Depression and Addiction: How Are They Linked & How to Treat Them

Depression affects millions of Americans. In 2020, an estimated 8.4% of all adults experienced a major depressive episode in the past year.¹ Depression can affect anyone, but people with substance abuse issues may be more vulnerable to depression.²

This article will discuss depression, how it can co-occur with addiction, and effective treatment for co-occurring disorders.

What Is Depression?

Major depressive disorder—or clinical depression—is a serious mental health condition with symptoms that can adversely impact physical health, mood, and cognition in a manner that disrupts a person’s ability to perform basic functions associated with daily living, such as working, parenting, or eating.³ Symptoms such as depressed mood, diminished interest or pleasure in daily activities, as well as sleep or appetite disturbances may last between a few weeks to a few years in some people.³ In order for a diagnosis of depression to be made, the patient must experience symptoms for at least 2 weeks.³

A diagnosis of depression should be made by a medical professional.⁴ If you are concerned that you or a loved one may be dealing with depression, talk to your primary care physician or another treatment provider.

Symptoms of Depression

Symptoms of depression may include: ³

• Persistently depressed mood.
• Loss of interest in previously enjoyed activities.
• Changes in appetite or weight.
• Oversleeping or having difficulty falling or staying asleep.
• Fatigue.
• Speaking and moving more slowly than usual.
• Restlessness or having trouble staying still.
• Feeling pessimistic or hopeless about the future.
• Difficulty making decisions or concentrating.
• Physical symptoms, including body aches and headaches.

What Causes Depression?

Research suggests that genetic, biological, and environmental factors all contribute to a person’s risk for depression.^2,3 These include:³

• A family history of depression.
• Significant life changes, stress, or exposure to traumatic events.
• Certain other chronic illnesses (e.g., diabetes, cancer, cardiovascular disease Parkinson’s) as well as the medications used to treat these conditions.

Addiction shares many risk factors with depression (e.g., genetics, trauma, chronic stress), which partly explains why co-occurring depression and substance use disorder (SUD) is so common.⁵

Are There Different Types of Depression?

Yes, there are other forms of depression apart from major depressive disorder. Different types of depression include:^3,6

• Persistent depressive disorder (sometimes called dysthymia). Individuals with persistent depressive disorder will often experience periods of major depression as well as periods with less severe symptoms. These symptoms are recurring and can last for years.
• Seasonal affective disorder, also known as seasonal depression or SAD, occurs during the winter months when there is less natural sunlight. People who experience this condition typically find their symptoms lessen or disappear as winter turns to spring and summer.
• Postpartum depression affects some women after giving birth. Unlike the “baby blues”—mild depressive symptoms that clear within 2 weeks of delivery—postpartum depression involves extreme symptoms of sadness, anxiety, and fatigue that make it difficult for new mothers to care for themselves and their babies.³
• Psychotic depression is a very serious condition in which a person has a major depressive episode in addition to psychotic symptoms such as auditory or visual hallucinations and delusions (false beliefs)—often ones that are themselves thematically depressive.

Depression and Addiction: Co-occurring Disorders

The co-occurrence of depression and substance abuse is common. In 2020, more than 35% of adults who experienced a past year major depressive episode in the past year also struggled with an SUD.¹

There are a lot of reasons why a person might struggle with depression and substance abuse at the same time.² As mentioned previously, addiction and depression share common risk factors like trauma and chronic stress.^2,3

Additionally, some hypothesize that people with depression or other mental health issues may use drugs or alcohol to “self-medicate.” This refers to the ill-advised practice of using substances to relieve symptoms of a mental health condition.²

Although certain substances might temporarily alleviate some symptoms, ultimately they could also exacerbate the symptoms of mental health disorders like depression, both acutely and in the longer-term.^2,5

In some cases, it may be impossible to determine which came first: the depression or the substance abuse issue. It is likely that they both affect each other in more than one way.⁵

How to Treat Addiction and Depression

Having both a substance use disorder and a co-occurring mental health condition like depression may necessitate additional treatment considerations, as people with comorbidities often exhibit relatively poor treatment adherence and a higher likelihood of premature treatment dropout.⁸

A treatment approach that integrates the simultaneous management of the comorbidity—in this case, depression and substance use disorder—has been found to be consistently superior to an approach of treating each disorder separately.⁸

What Kind of Therapies and Treatments Work for Depression and Substance Abuse?

