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Substance Use and Co-Occurring Depressive Disorders man drinking and sad

Substance Use and Co-Occurring Depressive Disorders

Around one-third of people who suffer from depression also have a Substance Use Disorder. The two disorders exacerbate one another. If a person is abusing substances like alcohol or opioids, it may be hard to tell if they are depressed. Side-effects of these drugs can mimic those of depression. However, treating both disorders is necessary for a person’s long-term recovery.

Depression Symptoms and Statistics

Types of Depression

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 17.3 million adults in the US had at least one major depressive episode in 2017. 80% of people with depression report difficulty with daily activities like work, school, or social life.  While there are several types of depression, they all share common symptoms. Some typical signs of depression are: -Loss of interest in activities once enjoyed -Low self-worth -Feelings of hopelessness -Irritability -Trouble concentrating -Insomnia -Fatigue -Lack of energy -Changes in appetite and weight -Thoughts of suicide 

Major Depression

Major depression is diagnosed when a person experiences the majority of the above symptoms most days for two weeks or longer. Around 6.7% of US adults per year have at least one major depressive episode.

Persistent Depressive Disorder (PDD)

Persistent Depressive Disorder is a less severe but chronic form of major depression. It is usually diagnosed if symptoms are less intense but have been present for at least two years. Typically, people diagnosed with Major Depression have a mood baseline when they’re not experiencing depression. However, people diagnosed with PDD often cannot remember what it was like to feel “normal.”

Bipolar Disorder

People with Bipolar Disorder have periods of extreme highs and lows. When they are in a low period, they experience the symptoms of major depression. About 4.4% of people will experience Bipolar Disorder during their lifetime. 

Seasonal Affective Disorder (SAD)

SAD is a major depression that is influenced by the seasons. It most often occurs during the fall and winter months, but occasionally is brought on by spring and summer. About 5% of the US population will experience SAD during a given year.

Psychotic Depression

Psychotic Depression entails experiencing depression along with “psychotic” symptoms such as hallucinations, delusions, or paranoia. In one study of about 2,500 people seeking treatment for depression, 5.3% had psychotic symptoms. 

Postpartum Depression

Postpartum Depression takes place in the weeks and months after giving birth. 1 in 7 people may experience this form of depression in the year after giving birth.

 Premenstrual Dysphoric Disorder

People who have Premenstrual Dysphoric Disorder experience symptoms of depression beyond typical premenstrual syndrome (PMS) at the start of their period.  

Atypical Depression

A person with Atypical Depression has a pattern of depressive symptoms, but is able to feel temporary relief by positive experiences. Atypical Depression tends to have an earlier onset than Major Depression.


In the year 2012, 2.7 million people over 18 in the US had a co-occurrence of depression and Substance Use Disorder.  Around 16.5% of those with a major depressive disorder have an Alcohol Use Disorder. About 18% have a drug use disorder. People dealing with feelings of hopelessness, low self-worth, or other symptoms of depression may turn to substances for relief. However, substances make the depressive episodes more severe, initiating a vicious cycle.  People suffering from depression without a co-occurring Substance Use Disorder have about a 10% lifetime suicide risk. With and a co-occurring Substance Use Disorder, that risk increases to 25%. 

Alcohol and Depression

Alcohol Use Disorder and Depression frequently co-occur. Teenagers who have experienced a period of major depression are twice as likely to start drinking. However, as alcohol is a depressant, people with Alcohol Use Disorder will experience more severe symptoms of depression. Chronic alcohol abuse also creates problems in people’s lives, which often worsens their depression.

Opioids and Depression

Of people who have been prescribed opioids, those with depression are twice as likely to transition to long-term use. However, according to the FDA, having depression decreases a person’s response to opioids. In addition, opioids can cause or exacerbate symptoms of depression. A 2016 study found that 10% of patients who were prescribed opioids experienced symptoms of depression after a month. As such, people may use more and more opioids to try to numb the symptoms of depression or chronic pain. This contributes to or incites depression.

Benzodiazepines and Depression

Benzodiazepines, or benzos, are a central nervous system depressant. This means that this class of drugs has the potential to cause symptoms of depression, especially if abused. According to the American Psychiatric Association, more than 17% of people who take benzos abuse them.


While there is no evidence that marijuana increases depression, people who are depressed may be more likely to use marijuana.

How Does Substance Use Disorder Affect Depression?

People with Substance Use Disorder are more likely to have depression and vice versa. People may drink or use drugs in an attempt to alleviate their depression, but chronic abuse of substances worsens depression. In addition, no matter what the substance, withdrawal will often mimic symptoms of depression.


As with any co-occurring mental health disorder, it is imperative to treat both. Without treating them together, they will continue to exacerbate one another and both will worsen. According to SAMHSA, treatment for a mental health disorder can reduce the risk of relapse of a Substance Use Disorder. Treatment for a Substance Use Disorder can help people manage the symptoms of a mental health disorder. 

There is Help at Amatus Recovery Centers

If you are suffering from addiction and co-occurring depression, there is hope. At Amatus Recovery Centers across the country, we offer treatment for substance use and co-occurring mental health disorders. We will design a treatment plan specifically for you, including multiple types of therapy, aftercare planning, support groups, and more. At every one of our treatment centers, we provide you with the tools you need to build towards long-term recovery.


First call to Amatus Recovery Centers:

  • Professionals are available around the clock to speak with you.
  • Get you started on the way to recovery.
  • Reach out to us for more information.