Being afflicted with a mental health or substance use disorder can cause great challenges to a person’s life. When someone struggles with both at the same time, it’s referred to as a dual diagnosis or co-occurring disorder. Perhaps not surprisingly, research data has shown that substance use and mental illness are associated. For example, one study indicated those who have at some period in their lives been diagnosed with a mental illness drink nearly 70% of the alcohol in the U.S. and consume over 80% of the nation’s cocaine.
One of the most common mental illnesses co-occurring with a substance use disorder (a.k.a., chemical dependency, addiction to alcohol and/or drugs) is depression. Those who grapple with issues of alcohol or drug abuse and dependency have been found to be more likely to suffer from depression, and vice versa.
Those working in the fields of brain research, psychology and addiction medicine have asked themselves, “What is at the root of this relationship?”
The simplified answer is that when a person is depressed, they may turn to drinking or drugs to temporarily lift their mood or state of mind, especially when there are feelings of guilt or despair. However, alcohol and other drugs can ultimately result in intensified feelings of sadness, loneliness or isolation.
On the other hand, when the euphoric “high” wears off, some people can find themselves struggling to cope with the effects and consequences the addiction has had in their lives, leaving them feeling depressed.
According to data from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), approximately one out of three U.S. adults who have a chemical dependency also struggle with depression. Of those who experience recurring major depression, about one in six adults have a substance use disorder (alcohol and/or drug addiction).
Since a number of the symptoms of substance use disorders are similar to or can imitate those of depression, diagnosing depression can be challenging when one is drinking or using drugs. Some of the more recognizable signs of depression include the following:
- Increased irritability or anger
- More frequent moodiness
- Lack of interest in activities
- Increased fatigue, lack of energy and/or changes in sleep patterns
- Changes in appetite
- Feelings of guilt or despair
- Trouble concentrating
- Suicidal thoughts
The “good news” is that evidence-based comprehensive treatment is available for both depression and substance use, which can provide relief, recovery and ongoing support for those afflicted by both disorders.
Studies have shown that medication in conjunction with counseling and behavioral support can frequently bring about successful outcomes for those experiencing depression and a substance use disorder. The professionally trained medical staff at a treatment center may prescribe antidepressants to help reduce depressive symptoms, while also using addiction medicines to treat substance use disorders (either alcohol or drugs or both).
It should be noted that, in order to most effectively address alcohol/drug addiction and learn healthy coping strategies for depression, many people find engaging in intensive outpatient or inpatient treatment is necessary.
Upon seeking treatment for alcohol/drug abuse issues and depression, it may prove best to get medical attention to address the withdrawal symptoms of whatever substance you’re struggling with. That is, a period of abstinence may be required before an accurate diagnostic assessment can be made.
In addition, it’s highly recommended you seek, in your initial discussions with a medical doctor—in a treatment center or hospital setting—about treatment programs and protocols that address both disorders.
Oftentimes, treatment of co-occurring disorders includes medications, therapeutic counseling, behavioral therapies, medical support, peer support to help one recover and maintain one’s abstinence from the addictive substance(s), as well as follow-up support to prevent relapse.
If you or someone you know is struggling with depression, as well as any substance use issues, it will be wise to seek help by talking with your physician or seeking out treatment and support, in order to address the issues you’re facing and develop protective coping skills to reduce the risk of relapse or worsening your depression.
 Saffer, H., et al. “Mental Illness and the Demand for Alcohol, Cocaine and Cigarettes.” National Bureau of Economic Research. Jan. 2002.
 “Understanding Alcohol Use Disorder.” NIAAA. April 2021.
 Hides, L., et al. “Psychological Interventions for Co-occurring Depression and Substance Use Disorders.” The University of Queensland School of Psychology. Nov. 26, 2019.