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Dissecting the The Vicious Cycle of Substance Use and Depression

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Mental well-being is a fundamental part of anyone’s life, and being aware of it is one of the first steps a person can take towards a healthier tomorrow. In this blog, we will understand the link between two of the most common mental health issues, depression and Substance Use Disorder (SUD). We will understand how the two disorders interact and how one can aggravate the symptoms of the other. 

Introduction to Depression and Substance Abuse

Depression is the most prevalent mental health disorder in the world. It is characterized by long and deep feelings of sadness. Depression comes in multiple types, and overall, the disorder affects how you feel, think, and behave.

Substance Use Disorder is also a major mental health condition affecting millions worldwide. It refers to the continued abuse of a substance (drug, alcohol, and more) in the face of rising physical and mental health issues. 

The Prevalence of Depression and Substance Abuse Comorbidity

Studies have shown that there is a high prevalence of Substance Use Disorders (SUD) in those with Major Depressive Disorder (MDD) (the most common form of depression). The three most common types of substances that were misused by those with MDD included alcohol, illicit drugs, and marijuana. This points towards an urgent need for more detailed studies around this and for intervention programs to address this issue.

Common Symptoms of Depression

Depression is a disorder that is hard to detect since it can be camouflaged as regular mood disturbances for a long time. Identifying the symptoms early and seeking help makes a huge difference in the recovery journey, though. Here are some symptoms to look out for when it comes to depression:

  • Decreased interest in work, hobbies, and personal aspirations
  • Feelings of worthlessness, hopelessness, and pessimism
  • Increased irritability
  • Difficulty concentrating
  • Sleep disturbances
  • Changes in appetite and weight

Depression and Alcohol 

Often used as a coping mechanism against the symptoms brought about by depression, alcohol is a central nervous system depressant. It carries with it a high risk of dependence and can worsen the symptoms of sadness and spiralling associated with depression. 

It can also make a person impulsive and more prone to dangerous behaviours. Alcohol also interferes with the functioning of antidepressant medication, a crucial part of the treatment process for depression. 

Depression and Marijuana Abuse

Marijuana is a substance that is often associated with feelings of joy, dissociation, and general mental well-being because of its effects. However, prolonged usage of marijuana can impair the brain’s functioning and can worsen the risk of severe depression. Marijuana also interferes significantly with the treatment program for depression and can cause multiple other complications. 

The Impact of Stimulants on Depression

Stimulants like cocaine or methamphetamine are often consumed since they give a feeling of euphoria or elation. However, consumption of such substances also leads to a crash in mood after their period of effects, which can severely worsen symptoms of depression

The substances also carry a high risk of dependence and can lead to feelings of anxiety, paranoia, and more, further dampening the recovery process from depression. 

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Neurochemical Changes and the Risk of Addiction

Addiction or SUDs can, over time, alter the brain’s structure and chemistry. Constant use of substances can make the body dependent on elevated levels of dopamine and other neurotransmitters to function normally. 

This, in turn, necessitates further consumption of the substance, turning into a vicious spiral. Over time, more of the substance is required to produce the same “high” or neurochemical effect, leading to increased consumption of the substance.

This brings into factor other risks like overdose and physical health complications, making the recovery from depression and SUD that much harder. 

The Role of Substance Use Disorders in Escalating Depression Vulnerability

As explained above, SUDs can cause significant changes in brain chemistry and structure. This can lead to mood shifts and imbalances, all of which come together to worsen the symptoms of depression. 

Further, SUDs bring with them a lot of financial, emotional, and interpersonal strains and stressors, causing further exacerbation of depression symptoms. This makes a person who is already battling the disorder or on the verge more likely to face more severe symptoms over time. 

The Influence of Inflammation on Mood

Inflammation is a bodily response to any kind of foreign attack or foreign body intrusions. These defence mechanisms come with a cost, though. The cytokines released during the inflammatory response can affect neurotransmitter function and cause mood changes. Constant or regular cycles of inflammation can make a person more susceptible to developing depression over time. 

Cortisol's Role in Substance Use and Depression

While Dopamine is the neurotransmitter most commonly associated with mental health conditions, Cortisol plays a crucial role, too. Elevated levels of Cortisol, the stress hormone, can lead to significantly hampered brain functioning, reduced resilience, and much more. This can make a person more likely to develop mental health disorders like depression. 

