The link between depression and substance abuse

Many people with depression or other mental health issues are also affected by substance abuse.

Substance use disorder (SUD) is a condition that affects a person’s brain and behavior. This can lead to an inability to control the use of substances like alcohol and drugs.

Substance abuse can lead to addiction, which means a person is unable to stop a behavior or stop using a particular substance.

According to the National Institute of Mental Health (NIMH), approximately half of all people with SUD also have a mental health problem, such as depression. While symptoms of depression such as low mood can cause a person to abuse drugs and alcohol, SUD can also cause depression. This can trigger brain changes that make a person more likely to develop a mental health problem.

Read on to learn more about the link between depression and addiction, treatment options, and recent research findings.

According to research, about half of people who experience SUD also have a mental health condition. Concomitant conditions May include:

Although substance abuse and mental health problems frequently occur together, one does not necessarily cause the other. experts to suggest three possibilities that may explain the link:

Drug addiction and brain changes

Substance use can lead to changes in the structure and functioning of the brain. These changes can make people more likely to develop a mental health problem.


Some people with mental disorders may use alcohol or drugs to self-medicate. However, although some medications can temporarily relieve a person’s symptoms, they can make them worse in the long run.

Changes in the brain associated with mental health issues can also increase the rewarding effects of certain substances. This can make a person more likely to experience substance abuse.

Common risk factors

People at higher risk for mental health problems may also be at risk for substance abuse. There are common risk factors, including environmental factors such as trauma and stress.

During the COVID-19 pandemic in 2020, the number of people living with mental health issues and addiction rates increased. Accordingly, much of the recent research on depression and the SUD considers COVID-19 to be a factor.

A study found that adults – especially young adults – reported significantly high rates of mental health problems in 2020. Levels of suicidal ideation and substance abuse also increased.

The increase in substance abuse reports demonstrates the damages suffered by communities as an indirect result of COVID-19. According to American Medical Association, every state in the United States has reported a spike or increase in overdose deaths or other issues during the pandemic. The rise in deaths may be linked to more people seeking drugs, such as fentanyl, as a form of self-medication for mental health issues.

Another 2020 study also found that COVID-19 is directly linked to an increased risk of psychiatric disorders. This suggests that almost 6% people diagnosed with COVID-19 will develop a psychiatric disorder that they did not have before.

According to the CDC, 13% of US adults said they started or increased their substance use to cope with stress or emotions related to COVID-19.

Symptoms of depression can differ from person to person. However, common symptoms can include:

  • despair
  • feelings of guilt
  • lack of interest in activities
  • changes in appetite and sleep
  • lack of concentration
  • suicidal thoughts
  • physical aches and pains
  • feel restless
  • less physical activity

Symptoms of substance abuse also vary depending on the person, their existing mental health issues, and the substance they are using.

Continued use of a substance can negatively affect a person’s health and personal life, causing:

  • impaired daily functioning, such as skipping hygiene routines
  • decrease in physical health, such as sudden weight loss or interrupted sleep
  • financial constraint
  • mood swings
  • decreased leisure participation
  • increased isolation and reduced social interaction

As a rule, drug addicts also present one or more of the criteria for dependence defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). These include:

  • strong cravings or urges to use substances
  • withdrawal symptoms when stopping substance use
  • repeated unsuccessful attempts to stop or control substance use
  • substance tolerance
  • using substances in larger amounts for longer periods of time than intended

To diagnose SUD, a licensed medical or mental health professional must identify a person as having one or more of the 11 criteria defined by the DSM-5.

If a person meets 1 to 2 criteria, doctors consider them to have mild SUD. Their condition is moderate if they meet 3 to 5 criteria and severe if they meet 6 or more.

According to the NAMI, for a mental health professional or doctor to diagnose someone with depression, they must have had a depressive episode that lasted more than 2 weeks and included symptoms such as:

  • suicidal intentions or thoughts
  • loss of pleasure or interest in activities
  • tired
  • change in weight or appetite
  • feelings of guilt or low self-esteem
  • sleep disturbances
  • feeling sluggish or restless
  • difficulty making decisions or concentrating

If a person has symptoms of both SUD and depression, a doctor may diagnose them with both conditions at the same time. However, other people will receive the diagnoses separately.

A mental health professional will usually treat a person’s SUD and depression together. As the symptoms of the conditions can overlap, so can their treatments. Certain medications and therapies can treat both SUD and depression, and treating the conditions at the same time may be more effective.

A doctor must tailor a treatment plan to a person’s specific conditions and symptoms. Treatments may include:

Behavioral therapy

A popular option is cognitive behavioral therapy. It is a form of talk therapy where the mental health professional aims to help a person learn new ways to cope with difficult situations by challenging irrational thoughts and changing existing behaviors.


A doctor can prescribe antidepressant medications to treat depression. Examples include:

If a person has SUD, a doctor can prescribe medications specific to the type of substance they are abusing. These may include:

Although treatments and medications can help people with depression and SUD, living with either or both of these conditions can be difficult. People may find it helpful to seek help from organizations and support groups. Some options include:

The Substance Abuse and Mental Health Services Administration also offers a behavioral health treatment services locator to help find mental health and addiction treatment facilities and programs across the United States.

About half of all people who abuse substances also have a mental health problem, such as depression. Although there is a connection between the two, one does not necessarily lead to the other.

Recent research focuses heavily on the increase in mental health issues and substance abuse due to factors related to the COVID-19 pandemic. Although living with these conditions can be difficult, a doctor can recommend treatments, including medication, therapy, or both.

Harry D. Gonzalez