Substance abuse and depression are two of America’s major ongoing public health concerns. About 4% of all US adults have a severe depressive illness called major depression, while the other 6% have depressive illnesses that are less severe but still medically significant. At the same time, roughly 22% of American teens and adults abuse legal or illegal drugs. While many cases of depression occur in people who don’t abuse drugs and vice versa, there are definite connections between these two health issues. Effective treatment for depression can potentially lower an individual’s future risks for drug abuse.
In addition to major depression, forms of depressive illness include dysthymic disorder (dysthymia), minor or mild depression, postpartum depression, and seasonal affective disorder, as well as two conditions-bipolar disorder (manic-depression) and psychotic depression in which depressive symptoms play a major role. Generally speaking, individuals with medically serious depression experience varying degrees of feelings, such as worthlessness, hopelessness, sadness, and helplessness, that trigger a withdrawal from the routines and social interactions that make up the core of most people’s lives. In their most serious forms, these feelings can lead to extreme, debilitating life disruptions and persistent suicidal thoughts or active suicide attempts.
Substance abuse is a term that describes any form of drug use that does not have a clear, medically sanctioned purpose. Usually, people use this term in reference to the misuse of substances that significantly alter normal mood or perception and/or have the ability to produce a drug addiction. In the case of legal prescription drugs, abuse occurs when a person with a prescription increases his or her dosage without a doctor’s approval; when a person without a prescription uses someone else’s prescribed medication; or when drug use occurs in the absence of any kind of prescription. Illegal drugs such as cocaine, methamphetamine, Ecstasy, and heroin have no legitimate medical use; therefore, from both a medical and legal perspective, the use of these substances in any circumstances qualifies as a form of drug abuse.
Depression and drug abuse intersect in several different ways. First of all, a significant amount of substance abuse stems from a desire to escape from the effects of depression symptoms. A person subjected to high levels of social and/or personal stress may also start using drugs during roughly the same time period in which depression symptoms first manifest. People already abusing drugs may develop depression either in response to a drug’s effects on brain chemistry or in response to the sudden absence of a drug (a phenomenon known as withdrawal). Drug use may also lead to depression in combination with serious legal problems, relationship difficulties, or money problems. Drugs specifically associated with the onset of depression symptoms include barbiturates, opioid painkillers, and, to a lesser extent, cocaine, Ecstasy, methamphetamine, and amphetamines.
The teenagers who respond well to major depression treatment have more or less identical risks for future substance abuse as teens who do not respond well to depression treatment. While no one knows for sure why this is the case, the researchers suspect that the overwhelming popularity of substance abuse among young adults may play a key role.