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The Complex Relationship Between Addiction and Depression

Grace Ogren
 December 30th, 2022|   Clinically Reviewed by 
Rajnandini Rathod

Depression can be either a cause or symptom of addiction. Some people try to self-medicate their symptoms, which leads to addiction. Others get depressed because of their substance use. But there’s a reason these 2 conditions appear together so often. If you have signs of both, you might need specialized treatment at a rehab for depression and addiction.

Common Causes of Depression and Addiction

Depression and addiction often occur at the same time. And in fact, having depression doubles your chance of developing addiction.1 But the link goes both ways. Taking drugs can also cause depressive symptoms.2

What’s more, these 2 diagnoses have overlapping causes.3 The same factors that put you at risk for depression can also make you vulnerable to drug abuse:

Addiction and depression cause similar brain activity.1 And acute symptoms activate the same neural pathways over and over again. If you have depression, that happens during a depressive episode. With addiction, it happens when you take drugs. Both conditions make those pathways more and more sensitive over time. So without proper treatment, either one will continue getting worse. And, you’ll become even more vulnerable to the other.

Getting the Right Diagnosis

To get the right type of treatment, you first need an accurate diagnosis. And that can be more complex than it sounds. For example, if your depression is the result of drug use, your recovery will need to include addiction treatment.

Depression can co-occur4 with a wide variety of health issues. These can include mental health conditions, like anxiety, and even physical ones. For example, diabetes is linked to depression.5 And sometimes it’s just a symptom of a more complex diagnosis.

Depression as a Symptom of Bipolar Disorder

Bipolar disorder is a mood disorder that occurs in over 50% of people with addiction.6 People with this condition experience periods of depression interspersed with mania. And because it’s a primary symptom, bipolar is often misdiagnosed as major depression.7

If you get the wrong diagnosis, it can interfere with your recovery. And it doesn’t just delay your progress—it can also make your symptoms worse.  For a person with bipolar, antidepressants can trigger manic episodes. They can also cause intense swings between mania and depression, called rapid cycling.

Addiction can exacerbate your mood disorder8 symptoms. That’s true whether you have bipolar disorder, major depression, or something else. If you’re healing from both addiction and any other mental health issue, you might consider going to rehab for co-occurring disorders.

Treatments for Depression and Addiction

Depression and addiction are receptive to similar types of treatment. That means you can heal from both simultaneously. You might even find that focusing on one condition helps you heal from the other. For example, data shows that most depressive symptoms resolve during addiction treatment.9 But that’s not true for everyone.

When you enter recovery, you might not know which condition came first. But you can work with your care team to answer that question. If your depressive symptoms fade after detox, you might just focus on healing from addiction. But if you do have clinical depression, there are several ways to approach treatment.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) teaches patients to cope with difficult thoughts. You’ll learn practical skills that help you live with and regulate even the most intense emotions.

CBT treats depression and addiction10 by helping people build self-confidence. And data shows that it has lasting effects, supporting your long-term recovery.. You can also combine this therapy with other types of treatment, like medication.

Medication for Depression

Depending on your physical health, your care team may recommend prescribed medication. For example, it’s common to treat depression with selective serotonin reuptake inhibitors (SSRIs),11 like Prozac or Zoloft. Preliminary data shows that SSRIs may also support addiction recovery. Specifically, they might help people quit smoking or heal from sex addiction.12

SSRIs typically take full effect after 6 weeks. And while they’re a common treatment for depression, they aren’t right for everyone. You may need to try a few medications before you find the right fit. Or, if you have treatment-resistant depression, you might need to take a different approach.

Alternative Treatments

If traditional therapy and medication aren’t working for you, there are many other ways to treat depression. Some of these methods are experimental, while others are highly researched but less well known.

These alternative treatments aren’t replacements for traditional medical care. But you can combine them with other therapies, or even attend a holistic rehab program. There’s no right or wrong way to plan your recovery—just the way that works best for you.

