Depression is a mental health disorder that can alter not just how a person feels, but also how that person thinks, acts, and makes their way through daily life. For some, depression can be the driving force behind their substance use, since alcohol and drugs can be seen as a means by which to dull emotional pain or escape big feelings. For others, substance use can lead to or exacerbate depression symptoms, creating a harmful pattern of behavior that is difficult to escape. In any event, the connection between depression and substance use is a complex, two-way relationship that calls for careful medical attention.
At Empowered Recovery Center, we understand how intertwined depression and addiction can be. Whether you are seeking help for yourself or someone you love, knowing more about depression and substance use can be the first step toward healing. If you’re ready to begin treatment, contact our drug and alcohol rehab in Atlanta to get started.
What is Depression?
Depression is a chronic mood disorder that affects over 350 million people worldwide. It causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder (MDD) or clinical depression, depression affects how a person feels, thinks, and behaves and can lead to a range of emotional and even physical problems.
Depression is more than just melancholy, ennui, or a case of “the blues.” There are several different types of diagnosable depression and it does not affect everyone the same way. At its most extreme, depression can make people feel like life is not worth living. Depression often requires long-term treatment that involves therapy and medication.1
Symptoms of Depression
For some people, depression occurs just once in their lives. For others, depression occurs multiple times. Depressive symptoms can often be severe enough to create problems in day-to-day activities like work, school, social activities, or relationships with others. The most common symptoms of depression include:1
- Feelings of sadness or hopelessness
- Angry outbursts, irritability, or frustration, even over small matters
- Loss of interest or pleasure in many activities, including sex, personal hobbies, or exercise
- Sleep disturbances, including insomnia or sleeping too much
- Fatigue, so even small tasks require extra effort
- Reduced appetite and weight loss or frequent food cravings and weight gain
- Anxiety, agitation, or restlessness
- Slowed thinking, speaking, or body movement
- Feelings of worthlessness or guilt, fixating on past failures or indulging in self-blame
- Trouble thinking, concentrating, making decisions, and remembering things
- Frequent or recurrent thoughts of death or suicide
- Unexplained physical ailments
What Causes Depression?
The exact cause of depression remains unknown. However, medical researchers believe the disorder arises from a combination of genetic, biological, psychological, and environmental factors.
Certain imbalances in brain chemistry are thought to play a significant role. One’s genetic predisposition is also considered a major contributor, as people with a first-degree relative who is living or has lived with depression are roughly three times more likely to develop the disorder than those without. Depression can also occur in anyone, including those with no known family history.
External circumstances and physical health can also influence the onset of depression. Stressful life events such as trauma, loss, divorce, social isolation, or a lack of support can act as depression “triggers.” Chronic medical conditions like diabetes and cancer can increase one’s vulnerability to developing depression. Also, certain medications and the long-term use of substances like alcohol can induce or exacerbate depressive symptoms in users.2
What Are the Types of Depression?
Depression can present in a variety of forms, each with its own characteristics, causes, and durations. Every type of depression requires its own diagnosis and treatment, so understanding the distinctions between different kinds of depression can be a crucial step toward effective care. Types of depression disorders include:2,3
- Major Depressive Disorder (MDD). Also known as clinical depression, MDD is the most common and severe form of depression. It involves a persistently low mood, loss of interest in once-preferred activities, and other symptoms including sleep disturbances, appetite changes, and feelings of general worthlessness.
- Persistent Depressive Disorder (PDD). PDD or dysthymia is a form of chronic depression with symptoms that are less intense than major depression but can last longer, often for years. PDD includes a consistently low mood and other depressive symptoms that come and go with time.
- Seasonal Affective Disorder (SAD). SAD follows a seasonal pattern, most commonly beginning in late fall or early winter and resolving by spring or early summer. It is considered a subtype of MDD.
- Bipolar Disorder. Also known as manic depression, bipolar disorder includes episodes of depression alternating with periods of elevated mood and increased activity known as mania or hypomania. The depressive episodes of bipolar disorder can feel similar to those of Major Depressive Disorder.
- Psychotic depression. This form of depression includes symptoms of MDD along with psychotic symptoms, including delusions and hallucinations.
