Dual Diagnosis Treatment: Depression and Substance Use Disorder
Depression is a mood disorder that commonly co-occurs with substance use disorder. There is often a vicious cycle in depressive disorders and substance abuse disorders in which they intensify the effects of each other. Depression can increase the risk of suicidal thoughts and suicidal ideation. Dual diagnosis treatment is the best way to address and manage both disorders.
What is Depression?
Depression is a mood disorder that causes a persistent feeling of sadness or loss of interest.
When you’re depressed, life doesn’t have the same zing, energy, and hope you usually enjoy. Depression is influenced by a disturbance in serotonin activity levels in your central nervous system. Serotonin is responsible for feelings of happiness and well-being.
Sadness is a defining characteristic of most depressive cases, but you might also feel empty or irritable. Unfortunately, due to societal stigma, up to 60% of people who suffer from depression do not seek treatment. Depression can also increase your risk for suicidal thoughts and ideations.
Some different kinds of depressive disorders include:
- Disruptive mood dysregulation disorder (children/adolescent irritability)
- Major depressive disorder (Severe depression)
- Persistent depressive disorder (Moderate depression)
- Premenstrual dysphoric disorder (Severe mood swings during a woman’s cycle)
- Depressive disorder due to another medical condition
Many sufferers attempt to blunt the experience of depression with substance abuse. Alcoholism is often a co-occurring disorder and can exacerbate the negative feelings which lead to depression in the first place.
Common Symptoms of Depression
To be clinically diagnosed as “depressed,” an official diagnosis must be made according to the criteria included in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). 5 out of 9 criteria must be present daily (“depressed mood” or “interest/pleasure reduction” is mandatory) for two consecutive weeks:
- Inconsistent sleep
- Loss of interest or pleasure in formerly satisfying activities
- Non-specific worthiness or guilt
- Lack of maintaining focus
- Dietary disruptions
- Changes in the way you talk, walk or move
- Thoughts of suicide
- Persistent negative mood
In the United States, over 15 million physician office visits were conducted in 2019 in which various depressive disorders were the primary diagnosis. In all physician visits, 11% of them listed depression on the medical record. Out of the 1 billion total physician visits in 2019, approximately 110 million of them reported the presence of depression.
For comparison, in 2021, all opioid-related deaths accounted for about 80,000 deaths. That means there are half (50%) as many deaths attributed to depression as there are deaths attributed to the entirety of opioids.
Depression and Substance Abuse
Depression and substance abuse often co-occur. Depression symptoms can lead to substance abuse and vice versa. The experience of depression can lead sufferers to self-medicate with substances like alcohol or other drugs.
Depression and drug addiction can create a vicious cycle. Oftentimes alcohol is abused by depressive disorder sufferers due to its central nervous system (CNS) depressant effects. Unfortunately, the euphoria from drinking is a fleeting sensation.
Despite the initial dopamine surge you get from drinking, your body will still feel the lack of serotonin needed to stay happy. The best way to address depression is with holistic, medical, and mental health treatment that addresses both substance or alcohol use and depressive disorders.
Dual Diagnosis: Depression and Substance Abuse
One helpful treatment for co-occurring disorders like depression and substance abuse is Dual Diagnosis treatment. A dual diagnosis treatment program identifies each disorder and then applies unique interventions for each.
Co-occurring disorders tend to intensify the effects of the other, leading to a vicious cycle that is hard to escape. Dual diagnosis programs will address each disorder as a separate diagnosis that needs its own individualized treatment plan.
Common dual diagnosis treatments for depression and substance use disorder may include:
- Cognitive behavioral therapy
- ACT Therapy
- EMDR Therapy
- Family Therapy
Also, levels of care in which treatment for co-occurring substance use disorder and depression occurs may include:
- Partial Hospitalization Program
- Intensive Outpatient Program
- Outpatient Care
Cost of Dual Diagnosis Treatment for Depression
The cost of dual diagnosis treatment for depression and substance abuse can depend on a number of factors. Your needs, history, and desired lifestyle during treatment play a big part in what the cost will be.
The higher level of care you need, the longer your treatment may be and the more it will cost. The length of stay, intensity of care, and different kinds of therapies chosen will all play a part in determining the cost.
It’s possible that insurance may cover some or all of your treatment. For a customized cost evaluation, call now.
Frequently Asked Questions about Depression
If someone you know or love is struggling with drug addiction and depression, urge them to seek professional help immediately. What they need is a team of medical professionals who are trained in treating co-occurring disorders like depression and drug addiction.
Drugs do not CAUSE depression, per se. There are many “causes” for depression, which cannot be pinned down to a single factor. Rather, it can be safely said that many people who engage in substance abuse also experience depressive symptoms. Even an indirect relationship between depression and substance abuse should be enough to make you reconsider taking drugs while you are depressed.
There are many different kinds of treatments for depression. Pharmacotherapeutic medications like SSRIs are perhaps the most common treatment. These boost your body’s serotonin levels. Psychotherapies like Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) are also effective:
- CBT is a talk-based therapy that involves identifying negative thoughts and replacing them with realistic, objective ones.
- IPT is a time-limited treatment that centers around grief, interpersonal disputes, role transitions, and interpersonal deficits.
For patients who do not respond to pharmacotherapy, there is another proven option: Electroconvulsive Therapy (ECT).
Under the direction of a team of trained medical professionals, ECT sends an electric current through your brain, which simulates a small seizure. Rarely a first-line treatment, ECT has been shown to be highly effective in alleviating major depressive symptoms.
Are you or a loved one struggling with depression?
 Depression – statpearls – NCBI bookshelf. (n.d.). https://www.ncbi.nlm.nih.gov/books/NBK430847/
 U.S. Department of Health and Human Services. (n.d.). Depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/depression
 Centers for Disease Control and Prevention. (2023, May 17). FastStats – depression. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/fastats/depression.htm