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Why is Depression and SUD Co-Occurring?

What is a co-occurring disorder? Why are depression and SUD co-occurring? Read on to learn more about co-occurring disorders and depression.

Why is Depression and SUD Co-Occurring?

A co-occurring disorder or condition occurs when a substance use disorder exists simultaneously as another type of mental disorder. There are certain mental disorders which are most common as a co-occurring disorders, including anxiety and depression. 1

co-occurring disorder

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Relationship Between Depression and Substance Abuse

One of the main reasons behind this is because substance use disorders can lead to chemical and hormonal imbalances. It can also cause a decreased ability to regulate behaviors, thoughts, and medications, which can increase problems with brain chemicals.
Although depression is caused by more than just changes in brain chemistry, having certain chemicals in the brain be too high or low can lead to an increased risk of depression. 2

What is Depression?

Depression is a group of mental conditions that affect mood. While clinical depression is the most thought of form of depression, you may also see it manifest in bipolar disorder or other types of depression, which will be discussed in greater detail further below. 3
In 2020, an estimated 21.0 million adults in the United States had at least one major depressive episode. 4

Depression After Using Drugs

Depression is one of the most common co-occurring disorders after substance misuse. This is because of substance use disorders’ impact on the body and one’s relationships with those around them. While there can be chemical effects on the brain and body, substance use disorders can make connecting with loved ones more difficult. This can lead to isolation, loneliness, and, consequently, depression.

Different Types of Depression

Although depression is typically referred to as a single disorder, there are several different types of depression that an individual may experience. These can vary in symptoms and severity; some may be a more common co-occurring disorder than others.

Major Depressive Disorder (MDD)

Major depressive disorder, also known as MDD or clinical depression, is the most thought of form of depression. It can be caused by a combination of biological, psychological, and social factors. MDD is characterized by a loss of interest in daily life and activities and a chronically depressed mood.
MDD is most seen in instances of a co-occurring disorder. It can be seen with SUDs and other mental disorders like anxiety.

Persistent Depressive Disorder (PDD)

Persistent depressive disorder is known as a milder form of MDD. However, while the overall symptoms and manifestation of PDD tend to be milder than MDD, your current depressed mood can vary. It may sometimes be more severe, even if other symptoms are not.

Seasonal Affective Disorder (SAD)

Seasonal affective disorder is a type of depression that occurs at certain times of the year in correlation with the seasons. Typically, you’ll notice an increase in symptoms during the winter months when there is less sunlight.

Postpartum Depression

Postpartum depression is a unique, situational type of depression. It only occurs after birth, though symptoms can take several days or weeks. It is most like major depressive disorder. However, it can also include other symptoms revolving around the new child and the changes in daily life.

Depression With Psychotic Features

Sometimes, the symptoms of major depressive disorder, or even other types of depression, may vary. This includes severity. Some individuals may notice depression with psychotic features or symptoms. This means that their depression can lead them to experience psychosis.
Depression as a co-occurring disorder may have a higher chance of occurring with psychotic features. This is because, as a co-occurring disorder, the individual is simultaneously impacted by two or more other conditions.

Symptoms of Depression

Because there are many different types of depression, there can be a variety of symptoms to occur. These symptoms may vary based on the individual and depending on whether or not their depression is a co-occurring disorder. However, regardless of the variations in depression, there are some keystone symptoms to be aware of.
Some of these symptoms of depression may include:
  • Persistent feelings of sadness
  • Frequent crying or tearfulness
  • Excessive guilt
  • Feelings of worthlessness
  • Irritability
  • Restlessness or agitation
  • Low energy levels
  • Fatigue
  • Difficulty concentrating
  • Physical complaints
  • Frequent thoughts of death
  • Suicidal thoughts, ideation, or attempts

What is The Link Between Depression and Addiction?

Depression is a common co-occurring disorder to develop while dealing with addiction and substance use. This is because addiction involves several different components, including biological and social.

Substance Misuse and Brain Changes

One of the main components of addiction and substance misuse is the changes to brain chemistry. Whether the subject of addiction is alcohol or an illicit substance, addiction can lead the brain to react differently to different natural chemicals. It can also cause the brain to produce more or less important chemicals, such as dopamine.
Depression can be a complex disorder with various causes. However, while brain changes may not be the only cause of depression, addiction and its changes can be significant factors. Therefore this combination is common with co-occurring disorders.


While co-occurring disorders often view how addiction can cause depression, it is also important to note that depression can cause addiction. As mentioned previously, depression can cause many different symptoms varying in severity.
These symptoms can be uncomfortable and difficult to navigate. As a result, some individuals turn to substance use to self-treat their depression symptoms. Over time, this can lead to a substance use disorder and addiction.

Disorders that Often Co-Occur with Depression

Substance use disorders aren’t the only condition that can co-occur with depression. Below, you’ll find a list of other conditions that may occur at the same time as depression, including:
  • Alcohol or substance use disorders
  • Anxiety disorders, particularly social phobia, panic disorder, and generalized anxiety disorder
  • Borderline personality disorder
  • Eating disorders
  • Obsessive-compulsive disorder
  • Posttraumatic stress disorder
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Treatment for Comorbid Depression and Substance Use Disorder

Treating comorbid disorders can be complex. It is important to treat both conditions simultaneously without hampering the treatment progress for the other. As a result, several treatments are often used in combination. Some examples of beneficial treatment for co-occurring disorders include:

How to Cope With depression and substance abuse

Navigating depression and substance abuse can be difficult. Here are some of the best ways to cope with helping increase your day-to-day quality of life while seeking treatment:
  • Support groups
  • Don’t isolate yourself  
  • Stay active if possible
  • Be gentle with yourself

Find the Right Treatment for Depression and Substance Abuse at Ripple Ranch Recovery Center

Mental disorders can be difficult for both you and your loved ones. Co-occurring disorders can be even more challenging to navigate. However, you won’t need to undergo treatment alone at Ripple Ranch Recovery Center.

Our team of certified professionals is prepared to meet you wherever you are in your recovery journey to provide state-of-the-art care. To learn more about co-occurring disorders and our treatments, contact us today.