How Depression and Substance Abuse Connect

Edited by Beth Durling

Last updated October 1, 2020

Depression is common among both adults and adolescents in the United States. The mental health condition affects about 7% of people 18 and older and roughly 13% of individuals between the ages of 12 and 171. All too often, those suffering from depression also struggle with drug addiction or alcoholism.

How do depression and substance abuse connect, and what’s the best treatment method for co-occurring disorders? Northbound Treatment has been helping people overcome addiction for over 30 years at our rehabilitation center, and we offer dual diagnosis programs for those facing both mental illness and substance abuse disorder (SUD). Keep reading to learn about the link between depression and SUD and the importance of dual diagnosis treatment for co-occurring conditions.

The Link Between Depression and Substance Abuse

Depression and other mental health conditions co-occur with SUD in about 4% of adults in the U.S. and about 2% of adolescents. In 2018, 13% of adolescents with SUD experienced at least one major depressive episode, and those with depression were nearly two times as likely to use illicit drugs than those without. Similarly, depression affects almost a quarter of adults with substance abuse disorder2.

What’s more, individuals who’ve been diagnosed with a mental health condition at some point in their lives account for nearly 70% of all alcohol consumption and almost 85% of all cocaine consumption in the U.S.3 The prevalence of depression among people with substance abuse disorder suggests that the conditions feed into each other. People experiencing major depressive episodes are more likely to abuse drugs and alcohol, and vice versa.

For individuals with severe depression, using drugs and alcohol can feel like an easy solution for numbing their pain. While substance abuse may temporarily mask emotional turmoil, destructive behavior can make the depression even worse. The more a person consumes addictive substances, the more their body will depend on them to feel “normal.” After a while, this chemical dependence can be all-consuming, leading to other serious problems. Substance abuse often wreaks havoc on an individual’s physical and mental health, as well as their relationships, finances, and job performance.

There’s an undeniable link between mental illness and substance abuse, and this connection shouldn’t be overlooked when it comes to treatment. To successfully overcome alcohol or drug addiction, co-occurring mental illness must be not only acknowledged but also treated simultaneously.

What Occurs First, Depression or Substance Abuse?

As we mentioned, clinical depression is often a gateway to SUD, as alcohol and drugs can offer a temporary escape from psychological distress. And yet, in some cases, substance abuse can result in a bout of depression or even major depressive disorder (MDD). Since drug and alcohol dependence impact virtually all aspects of a person’s life, the negative consequences can lead to depression or other mental health disorders, like anxiety, codependency, or borderline personality disorder.

Sometimes, it’s unclear whether depression precedes a substance abuse disorder or if it’s the other way around. Many of the symptoms overlap, and without a timely diagnosis, it can be hard to determine how long someone has been struggling with mental illness.

At any rate, co-occurring conditions should be treated concurrently. If depression is treated without addressing drug addiction or vice versa, either or both disorders can worsen. Also, the sooner an individual gets help, the better. If you think your loved one might be suffering from co-occurring disorders, it’s important to know what to look for and be prepared to present them with treatment options.

Signs and Symptoms of Substance Abuse and Depression

While depression is common, it’s important to note that almost everyone experiences sadness once in a while. Normal sorrow and grief are typically somewhat brief. For instance, you can expect a person to grieve after losing a loved one. However, a prolonged grieving period or becoming emotionally incapacitated over loss could be indicative of underlying depression.

If you’re concerned about your close friend or family member’s psychological state and substance abuse, knowing the characteristics of depression and SUD is a critical first step in helping them get the appropriate treatment.

When a person is depressed, they may:

  • Lose interest in activities they used to enjoy
  • Become lethargic or have low energy levels
  • Cry frequently or appear inconsolable
  • Become apathetic
  • Sleep more or less than normal
  • Eat more or less than usual
  • Gain or lose weight
  • Withdraw from family and friends
  • Perform poorly at work
  • Have difficulty meeting obligations
  • Use drugs or drink more alcohol than normal

If you observe these signs and symptoms, your loved one could be battling depression. Since the condition can be chronic and made worse with substance abuse disorder, early detection of both conditions and prompt treatment is vital.

