Depression and Substance Abuse | Dual Diagnosis


Clinical Depression (major depressive disorder) is a very common and severe mental disorder1. Depression can dramatically take a toll on a person’s ability to carry out everyday life activities. Depression causes severe symptoms that affect how people feel and think. It also has effects on relationships with family, friends, and significant others.

Feeling low in life is something that everyone experiences from time to time. Some may recognize this as having the “blues.” This feeling generally happens during times of loss, grief, frustration, or even an unexpected change.

However, this feeling tends to be short-lived and passes after a brief period. For people who struggle with depression, this feeling lasts daily for at least two weeks. These days are referred to as depressive episodes.

Signs and Symptoms of Depression

Not every person will experience the same depressive symptoms. Some people may experience only a few symptoms, while others may experience many. The severity and how often the depressive symptoms occur will depend on the person’s specific mental disorder. Depression typically starts between the ages of 15 to 30 and is more common in women.

Some common signs and symptoms2 people will experience if they are suffering from depression include:

Persistent sadness, anxiety, or emptiness

Feelings hopeless, or pessimistic

Feeling on edge

Feelings of guilt, worthlessness, or helplessness

Loss of interest or pleasure in hobbies and activities

Low energy or fatigue

Moving or talking more slowly

Feeling restless

Difficulty concentrating, remembering, or making decisions

Difficulty sleeping, early-morning awakening, or oversleeping

Loss of appetite and/or weight changes

Thoughts of death or suicide, or suicide attempts

Aches or pains, headaches, cramps

Common Types of Depression

Two of the most common types of Depression are Major Depression and Persistent Depressive Disorder.

Major Depression

A person diagnosed with Major Depression will experience symptoms daily for at least two weeks. This episode of symptoms will interfere with one’s ability to work, sleep, eat, and live a happy and healthy life. An episode can happen only once, but it is common for a person to suffer from several episodes in their lifetime.

Persistent Depressive Disorder (Dysthymia)

A person diagnosed with Persistent Depressive Disorder will find themselves having symptoms of depression that last for at least 2 years. This type of depression may have episodes of major depression, along with periods of less severe symptoms.

There are types of depression that can develop due to particular circumstances. These include Seasonal Affective Disorder (SAD), Postpartum Depression, and Psychotic Depression.

Seasonal Affective Disorder (SAD)

SAD is a type of depression that comes and goes throughout the seasons. The person will usually begin to feel the symptoms in the late fall and early winter. The signs will start to fade come spring and summer.

Postpartum Depression

Postpartum Depression is a type of depression women can experience during pregnancy or after delivery. The person will undergo full-blown significant depression symptoms.

Psychotic Depression

Psychotic depression is a type of depression that occurs when a person has severe depression plus some form of psychosis. Examples of psychosis3 include having disturbing delusions or hearing or seeing things that are not there.

Medical Diagnosis Types

Depression Diagnosis

Before someone can be diagnosed with depression, they must reach out to a healthcare professional. The healthcare professional will perform a thorough diagnostic evaluation, which includes an interview and possibly a physical examination.

In some instances, a blood test may be required to rule out any medical conditions that could be causing depressive symptoms. The diagnostic evaluation is to identify specific depressive symptoms, medical and family history, cultural factors, and environmental factors. Once a diagnosis is made, the healthcare professional can begin an appropriate course of treatment.

Dual Diagnosis

Many people who suffer from depression often turn to alcohol and drug use to escape or bring them feelings of happiness. This can become a vicious cycle. When someone falls into this cycle of depression and addiction, they are considered to have a co-occurring disorder. This is also commonly referred to as having a dual diagnosis.

A dual diagnosis4 can consist of any combination of mental disorders and addictions. Research shows roughly one-third of adults who suffer from depression also struggle with some substance abuse.

Depression/Alcohol Abuse

Depression combined with alcohol abuse is one of the most common forms of dual diagnosis. Several studies6 found that approximately 60 percent of alcoholics have experienced a major depressive episode. The remaining roughly 40 percent who have suffered from a depressive episode, likely have an independent major depressive disorder.

It can be challenging to pinpoint where drug addiction begins, and depression ends. Since the brain recognizes alcohol as a depressant, it feeds into a person’s depressive symptoms. They are only making it more difficult for the person to stop the cycle.

Depression/Substance Abuse

Another common form of dual diagnosis is depression combined with substance abuse. Roughly 18% of people5 suffering from depression also experience drug and alcohol disorders. Specific drug abuse and addictions can affect the brain and lead a person to experience one or more symptoms of depression. Again making it very difficult for a person with this dual diagnosis to end the vicious cycle.

A person suffering from depression and a substance use disorder is at high risk of injury, self-harm, or suicide. It is essential to treat these disorders at the same time.

Is Dual-Diagnosis Common?

Because of numerous studies and results, the short answer is yes. Reports in 2018 conducted by the National Survey On Drug Use & Health, showed that there were approximately 9.2 million7 adults in the United States who had experienced both mental health conditions, along with a mild to a severe substance use disorder.

Dual Diagnosis Treatment Options

Treatment plans for both Depression and drug addiction9 may include intervention, detoxification, inpatient and outpatient rehabilitation, various medications, and different forms of therapy.


The initial hurdle patients run into with dual diagnosis treatment is the detox process. Inpatient detox programs8 are considered more effective because not having the round the clock availability of doctors creates a much safer environment.

Attempting to detox at home instead of a treatment center will only increase the risk of health complications arising. Trained medical staff will supervise the patient for up to seven days and may administer medications to ease the often harsh withdrawal symptoms.

Inpatient Rehab

An individual who is experiencing patterns of addiction while suffering from a mental illness may find the comforts of a qualified inpatient rehab center like A Better Life Recovery7 in Orange County very beneficial. The soothing and calm atmosphere is ideal when receiving care from our treatment professionals.

Outpatient Rehab

Dual diagnosis outpatient programs10 are more flexible than inpatient options. For those individuals participating in an outpatient program, they can expect to spend 30 or more hours per week at our luxurious Orange County rehab treatment facility11.

Joint Commission Accreditation

Today’s behavioral health care environment is changing rapidly, and providers are experiencing even more quality and accountability pressures in the behavioral health care marketplace. The Joint Commission12 is the nation’s leading behavioral health care accrediting body, and they provide a framework to help manage risk and enhance the quality and safety of care, treatment, and services. Essentially, earning accreditation from The Joint Commission is a “gold seal of quality” and a mark of distinction for behavioral health care organizations.