Depression and Addiction

Depression and Addiction Among Americans

Depression and addiction often go hand in hand. Many people who are struggling with addiction also suffer from depression.

According to the 2022 State of Mental Health in America report, 2.5 million young people in the United States struggle with severe depression, and multiracial youth are at greatest risk. The report also notes that nearly 4.8% of American adults say they have serious thoughts of suicide. That’s a lot of people suffering.

If you are dealing with depression, addiction, or both, it is important to get help. Many resources are available.

What Is Depression?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), describes depression as having feelings of sadness and a low mood as well as losing interest in activities that used to be pleasurable. These symptoms must last at least two weeks and mark a decrease in the individual’s normal level of functioning. The person must also exhibit at least five of these additional symptoms:

  • Change in appetite, losing or gaining weight
  • Insomnia or sleeping too much
  • Fatigue and low energy most days
  • Feeling worthless, guilty, and hopeless
  • Inability to focus and concentrate that may interfere with daily tasks at home, work, or school
  • Unusually slow or agitated movements that may be noticeable to others
  • Thoughts of dying that may include suicidal ideation or attempts

Simply put, depression is a mental health disorder that causes a person to feel persistently sad or low. It can cause someone to withdraw from friends and family and have difficulty keeping up with their normal daily routine.

Fatigue is a common sign of depression. It can make it difficult to get out of bed in the morning or do anything that requires energy or motivation. Causes of depression fatigue can include:

  • Sleep problems
  • Diet
  • Stress
  • Medications, including some used to treat depression

Another common sign of depression is a change in appetite. Some people with depression may lose their appetite and lose weight while others may eat more than usual and gain weight.

Depression can also manifest with other physical symptoms, such as headaches, body aches, and digestive problems. These symptoms can make it difficult to concentrate or get a good night’s sleep.

If you think you might be depressed rather than just sad, talk to your doctor or a mental health professional as soon as possible.

What Causes Depression?

The causes of depression are not fully understood, but there are several contributing factors.

Genetic Factors

Depression often runs in families. This may be due to a combination of genetic and environmental factors. If you have a close family member who has depression, you may be more likely to experience it yourself. This is because you may have a genetic predisposition to the condition. Scientists believe that depression is probably 40% to 50% inherited and that the percentage could be higher for severe depression.

Biological Factors

In some cases, depression may be caused by changes in the brain. This can be due to a chemical imbalance or other problems with the way the brain functions. For instance, people with a history of head injuries may be more likely to experience depression.

Changes in the brain can also be caused by medical conditions, such as a thyroid disorder or an autoimmune disease. These conditions can cause changes in hormone levels, which can lead to depression. Women who are pregnant, nursing, in the week before menstruation, or going through menopause may also experience depression because of hormonal changes in their bodies.

Psychological Factors

Depression is also thought to be caused by psychological factors such as stress or trauma. If you are mourning the death of a loved one, you may be vulnerable to depression because your brain may have a hard time processing the event.

Grief can also overwhelm you with sadness and loneliness. It’s a good idea to talk with a mental health professional if you feel you’re not coping with grief as well as you expected to.

Environmental Factors

There are many environmental factors, such as poverty or social isolation, that can lead to depression. Financial stress makes it difficult to afford basic necessities, such as food or housing. Social isolation can also lead to depression because it can make you feel lonely and unwanted by others.

The Addiction Process: How It Begins and Progresses

The addiction process often begins when someone uses substances to cope with difficult life circumstances, such as trauma, stress, or mental health issues. The person may start using substances recreationally and then find that they need to use them more and more to get the same effect.

As the addiction progresses, the individual may start to neglect responsibilities such as work, school, or family obligations. They may also start to isolate themselves from friends and family. They may start to experience financial problems and legal problems.

What Is the Connection Between Depression and Addiction?

There is a strong connection between depression and addiction. People who are struggling with depression may turn to mind-altering substances in an attempt to self-medicate because substances can provide temporary relief. However, substance abuse can also make depression worse because it can lead to financial stress and social isolation.

Changes in the brain caused by substance misuse can make it difficult to cope with depression. Drugs interfere with the way neurons send, receive, and process signals via neurotransmitters.

