Why Does Depression Often Co-Occur With Substance Abuse?

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When you have substance use disorder (SUD) and another mental health disorder simultaneously, those disorders are said to co-occur. Another term that may apply is dual diagnosis. When SUD and other mental health disorders are left untreated, there is an increased risk of developing disorders that co-occur.

Depression and SUD frequently co-occur. Understanding why mental health disorders like depression often co-occur with substance abuse is the first step in recognizing an individual's need for treatment if and when challenging mental health symptoms arise.

How Often Do Mental Health Disorders Co-Occur?

A publication by the National Insitute on Drug Abuse (NIDA) explains that in 2017, nearly 7.7 million individuals had co-occurring disorders. It continues: “Of the 20.3 million adults with substance use disorders, 37.9% also had mental illnesses." Further, “Among the 42.1 million adults with mental illness, 18.2% also had substance use disorders.”

Having disorders that co-occur is very common. However, this does not necessarily mean that one condition caused the other. In some cases, it can be challenging to determine which condition developed first.

What is more important is effective treatment. Treating both disorders in tandem is necessary to ensure effective and lasting recovery.

Why Do Mental Health Disorders Co-Occur With Substance Abuse?

According to the National Insitute of Mental Health (NIMH), three possibilities may explain the prevalence of co-occurring disorders. These include:

#1. Both mental health disorders and SUD develop from shared risk factors.

Genetic vulnerabilities as well as untreated trauma or stress are among the most common risk factors for these conditions.

#2. Mental health disorders can influence substance abuse and trigger the development of SUD.

Untreated mental health disorders can make an individual more vulnerable to using alcohol and other drugs to self-medicate. Unfortunately, self-medication leads to further issues in the long run. Substance use worsens the symptoms of a mental health disorder over time. It also triggers the development of chemical dependency and potentially SUD.

#3. Substance use and SUD can trigger the development of mental health disorders.

The repeated use of alcohol and other drugs can cause lasting changes to brain structure and functioning. These changes can make it more likely for an individual to develop a mental health disorder.

As you can see, there is no one underlying reason that disorders co-occur. Often, individuals may think that one condition must be responsible for triggering the development of the other.

However, there is also the possibility that neither condition triggered the development of the other. Rather, they both developed separately through shared risk factors. This is crucial to understand when considering one's personal vulnerability to developing either or both conditions.

When Depression Is Left Untreated

Depression is a serious type of mood disorder that affects how an individual thinks, feels, and functions in daily life. There are several different types of depression. The most common are major depressive disorder (MDD) and persistent depressive disorder (PDD).

Like other mental health disorders, depression may go untreated for a variety of reasons. Some individuals may hesitate at receiving a diagnosis for fear of stigma or judgment. Many people with depression struggle in silence because they do not want to become a burden to others in the same way they feel like a burden to themselves.

Leaving depression untreated, however, can increase an individual's risk of a variety of health complications, including substance abuse. Some of the most problematic signs and symptoms of depression include:

  • Persistent sadness or hopelessness
  • Feelings of worthlessness or guilt
  • Suicidal ideation
  • Losing interest in activities once found pleasurable

When these symptoms are left untreated, an individual may turn to alcohol and other drugs to self-medicate. Although self-medicating may provide temporary relief from symptoms, it only masks the underlying problems. In addition, as mentioned previously, it can trigger the development of SUD and addiction.

NIDA highlights the fact that disorders which co-occur are comorbid. This means that the interactions that occur between mental health disorders and SUD can worsen the course and trajectory of both conditions. Professional treatment is required to establish sobriety and lasting recovery from both conditions and their symptoms.

When Substance Abuse Is Left Untreated

Similarly, when substance abuse or SUD is left untreated, it can cause severe health concerns. Over time and through repeated use, an individual may experience increased tolerance to their substance of choice. This causes them to need more of a substance to achieve the desired effect.

If they stop using the substance, they will experience worsened withdrawal symptoms. This incentivizes them to continue engaging in substance use to avoid experiencing such discomfort.

It is likely only a matter of time before an individual struggling with substance abuse develops a co-occurring disorder, like depression. Depression is especially common because withdrawal symptoms can cause an individual to feel hopeless, worthless, or guilty for their actions. Yet they may still feel unable to cease their substance use without professional intervention. Fortunately, Pathways Recovery Center is here to assist individuals in the treatment and recovery process.

Recovery When Depression and Substance Abuse Co-Occur

At Pathways Recovery Center, we are well-versed in the treatment of mental health disorders. We specialize in treating SUD and the disorders that co-occur. Additionally, we understand the complications that often result from the interactions of co-occurring disorders. Our passion is to encourage recovery for those who are struggling.

We can effectively guide and support individuals in achieving lasting sobriety and recovery by treating co-occurring disorders in tandem. Individualized treatment is key for people with disorders that co-occur.

Mental health disorders commonly co-occur with substance abuse. This is why it is imperative to participate in early intervention services when mental and behavioral health concerns begin to surface. When depression is left untreated, it can incentivize you to engage in self-medication practices in an attempt to find relief from distressing symptoms. Similarly, when substance abuse is left untreated, withdrawal symptoms can trigger the development of depression. Pathways Recovery Center understands the need for treating co-occurring disorders together to ensure effective and long-lasting recovery. We offer many types of treatment programs to meet you where you are in your healing journey. To learn more about how we can help, call us today at: (888) 771-0966.

Clinically reviewed by 

Moses Nasser
Dr. Moses Nasser, a double board-certified physician in Family Medicine and Addiction Medicine, with expertise in holistic healing, addiction medicine, and psychiatric care, holds an X-waiver to prescribe buprenorphine and has extensive experience in mindfulness-based customer service and medication-assisted treatment.

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