Clearing the Clouds

Depression and addiction have so much in common, it can be hard to tell which one has the greater impact on your life. But there’s a silver lining to their overlapping symptoms. With the right treatment, recovery can be straightforward. In the long term, you can use the same coping skills to manage any ongoing symptoms. But most importantly, healing means learning about the complex relationship between these conditions. And doing that will teach you more and more about yourself.

Browse rehab centers that treat depression to learn about their amenities, photos, and reviews.

Reviewed by Rajnandini Rathod

  1. Quello, S. B., Brady, K. T., & Sonne, S. C. (2005). Mood disorders and substance use disorder: A complex comorbidity. Science & Practice Perspectives, 3(1), 13–21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851027/ [] []
  2. Substance use and co-occurring mental disorders. (n.d.). National Institute of Mental Health (NIMH). Retrieved December 20, 2022, from https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health []
  3. Pettinati, H. M., O’Brien, C. P., & Dundon, W. D. (2013). Current status of co-occurring mood and substance use disorders: A new therapeutic target. American Journal of Psychiatry, 170(1), 23–30. https://doi.org/10.1176/appi.ajp.2012.12010112 []
  4. CDCTobaccoFree. (2022, September 14). Depression and anxiety. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/campaign/tips/diseases/depression-anxiety.html []
  5. Holt, Richard I. G., et al. “Diabetes and Depression.” Current Diabetes Reports, vol. 14, no. 6, June 2014, p. 491. PubMed Central, https://doi.org/10.1007/s11892-014-0491-3. []
  6. Quello, Susan B., et al. “Mood Disorders and Substance Use Disorder: A Complex Comorbidity.” Science & Practice Perspectives, vol. 3, no. 1, Dec. 2005, pp. 13–21. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851027/. []
  7. Singh, Tanvir, and Muhammad Rajput. “Misdiagnosis of Bipolar Disorder.” Psychiatry (Edgmont), vol. 3, no. 10, Oct. 2006, pp. 57–63. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945875/. []
  8. Iqbal, Muhammad N., et al. “Treatment for Substance Use Disorder With Co-Occurring Mental Illness.” FOCUS, vol. 17, no. 2, Apr. 2019, pp. 88–97. focus.psychiatryonline.org (Atypon), https://doi.org/10.1176/appi.focus.20180042. [] []
  9. Nunes, Edward V., and Frances R. Levin. “Treatment of Co-Occurring Depression and Substance Dependence.” Psychiatric Annals, vol. 38, no. 11, Nov. 2008, p. nihpa128505. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722074/. []
  10. McHugh, R. Kathryn, et al. “Cognitive-Behavioral Therapy for Substance Use Disorders.” The Psychiatric Clinics of North America, vol. 33, no. 3, Sept. 2010, pp. 511–25. PubMed Central, https://doi.org/10.1016/j.psc.2010.04.012. []
  11. Torrens, Marta, et al. “Efficacy of Antidepressants in Substance Use Disorders with and without Comorbid Depression. A Systematic Review and Meta-Analysis.” Drug and Alcohol Dependence, vol. 78, no. 1, Apr. 2005, pp. 1–22. PubMed, https://doi.org/10.1016/j.drugalcdep.2004.09.004. []
  12. Efrati, Yaniv, and Mateusz Gola. “Treating Compulsive Sexual Behavior.” Current Sexual Health Reports, vol. 10, no. 2, June 2018, pp. 57–64. Springer Link, https://doi.org/10.1007/s11930-018-0143-8. []
  13. Ivan Ezquerra-Romano, I., et al. “Ketamine for the Treatment of Addiction: Evidence and Potential Mechanisms.” Neuropharmacology, vol. 142, Nov. 2018, pp. 72–82. ScienceDirect, https://doi.org/10.1016/j.neuropharm.2018.01.017. []
  14. Breed, Cindy, and Catherine Bereznay. “Treatment of Depression and Anxiety by Naturopathic Physicians: An Observational Study of Naturopathic Medicine Within an Integrated Multidisciplinary Community Health Center.” Journal of Alternative and Complementary Medicine (New York, N.Y.), vol. 23, no. 5, May 2017, pp. 348–54. PubMed, https://doi.org/10.1089/acm.2016.0232. []

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