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How Are Depression and Substance Abuse Related?

By Jon McKenna
Medically Reviewed by Yilang Tang, MD, PhD on July 11, 2021
Learn why some people struggle with both mental health and substance abuse.

The statistics couldn’t be clearer: People dealing with a substance abuse problem should be aware of the risk of depression.. 

  • About 20% of Americans who currently have an anxiety or mood disorder such as depression also have a substance use disorder, and vice versa, according to the Anxiety and Depression Association of America. Over those people’s lifetimes, that percentage will rise to about 50%, according to the National Institute on Drug Abuse.
  • Roughly 9.5 million U.S. adults age 18 and older reported having a dual diagnosis of substance use disorder and a mental illness like depression in the 2019 National Survey on Drug Use and Health.

According to Mayo Clinic, people with depression are more likely to develop an addiction to drugs or alcohol as they try to cope with painful feelings. On the flip side, alcohol and depressant drugs can increase feelings of sadness and fatigue, and people can experience depression as the effects of drugs wear off or as they face the impact of addiction.

Substance Abuse and Depression

Depression that is triggered by substance abuse may correct itself once the drug problem is treated, Aaron Sternlicht, LMHC, CASAC, a therapist and co-founder of Family Addiction Specialist in New York, tells WebMD Connect to Care. It’s not so easy if you have turned to drugs or alcohol to cope with depression.

“Since alcohol and drugs release feel-good neurotransmitters in the brain, they can help numb unpleasant emotions and release feelings of euphoria,” Sternlicht says. “Unfortunately, using substances to cope with depression is a short-term solution that ends up with long-term consequences. As the individual becomes increasingly dependent on the substance, their low mood actually can exacerbate.”

The substance abuse may further disrupt the brain chemicals of someone experiencing depression and make his or her depression symptoms more severe, Sternlicht says.

“Ultimately, you have to treat both conditions simultaneously,” Lindsay Israel, MD, a psychiatrist and chief medical officer of the Success TMS mental health clinics, tells WebMD Connect to Care.

“In my experience, feelings of guilt and remorse also link the two. In depression, it’s an irrational response. In addiction, one of the signs that someone probably has a drug problem is they feel very badly about using after going on a bender,” Israel adds.  

Keith King, director of the University of Cincinnati’s Center for Prevention Science, offers WebMD Connect to Care this guidance:

“The No. 1 thing is to know the symptoms of depression and substance abuse. Do your research. Then go for help if you match up. But maybe a third—and that’s being generous—of people who have depression seek help. And with substance abuse, denial is also a huge problem.”

It's therefore important to be clear and honest with yourself or your loved one if the signs of either depression or substance abuse are present. 

Don’t Wait. Get Help Now.

If you or a loved one are struggling with addiction, WebMD Connect to Care Advisors are standing by to help. 

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