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Co-Occurring Depression and Substance Use

When it comes to drug or alcohol abuse, it is extremely common for individuals to also struggle with varying types of mental illnesses. Depression is one of the more common disorders that most clinicians see when addressing the needs of men and women who struggle with drug or alcohol abuse. One study found that 32% of men and women who suffer from depression also struggle with substance use disorders. This number can further be broken down into 16.5% who struggled with alcohol abuse and 18% that primarily suffered from drug abuse.

Why Depression and Substance Misuse Co-Occur

In most cases, co-occurring depression can be separated into two different categories. The first occurs as a predecessor to substance abuse. This means that the person struggled with depression prior to drug or alcohol use. In this instance, research shows that men and women will use different substances as a form of self-medication. One study found that about 38.1% of individuals admitted to using drugs to diminish symptoms of depression. Similar research has analyzed the impact of self-medication in adolescents who suffer from depression and found a large correlation between the two disorders. 

The second occurrence of depression and substance abuse happens when an individual uses drugs or alcohol which then leads to the development or worsening of depression. A side effect of certain drugs may include depression, especially if the individual has mental illness already present within the family or if they have been using these substances for a long time. Then, in order to combat these feelings, more drugs or alcohol are used and the cycle continues.

Substance Abuse and Co-Occurring Depression
Drug Use Linked to


Though there is not one specific drug linked to co-occurring depression, there has been ample research on the different substances that may be used and how they either cause or worsen depression within the user.


One study found that the use of stimulants, like meth or cocaine, is much higher in men and women who also suffer from depression. When taken, stimulants increase the speed at which signals are transmitted through the brain. This can lead to increased feelings of euphoria, increased alertness or talkativeness, higher heart rate and blood pressure, and heightened sensations of overall wellbeing. So, because of these side effects, individuals who struggle with depression may seek the increase in serotonin that comes with using these drugs. 

Among college students, it was found that approximately 17% of individuals misused stimulants. Of this 17%, a high proportion also admitted to dealing with psychological side effects such as increased depression. We see this specifically through the misuse of medications commonly prescribed to treat ADHD, like Adderall. Many students resort to unprescribed Adderall use as a way to increase focus or to cram for an upcoming exam. When misused, however, this stimulant can pose a threat to the user and can actually become extremely addictive. Side effects of Adderall addiction include increased anxiety, depression when the drug is not present within the user’s system, increased sociability, sleeping difficulties, and more.


Substances that exhibit depressant effects include alcohol, benzodiazepines, and some opioids. When used, they depress the nervous system and cause effects such as decreased coordination and response time, relaxation, drowsiness, and unconsciousness to name a few. The more a person uses these substances, the more they will need in order to obtain similar effects. What once may have started as a form of relaxation may turn into the consumption of a deathly amount of drugs or alcohol. 

Studies conducted by Yale University’s Department of Medicine show that the use of alcohol and other depressants is higher in individuals who also struggle with depression. 16% of these individuals struggle with co-occurring alcohol abuse and depression, and 30% of individuals who struggle with depression will have a lifetime occurrence of alcohol abuse. For individuals who struggle with both conditions at the same time, the incidence of suicide and decreased overall health within the individual increases significantly.


Symptoms of Co-Occurring Depression

Because of the ways in which substances affect the brain and the body, the symptoms of depression a person may experience can often be different than if they were to only suffer from depression alone. These symptoms may include a change in sleeping patterns, an increasing occurrence of suicidal thoughts, feeling guilty when using drugs or alcohol, and an increasing lack of interest in activities the individual once used to enjoy to name a few. 

Unfortunately, co-occurring depression is often overlooked and underdiagnosed in people who abuse drugs or alcohol. The symptoms are so similar in both conditions that clients are often only treated for one which does not solve the entire issue as a whole. When this happens, relapse is often the consequence and can lead to even more serious side effects such as blackouts, coma, and death. 

Many people who suffer from co-occurring depression may also use a combination of substances together. This may include combining prescription antidepressants with alcohol or combinging drug and alcohol use at the same time to combat symptoms.

Depression Treatment

How to Treat Co-Occurring Depression

When it comes to treating substance abuse and co-occurring depression, the main goal is to address both of these conditions at the same time. Studies have investigated the best way to do this and may include treatments such as mindfulness training, cognitive behavior therapy, and 12-step programs. Across the board, these studies also show that the main predictor in maintaining sobriety and success in treating depression is attendence in addiction treatment programs. The more a person commits to their program and attends the therapy sessions or groups that are recommended, the better their outcome at remaining sober long-term.

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