Depression and Addiction: Are They Related?

According to multiple national surveys, about 50% of people who experience a substance use disorder will also experience a mental illness during their lives and vice versa.¹

When a substance use disorder and mental health disorder occur in the same person at the same time, they are called co-occurring disorders. A dual diagnosis is another name for when mental health disorders and substance use disorders occur together. Dual diagnosis and co-occurring disorders are terms that can be used interchangeably, as they refer to the same thing.²

This article will explore the link between depression and addiction, the symptoms of depression, and effective treatment options for these co-occurring disorders.

What Is Depression?

Depression is a serious mental health disorder characterized by a sad, irritable, or empty mood that significantly impacts a person’s ability to function in everyday life.³ This common mood disorder affects how you feel, think, and act.⁴

Risk factors for depression can come from a combination of causes, including the following:⁴

• Biological
• Genetic
• Environmental
• Psychological
• Major life changes, stress, or trauma
• Certain medications or physical illnesses

What Are the Different Types of Depression?

Within the overarching category of depressive disorders are sub-categories with similar characteristics but with distinctions in the duration, timing, or the presumed cause of the depressive disorder.³

Some types of depression are as follows:⁴

• Major depressive disorder (MDD): A mental health disorder characterized by a loss of interest in almost all activities previously enjoyed, depressed mood, change in sleep patterns, change in appetite, suicidal ideations, feelings of guilt, low energy and psychomotor agitation, nearly every day for at least a 2-week period.
• Persistent depressive disorder (PDD): This disorder, also referred to as dysthymia, is considered the more chronic form of depression. It occurs when individuals experience depressive symptoms almost every day for 2 or more years. Compared to MDD, individuals with PDD can experience similar but less severe symptoms.
• Seasonal affective disorder (SAD): Depression that occurs during the winter months and returns each year. This type of depression usually subsides when there is more natural light during spring and summer.
• Postpartum depression: Occurs when women experience major depression after child delivery. It can make it difficult for a mother to care for herself or her baby.
• Depression with psychotic features: A combination of severe depression and a form of psychosis, which includes having delusions or hallucinations.

What Are the Symptoms of Depression?

Symptoms of depression may include:³

• A persistently depressed mood (feeling empty, hopeless, or sad).
• Noticeably decreased pleasure or interest in all, or almost all, activities.
• Significant changes in weight and appetite.
• Sleep disturbances (insomnia or hypersomnia).
• Psychomotor agitation (restlessness, foot tapping, pacing, etc.).
• Loss of energy and fatigue.
• Feelings of worthlessness or inappropriate and excessive guilt.
• Indecisiveness or a diminished ability to think and concentrate.
• Recurrent thoughts of suicide and death.

Depression can only be diagnosed by a medical professional. However, knowing the symptoms of depression can be helpful in identifying when to seek help.

Does Addiction or Depression Happen First?

It is often unclear whether addiction or depression happens first in an individual, and the co-occurrence of these disorders does not mean that one caused the other.⁵

The relationship between mental health disorder and substance disorders includes the following:⁵

1. Common risk factors contribute to both disorders simultaneously. Genetics, the environment, stress, and trauma affect the brain and its functioning, which can lead to the development of substance use disorders and mental health disorders. It is estimated that 40-60% of a person’s vulnerability to developing a substance use disorder is due to genetics.
2. Mental health disorders may contribute to the development of substance use disorders. Some individuals with mental health disorders may misuse drugs and alcohol as a form of “self-medication” to numb or try to eliminate their symptoms of depression. Although substances may temporarily alleviate the negative symptoms of depression, they can worsen the depression and lead to the development of a substance use disorder.
3. Substance use and addiction can contribute to the development of mental health disorders. Misusing drugs and alcohol can lead to changes in the brain that also affect mood regulation and impulse control which can affect an underlying predisposition to a mental health disorder. For example, alcohol use disorder has been found to increase the risk of developing major depressive disorder.

Regardless of whether depression or a substance use disorder occurred first, these comorbid illnesses can impact each other negatively.⁶

How Do Co-Occurring Disorders Affect Treatment?

Treatment can be complicated by the presence of co-occurring disorders.⁷ Co-occurring disorders may cause patients to have extensive treatment needs and unfortunately, these needs can often go unmet.⁸

When comparing people with substance use disorders and depression to people with depression alone, those with co-occurring disorders tend to have:⁸

• More severe mood symptoms.
• Worse functioning.
• Higher risk of suicidal thoughts.
• Increased psychiatric comorbidities.
• Increased mortality.

Treating both depression and substance use disorders together—known as integrated treatment—has been found to yield better results than treating each disorder separately.⁷ Integrated treatment, involves multiple science-backed treatment methods that can include therapy and medication.⁹

Using Medications for Dual Diagnosis Treatment

Medications can be a helpful tool for treating co-occurring disorders as they have been found to alleviate symptoms of many mental and substance use disorders.^8,9

Various medications have been found effective for treating depression, including:^10,11,12

• Selective serotonin reuptake inhibitors (SSRIs). This type of medication works to increase serotonin activity by inhibiting the reuptake of serotonin. SSRIs tend to be a first-line medication for depression because of their tolerability, safety, and efficacy.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs). Another commonly prescribed medication used to treat depression is an SNRI. These inhibit the uptake of both serotonin and norepinephrine.
• Bupropion. This antidepressant has a mechanism of action that is not completely understood. It weakly inhibits the reuptake of dopamine and norepinephrine, and this seems to lead to its effectiveness. This particular medication is also used for smoking cessation.

Common Therapy Types Used for Depression and Addiction

With or without the assistance of medication, behavioral therapy is an effective treatment for both depression and substance use disorders.⁹ Behavioral therapy can be offered in a group or individual setting and may include:^9,13

• Cognitive behavioral therapy (CBT): Shown to be effective for both mood disorders and substance use disorders, CBT helps patients modify harmful beliefs and behaviors that interfere with daily life.
• Dialectical behavior therapy (DBT): DBT works to reduce behaviors involving self-harm such as drug use and suicidal thoughts or attempts.
• Motivational interviewing (MI): MI helps patients build and strengthen their commitment to change.

Finding the Right Rehab for Co-Occurring Depression and Substance Use Disorder

When choosing a rehab program for you or your loved one, it is important to look for programs that provide evidence-based treatment tailored to each individual patient’s needs. At Recovery First, we use an integrated treatment approach and specialize in treating co-occurring disorders.

Our addiction treatment programs also include holistic therapies to assist in each patient’s healing and recovery. These include:

• Art therapy.
• Music therapy.
• Meditation and mindfulness.
• Spirituality group therapy.
• Recreational therapy.

We offer all levels of addiction treatment at our inpatient rehab facility near Miami. Depending on the needs of each individual, one of the following levels of care may be most appropriate:

• Medical detox
• Inpatient addiction rehab
• Outpatient drug and alcohol rehab

Paying for Dual Diagnosis Treatment

There are several ways to pay for dual diagnosis treatment at our Hollywood, FL, residential rehab. Many patients have insurance that covers substance use treatment. However, specific coverage varies by insurance plan. Complete our confidential to find out what your insurance covers at Recovery First.

For those without coverage, or whose insurance does not cover all costs, there are other rehab payment options. If you or a loved one is ready to get help with recovery, start the admissions process today or call one of our compassionate admissions navigators at .