When a drug or alcohol use pattern begins to interfere with day-to-day functions, health, and overall quality of life, we know a substance use disorder is involved and goes beyond the association with drug or alcohol usage. Many people overlook the connection between depression and substance use disorders because they are unaware that people living with depression are more likely to develop this connection. According to Health Line, substance use disorders and mental health conditions concur so often that experts have decided to call this unique combination “dual diagnosis.”

When it comes to having a dual diagnosis, major depression is the most commonly diagnosed mental health condition among people in this category.

• 25% of people with major depressive disorder (MDD) also have a substance use disorder.
• 8% of people with MDD also have alcohol use disorder.
• 8% of people with MDD also have illicit drug use disorder.
• 7% of people with MDD also have cannabis use disorder.

In the same way that depression can factor into substance use, substance use disorders can also play a significant part in depression, depending on the severity. Living with depression can cause many to feel the need to use alcohol and other substances to help ease or manage their depression. This is a form of self-medicating. Some people self-medicate to boost their energy levels, while others do so to gain sleep at night. Others might be motivated to self-medicate because of its power to lift moods and soothe unwanted emotions. While this method can mask or erase specific symptoms related to depression, it is only temporary.

Symptoms of depression typically come back in a full circle once the person stops using substances.

If a person starts living in a world where substance use is prominent, it can contribute to depression in many ways. Substances such as alcohol can release dopamines in your brain that produce feelings of pleasure. These same substances can cause increased inflammation in the brain, making it harder for your brain to produce mood-boosting chemicals like serotonin and dopamine. Withdrawals from substance use can also contribute to depression. When a person stops using, the brain takes its time adjusting and producing the expected levels of serotonin, dopamine, and other necessary chemicals for everyday healthy living. While this happens, a person might start feeling low, numb, or even have difficulty finding pleasure or interest in regular activities, all similar signs of depression. Because depression and substance use disorders can feed into each other, it is always important to pay attention to related signs and symptoms.

• Spending large amounts of time thinking about the next opportunity to drink alcohol or use substances.
• Knowing your substance use has hurt your career and relationships, but not bringing yourself to a stopping point.
• Feeling even more exhausted and bitter about life once the effects of the drugs or alcohol wear off
• Needing more and more of a particular substance to stabilize your mood and energy.
• Feeling guilty or ashamed about your substance use but not being able to stop
• Feeling so hopeless about your future, the long-term effects of substance use do not matter anymore.

If any of the signs above affect your daily life, a substance abuse professional who conducts alcohol and drug evaluations can offer more support and guidance. The goal of an alcohol and drug evaluation is to determine whether an alcohol or drug dependency is present and its cause(s). This makes it possible for any substance abuse professional to decide the proper course of action for recovery or intervention. In the case of dual diagnosis, alcohol and drug evaluations can address both mental health conditions and substance use disorders at the same time. At the end of an alcohol and drug evaluation, your substance abuse professional may recommend a treatment approach to help you recover. This can include but is not limited to medication, therapy, support groups, education, individual counseling, outpatient rehabilitation, intensive outpatient rehabilitation, in-patient rehabilitation, detoxing, and so much more. The resources and opportunities for tackling dual diagnosis are just as readily available as it is for someone diagnosed with just one behavioral health condition.

People often wonder whether their depression occurred independently or through substance use. To find this answer, it helps to consider how and when depression symptoms appeared. Primary depression can be identified when the depression occurs or persists even in a period or stage of stable or no substance use. Substance-induced depression can be identified when it appears after prolonged substance use and subsides/improves once substance use decreases. It’s good to know where your dual diagnosis started, but at the end of the day; no matter which condition appeared first, the most important thing to know is that both depression and substance use disorders can improve with treatment, and professional support can make a big difference in symptoms.