When a person is abusing substances, they may:

  • Become lethargic or appear abnormally drowsy
  • Have notably small “pinpoint” pupils or bloodshot eyes
  • Breath slowly 
  • Talk slower than usual or have slow reaction times
  • Appear agitated, distracted, or paranoid
  • Frequently seem confused or disoriented
  • Exhibit uncharacteristic outbursts
  • Sleep more or less than usual
  • Lose weight or have a decreased appetite
  • Lose interest in activities they used to enjoy
  • Exhibit secretive behaviors
  • Withdraw from family and friends
  • Perform poorly at work
  • Have difficulty meeting obligations

As you can see, both disorders can impact a person’s appetite, weight, sleep, and mood. Severe depression and substance abuse often lead an individual to withdraw from their social circle, disengage in their usual activities, and fail to meet various obligations.

Why Dual Diagnosis Treatment is Vital for Depression and Substance Abuse

Co-occurring disorders can be challenging to treat because the effects of each condition tend to intensify the other. For instance, if someone is addicted to drugs and only receives treatment for depression, their dependence on drugs will create a barrier for effectively overcoming mental illness. And it goes both ways. If a person is depressed and enters into a drug rehab program that only addresses substance abuse, their emotional turmoil will likely prevent them from achieving long-term sobriety. This is why dual diagnosis treatment is essential for those suffering from SUD and co-occurring depression– it treats the substance abuse problem while simultaneously addressing the mental health issue at hand. In this way, patients are able to treat these intertwined issues more effectively. 

As outlined by SAMHSA (Substance Abuse and Mental Health Services Administration), dual diagnosis programs should4:

  • Help patients understand the nature of their mental illness and the underlying causes of their addiction
  • Demonstrate that full recovery from SUD and depression is possible
  • Motivate patients to make drastic life changes
  • Help patients build practical skills for addressing negative thoughts and triggers
  • Help clients identify and change behaviors that contribute to SUD

Though more rehab centers are beginning to offer integrated treatment for co-occurring disorders, still far too few are equipped to care for dual diagnosis patients. At Northbound, we understand the complexity of substance abuse and mental illness, and our approach never overlooks the connection between the two.

Dual Diagnosis Rehab in Orange County

When someone dear to you is struggling with drug abuse and a depressive disorder, it’s natural to want to support them in any way you can. But when it comes to substance abuse and mental illness, helping a loved one isn’t always easy. While anyone over the age of 18 must willingly agree to get care for their co-occurring disorders, you can help guide them to the right treatment program. To learn more about how to help someone with drug addiction & depression or alcohol abuse, head over to our blog. 

Here at Northbound, we proudly offer dual diagnosis treatment at our rehab facilities in Orange County. After an initial assessment, clients work with their care team to develop a personalized treatment plan. This usually involves the full continuum of care, starting with detox, then residential rehab, followed by outpatient treatment, and finally, ongoing addiction support. Successful treatment plans for depression and substance abuse disorder often consist of individual psychotherapy, group counseling, family therapy, experiential therapies, community activities, and sometimes medication.

Above all, support, motivation, and ongoing accountability are the keys to overcoming mental illness and addiction. No matter where you or your loved one are starting, full recovery and a happy, functional life are possible.

Call Northbound Treatment today at (888) 978-8649 to learn more about our approach to dual diagnosis rehab.

External sources:

1. https://www.nimh.nih.gov/health/statistics/major-depression.shtml

2. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf

3. https://www.nber.org/digest/apr02/w8699.html

4. https://www.samhsa.gov/find-help/disorders

Article Reviewed by Beth Durling

Beth DurlingBeth Durling BA, CADCII, ICADC is the Clinical Director of Northbound Treatment Services. She is also the proud owner of The Durling Group, Inc., a national consulting firm, where she worked closely with large scale corporations, healthcare companies, and universities, helping to enhance outcomes.

Beth founded and resided as CEO for The Center for Life Change, a non-profit drug and alcohol treatment center in Riverside County where she gained national recognition for her outcomes as a leader in the field of addiction surrounding patient care, specializing in retention strategies for both staff and patients.

She also founded The Heart Culture Academy, creating a collaborative national community of trained influencers, helping people change their relationships, their work environments and personal lives through her published Model, Heart Culture.

Beth believes individual lives can be enhanced through learned consciousness, utilizing her specialized techniques that offer long-lasting, connection-based relationships. She has toured the country speaking and distributing this message.

Beth has been writing and speaking to assist individuals and organizations through transformative processes for the last 25 years. She is the mother to two adult children, Ridge and Rachel and resides in San Clemente, California.

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