Withdrawal Symptoms and Their Impact on Mental Health

Withdrawal symptoms refer to a set of symptoms that a person develops during the withdrawal period from a substance they may have abused or been dependent on. These symptoms can turn into severe depression or anxiety, along with mood swings, irritability, and more since the body adjusts to a lack of access to the substance to maintain an elevated mood. 

Though part of the recovery process in many cases, the withdrawal period necessitates the presence of comprehensive medical and mental health support around a person. 


SUDs are often associated with social withdrawal and isolation as a person devotes more time and effort to substance consumption. This form of isolation and lack of social connections can severely worsen depression symptoms and lessen the likelihood of a person seeking help for any symptoms they may be facing. 

Depression and Substance Abuse in Adolescence

Adolescents are at an increased risk of both depression and substance abuse due to the developmental changes they face throughout the period of adolescence. Both depression and SUDs can alter their development if left undetected and lead to long-term emotional and physical health issues. 

Recognizing the Signs of Substance Use Disorders in the Context of Depression

Recognizing SUDs in people who are battling depression as well can be tricky. Some things to look out for could include:

  • Increased need for secrecy
  • Neglecting personal, professional, or academic responsibilities despite warnings or criticisms
  • Drastic changes in mood that are uncharacteristic to the person’s general behavioral pattern
  • Red eyes, unexplained injuries, and/or poor personal hygiene.

These signs, if detected early, can help in early intervention as well, leading to a significantly better prognosis for the individual. 

Warning Signs of Concerning Substance Use

While all usage of substances is damaging to the human body, there is a point past which the risks far outweigh any benefits that the individual might have perceived. Signs of such concerning usage of substances could include:

  • Frequent signs of intoxication, bordering on daily/constant usage.
  • A complete breakdown in daily functioning with regard to personal hygiene, work, academics, relationships, and more.
  • Developing financial strains attributable to substance use
  • Social isolation/withdrawal

These warning signs are often extremely important since they can indicate a rapidly deteriorating situation in a person’s life. Identifying these and seeking help is the most important step during this period. 

Determining the Primary Issue: Depression or Substance Use?

Let’s be clear: only a mental health professional can diagnose and figure out the order in which these two disorders might have manifested. Depression, in many cases, can be the trigger that leads to substance use as a coping mechanism. 

On the other hand, SUDs can often mimic depression symptoms while also exacerbating any previously existing vulnerabilities. Consulting a mental health professional is the only way to get a clear picture of what is ailing the person.

The Complications of a Dual Diagnosis: Depression and Substance Use Disorders

A diagnosis of both depression and SUDs can be a complex challenge for anyone to navigate. This is because the disorders can often worsen each other’s symptoms while also bringing in a host of other physical and mental health challenges. This necessitates an integrated approach to treatment that focuses on addressing both disorders simultaneously, leading to long-term sustainable recovery. 

Challenges in Managing Dual Diagnosis

Managing a dual diagnosis can be tricky since both disorders can clamour for immediate attention. Integrated treatment is key in such situations and necessitates coordinated efforts from a multidisciplinary treatment team. Things to manage include medication, social stigma, and developing personalized therapy approaches to ensure sustained and long-term recovery. 

The Increased Risk of Suicide

Individuals who are battling both Depression and SUDs can often face an increased risk of suicide. The combination of depression and SUDs can leave a person feeling hopeless and lost. Further, addiction is often associated with a lowering of inhibitions, leading to an increased likelihood of self-harm or suicide. Emergency intervention is necessary in these situations.

If you or anyone you know is suspected to be in such a situation, please reach out to an emergency helpline immediately. You can talk to our trained psychologists immediately at +91-9741476476.

When to Seek Professional Help

The earlier, the better the scenario with all mental health disorders. Both depression and SUDs warrant immediate mental health or medical intervention. Seeking help when you see signs of either of the disorders is the best possible option for effective and long-term recovery. 

Treatment Approaches for Dual Diagnosis: Depression and Substance Use

Treating a diagnosis of both depression and SUD can involve a multi-pronged approach. It needs to combine medical, psychological, and social interventions. The need is also for integrated treatments that address both disorders and can improve overall mental health and a person’s quality of life.

