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How Are Depression and Addiction Related?

Depression and addiction are complex and can feel impossible to manage—especially if someone is dealing with them simultaneously. Fortunately, help is available for both disorders. Understanding the risk factors, symptoms, and treatment options can help people with dual diagnoses feel more empowered and engaged in their healing process.

Relationship Between Depression and Substance Abuse

Depressed man holding his head in his bedroom
Depression is one of the most prevalent mental disorders in the United States. An estimated 16.1 million American adults over age 18 experienced at least 1 major depressive episode in the past year in 2015. That’s equivalent to 6.7% of all adults in the country.1

According to the 2014 National Survey on Drug Use and Health, 7.9 million Americans also have dual diagnoses. The term dual diagnosis refers to having a mental illness, such as depression, and a substance use disorder at the same time.2

Both disorders can affect one another. For instance, some people with depression may use substances to ease their symptoms. On the flip side, substance use can exacerbate mental illness symptoms or even cause them, in some cases.

Research shows that up to 1/3 of people with depression also meet the criteria for a substance use disorder. This comorbidity is associated with an increased risk of suicide, social/personal impairment, and other psychiatric conditions.3

Locating appropriate care and treatment for people struggling with a dual diagnosis is essential for recovery from both conditions.

Risk Factors

Depression doesn’t have a single cause. But several genetic, environmental, psychological, and biological risk factors are linked to its onset.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) outlines several risk factors for depression including: 4

Substance abuse also has several risk factors. These can include: 4,5

As the United States continues to become more proactive in identifying and treating mental illness, research continues to improve our understanding of risk factors and preventive measures.

Signs

Everyone experiences sadness from time to time. However, major depression (or clinical depression) is a diagnosable condition characterized by low or depressed mood for most of the day, nearly every day, for at least 2 weeks. Symptoms of major depression include:4,6

Addiction refers to the problematic abuse of substances despite serious interpersonal, financial, or medical consequences.

When someone has an addiction, they may display or experience at least a few of the following signs, symptoms, and behaviors:4,7

By nature, addiction can be progressive, meaning these symptoms often get worse until the substance user gets help.

Depression After Using Drugs

Withdrawal from certain types of drugs and alcohol sometimes results in a set of symptoms that overlap with or resemble those seen in cases of depression.
sad woman sitting in bed, concept on insomnia

As indicated, the use and withdrawal of these common substances may also intensify preexisting mental illness symptoms—another reason it’s so important for people suffering from addiction and depression to be evaluated by an addiction professional for thorough diagnosis and treatment.

Recovery Process

Help and treatment are available for depression and addiction, and recovery is possible.

Ideally, both conditions should be treated simultaneously through an integrated treatment to avoid relapse.2 Many symptoms of depression can return (and even worsen) after the drug user becomes abstinent.

Many physicians and clinical treatment teams recommend a combination of medication and therapy for the best outcomes.

Medications

Several types of medications may be used to help manage depression. Research and scientific advancements have improved the scope of treatment and decreased the side effects associated with the most commonly used medications.

Common medications for depression include:9

Today, several medications are also used to treat alcohol and opioid dependence and reduce substance cravings.

Common medications include:

No single medication has been approved to simultaneously treat both depression and substance abuse. But those with dual diagnoses appear to respond well to a combination of medications in conjunction with psychotherapy.

Therapies

Many evidence-based therapies are used to manage depression. These include the following: 9

Several evidence-based therapies are also used for addiction treatment. These include: 12

Other Tips

In addition to medication and therapy, those with depression can improve their well-being and mood through their daily actions. The National Institute on Mental Health recommends: 6

Treatment Programs

There are many types of treatment available for people struggling with dual diagnoses. The most appropriate type of treatment will depend on the severity of the conditions and one’s history of treatment (e.g., any previous courses of treatment, any previous treatment complications).

If you or a loved one is struggling with depression or addiction, help exists. Reach out today to receive the support and care you need.

If you are feeling actively suicidal or at risk of hurting yourself, please contact the National Suicide Prevention Lifeline.

Sources

  1. National Institute of Mental Health. Major Depression Among Adults.
  2. National Alliance on Mental Illness. (2017). Dual Diagnosis.
  3. Davis, L., Uezato, A., Newell, J., & Frazier, E. (2008). Major depression and comorbid substance use disorders. Current Opinion Psychiatry, 21(1),14-8.
  4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Arlington, VA: American Psychiatric Publishing.
  5. National Institute on Drug Abuse. (2003). Preventing Drug Use among Children and Adolescents (In Brief).
  6. National Institute of Mental Health. Depression.
  7. National Council on Alcoholism and Drug Dependence, Inc. (2017). Signs and Symptoms.
  8. Substance Abuse and Mental Health Services Administration. (2005). Substance Abuse Treatment For Persons With Co-Occurring Disorders.
  9. National Institute of Mental Health. Depression: What You Need to Know.
  10. National Institute on Drug Abuse. (2012). Alcohol Addiction.
  11. National Institute on Drug Abuse. (2012). Opioid Addiction.
  12. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.