Why are Depression and SUD Co-Occurring?

Learn more about what defines a co-occurring disorder, potential risk factors, and how depression and SUD are co-occurring.

Table of Contents

Relationship Between Depression and Substance Abuse

Frequently used and abused drugs have direct brain-damaging effects that can lead to depression. This can inevitably lead to one developing a co-occurring disorder.

Emotions are frequently improved by substances such as cocaine or alcohol, but when usage stops, users frequently face a plummet into depression. Many other commonly abused substances can also cause depression, either while the user is high on the substance or when they are going through withdrawal.

Co-occurring Disorder

Why Do People Use Drugs?

A lot of people with depression try to take care of themselves. They may struggle with accepting that they are depressed or understanding how it can be addressed with medicine or counseling. If a recent recovery attempt has failed, an individual may feel guilty or frustrated, leading to further abuse
Alcohol and drug abuse are used as a way to cope and improve moods. 

An individual can alter their feelings for a short time, but in the long run, they end up causing far more serious issues for themselves because the drug makes the depression worse over days, weeks, or months.

What is Depression?

Depression is a prevalent mental illness marked by persistent unhappiness and a lack of interest or pleasure in things that were once rewarding or enjoyable. Additionally, it may impair appetite and sleep, leading to concentration problems and fatigue that are likely to occur.1

There are several diagnosable forms of depression, ranging from mild to severe in symptoms. Some people experience depression chronically (longer than two years) and some experience full recovery. The effects of depression on mental health can be life-threatening if left untreated.

Depression Following Drug Use

Both depression and substance misuse have a direct causal relationship.

Dopamine levels are lower in those who suffer from depression, and dopamine levels have also been linked to substance abuse. The neurotransmitter most frequently linked to depression and other mood disorders is the hormone serotonin. Abuse of drugs or alcohol can cause or make loneliness and depression feel worse. Similar to this, serotonin receptors can become altered in alcoholics.

Different Types of Depression

While depression symptoms often overlap with other mental disorders, there are several types of diagnosable depression; these will be detailed below.

Major Depressive Disorder (MDD)

Major depression (clinical depression) symptoms are severe and overwhelming, lasting for longer than two weeks. The symptoms make day-to-day tasks challenging.

Persistent Depressive Disorder (PDD)

Another name for PDD is dysthymia. PDD symptoms are milder than those of major depression. However, PDD symptoms might last for up to two years in some people

Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder (SAD), a form of depression connected to changes in light, typically manifests in the winter. These symptoms of depression might also include anxiety, mood swings, binge eating, and difficulty sleeping.

A person must experience these symptoms for three consecutive winters in order to be diagnosed with SAD.

Postpartum Depression

Pregnancy and the first year following childbirth can both lead to postpartum depression. The “baby blues,” which are cases of melancholy, anxiety, or stress, are not the only symptoms.

Depression with Psychotic Features

Psychotic depression is characterized by severe depressive symptoms as well as hallucinations or delusions. Hallucinations involve seeing, hearing, or feeling touched by things that aren’t actually there, whereas delusions are beliefs in things that aren’t grounded in reality.

Symptoms of Depression

Indications of depression to be cognizant of include:

  • Persistent feelings of sadness
  • Excessive guilt
  • Feelings of worthlessness
  • Irritability
  • Restlessness or agitation
  • Fatigue
  • Difficulty concentrating
  • Physical pain
  • Frequent thoughts of death or suicide
  • Thoughts of self-harm

What is the Link Between Depression and Addiction as a Co-Occurring Disorder?

Depression and addiction coincide with overlapping symptoms, and one often leads to the other. This is known as a co-occurring disorder. Here are other things they share in common:

Substance Misuse and Brain Changes

The structure and functioning of the brain can be altered by substance use. People may become more susceptible to certain mental health conditions as a result of these changes.2


Sometimes using drugs and alcohol can seem like a simple fix for those who are depressed and believe there is no end in sight. These drugs might make people feel happier and temporarily relieve any emotional suffering.

