Can Depression And Anxiety Lead To Substance Abuse?

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Dual diagnosis, or the presence of a substance use disorder along with a mental health disorder, is common among people seeking treatment. Sometimes substance use instigates depression or another mental illness, but other times, a mental illness leads to substance abuse.

Can Depression And Anxiety Lead To Substance Abuse?

Depression is a common mental health disorder, affecting over 8% of U.S. adults in 2021. Anxiety disorders are even more common, with 30% of adults expected to experience one sometime in their lives.

Depression and anxiety can lead to substance abuse as a way to self-medicate against the effects of these mental illnesses.

What Is Depression?

Depression is a mood disorder that affects how you feel and impacts your thoughts and actions.

Depression causes persistent feelings of sadness as well as a loss of interest in activities that you normally enjoy doing.

It is important to note that depression is different from grief, though both potentially lead to substance abuse.

Symptoms Of Depression

The symptoms of depression can be wide-ranging and affect multiple aspects of your life.

Symptoms of depression include:

  • loss of interest in pleasurable activities
  • sadness
  • difficulty falling asleep or staying asleep
  • weight gain or loss
  • fatigue
  • feelings of worthlessness and low self-esteem
  • physical actions like handwringing or pacing that accompany feeling antsy
  • difficulty concentrating
  • suicidal thoughts

Types Of Depression

There are several different types of depression. These mental health conditions all have similar effects but often stem from different causes or last for different lengths of time.

Types of depression may include:

  • postpartum depression
  • major depressive disorder
  • psychotic depression
  • persistent depressive disorder
  • seasonal affective disorder

Bipolar disorder is another mood disorder that is different from depression. But a person who lives with bipolar disorder can experience episodes of depression.

What Is Anxiety?

Anxiety disorders describe different levels and expressions of anxiety that go beyond the stressors and anxious feelings that are a normal part of life.

Anxiety disorders involve more than worry or being afraid of something. Rather they include symptoms that interrupt people’s lives and interfere with their school, relationships, or work.

Symptoms Of Anxiety

There are many different symptoms related to anxiety disorders, most of which are found in generalized anxiety disorder (GAD).

Symptoms of GAD include:

  • being on edge
  • restlessness
  • easily fatigued
  • irritability
  • difficulty concentrating
  • trouble sleeping
  • headaches
  • stomach aches
  • muscle aches
  • sweating
  • diarrhea
  • nausea

Types Of Anxiety Disorders

Just as there are different types of mood disorders, there are different types of anxiety disorders.

Anxiety disorders include:

  • social anxiety
  • panic disorder
  • obsessive-compulsive disorder
  • phobias

How Depression And Anxiety May Lead To Substance Abuse

Depression and anxiety may lead to alcohol and drug abuse if people don’t know that they have mental health problems and just want to feel better.

Or they may lead to substance abuse if people know they have depression or an anxiety disorder but don’t have access to effective treatment.

In either case, both substance misuse and mental health issues can get worse when the two co-occur.

Substance Use As A Way Of Self-Medicating

For people who either don’t know they have a mental health condition or know and can’t get treatment, alcohol or drug use may become a way of self-medicating.

One definition of self-medication is taking drugs, homeopathic remedies, or herbs at your discretion or the advice of someone else, without consulting a doctor.

Where it involves pharmaceutical or illicit drugs and mental illness, self-medication can lead to co-occurring substance abuse, such as opioid or alcohol use disorder.

How Self-Medicating Leads To Substance Abuse

Substances such as alcohol or cannabis may temporarily alleviate symptoms of depression because of how these substances affect the brain.

Serotonin is a neurotransmitter in the brain that affects mood along with learning, memory, and cognition.

Some substances raise levels of serotonin and other neurotransmitters related to mood, including norepinephrine and dopamine.

As people experience these effects, they begin to associate feeling better with the substance they are taking and can become addicted.

Substances Used To Self-Medicate Depression And Anxiety

Researchers have uncovered common links between depression or anxiety and certain substances. For example, a Canadian study found that 69% of college students surveyed who had depression or anxiety also engaged in alcohol abuse or cannabis abuse.

Alcohol And Self-Medication

Alcohol interacts with serotonin, norepinephrine, and dopamine transmitters in a way that causes people who consume alcoholic drinks to feel a lift in their mood.

However, alcohol is also a central nervous system depressant and can cause someone who tends toward depression to ultimately feel more depressed after this initial lift.

Self-Medicating With Cannabis

Cannabis is a psychoactive drug that has been legalized in many states. Some people may use cannabis to treat anxiety because of other medical uses that it has been found to have.

There are two active compounds in marijuana. CBD is not associated with the high that marijuana produces but has been shown to decrease anxiety at multiple dose levels.

The other compound in marijuana, TCH, does produce the high. Low doses of THC may reduce anxiety, but higher doses have been shown to increase it.

Also, research suggests that heavy use of cannabis starting in adolescence or young adulthood can create a vulnerability to psychosis.

Treatment For Anxiety And Depression

If you are experiencing anxiety or depression, receiving psychiatric treatment from a mental health professional can prevent the condition from becoming a risk factor for addiction.

Treatment options for depression and anxiety include medication such as antidepressants, which safely raise levels of serotonin or other neurotransmitters to address the symptoms of depression. These medications are not habit-forming and help control recurring depressive episodes.

Another approach is through behavioral therapy. Mental health professionals use behavioral therapies to give people the tools to recognize triggers and strategies to cope with negative thoughts.

Dual Diagnosis Treatment

Dual diagnosis treatment address the comorbidity of a substance use disorder and mental health disorders such as depression and anxiety.

Dual diagnosis treatment can address several other co-occurring disorders as well.

Other mental health disorders that c0-occur with addiction include:

  • post-traumatic stress disorder (PTSD)
  • schizophrenia
  • bipolar disorder
  • personality disorder

Co-occurring disorder treatment can happen at the outpatient or inpatient level. A treatment facility may also be able to diagnose you if you think you are experiencing mental health issues.

Behavioral Therapy

Similar to addiction treatment or the treatment of mental health problems, dual diagnosis treatment involves behavioral therapy in group and individual settings.

Behavioral therapies used to treat a dual diagnosis include:


Medication may also be a component of treatment. This may include medication for substance use disorders, such as methadone for opioid use disorder or disulfiram for alcohol use disorder.

It may also include antidepressants or antianxiety medication.

The goal of a medical approach is to control symptoms so that therapy can address aspects of behavioral health and provide strategies to maintain general well-being.

Peer Support

Peer support is an important component of dual diagnosis treatment. Members of these groups in a treatment program can help each other address the complex issues of addiction and also provide encouragement and accountability.

People with dual diagnoses and their family members also find support outside of a drug addiction treatment program by joining support groups.

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