The Vicious Cycle of Substance Abuse Disorders & Depression

Depression and addiction are often experienced hand-in-hand, sometimes as a dual-diagnosis. The symptoms of substance abuse disorders can look almost identical to many depressive disorders. In addition, understanding the relationship between depression and addiction is complicated because depressive disorders and substance use disorders can be caused or made worse by each other.

For instance, someone experiencing grief or trauma may turn to alcohol or drugs to cope. Using alcohol or drugs can cause depressive symptoms, either during intoxication or during withdrawal. This can in turn intensify feeling of grief and sadness, causing the person to drink and use more to deal with their sadness.

Substance Use and Mood Disorders

“Downers” or “depressants” are substances that create a depressant effect in the human body. They can lower heart rate and breathing which can lead to a feeling of being “down” or depressed. Alcohol, pain pills, opioids, heroin, and benzodiazepines like Klonopin and Xanax are examples of “downers.”[1]

“Uppers” are substances that create a stimulant effect in the human body. They can increase heart rate and create a feeling of increased energy and excitement. Cocaine, methamphetamine, Adderall, Ecstasy, and caffeine are examples of “uppers.”[2]

An issue with using either uppers or downers is that they could both cause depressive symptoms. Downers naturally cause those depressive symptoms. That is what they are made to do. Uppers create the opposite effect. Someone might feel full of energy and confidence when on a stimulant. The problem is when they come down off of it. Using a stimulant floods the brain and body with hormones that heighten the senses and increases awareness for a short time. When the stimulant wears off there is a depressive feeling left behind. This is caused by the extra hormones wearing off and the brain and body trying to catch up. Anyone who has ever experienced a “coffee crash” or “sugar crash” has gotten a sneak peek at this feeling. The feelings are intensified when using strong stimulants.

So using either downers or uppers, or both, can cause depression. The cycle of addiction is continued when an individual uses a substance on top of their depression in order to feeling better. Or even simply to feel normal again.

Symptoms of Dual Diagnosis Substance Abuse and Mood Disorders

Mental health professionals are trained to look for risk factors of depression and substance use disorders. When someone checks the boxes for both a substance use disorder and a depressive disorder it is called a dual diagnosis or a co-occurring disorder[1]. It takes many years of study and experience to properly diagnose someone with a dual diagnosis of substance use disorder. The behaviors and thoughts of an individual with an addiction can be very similar to the thoughts and behaviors of someone with depression.

Licensed clinicians can diagnose an individual with Major Depressive Disorder if certain criteria are met. Symptoms of this disorder include, but are not limited to, the following over a 2 week period

  • Depressed mood most of the day, nearly every day
  • Significant weight change
  • Lack of interest in most activities throughout the day, nearly every day
  • Fatigue or lack of energy nearly every day
  • Not being able to sleep, or getting too much sleep, nearly every day
  • Feelings of worthlessness or excessive guilt nearly every day
  • Recurrent thoughts of death, or suicidal ideation, nearly every day

Diagnosing Co-Occurring Mental Health Issues and Addiction

Many of these symptoms can be caused by being intoxicated on depressants, or coming off of or experiencing withdrawal from stimulants. Another criteria that must be met in order to be properly diagnosed with a Depressive Disorder is the episode is not caused by, or made worse by, the effects of a substance.

In order to get properly diagnosed and treated for a Depressive Disorder it is very important that an individual disclose their substance use history with their mental health professional. The good news is co-occurring disorders such as Major Depressive Disorder and Alcohol Use Disorder can be treated at the same time with successful outcomes.

Help is Available for Addiction and Mental Health Comorbidities

If you or a loved one is struggling with substance abuse and depression, we are here to help. Contact us today to schedule a to get started on your recovery.








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