- Disruptive Mood Dysregulation Disorder (DMDD). Primarily diagnosed in children, DMDD involves chronic irritability and frequent, intense outbursts. Symptoms typically begin before age 10.
- Premenstrual Dysphoric Disorder (PMDD). PMDD is a severe form of premenstrual syndrome (PMS) characterized by mood-related symptoms like sadness, irritability, and anxiety. Such symptoms appear in the week or two before menstruation and subside once menstruation begins.
- Depressive disorder due to another medical condition. Some medical conditions, such as hypothyroidism, heart disease, Parkinson’s disease, or cancer, can cause changes in the body that lead to depression. Treating the underlying condition often alleviates the depressive symptoms.
- Prenatal and postpartum depression. Prenatal and postpartum depression occur during pregnancy or shortly after childbirth. Also referred to as “Major Depressive Disorder with Peripartum Onset,” these two conditions involve common depressive symptoms and can significantly affect a new or expectant parent’s psychological health.
- Atypical depression. A subtype of MDD, atypical depression features mood reactivity (temporary improvement in mood in response to positive events), increased appetite, excessive sleep, and sensitivity to rejection.
Is There a Connection Between Depression & Substance Use?
There appears to be a strong connection between depression and substance use, with many people turning to drugs or alcohol as a way to cope with their depressive symptoms. This behavior is known as self-medication.
However, while it feels like a “quick fix” in the moment, self-medication tends to make things worse over time. Multiple research reports have found that people living with MDD are more likely to develop a substance use disorder (SUD), and vice versa. This overlap is called comorbidity, meaning that two or more disorders are at work in one person, with symptoms occurring at either the same time or one after the other.4,5
Does Substance Use Affect Depression Treatment?
Yes, substance use affects depression treatment, as comorbidity between depression and SUD tends to complicate the treatment and recovery process. The reason for this is that comorbidity goes both ways, with depression tending to lead to substance use, and substance use leading to or exacerbating depression.
One challenge of treatment is that when someone stops using a substance, withdrawal can bring on symptoms that closely resemble depression. This makes it difficult for clinicians to discern whether a person is dealing with a true depressive disorder or merely experiencing temporary withdrawal symptoms. Overlapping withdrawal and depression symptoms include:6
- Feelings of sadness or hopelessness
- Fatigue or low energy
- Difficulty sleeping or oversleeping
- Loss of interest in pleasurable activities
- Trouble concentrating
- Irritability or restlessness
Because of the overlap in symptoms, mental health professionals need to consider the timing of a patient’s withdrawal. Monitoring symptoms over time is often necessary in discerning withdrawal from depression.
Can You Treat Depression & Addiction at the Same Time?
Yes, you can treat depression and addiction at the same time. In fact, many treatment programs offer what is known as dual diagnosis treatment, which addresses the SUD and co-occurring mental health disorder at the same time. Such a treatment approach accounts for how depression and addiction can influence and impact each other by providing coordinated care that targets both disorders.
Dual diagnosis treatment is recommended for those with co-occurring disorders, as focusing on just one disorder while leaving the other untreated increases the risk of relapse or worsening mental health symptoms.7
How is Depression & Addiction Treated?
Dual-diagnosis treatment of an SUD and depression can take place in a variety of settings, though treatment should begin with a period of detox. Detox is the process of ridding toxic substances from the body while managing any withdrawal symptoms that can occur.
After this detox period, patients move through one or more treatments designed to help them recover. Different treatment approaches include residential treatment, partial hospitalization (PHP) treatment, intensive outpatient (IOP), standard outpatient (OP), and aftercare. The exact treatment modality depends on the specific person and their needs.
In treatment, patients typically receive therapy, counseling, and group support to help them develop coping mechanisms and avoid relapse, or once again turning to substances, by defining and working through their individual triggers. Empowered Recovery Center in Atlanta also employs holistic therapy, offering mindfulness and breathwork exercises that have been found to improve patients’ mental health.
Dual diagnosis treatment may also include the issuance of prescription medications to manage the patient’s drug or alcohol withdrawal symptoms. This is known as medication-assisted treatment, or MAT for short.
