Depression can lead to substance use disorder, and vice versa. With the right treatment, it’s possible to manage both conditions.

The link between depression and substance use disorder (SUD) is complex, and the two can be related.

Depression may motivate you to drink alcohol or use another substance to gain relief. Over time, chronic use and withdrawal can trigger or worsen the symptoms of depression.

Treatments are available for both SUD and depression. In many cases, when people receive treatment for one condition, the symptoms of the other condition improve, too.

Depression is a mental health condition marked by low mood, feelings of hopelessness, loss of pleasure, and changes in eating and sleeping habits. In some people, and often men, depression may look like overworking, overexercising, or anger instead of sadness.

Depressive disorders commonly associated with substance use disorder include:

Substance use disorder (SUD) is a chronic condition in which a person continues to use substances despite experiencing harmful consequences.

SUD can be mild to severe and significantly contribute to disability and mental health conditions, including depressive disorders.

Research from 2020 shows that depression often occurs with substance use, particularly alcohol use disorder (AUD).

Although evidence suggests a strong link between the two disorders, the cause-and-effect relationship is unclear.

It’s clear, though, that depression can lead to substance use and vice versa.


Genetics play a significant role in both substance use disorder and depression.

A 2005 review suggests that you may be more likely to have family members with mood disorders if you have SUD.

This may be because specific gene variants contribute to both disorders.

Research reveals that genetics might cause brain changes that:

  • makes you more prone to developing SUD and depression
  • causes a response to initial substance exposure that promotes chronic misuse
  • makes you more susceptible to mood disorders

How depression may lead to substance use disorder

It’s common for people who feel depressed to turn to alcohol and other substances. These can temporarily relieve symptoms.

About 32% of people with mood disorders also have SUD. SUDs are especially common in people with bipolar disorder. Fifty-six percent of people with bipolar disorder also have a lifetime SUD. Of those with MDD, 18% have SUD.

People with depression sometimes reach for substances that can boost their mood and give them more energy, like cocaine or amphetamines. But while these substances may help with mood symptoms, this is only temporary. Over time, they can worsen depression symptoms.

How substance misuse may lead to depression

In most people, chronic substance use and withdrawal lead to symptoms of depression or anxiety. In people without a history of mood disorders, depression symptoms may disappear after medically managed treatment.

The time it takes to feel better varies from person to person. The type of substance and length of SUD can also impact how long it takes for depression symptoms to subside.

Substance use often worsens existing symptoms in those with a history of mood disorders. In some cases, substance use can mask an underlying mood disorder, which may not be obvious until after therapy for cessation.

Also, intoxication and withdrawal symptoms can mimic symptoms like mania and depression.

For example, chronic use of central nervous system stimulants, like cocaine and amphetamines, may cause symptoms similar to bipolar disorder.

Substance withdrawal can also lead to depressive feelings, apathy, and suicidal thoughts.

Research shows that using alcohol, opioids, and sometimes cannabis have links to depression.

Chronic use of CNS depressants can also cause depressive symptoms, including problems concentrating and difficulty finding joy in typical activities. Withdrawal can also cause symptoms like anxiety and agitation.

For these reasons, it’s difficult to diagnose a depressive disorder when a person has an active SUD.

If you have depression and SUD, it’s vital to receive treatment for both conditions. Your doctor may prescribe medications to help with withdrawal symptoms and may use antidepressants and SUD maintenance medications afterward to treat depression and substance use disorder.

You may need close supervision in an inpatient facility to help you withdraw safely and more comfortably.

Close supervision is especially important if you have a history of depression since withdrawal tends to worsen depression symptoms.

Also, withdrawal from some substances, such as alcohol and benzodiazepines, can be life threatening.

During withdrawal, you may already have started medications for your SUD. If not, you may want to consider discussing them. The medications have the best evidence in treating SUDs.

Other helpful options to aid your recovery and symptom management include cognitive behavioral therapy (CBT).

You may also consider joining a 12-step program, such as Alcoholics Anonymous (AA), or a non-12-step group like SMART recovery.

These programs can help you on your recovery journey by supporting and connecting you with others going through the same experience. It can help to know you’re not alone.

If you live with depression and substance use, you’re not alone. Many support groups and healthcare professionals can help you.

While treating depression with SUD is challenging, it’s possible. Many people successfully manage both conditions.

Need some guidance on where to start looking for help? You can find out more here about how to start your recovery journey.

If you’re looking for someone to talk with, consider checking out these resources:

Suicide prevention

Remember that you’re not alone, and resources are available to you. If you need to talk with someone right away, you can:

Not in the United States? You can find a helpline in your country with Befrienders Worldwide.

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