Understanding the Complex Relationship Between Substance Use Disorders and Depression


Understanding the Complex Relationship Between Substance Use Disorders and Depression

You might be surprised to learn that people with depression have a higher risk of developing substance use problems than those without the illness.

Drug or alcohol use patterns that are part of substance use disorders might start to affect your ability to operate normally, your health, and your quality of life. Substance use disorders, in other words, go beyond casual drug or alcohol use.

Dual diagnosis refers to the mix of substance use disorders and mental health issues, which occurs so frequently. Among those with a dual diagnosis, major depression is the mental health disorder that is most frequently identified.

You may read more about the link between substance use and depression as well as the special dangers of having a dual diagnosis down below. Additionally, whether or not you satisfy the requirements for a dual diagnosis, you can discover advice on how to obtain help for substance abuse and depression.

·       Is there a link between depression and substance use disorders?

If you struggle with depression, you might turn to alcohol and other drugs to lessen or better control your symptoms. Self-medication is a common term for this.

Evidence indicates that people with depression are almost twice as likely to self-medicate with alcohol as with drugs, according to a reliable source.

People may self-medicate for a variety of causes, including:

o   Managing unpleasant emotions: Constantly feeling depressed, lonely, or furious can be draining. For some people, consuming alcohol might help them unwind, take their mind off their suffering, or "numb" their agony.

o   Increasing mood: Even when positive things happen in your life, depression can make it difficult to feel joy or happiness. Some people may believe that drinking alcohol or using other drugs is the only way to feel happy or any emotion at all.

o   Sleeping: Insomnia and depression are frequently related. Sedatives are used by some people to fall asleep.

o   Increasing energy: Depression frequently depletes energy, in part because of lack of sleep. To feel more alert, some individuals may utilise stimulants.

Indeed, alcohol and drugs may momentarily hide or lessen your symptoms. However, they are unable to eliminate those symptoms or heal the underlying problem. In other words, your depression symptoms will usually return after you stop using them.

Over time you may find that you need to use more of the substance to have the same effects.

Over time, you can also develop a dependence on the drug, meaning you require it for your body to function normally. Addiction risk may be increased by dependence.

       More information about the various addictions

People without access to mental health services frequently self-medicate. If you have untreated depression, you may find yourself doing everything it takes to alleviate your symptoms.

Youth are more prone to experience the onset of disorders including sadness and anxiety, according to research from 2018. Quicker detection of these ailments can lessen the likelihood that they'll also develop a substance use disorder.

·       Do substance use disorders raise the chance of developing depression?

Depression can influence substance use, while substance use disorders can influence depression. Depression is more likely to be exacerbated by more severe substance use problems.

In four ways, substance use can aggravate depression:


Numerous chemicals, especially alcohol, can cause your brain to temporarily release dopamine, which can result in pleasurable feelings.

However, they may also make the brain more inflammatory. Your brain has a tougher time producing mood-enhancing substances like serotonin and dopamine on its own when there is inflammation.

o   Cortisol

Drugs and alcohol affect your brain's levels of mood-enhancing chemicals in more ways than one. Levels of hormones linked to stress can also be significantly raised by them.

A 2014 review of the literature found that MDMA users have up to four times the amount of the stress hormone cortisol in their body compared to non-users.


Regular alcohol or drug usage might cause your brain to become dependent on those substances to function.

When you abruptly stop using those substances, it could take some time for your brain to adjust and resume producing the normal amounts of serotonin, dopamine, and other vital neurotransmitters. Meanwhile, depression might also cause you to feel depressed, numb, or struggle to find enjoyment or interest in your routine and everyday activities.

As a result, you might find yourself turning to drugs or alcohol once more to feel like yourself.


Regularly abusing drugs and alcohol might eventually ruin your employment or academic performance, not to mention how it can impact your relationship.

Being alone might make it harder to receive support, compassion, and affection. Emotional support can be quite helpful in managing and coping with mental health issues. This may contribute to explaining why loneliness raises the risk of acquiring depression.

    One need not inevitably lead to the other

Another rationale for dual diagnosis is possible. Depression and substance use disorders may occasionally have the same underlying cause.

SUD and depression can both be brought on by malfunction in specific areas of the brain, including the:

o   Your sleep-wake cycle is governed by your circadian clock.

o   Your stress response is controlled by your hypothalamic-pituitary-adrenal axis, and your reward circuits, which govern your motivation and satisfaction

A dual diagnosis can also be influenced by trauma and abuse, particularly if the abuse occurred when the patient was a child.

In comparison to peers who did not encounter childhood abuse, those who endured abuse, neglect, or other forms of maltreatment are up to three times more likely to experience depression. You have a higher chance of getting a substance use disorder.

     Warning signs to watch out for

You might have a positive relationship with alcohol and other drugs even if you suffer from depression. However, since substance use disorders and depression can reinforce one other, it never hurts to exercise some caution.

