Honor the power of your voice and begin your journey with us today!
Honor the power of your voice and begin your journey with us today!

The Toxic Relationship Between Depression and Addiction

It’s no surprise that depression and addiction are closely related, as both conditions feed into each other in addition to having a cause and effect type of relationship. The toxic relationship between depression and addiction is hard to understand, as many symptoms of both conditions are similar in nature. When looking into a mental health disorder like depression, it is important to consider all the factors that play into and perpetuate the behaviors associated with that disorder— especially if a substance use disorder is present.

Taking a Look at Addicts and Alcoholics

In research dating back to studies conducted in 1964, it was found that amongst addicts, “The personality studies indicate that addicted patients frequently show psychopathic tendencies and a variety of emotional problems. There is evidence from several studies that one of these emotional problems is depression” (Robbins). The psychopathic tendencies that were mentioned can speak of the following signs and symptoms of depression: apathy, disinterest, shallow experiences of emotions, inhibited ability to control behavior, desire for instant gratification, sensation-seeking behavior, etc.
There is a common saying about addicts, “addicts aren’t addicted to drugs, they are addicted to escaping reality.” This quote or saying speaks volumes about the nature of the relation between addiction and depression. Unsurprisingly, one study “…found heroin users tended to score higher than normals on the Zung scale of depression” (Robbins). The massive link between depression and substance use disorders cannot be ignored. In a recent study conducted and published by Brown University, researchers found “…that women in drug court who are experiencing current major depression are more likely to use crack within four months than other women in drug court” (Brown University).

What is the Relationship?

“Depression is a mental illness frequently co-occurring with substance use. The relationship between the two disorders is bi-directional, meaning that people who abuse substances are more likely to suffer from depression, and vice versa” (Smith). The volume of people suffering from depression that use substances, are using and abusing substances as a way to cope with their symptoms of depression. Substance use disorders result from a compulsive effort to feel better, or escape from reality.
When your reality is depression, escaping quickly turns into a constant effort to escape and feel differently. Because of this consistent alcohol and drug abuse, sufferers of depression will then experience overwhelming feelings of their depression once the substance’s effect wears off. People who have never before struggled with depression can also experience signs and symptoms of depression once the effects of their drug use wears off, and they are left to face the consequences and impact of their addiction.

Indicators of a Substance Use Disorder

Based upon the criteria for substance use disorders, originally found in the Diagnostic and Statistical Manual of Mental Disorders, indicators of a substance use disorder include meeting two or more of the following criteria within the past 12 months:

  1. Using more of a substance than initially intended, or for a longer period of time than intended
  2. You’ve made more than one attempt to cut back or quit entirely, but haven’t been successful
  3. You spend a lot of your time using the substance
  4. You’ve neglected major roles or obligations and/or failed to meet responsibilities at work, school, or home to use the substance
  5. Your substance use has caused relationship problems or conflict with others
  6. Physical health problems or psychological issues are caused or exacerbated by your substance use
  7. You’ve skipped or stopped participating in activities that you once enjoyed, in order to use the substance
  8. You experience a strong urge, or craving, for the substance
  9. You’ve used the substance in ways that are physically hazardous to yourself and/or others, (i.e. overdosed, driven while under the influence, or blacked out)
  10. You’ve built up a tolerance to the substance so that you have to use more to get the same effect
  11. When you’ve stopped using the substance, you’ve experienced withdrawal symptoms

Types of Depression

There are different types of depression. Depression can exist without a trigger, or be brought on by a major life event or life changes. Some depression is cyclic, comes and goes at random, or comes during certain circumstances. Each type of depression holds a set of signs and symptoms, but it is always recommended to seek out a medical professional for a formal diagnosis. At Royal Life Centers, we perform an initial assessment for each guest upon their arrival to our facilities, evaluating for any co-occuring disorders.
The types of depression include: major depressive disorder (aka clinical or unipolar depression), dysthymia (aka persistent depressive disorder), seasonal affective disorder (aka major depressive disorder with seasonal pattern), bipolar depression (result of bipolar disorder), postpartum depression (aka peripartum depression), atypical depression, situational depression, premenstrual dysphoric disorder, and psychotic depression (aka major depressive disorder with psychotic symptoms).


