Last Updated on December 27, 2021 by Dr. Alberto Solà

Substance abuse is difficult enough to deal with on its own, but it is even tougher if you add depression to the mix. Unfortunately, the two go hand in hand more frequently than you may think—according to the Anxiety and Depression Association of America, roughly 20% of people with a substance abuse problem also have a mood disorder such as depression or anxiety, while roughly 20% of people who are depressed also misuse drugs and alcohol.

Life with depression and substance abuse can be unbearable, with both disorders feeding off each other and creating a vicious circle that seems unending. However, with the right treatment, you can break the cycle and move forward.

Substance Abuse

Substance abuse disorder is a continuum of drug or alcohol abuse that worsens as it progresses through its various stages. Drug use may start for a variety of reasons—social experimentation, coping tool for life’s problems—but typically the goal is to get the high that substances trigger by chemically impacting the brain.

That chemical effect can be so powerful that you want to continue using the substance. As you do, your brain adjusts and becomes used to the rush that occurs, which means you need more of the substance to achieve something close to that original high. As this tolerance develops, you will also start to feel dependent on the substance to get you through the day. This is when your daily life responsibilities can begin to suffer, as your substance abuse takes up much of your time—you’re thinking about where you can get your hands on drugs or alcohol, when you can find time to take it, or figuring out how to get more of it to curb the withdrawal effects that are sure to come with prolonged use.

As you lose the motivation to fulfill school, work, or family obligations, and as your substance abuse becomes all-consuming, you may begin taking risks to support your habit. These risks can put you personally at risk, or endanger the lives of others. You are probably also spending a fair amount of time trying to cover up the extent of your substance abuse problem, which means you may be lying to loved ones or withdrawing from close relationships in order to avoid any hard questions.

Once you hit the point where you can’t function on a daily basis without drugs or alcohol, you have reached the final stage of your substance abuse disorder: addiction. At this point, your addiction is probably manifesting itself in different negative side effects both physically and emotionally—and one of those side effects can be depression.


While depression can be a common hazard of substance abuse, it can work the other way around as well. In fact, one in six Americans will have major depressive disorder at least once in their lifetimes, according to the American Psychiatric Association, and for some people, substance abuse is their way of coping with it.

Depressive episodes can be mild to severe, and they are considered medical conditions. For an official diagnosis of depression, you must experience some of the following symptoms just about every day for at least two continuous weeks:

  • Feeling worthless
  • Changes to appetite and subsequent weight loss/gain
  • Anxiety or restlessness
  • Difficulty with cognitive function (memory, decision-making, focus, clarity of thought)
  • Speaking or thinking more slowly than normal
  • Overwhelming sadness or hopelessness
  • Loss of interest in pleasurable activities
  • Difficulty sleeping, which can lead to fatigue and lethargy
  • Physical pain
  • Suicidal thoughts or actions

The Relationship Between Depression and Substance Abuse

Taken individually, substance abuse and depression are both serious disorders that require experienced and professional treatment. But if you have both conditions simultaneously, then it’s critical to get the proper care.

That is because when depression and substance abuse are linked like that, they are considered co-occuring disorders, and this is what is called a dual diagnosis. In essence, it means the conditions are irrevocably intertwined. For instance, if you drink too much to numb your depressive feelings, you can’t treat only the depression—you have to also address the substance abuse and learn healthier coping techniques. Otherwise, you will be stuck in the same self-destructive substance abuse habits. Conversely, depression can be a side effect of chronic use of drugs such as cocaine, methamphetamine, LSD, and inhalants, among others. Whole-person, comprehensive care requires that both issues be addressed in order to have a sustainable recovery.

With a dual diagnosis, it doesn’t matter which comes first—depression and substance abuse must be addressed equally. If this describes your situation, or that of a loved one, you should know that you are not alone: In 2018, 9.2 million American adults had co-occurring disorders, according to the National Survey on Drug Use and Health. That is why forward-thinking treatment facilities, such as our ibogaine treatment center, offer dual-diagnosis inpatient programs.

A major component of these treatment plans is detoxification, to get the substance cleared from your system. At Clear Sky, the powerfully effective, plant-based ibogaine is used to help patients reach a clear, drug-free state. That will prepare you for another important part of dual-diagnosis treatment, which is therapy, most often cognitive behavioral therapy. Therapeutic treatment can be done one on one, in small group settings, or, if applicable, with family members. Support groups are critical for finding encouragement from people who have been in your situation and these meetings can be a source of healthy, lasting bonds. Finally, a medical professional may need to oversee a medication treatment plan to help address mood disorders such as depression.

You can break the cycle of substance abuse and depression simply by reaching out to a program that can help you regain hope. Contact Clear Sky Recovery today.