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Depression and Substance Abuse. The Chicken Or The Egg?
Author: Phil Kosanovich
Published: July 14, 2020
depressed woman sits on a sofa whilst clasping her head in her hand

Everyone experiences low moods occasionally. For many people it comes and goes, and can be helped to move along by exercise, dietary changes, or simply talking about it. Life today is fast paced, and we are bombarded with content in the media, images of beautiful people looking happy, images of war torn countries and injured children, news about this politician or that politician saying this or that. It’s all a bit much sometimes, so it’s natural to feel numb to life and all that comes with it.

But sometimes the dark cloud does not move on so easily for those who are suffering from depression. Depression affects millions of people and prevents them from living normal, happy lives. Clinical depression is a serious mental disability with severe consequences for the individual or his or her loved one.

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Substance abuse is quite common among those who are suffering from depression, according to the Anxiety and Depression Association of America, about 20% of Americans who suffer from depression also suffer from alcohol or substance abuse. Often they will use substances as a means of numbing difficult emotions or as an escape from reality. Substance abuse further amplifies the symptoms of depression, however, so it’s often hard to figure out the initial cause when someone suffering from depression has a substance abuse problem.

Figuring out which came first – the depression or the substance use – is important in finding the right treatment option. Someone who was suffering from depression before developing an addiction will need to undergo treatment and take medication for longer than someone who developed depression as a result of substance abuse, and the approach will differ.

Alcohol, for example, is a central nervous system depressant, so its use and abuse tends to trigger common depression symptoms such as lethargy, sadness, and hopelessness. Cocaine and ecstasy trigger depression symptoms by depleting the levels of serotonin in the brain. Coming down from any of these substances makes the user feel negative moods, which over time can appear without the drug.


There is a strong two-way connection between depression and substance abuse. One tends to feed the other. Those with a mental health diagnosis use more substances than the general population, and those with substance abuse issues have higher rates of mental illness than the general population. It is difficult to address both issues at once as there are often factors that get in the way, like self-medicating. For example, an individual may use cannabis to ease their anxiety, and believe that without the anxiety there would be no need to use cannabis. The flaw in this concept is that the use of a substance like cannabis to ease anxiety can lead the user to believe that they need the drug to deal with their anxiety, creating a reliance or dependency.

These two issues are frequently diagnosed together, which is known as a dual diagnosis. Co-morbid disorder and co-occurring disorder are terms that are also used in this circumstance.  A dual diagnosis occurs when there is a combination of a mental disorder – anxiety, depression, bipolar disorder – and an addiction issue – sex, drugs, alcohol. Most dual diagnoses include a depressive disorder as part of the diagnosis. ‘Mood disorders, including depression and bipolar disorders, are the most common psychiatric comorbidities among patients with substance use disorders’

With clinical depression, the risk of self-harm, suicide, and accidental injury is greatly increased. Sometimes the self-harm can show itself in the form of substance abuse. The risk of using substances to numb emotional pain or to escape from the feeling of depression is that you can go too far, and accidentally (or intentionally) hurt yourself – physically, mentally, and emotionally. Depression can also weaken an individual’s immune system, which makes the sufferer more susceptible to physical ailments and chronic illness. Add drugs or alcohol, and the risk to your physical and emotional health is significantly increased.

The good news is that the treatment options are available. At Cornerstone we are able to deal with all substance abuse issues and have connections to a plethora of expert therapists who will be able to work with you to help overcome depression or any other mental health issue you may be struggling with. Don’t keep fighting alone, reach out to Cornerstone and let us help you win the battle.

Related illnesses and substance-abuse accessed 1/3/2020

Quello, Susan B et al. “Mood disorders and substance use disorder: a complex comorbidity.” Science & practice perspectives vol. 3,1 (2005): 13-21. doi:10.1151/spp053113

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