Several indicators of possibly concerning substance use include:

o   You ponder a lot about when you'll get another chance to consume alcohol or take drugs.

o   You are aware that your drug usage has hurt your relationships and work, but you find it difficult to care or give up the drug.

o   You become even more worn out and pessimistic about life as the effects of the drugs or alcohol wear off.

o   To maintain a constant level of energy and mood, you need more and more of the drug.

o   You struggle to stop using drugs despite feeling guilty or ashamed about it.

o   The potential long-term ramifications of substance use don't seem to matter all that much in comparison since you feel so gloomy about the future.

If you've observed any of the aforementioned symptoms, a mental health expert can provide additional assistance and advice on what to do next.

      Dual diagnosis risks

If you have both depression and a drug use disorder, it could be more difficult for you to control your symptoms than if you just had one of them.

People with dual diagnoses are more likely to: Compared to those with a single condition at a time

o   More profound depression symptoms

o   Relapse after trying to stop using drugs

o   A lesser standard of living

o   Suicide attempt

The order in which the diagnoses occur may have an impact on the likelihood of suicide, according to a 2013 longitudinal study trusted Source on 816 participants. The study tracked people from the ages of 16 to 30 to determine how many went on to develop alcohol use disorder, depression, or both conditions simultaneously.


Most persons who experienced both diseases concurrently first experienced depression. More than a third of this group disclosed having attempted suicide at least once.

The rates of attempted suicide in this cohort were as follows:

o   Twice as high as they were for those who first experienced depression before alcohol use disorder

o   Three times higher than they were for individuals who simply experienced depression

o   When compared to persons who merely had alcohol use disorder, they were nine times higher.

The authors of the study speculate that this group may have had more severe and persistent forms of depression than the other participants, but they were unable to determine why this group had a greater prevalence of suicide attempts.

·       Getting assistance for two diagnoses

Typically, dual diagnosis treatment simultaneously tackles both mental health issues.

Or, to put it another way, you don't have to stop using drugs to get treatment for depression. Similarly, you don't have to wait for your depression to get better before seeking help for your drug use.

A treatment plan that incorporates medication, therapy, and support groups may be suggested by a therapist or other qualified professional.


The physiological causes of depression and substance use disorders can be treated with medication.

The neurotransmitters implicated in depression can be balanced by antidepressants. Although they don't directly address symptoms of a substance use disorder, they may nonetheless indirectly assist by easing the depressive symptoms that fuel the urge to use drugs.

The cravings and withdrawal symptoms you experience if you have an alcohol use disorder or an opioid use disorder can be lessened with medication.

Alcohol use disorder medications include:

o   Naltrexone

o   Acamprosate

o   Disulfiram

 Some examples of drugs for opioid use disorder.

o   Buprenorphine

o   Methadonene

o   Snaltrexone

While it is feasible to take antidepressants together with these medications, it is important to remember that some medications should not be used at the same time. Sertraline, an antidepressant, and methadone, for example, can both increase serotonin levels. Your serotonin levels could rise dangerously high and cause serotonin syndrome if you take them both at once.

You can learn more about your pharmaceutical treatment options from a doctor or psychiatrist.


Some of our mental health disorders' social and emotional foundations can be addressed through psychotherapy.

Some dual diagnosis strategies include:

o   With the use of cognitive behavioural therapy (CBT), you can address the false beliefs and harmful actions that contribute to both depression and substance abuse.

o   Motivational interviewing: This strategy can assist you in resolving ambivalent emotions related to substance use or self-destructive behaviours.

o   Dialectical behavioural therapy (DBT): This method can assist you in discovering and putting into practice new techniques for controlling emotional distress as well as for more effectively managing depressive symptoms, cravings, and withdrawal symptoms.


      Support Groups

Consider joining a support group if therapy is out of your current financial reach or if you don't feel ready to engage with a professional just yet. A support group can be joined in addition to individual therapy.

Support groups provide a venue for individuals with comparable issues and mental health symptoms to get together and assist one another on an equal footing. Members can commiserate, offer consolation, and celebrate victories.

If you have two diagnoses, you might look into:

o   Dedicated dual diagnosis support group called Double Trouble in Recovery

o   Alcoholics Anonymous SMART Recovery


     The Conclusion

Drug use and depression frequently coexist. Substance abuse can sometimes cause depression, although depression can also be exacerbated by substance abuse.

The gold standard for dual diagnosis treatment addresses all of your symptoms and concerns at once, regardless of whether the ailment manifested itself first. Medication, counselling, support groups, or a combination of them all may be a part of your healing process.

The most crucial thing to keep in mind is that both substance use disorders and depression can go better with treatment. Once you feel ready to ask for help, professional support can significantly reduce your symptoms.

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