Evidence-based behavioral treatment, often in combination with medications, is key to improving recovery outcomes for people with SUD and mental health issues like depression.^8,9

There are several different types of therapy available to people struggling with depression and substance use. For example, the following types of therapy are used to treat substance use disorder and co-occurring depression, with or without medication:^{10,11,12,13,14,15}

• Cognitive-behavioral therapy (CBT). CBT teaches patients to change old harmful behaviors (like substance use) by learning how to make new choices and engage in behaviors that produce positive outcomes.
• Motivational interviewing (MI). MI encourages patients to set goals and examine how their negative coping strategies come between them and these goals, motivating them to make organizational change.
• Interpersonal psychotherapy (IPT). IPT is a time-limited form of treatment for mood disorders. IPT views mood and someone’s life situation as being intertwined. People that are experiencing depression after a disturbing life event (e.g., the loss of a loved one, a dispute with a significant other, physical illness) build social skills and reorganize their lives over the course of 12-16 weeks.

There are also many medications that have proven effective at managing depression. About 13.2% of Americans make use of antidepressants at any given time.¹³ Common antidepressants include:^{3,16,17,18,19}

• Selective serotonin reuptake inhibitors (SSRIs). The most commonly prescribed antidepressants are SSRIs, which work by increasing serotonin activity in the brain by inhibiting serotonin reuptake. They are also associated with relatively fewer side effects than some other classes of antidepressants. Common SSRIs include fluoxetine (Prozac), paroxetine (Paxil), and (citalopram) Celexa.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) are another class of antidepressants that inhibit both norepinephrine reuptake and serotonin reuptake. Common SNRIs include venlafaxine (Effexor) and duloxetine (Cymbalta).
• Bupropion, which works differently than both SSRIs and SNRIs. Though its precise mechanism of action is not well understood, unlike the others mentioned, bupropion does not inhibit serotonin reuptake. Instead, it acts as a relatively weak reuptake inhibitor for both norepinephrine and dopamine, which is thought to confer its therapeutic action. In addition to its antidepressant activity, bupropion is also used to help people stop smoking.

Finding the Right Treatment for Depression and Addiction

Finding the right treatment can be overwhelming. When considering treatment options, it is important to ensure that the program uses treatments that are supported by scientific evidence, such as cognitive-behavioral therapy (CBT) and other empirically supported treatments.^3,20 Effective treatment facilities will provide individualized care, matching their treatment approaches to the needs of the person seeking treatment.^9,20

Desert Hope Treatment Center offers a range of empirically supported types of treatment for addiction and co-occurring disorders.

How to Pay for Co-Occurring Disorder Treatment

Mental health treatment and substance use disorder treatment is covered by most insurance policies.²¹ However, the extent of this coverage, and which treatment facilities accept the insurance plan will vary.

Fill out the confidential to check your coverage at Desert Hope Treatment Center. You can also call our rehab admissions team at for assistance in figuring out how to use health insurance coverage to pay for rehab.

You can also learn detailed information about your coverage by calling the number on the back of your insurance card and inquiring about coverage and costs associated with substance abuse treatment.

If you do not have insurance, there are other ways to pay for addiction treatment. For example, Desert Hope offers payment plans that help defray treatment costs.

Managing Depression and Addiction After Treatment

After completing substance use disorder treatment, many people benefit from continuing care programs (also known as aftercare). Aftercare programs can range from staying a sober living facility to attending peer support meetings like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).

Aftercare typically emphasizes strategies to prevent relapse and work through obstacles that may emerge during a person’s recovery.²²

Additionally, many people with SUD and major depressive disorder benefit from continued counseling and psychotherapy, and medication may also be administered in a long-term capacity to treat both conditions.^3,23

If you or a loved one struggles with substance use disorder and depression, Desert Hope Treatment Center can help. Please call an admissions navigator at to learn about the admissions process.