Drug addiction has similar symptoms to depression, “Because drug use symptoms can imitate the symptoms of depression, it can be difficult to diagnose depression when a person is actively using” (Smith). Depression can range in severity and therefore in intensity. Some depressed people may be suffering from major depression, without exhibiting many indicators in behavior.
Some common symptoms of depression include:

  • persistent feelings of sadness, hopelessness, and emptiness
  • consistent feelings of irritability, frustration, and anger
  • loss of interest or pleasure in activities that used to be enjoyable
  • excessive guilt
  • feelings of worthlessness
  • lack of energy
  • overly tired
  • trouble concentrating and making decisions
  • memory problems
  • talking or moving more slowly than usual
  • restlessness and trouble sitting still
  • disrupted sleep patterns, including insomnia or excessive sleeping
  • changes in appetite— either an increase in appetite or loss of appetite
  • changes in weight— either weight gain or weight loss
  • persistent headaches, other body pains, or digestive issues, with no clear physical trigger
  • suicidal ideation, or recurrent thoughts of death
  • anxiety
  • ruminating thought patterns
  • self-injurious behavior like engaging in self-harm
  • substance abuse and/or addiction, including heavy drinking and smoking
  • (ADA)


    Guests with a dual-diagnosis, also referred to as a co-occuring disorder, should attend a comprehensive addiction treatment program. A dual-diagnosis is when guests who have a substance use disorder or substance abuse issue, also have a mental health disorder. At Royal Life Centers, we are experienced in effectively treating guests with a co-occuring disorder. Guests who struggle with a co-occuring mental health disorder like depression need mental health support in addition to being treated for their substance abuse. Addiction recovery for these guests can only be achieved when both disorders are treated simultaneously. Not every drug rehab or rehabilitation program can effectively treat guests who have a mental health disorder in addition to their substance abuse, but Royal Life Centers is experienced in treating these types of cases. Treatment for depression needs to be ongoing and simultaneous to treatment for substance use disorders.

    Our Treatment

    At Royal Life Centers, our drug rehab centers have a variety of treatment options— including inpatient and outpatient treatment programs. Royal Life Centers has comprehensive addiction treatment programs including: medical detox, a residential inpatient program, a partial hospitalization program (PHP), an intensive outpatient program (IOP), an outpatient program (OP), sober living and graduate housing. We also provide services for alumni and family members alike.
    People with depression benefit greatly from psychotherapy. Royal Life Centers uses only proven effective methods of treatment, including intensive therapies. We offer intensive therapies including: individual therapy sessions, group therapy, behavioral therapies, adventure therapy, activity therapy, and equine therapy. We treat substance use disorders ranging from alcohol addictions, prescription drug addictions, illicit drug addiction, etc. Our treatment programs are all individualized. Guests work alongside their primary therapist and case manager to design their own treatment plans, tailored specifically to meet their personal needs, goals, and circumstances. We know that having depression and a substance use disorder can leave you feeling hopeless, but Royal Life Centers is here to help guide you and get your life back. Because We Care. Please reach out to us, we want to help you.

    Reach Out

    If you or someone you know is struggling with an addiction, please reach out to us at (877)-RECOVERY or (877)-732-6837. Our team of addiction specialists make themselves available to take your call 24 hours a day, 7 days a week. Because We Care.
    Hartney, Elizabeth. “What Are the Official Criteria for Addiction?” Verywell Mind, Verywellmind, 5 May 2019, www.verywellmind.com/what-are-the-official-criteria-for-addiction-22493
    Robbins, P.R. Psych Quar (1974) 48: 374. https://doi.org/10.1007/BF01562160
    “Signs of Depression « Ada.” ADA, Ada Health GmbH, ada.com/signs-of-depression/#general-signs
    Smith, Kathleen. “Substance Abuse and Depression: A Dangerous Downward-Spiral.” PsyCom- Substance Abuse and Depression, Vertical Health LLC, www.psycom.net/depression-substance-abuse

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