The Importance of Integrated Treatment

Integrated treatment approaches focus on addressing both depression and SUDs at the same time. Integrated treatment combines medication, psychotherapy, and supplemental therapies to ensure that symptoms of both conditions are managed effectively. Studies have shown that this is the most effective way of approaching recovery in case of a dual diagnosis. 


Medication is an important part of treating both depression and SUDs. Antidepressant medication is an important part of treating depression as it helps in stabilization of the mood. Medication also helps in managing the withdrawal symptoms associated with SUDs and detoxification. 

However, medication must be consumed only under the express supervision of a psychiatrist since there is a possibility of prescription drug misuse in case of a dual diagnosis in a person. 


Psychotherapy is an effective treatment option for a variety of mental health disorders, including depression and SUDs. Psychotherapy focuses on a guided approach to managing symptoms, developing healthy coping mechanisms, and modifying thought patterns and behaviour to ensure better recovery over time. 

Cognitive Behavioral Therapy (CBT) for Depression and Substance Abuse

CBT is seen to be one of the most effective psychotherapies and treatment options for a range of mental health disorders. CBT focuses on identifying negative thought patterns and replacing them with more positive alternatives. CBT also looks at modifying coping mechanisms to healthier versions to ensure effective and long-term recovery. 

Motivational Interviewing

This approach to therapy looks at changing a person’s motivation levels and reducing their tendency to indulge in harmful behavioral patterns. This is effective for those battling dual diagnoses as it offers space for non-judgmental and collaborative dialogues. This method of therapy helps people commit to positive changes in managing both depression and substance use disorders. 

Dialectical Behavioral Therapy (DBT) for Depression and Substance Abuse

DBT is a combination of CBT and mindfulness and helps address both depression and SUDs. This form of therapy can help a person regulate emotions, tolerate distress, and improve their relationship with people in their lives. DBT also focuses on giving people the tools to manage both depressive symptoms and the urge to consume substances. 

Support Groups

Support groups refer to a safe space where individuals battling similar mental health disorders can share their experiences with each other and learn from each other’s recovery journeys. Support groups are often conducted under the supervision of a trained mental health expert and can lead to positive outcomes for everyone involved. 

Role of Rehabilitation in Managing Depression and SUD

Rehabilitation programs create an environment for structured, comprehensive care for managing a dual diagnosis of depression and SUDs. These programs could include medical detoxification, therapy, life skills training, and continued support. All of this can create a holistic environment for recovery.

Criteria for Choosing a Depression and Substance Abuse Rehab

Things to look for in a depression and addiction rehab center include the following:

  • Experience of the organization in treating co-occurring disorders.
  • Experience and expertise of the treating team involved.
  • If the rehab has a multidisciplinary treating team or not.
  • The infrastructure that is present at the rehab.

Embracing Hope: The Journey Out of Depression and Addiction at Cadabams Anunitha

At Cadabams Anunitha, we focus on not only recovery from symptoms but also the holistic development of an individual. We drive a person towards independence in daily life while also helping them pursue their interests. We believe that an individual is not defined by the disorder they are battling.

If you are searching for a solution to your problem, Cadabams Anunitha’s De-Addiction Centre can help you with its team of specialized experts. We have been helping thousands of people live healthier and happier lives for 30+ years. We leverage evidence-based approaches and holistic treatment methods to help individuals effectively manage their Depression. Get in touch with us today. You can call us at +91 96111 94949


Book screening with our director of triage,  Kamlesh Verma

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1. What comes first, depression or substance abuse?

Depression and SUD can be co-occurring, and one can trigger the other. Depression can lead to a person turning to substances as a coping mechanism, while a person might develop depression as a part of spiralling into SUD. 

2. What is the link between substance abuse and mental health?

Substance abuse has a significant link with mental health disorders. Issues like anxiety, paranoia, depression, and much more are likely to occur more frequently in those who have a SUD in their life.

3. What are some effective treatments for dual diagnosis of depression and substance abuse?

Effective treatment options for those battling a dual diagnosis of depression and SUD include:

  • Medication management
  • CBT
  • DBT
  • Motivational Interviewing
  • Support Groups

4. Is substance abuse a psychological disorder?

Yes, substance abuse is a severe mental health and psychological disorder that has multiple mental health and physical health complications associated with it. 

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