Is Substance Misuse Causing Your Depression?

in Addiction
Published Feb 15, 2021
substance misuse causing depression

While depression and addiction seem to go hand in hand, the connection between the two is very complicated and oftentimes quite misunderstood. As it is, each disorder is hard enough to handle on its own, let alone manage when they’re both wrapped up with one another. Many Americans misuse substances because they’re depressed and then, in turn, become depressed because they use. It’s a vicious cycle that, sadly, many people find themselves lost in forever.

That said, there is hope.

The first step for those people struggling with the two disorders is to understand the many risk factors, causes, and symptoms at play. It’s also important to be aware of the various treatment options that are available for those with dual diagnoses. The more you know about addiction and depression, the more prepared—and empowered—you will be when it comes to achieving recovery.

Dual Diagnoses

Especially given the challenges of 2020, depression is something millions of Americans combat day in and day out. It’s one of the most common mental disorders in the US, as an estimated 17.3 million American adults, 7.1%, have had at least one depressive episode. The prevalence of major depressive episodes is higher among females than males. What’s more is that 8 million American adults have a dual diagnosis, which means having a mental illness and depression at the same time.

Those diagnosed with major depressive disorder and substance use disorder is known as “comorbidity.” This condition brings suicide risks, complications with one’s social interactions, and problems with personal lives —as well as dozens of psychiatric conditions. Knowing where and how to seek the appropriate care and treatment for a dual diagnosis is crucial to getting onto the right recovery path.

Risk Factors

There isn’t one cause or reason that depression can be directly linked to, though it does have several risk factors that can be responsible—sometimes all at once. A person’s environment, their genetics, their physical state, and their psychological condition are all factors that can drive depression.

More specifically, the National Institute of Mental Health details the many risk factors for depression, which include:

  • Traumatic childhood experiences
  • Family members with depressive disorders (diagnosed or undiagnosed)
  • Chronic medical conditions, like diabetes, obesity, and cardiovascular disease
  • Stressful life events or changes


Substance misuse also has several risk factors, including:

  • Family members who have a history of substance abuse
  • Little or no coping skills
  • Financial problems
  • High levels of stress
  • Aggressive behavior at any early age
  • Little parental involvement

Depression Signs & Symptoms

Depression isn’t simply about feeling “sad” or “down.” Everyone experiences sadness on some level on occasion. That said, major depressive disorder (also called “clinical depression”) is characterized by a sustained low mood during the day, nearly every day of the week, for at least two weeks.

The more you can understand and can recognize depression signs, the faster you can do something about it.

Some symptoms of major depressive disorder include:

  • Feelings of hopelessness and/or emptiness
  • Decreased energy
  • Persistent sadness
  • Anger and irritability
  • Difficulty concentrating and paying attention
  • Guilt, or feelings of worthlessness
  • Loss of interest and enjoyment in activities or hobbies
  • Insomnia, or hypersomnia (sleeping more than usual)
  • Restlessness and/or difficulty sitting still
  • A major increase or decrease in appetite and/or weight changes
  • Increased (and unexplainable) body aches and pains
Addiction Signs & Symptoms

“Addiction” is a word that’s as simple as it is complex. When someone struggles with an addiction, they’re engaging in a potentially harmful pattern of behavior that involves substances. Despite whatever personal, social, financial or medical consequences there are, many people will follow their addiction to grave ends. It’s also important to know that while there are many signs of addiction, most people won’t present each and every symptom at the same time.

Among the many signs, behaviors and symptoms of addiction:

  • Taking higher amounts of a substance (prescription drugs, for example) than intended
  • Having a desire to stop or reduce use, but not being able to do so
  • Wrestling with strong cravings for a substance
  • Spending considerable time and energy securing a substance, consuming it and, consequently, recovering from it
  • Continuing to use despite problems with work, school, or family
  • Constant fights with family and friends over substances
  • Risk-taking behavior, such as lying, stealing, gambling, etc.
  • Using the substance in hazardous situations (drinking and driving)
  • Developing a tolerance to the substance (needing more to achieve a desired effect)
  • Experiencing withdrawal from a substance when not using it

Compounding the overall problem is that addiction is a progressive disease, which means that the symptoms above will only worsen over time. Unless the person gets the help they need, it is virtually guaranteed that things will not improve or go in a positive direction.

Depression After Use

Withdrawing from drugs and alcohol will usually result in a series of symptoms that resemble depression symptoms:

  • Alcohol withdrawal symptoms include anxiety, insomnia, fatigue, sudden mood shifts.
  • Stimulant withdrawal (like from cocaine and methamphetamine) can include a depressed mood and a lack of pleasure derived from things that normally bring them pleasure or satisfaction. When a person comes down from a sustained high, they may experience extreme fatigue that can last weeks, too.
  • Hallucinogens such as LSD will bring withdrawal symptoms that range from delusions, dissociation, and depersonalization. Those who abuse hallucinogens can also experience prolonged depression, flashbacks and psychotic reactions.
  • Opioid withdrawal (prescription painkillers and heroin) commonly result in irritability, agitation, inexplicable body pains and depression. Opioid withdrawal can also lead to anxiety, insomnia and severe cravings over several weeks.