Medication Used to Treat Depression Disorders
Medications used to treat depression disorders are known as antidepressants. Antidepressants help to balance the chemicals in the brain that affect mood and emotions, including neurotransmitters like serotonin, norepinephrine, and dopamine.
Antidepressants are often prescribed as part of a broader treatment plan that includes therapy and other support programs. Common antidepressants used to treat depression disorders include:8,9
- Selective Serotonin Reuptake Inhibitors (SSRIs) like Fluoxetine (Prozac ®) and Sertraline (Zoloft ®) represent the first line of treatment for depression. These drugs increase levels of serotonin in the brain and are known to have fewer side effects than other antidepressants.
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) like Venlafaxine (Effexor XR ®) and Duloxetine (Cymbalta ®) increase both serotonin and norepinephrine levels in the brain. They are often used if and when SSRIs have proven ineffective.
- Atypical Antidepressants such as Bupropion (Wellbutrin ®) and Trazodone do not fit neatly into other categories, affecting brain chemicals in different ways. Bupropion, for instance, is often chosen because it does not typically cause weight gain or have sexual side effects.
- Tricyclic Antidepressants (TCAs) like Amitriptyline and Nortriptyline (Pamelor ®) are considered an older class of antidepressants. These medications are effective but tend to have more side effects. Medical professionals can turn to them when newer medications have failed.
- Monoamine Oxidase Inhibitors (MAOIs) like Phenelzine (Nardil ®) and Tranylcypromine (Parnate ®) are some of the earliest antidepressants developed. They can be effective but require strict dietary restrictions to avoid dangerous interactions.
- Esketamine (Spravato ®) is a nasal spray approved for treatment-resistant depression. It is used in combination with an oral antidepressant and administered only with medical supervision.
Treating Co-Occurring Depression Disorders in Atlanta
At Empowered Recovery Center in Atlanta, we understand that battling depression and SUD can be tough. However, with the right support, lasting recovery is within reach. Our rehab programs are designed to help you take back control and make lasting changes in your life.
We offer a range of addiction treatment options to fit your unique needs, including partial hospitalization (PHP), intensive outpatient (IOP), and standard outpatient (OP) programs. And we don’t stop there. After treatment, we provide one full year of free recovery coaching to help you stay supported after treatment ends.
Curious about the cost of rehab, or how insurance works in paying for treatment? Our rehab admissions team is here to answer your questions, go over your options, and even verify your benefits for you. Reach out to us today. Your recovery journey starts here.
References
- Mayo Clinic (2022). Depression (major depressive disorder). Mayo Foundation for Medical Education and Research. Retrieved May 8, 2025, from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
- Cleveland Clinic (2023). Depression. Cleveland Clinic’s Health Library. Retrieved May 8, 2025, from https://my.clevelandclinic.org/health/diseases/9290-depression
- MedLine Plus (2025). Depression. National Library of Medicine. Retrieved May 8, 2025, from https://medlineplus.gov/depression.html
- National Institute of Mental Health (2024). Substance Use and Co-Occurring Mental Disorders. National Institutes of Health. Retrieved May 9, 2025, from https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health
- U.S. National Library of Medicine (2021). The Association Between Substance Use Disorder and Depression During the COVID-19 Lockdown in Spain and the Moderating Role of Social Support: A Cross-Sectional Study. National Institutes of Health. Retrieved May 9, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC8475446/
- U.S. National Library of Medicine (2005). Mood Disorders and Substance Use Disorder: A Complex Comorbidity. National Institutes of Health. Retrieved May 9, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC2851027/
- Cleveland Clinic (2022). Dual Diagnosis. Cleveland Clinic’s Health Library. Retrieved May 9, 2025, from https://my.clevelandclinic.org/health/diseases/24426-dual-diagnosis
- U.S. Food and Drug Administration (2019). Depression Medicines. U.S. Food and Drug Administration. Retrieved May 9, 2025, from https://www.fda.gov/consumers/womens-health-topics/depression-medicines
- Johns Hopkins Medicine (n.d.) Esketamine for Treatment-Resistant Depression. The Johns Hopkins University. Retrieved May 9, 2025, from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/esketamine-for-treatment-resistant-depression
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