Substance Use and Depression


It is commonly thought that substance use covers an underlying problem like the person using is trying to manage an important and untreated illness with drugs or alcohol. And there is a great deal of research to support this. Actually, it is quite likely that a person using drugs or alcohol has a mental illness as well. This is called a co-occurring disorder when there is an untreated mental illness and a substance abuse issue on top of that.


Substance use, when looked at regarding depression, should be viewed as a way to cope with it, not a source of shame and disgrace. Drug or alcohol use is a way to change the way a person feels, and it is very effective in the short term, The issue arises that longer-term, it becomes an addiction and does more damage to the mind and body than depression.



Depression is best framed as a whole body illness. The reason for this is that it impacts every area of a person’s life. It impacts their mood, their relationships, their spirituality, their job, and their body. It can be physically painful and uncomfortable to try to exist with an untreated depression.

Now, everyone has down days or feels sad for a good reason. That is not depression. A major depressive disorder according to the DSM-5 is when a person has these symptoms for three or more weeks:


Depressed mood most of the day, almost every day, indicated by your own subjective report or by the report of others. This mood might be characterised by sadness, hopelessness, or feeling numb. Some may also feel bouts of anger, not due to some specific event.

Markedly diminished interest or pleasure in all or almost all activities most of the day nearly every day. This includes activities, hobbies, or things that used to bring joy and meaning to a person’s life.

Significant weight loss when not dieting or weight gain. Unexplained physical changes.

Inability to sleep or oversleeping nearly every day.

Agitation, constant activity, pacing or other activity similar to that. The unfocused anxiety that prevents a person from doing a normal physical activity like sleeping for example.

Fatigue or loss of energy nearly every day.

Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day.

Diminished ability to think or concentrate, or indecisiveness, nearly every day.

Recurrent thoughts of death, recurrent suicidal ideation with or without a specific plan, or a suicide attempt or a  specific plan for committing suicide.


Seeing this list, it is easy to see why someone would want to find a way to get away from these thoughts and feelings. If you can imagine what it is like to experience this every day, from the time you wake up, until the time you go to sleep, that gives you a clue as to why people will turn to substance use to just find some relief.


Substance use and depression

Depression is one of the most common underlying problems when it comes to substance use. According to the World Health Organization, anywhere from 3-10% of a country’s population will be clinically depressed. This presents as a large number of people that need help, and are seeking relief.


When it comes to co-occurring disorders, the numbers are almost as bad. In the U.S., for example, 20% of people with a major depressive disorder will have, or develop, a substance use disorder on top of that. This becomes numbers easily in the hundreds of thousands of people suffering from depression and substance use.



As painful as depression and addiction are together, help is available. It often comes in the form of an integrated treatment model, where the treatment facility will attend to both illnesses, the depression and addiction, simultaneously.


This comes in the form of talk therapy, like cognitive behavioural therapy or mindfulness-based approaches that look at the ways a person thinks and reacts to the world around them. Then with practice, retraining the brain to evaluate things differently, changing how we feel about them. Mindfulness-based approaches are focused more on helping a person stay grounded in the present, accepting what is not changeable, and stressing ways to cope with the world around them.


Education is also a key feature to treatment as well. A person needs to learn the signs of their addiction and illness, and when they are flaring up. They also need to understand the relationship between the addiction and the mental illness, as well as more helpful ways to treat themselves. Finally, antidepressants and other medications can treat illnesses and some of the symptoms of addiction and depression.


Working with all of these treatment options can give people the best chance to recover from their addiction and mental illness. Help and treatment are available and people recover from co-occurring disorders every day. If you or someone you love need help with one of these issues, please contact us immediately.

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