get treatment and start the recovery process.

To help a loved with addiction, you can:¹⁴

• Express your concerns in a gentle, nonjudgmental manner.
• Encourage, but not force, them to seek help.
• Offer to help them find a co-occurring treatment program.
• Learn more about co-occurring disorders.
• Participate in couples or family therapy with your loved one.
• Attend your own therapy and/or support groups like Al-Anon or Nar-Anon.

If your loved one is not open to help, be patient. Remind them you are there if they change their mind.

Treatment for Co-Occurring Depression and Drug or Alcohol Addiction

When it comes to co-occurring disorders like depression and addiction, treating both conditions concurrently (at the same time) is the standard of care, as studies have shown that integrated treatment for co-occurring substance use disorders and mental illness has been found to be more effective than treating one at a time.¹

If you or someone you know has a dual diagnosis, finding a facility that offers treatment for co-occurring disorders is important.

At Greenhouse Treatment Center near Dallas-Ft. Worth, we specialize in care for co-occurring disorders and offer multiple types of addiction treatment including:

• Medical detox.
• Inpatient rehab.
• Outpatient rehab.

If you come to our Texas rehab facility for a co-occurring disorder, you will receive treatment for your addiction and other mental health concerns. Our integrated treatment approach incorporates evidenced-based therapies that help patients understand how addiction and depression impact one another and discover healthier ways to cope.

To learn more about our programs, using insurance to pay for rehab, or other ways to pay for rehab, contact us today at . Our admissions navigators can help , answer any questions, and start the admissions process.