Using and withdrawing from these substances will also exacerbate any (or all) mental illness symptoms that someone may already have. That’s why it is critical that people with a dual diagnosis should be treated immediately by an addiction professional who is medically trained to deal with their condition.

It’s also important to note too that it can be dangerous to stop drinking suddenly, especially after drinking alcohol for a prolonged period of time. It can cause the body to experience alcohol detox withdrawal symptoms that include:

  • Nausea and vomiting
  • Delirium tremens
  • Seizures
  • Excessive sweating
  • Headaches
  • Anxiety
  • Tremors
  • Irritability
  • Depression
  • Increased heart rate
  • Difficulty sleeping
  • Hallucinations

There is a more serious side effect known as delirium tremens (DTs) that some people experience when they discontinue alcohol use. The DTs are periods of hallucinations, confusion, and disorientation. If an individual develops these and the condition goes untreated it could be fatal.

SAMHSA recommend professional intervention for alcohol detox:

For alcohol, sedative-hypnotic, and opioid withdrawal syndromes, hospitalization or some form of 24-hour medical care is generally the preferred setting for detoxification, based upon principles of safety and humanitarian concerns.”

– SAMHSA Detoxification and Substance Abuse Treatment Improvement Protocol, TIP 45

Recovery Options

Fortunately, recovery is possible for anyone .There is a wide range of available treatment solutions—not simply medication—for those who suffer from both depression and addiction disorders. That said, many professionals recommend a combination of both medication and therapy to help their patients achieve recovery.

Among some of the commonly prescribed depression medications out there:

  • Selective serotonin reuptake inhibitors (SSRIs), like Prozac, Zoloft, and Celexa
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as Effexor, Cymbalta, and Pristiq
  • Tricyclic antidepressants (TCAs), like Elavil and Anafranil
  • Monoamine oxidase inhibitors (MAOIs), which include Parnate and Nardil
  • There are also many different medications that treat alcohol and opioid dependence:
  • Naltrexone blocks opioid receptors and decreases some of the “reward” given by opioids.
  • Disulfiram (better known as Antabuse) triggers unpleasant reactions, such as nausea, when someone drinks alcohol
  • Widely used in the US, Methadone is a synthetic opioid agonist that reduces cravings and lowers the severity of other withdrawal symptoms.
  • Another synthetic opioid is buprenorphine, which helps to reduce withdrawal symptoms.
  • Remember that no one medication is the “magic cure” for both depression and substance use disorders. It’s only through a coordinated combination of medications and psychotherapy that people generally find success in treatment.

There are a range of behavioral therapies that can help treat depression, usually in combination with medication. Evidence-based therapies help manage depression include:

  • Cognitive behavioral therapy (CBT) helps people to alter their negative behavioral patterns, which contribute to depression. CBT helps patients to explore their behaviors and look at them in a more positive light. The technique also helps people to develop proactive coping skills, which makes it very effective in treatment for depression and substance use disorders.
  • Problem-solving therapy (PST) is tailored to each person’s needs as they cope with difficult life changes and/or stressful situations. Through a step-by-step process, patients identify problems and generate practical solutions to overcome them.
  • Interpersonal therapy (IPT) works to repair personal relationships by focusing on behavior changes and confronting difficult situations, such as grief or job loss.
  • Several evidence-based therapies are also used for addiction treatment:
    • Acceptance and Commitment Therapy (ACT) incorporates concepts of acceptance, mindfulness and personal values.
    • Contingency Management, also called motivational incentives or the prize method, uses behavioral interventions that provide or withhold reward in response to a measurable behavior.
    • Relapse Prevention is an intervention specifically designed to maintain recovery and prevent return to use.
    • Motivational Interviewing/Motivational Enhancement Therapies is a counselling approach that involves the person becoming motivated to change.
    • Behavioral Couples Therapy assists both individuals seeking support for the treatment of addiction.
    • Family Therapy uses psychotherapy to support families to resolve complete relational patterns and promote long-term recovery.
Other suggestions to alleviate depression

In addition to the above clinical interventions, there are some activities that can help to alleviate depression, including:

  • Increased physical exercise
  • Spending time with family, friends and loved ones
  • Setting realistic goals
  • Avoiding isolation.
  • Postponing any major decisions (purchases, job changes, etc.)
  • Learning more about depression and becoming proactive when seeing signs of it

It is always important to consult your physician before attempting any additional activities.

Solutions to treating dual-diagnosis

We can help overcome uncomfortable withdrawal symptoms and depression through effective, safe, and comfortable medical detox provided by addiction experts. Our patients are rarely uncomfortable because we provide an individualized plan for each patient and their needs.

At Gallus Medical Detox Centers, we bring compassion to the commotion. Peace to the pain. Empowerment to the powerless. If you or someone you know needs support with addiction problems, bring us your battle. Call us today and take the best, first step towards recovery: 720-704-1432

For information about finding a detox center, read our blog The Gallus Method: An Insight, or visit our alcohol addiction treatment page.

You may also want to read…

What Does an Alcohol Detox Look Like?

Key Signs & Symptoms of Alcohol Poisoning

How to Detox from Alcohol

What to Expect from an Alcohol Detox Center

Alcohol Awareness Month 2020