Depression and Addiction: How They're Connected
There’s a two-way relationship between depression and addiction. People with depression are at a higher risk of developing a substance use disorder. However, substance use worsens mood chemistry, which can drive self-medication further. Since many people have both, and since each condition can worsen the other, it is vital that addiction treatment providers understand depression. Learning about how depression and addiction are connected and how they’re treated can be empowering for people living with them.
The Link Between Depression and Addiction
Depression and addiction are common co-occurring disorders. They share similar risk factors, such as trauma and genetics. Both depression and addiction affect the brain and cause profound biological disruption. One of the most notable things we observe is the vicious cycle that transpires when someone with depression also grapples with substance abuse. There’s a reason it happens. More importantly, it is possible to break that cycle.
Often, depression causes symptoms like low motivation, difficulty concentrating, and trouble experiencing positive emotions (this is called anhedonia). Dopamine motivates you to take action. It channels your energy toward a task. Serotonin regulates mood, boosts happiness, and helps to regulate focus. These are just some examples of what these neurotransmitters do.
Substances cause surges of neurotransmitters like dopamine and serotonin. Your body gets used to and craves these surges if you use substances repeatedly, especially since these same neurotransmitters plummet without a constant stream once you develop a tolerance. When they plummet, you feel worse. Repeated use makes your body produce less of these hormones naturally. This often creates a self-medication pattern where you feel worse, keep using to combat it, and so on.
The brain can heal and recover from these changes with ongoing sobriety. People return to their baseline in time. This is something that happens gradually. Healing from depression and addiction takes patience. Increased depression is a common post-acute withdrawal symptom, which is just one reason why having support is so essential during the process.
Signs Depression and Addiction Are Occurring Together
People with depression and substance use disorders will experience symptoms of both, but what they look like can differ from person to person. Sometimes, those with depression and addiction are high-functioning. One may maintain a career and family life but struggle internally. This may not be the case for another person. All that to say, while the experience isn’t uniform and could be more hidden in one individual than it is for another, people who have depression and addiction always deserve help.
Signs that depression and addiction are occurring together might include, but aren’t limited to:
- Increased tolerance
- Continuing use despite consequences (e.g., relationship impacts, worsened mental or physical health)
- Not being able to cut down or quit a substance, even if you try or think you can
- Hiding substance abuse or lying about how much or how often you use
- Difficulty feeling positive emotions, like happiness, excitement, or joy
- Loss of interest in activities (e.g., hobbies) you would usually enjoy
- Depressed mood or feeling emotionally numb and “flat”
- Social isolation (e.g., pulling away from loved ones)
- Increased privacy or secrecy
- Sleeping more or less than usual
- Irritability or mood swings
- Feelings of hopelessness
- Changes in appetite
Some signs could depend on the type of drug a person is using. One person might turn primarily to stimulant drugs, which could bring erratic bursts of energy, jitteriness, or suppressed appetite. Another person could have depression and alcohol use disorder. This is a common combination. Or, they might use a combination of different substances.
Regardless, substance abuse tends to correlate with a person’s needs. It could be to escape depressive feelings, socialize more easily, care less, stop caring that you don’t care (e.g., in cases of emotional numbness), have more energy, sleep, or to avoid withdrawal symptoms and curb cravings once a person has developed an addiction.
Which Comes First - Depression or Addiction?
Whether addiction or depression comes first depends on the person. When you reflect on your history or go over it with a provider, there could be a clear understanding that depression came first. In other cases, there might not be. What matters most is getting an accurate concurrent diagnosis if you do indeed meet the criteria for both. This is often what opens the door to effective treatment. Comprehensive evaluations are critical for this reason. When performed correctly, they also help people avoid misdiagnosis.
How Depression and Addiction Are Treated Together
Dual-diagnosis (integrated) care treats addiction and co-occurring disorders like depression together. Usually, this involves a combination of therapy and careful medication management for the depression symptoms paired with addiction treatment. Cognitive behavioral therapy (CBT) is highly effective for many people with depression. It’s one example of the therapies we might use alongside other modalities used in depression treatment.
People receiving addiction or dual-diagnosis treatment at our center are monitored closely. We use a collaborative approach and value your perspective. Your treatment plan can be adjusted as needed (when you need more support, when something’s not working, or when you’re ready to step down to a lower level of care). For example, some people require trial and error to find the right antidepressant. Care should always be individualized. The goal is to make lasting changes that support long-term sobriety and overall health.
People usually start their journey with medical detox, which allows them to stop using drugs and alcohol safely with medical monitoring, emotional support from staff, and treatment for withdrawal symptoms. Therapy (whether inpatient, outpatient, or both) continues after detox. Free aftercare planning helps set people up for success as they exit treatment. We will work with you to choose the right program and starting level of care for you during the intake process.
Depression, Addiction, and Co-Occurring Disorders
Sometimes, other co-occurring disorders can go with depression and addiction. For example, anxiety, PTSD, eating disorders, OCD, or ADHD. If that’s true for you, getting help in a space where all of your concerns are acknowledged matters. Let’s say that you have a traumatic history in addition to addiction and depression. In that case, trauma therapy could be a key part of your dual-diagnosis treatment.
Getting Help for Depression and Addiction
At Sanford Behavioral Health, we help people heal from all mental health conditions and substance use disorders. Our integrated approach helps people with addiction, depression, and other concerns break the cycle. We have several in-person locations in the Grand Rapids, MI, area. Telehealth (virtual) programs are also available, expanding access to treatment for those in areas where it is not readily available.
With a full continuum of care and specialized programs available, we make it possible to get consistent, caring, and personalized support throughout the entirety of the healing process. This is true from the day you enter our doors to a time when you’ve finished treatment and need someone to talk to on a hard day.
It is possible to overcome addiction and co-occurring disorders. Having a team of healthcare providers who will listen and work with you makes a world of difference. Call Sanford Behavioral Health for dual-diagnosis treatment for depression and addiction in Michigan today at 616.202.3326 or contact us online to get started.