Lastly, people who have a family history of addiction may be more likely to experience both depression and addiction. They may have a genetic predisposition to both conditions.

Treatment for Depression and Addiction

If you are struggling with depression and addiction, it is important to seek treatment to help you manage your symptoms and cope with the challenges of both conditions. Treatment for depression may include medication, therapy, or a combination of both. Treatment for addiction involves detoxification, rehabilitation, and aftercare.


Many different types of medication can be used to treat depression. The most common type is antidepressants, which work by correcting the chemical imbalance in the brain that is thought to cause depression.

One of the most common types of antidepressants is selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing the level of serotonin, a chemical that helps to regulate mood, in the brain.

Another type of medication is tricyclic antidepressants (TCAs). TCAs work by blocking the reuptake of norepinephrine and serotonin, two chemicals thought to be involved in depression.

Monoamine oxidase inhibitors (MAOIs) are another type of antidepressant. It works by inhibiting the enzyme monoamine oxidase, which is responsible for breaking down norepinephrine, serotonin, and dopamine.

The most common side effects of antidepressants include nausea, vomiting, diarrhea, constipation, dry mouth, weight gain or loss, fatigue, drowsiness, insomnia, anxiety, irritability, and sexual dysfunction.

Antidepressants can take several weeks to work, so don’t expect immediate results. Some of the more serious side effects of antidepressants include suicidal thoughts, mania, and seizures. If you experience any side effects that concern you, it is important to contact your doctor immediately.


Many different types of therapy are used to treat depression. A common one is cognitive behavioral therapy (CBT), which works by helping you to identify and change the negative thoughts and behaviors that are associated with depression. For instance, if you are depressed because you believe that you are worthless, CBT can help you to build the self-confidence to challenge and change that belief.

Other types of therapy that can be used to treat depression include interpersonal therapy, problem-solving therapy, and psychodynamic therapy.

The Treatment Process for Depression and Addiction

Several steps are involved in a dual diagnosis of depression and addiction and deciding how to treat it.


During the assessment, a professional will evaluate your symptoms and medical history to determine whether you have depression, addiction, or both. They will also assess the severity of your symptoms and any underlying factors that may be contributing to your condition. After the assessment, you will be placed in a treatment program that is tailored to your specific needs.


The second step in the treatment process is detoxification, a process that rids your body of the toxins associated with addiction. During detox, you will be monitored closely by medical professionals who can help you through any withdrawal symptoms, which can include nausea, vomiting, diarrhea, anxiety, and irritability. Once you have completed detoxification, you will be ready to begin rehabilitation.


Rehabilitation is a process that helps you to recover from addiction and learn how to live a sober life. During rehab, you will participate in therapy sessions and activities that will help you to achieve this goal. One of the most important aspects of this step is learning how to cope with triggers: people, feelings, places, or situations that make you more likely to use. Learning how to deal with these will help you to avoid relapsing.

Some of the activities in which you may participate during rehabilitation include group therapy, individual therapy, and 12-step programs.

Rehab can be an uncomfortable and difficult process. However, it is important to remember that you are not alone. There are many people who have gone through rehabilitation and have come out the other side stronger, healthier, and happier.


Once you have completed rehabilitation, it is important to continue with aftercare because it helps to prevent relapse and keep you on the path to recovery. Aftercare can include participation in 12-step programs, therapy, and support groups.

Usually, the treatment process for depression and addiction takes several months to complete. However, this varies from person to person. Some people need to stay in treatment longer than others. The most important thing is that you are willing to commit to the treatment process and follow through with it.

If you or someone you know is struggling with depression and addiction, help is available. Depression and addiction are serious problems, but they are also treatable. So, seek out the resources that are available to you. With the right help, you can overcome depression and addiction and lead a rewarding life of sobriety.


Medically Reviewed By:

Robert Gerchalk

Robert is our health care professional reviewer of this website. He worked for many years in mental health and substance abuse facilities in Florida, as well as in home health (medical and psychiatric), and took care of people with medical and addictions problems at The Johns Hopkins Hospital in Baltimore. He has a nursing and business/technology degrees from The Johns Hopkins University.

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