These substances can, however, develop an addiction. Their body will get more dependent on their effects as they take more of them. Substance usage over time can worsen depressive symptoms as well as result in long-term health issues like brain damage.2

Common Risk Factors for Developing a Co-Occurring Disorder

Substance abuse may be more likely in people who are at increased risk for mental health issues. There are risk factors that are common to both groups, such as stress and trauma in the environment.2

Disorders that Often Co-Occur with Depression

Depression can often overlap with other mental illnesses, such as the following co-occuring disorder risks:

Treatment for Comorbid Depression and Substance Use Disorder

Most treatments generally provide resources that are beneficial for both as a co-occurring disorder. Some examples will be discussed further below.

Cognitive Behavioral Therapy (CBT)

CBT is intended to change negative ideas and unhelpful behaviors, and it is highly effective for those with substance use disorders. The most effective psychotherapy for young patients with anxiety and mood disorders is cognitive behavioral therapy (CBT).

Group Therapy

Integrated Group Therapy is created especially for people with bipolar disorder and substance use disorders that aim to deal with both issues simultaneously. This treatment typically works in conjunction with medication and is mostly based on CBT principles. IGT emphasizes the connections between the illnesses, the connection between thoughts and behaviors, and how these factors affect both recovery and relapse.


Antidepressants are effective drugs available for treating addictions to opioids, alcohol, and nicotine, as well as many other illnesses. For instance, bupropion is authorized to treat nicotine addiction and depression.

Family Therapy

A variety of therapeutic modalities called family therapy make an effort to leverage the family’s assets, knowledge, and strengths to help them maintain a drug- and alcohol-free lifestyle. Additionally, it aims to lessen the negative effects of addiction and depression on both the drug user and his or her family.

Dialectical Behavior Therapy (DBT)

DBT is primarily intended to lessen self-harming behaviors, drug use, and suicidal attempts, thoughts, or urges. People who fit the criteria for borderline personality disorder can benefit from it, which makes it one of the few therapies that work.

How to Cope With Depression and Substance Abuse as a Co-Occurring Disorder

Depression and substance abuse can feel like being caught in a cycle. Experiencing a co-occurring disorder can make it challenging to even know where to start in regards to recovery. 

While addiction can often be a way of coping with life’s stressors, it’s necessary to find healthy coping mechanisms and to practice self-care. Some treatment and wellness opporunities in managing a co-occurring disorder will be discussed below.

Support Groups

Finding sober companions is one of the most crucial things you can do to stay sober. Even though it could be difficult to end harmful relationships from your past, spending time with others who understand your need to be abstinent will be beneficial in the long term.3

Don’t Isolate Yourself

Being social can lift your spirits. You will always have someone to talk to when you’re feeling down if you stay in touch with friends and family.3

Stay Active if Possible

Start exercising. There is proof that exercising can improve your mood. Start slowly if you haven’t worked out in a while by going for 20 minutes of daily walks.3

Be Gentle with Yourself

When you complete a challenging task or get through a challenging situation, congratulate and reward yourself.4
Co-occurring Disorder

Find the Right Treatment for Depression and Substance Abuse as a Co-Occurring Disorder

Without the right care, illnesses like depression and addiction may keep returning, negatively affecting a person’s work, school, or personal life. In the worst-case scenario, symptoms can be life-threatening. It’s essential to create a strategy to improve your health, and both depression and substance abuse treatment as a co-occurring disorder to increase your quality of life.

Everyone’s journey is unique to them, which is why treatment should take place in a supportive and encouraging environment. Immediate treatment produces the best results, so don’t wait to reach out.

Get Help for Any Co-Occurring Disorder at Soledad House

Work towards long-lasting sobriety and also live a healthy, happy life without the constraints of a co-occurring disorder with the help of our passionate team of medical professionals at Soledad House.

Our team will outline a comprehensive treatment plan that is individualized for your healthcare needs and personal goals. We will take a whole person approach to healing the root of your co-occurring disorder, enabling you to regain sustainable autonomy over your life once more. If you or a loved one are seeking guidance for depression and substance abuse, contact us today to start your recovery.