When Depression and Addiction Co-Occur

Update on 09/18/23

Content review by Derek Wilksen, CEO

When you experience symptoms of depression, such as persistent sadness and hopelessness, life can feel unmanageable. It is not uncommon for people to turn to alcohol and other drugs in an attempt to self-medicate these feelings away. However, self-medicating with substances is a slippery slope. Not only can alcohol and other drugs exacerbate already-present depressive symptoms, but they can also lead to the development of chemical dependency and substance use disorder (SUD).

The Connection Between Depression and Addiction

As there is an undeniable link between depression and addiction, it is imperative to recognize the underlying causes of this link and work to prevent the development or worsening of either or both conditions.

Depression Basics

Major depressive disorder (MDD), more commonly referred to as depression, is a serious mood disorder. To be diagnosed with depression, an individual must experience depressive symptoms every day, nearly all day, for a period of at least two weeks. This period is known as a depressive episode. In 2020 alone, nearly 21 million adults aged 18 or older — eight percent of all U.S. adults — experienced at least one depressive episode. This shows how prevalent depression truly is in our nation.

There are various types of depressive disorders, all characterized by specific symptoms or causes. These types include:

  • Major depression
  • Persistent depressive disorder
  • Perinatal depression
  • Seasonal affective disorder
  • Depression with symptoms of psychosis

Signs and Symptoms of Depression

Symptoms of depressive disorders can include, but are not limited to:

  • Persistent feelings of sadness or hopelessness
  • Loss of interest in activities once found pleasurable
  • Changes in eating patterns, such as overeating or restricting food intake
  • Changes in sleeping patterns
  • Chronic exhaustion
  • Digestive problems, headaches or other aches and pains
  • Suicidal ideation

Addiction Basics

Addiction is a chronic and complex disease of the brain. SUD is characterized by compulsive drug-seeking and drug-using behavior. While a person’s initial decision to use alcohol and other drugs may be voluntary, substance use interferes with brain structure and functioning and alters it in such a way that motivates repeated substance use. When this happens, substance use is no longer a choice and the brain views it as a necessity for regular functioning.

Nearly all brain areas are affected by substance use and related addictions, including:

  • Learning
  • Judgment
  • Memory
  • Stress
  • Behavior
  • Decision-making
  • Self-control
  • Emotional regulation

Signs and Symptoms of Substance Use Disorder

Symptoms of SUD include, but are not limited to:

Behavioral Changes

  • Reduced performance at work or school
  • Using substances in high-risk situations
  • Engaging in increasingly secretive behavior
  • Changes in eating and sleeping patterns
  • Unexplained changes in personality
  • Sudden mood swings
  • Lacking motivation

Physical Changes

  • Sudden changes in weight
  • Malnutrition or deterioration of physical appearance
  • Tremors, slurred speech or impaired coordination

Social Changes

  • Sudden changes in friend groups
  • Legal problems related to substance use
  • Increased interpersonal conflict
  • Isolation

Why Do Depression and Addiction Co-Occur?

Co-occurring disorders happen when a mental health disorder and SUD occur simultaneously. Researchers have found three potential causes that could answer why co-occurring disorders develop. For depression and addiction, these reasons include:

Shared Risk Factors of Depression and Addiction

Risk factors for both SUDs and depression include:

  • Genetic risk factors: Family history of substance use or mental health disorders and presence of untreated SUD or mental health conditions
  • Environmental risk factors: Unmanaged stress, untreated trauma, lack of self-worth, insufficient support systems, lack of parental supervision or attachment, poor nutrition and unresolved grief and loss

Depression and SUD

Another possibility of why these conditions occur together is because individuals with depression may turn to alcohol and other drugs to self-medicate. Similarly, changes to the brain that are caused by mental health disorders can enhance the rewarding effect of substances, which perpetuates repeated substance use.

Substance Use Triggers Depression

Lastly, substance use can trigger brain changes that can make an individual more likely to develop a mental health disorder, such as depression. Similarly, substance use, along with the negative social stigmas and stereotypes of individuals that use substances, can contribute to worsening feelings of worthlessness, guilt and shame that lead to depressive symptoms.

Recovery from Co-Occurring Disorders

Recovery from any co-occurring disorders, including depression and addiction, requires treatment that heals both conditions simultaneously. It can be challenging for health professionals to diagnose these conditions separately due to overlapping symptoms. In any case, treatment should still work to address the underlying causes of all symptoms an individual experiences.

Treatment usually involves a combination of medication and psychotherapy, which is the most effective treatment route for managing and overcoming co-occurring disorders. Psychotherapy modalities may include behavioral therapies, such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT). Treatment programs may also encourage participation in mutual self-help groups to foster a sense of community, as social support plays a key role in facilitating successful recovery.

If you or a loved one is struggling with depression or substance use that is interfering with your ability to function normally in daily life, treatment is available.

Casa Palmera is an addiction and co-occurring disorder treatment facility that has extensive experience treating depression and addiction that exist together. We utilize individualized care when treating our patients, especially those in our co-occurring disorder treatment program. Our facility offers a wide range of treatment opportunities and recovery resources for our patients to give them their best shot at achieving and sustaining lifelong recovery. To learn more about our treatment facility and programs, contact us today.


This blog is for informational purposes only and should not be a substitute for medical advice. We understand that everyone’s situation is unique, and this content is to provide an overall understanding of substance use disorders. These disorders are very complex, and this post does not take into account the unique circumstances for every individual. For specific questions about your health needs or that of a loved one, seek the help of a healthcare professional.