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Substance/Medication-Induced Depressive Disorder

Rashmi Nemade, Ph.D., edited by Kathryn Patricelli, MA

The use and abuse of certain medications, drugs of abuse and/or alcohol can lead to classic symptoms of major depressive disorder. However, a depressed mood or sense of hopelessness can also lead to a cycle of substance use. Often, people who feel down use drugs or alcohol in order to try to make their pain go away. This is often referred to as self-medicating. However, this often leads to a person continuing to use the drugs or alcohol and can even lead to addiction. This drug use can then make the person's moods and self-esteem even lower.

Depressive symptoms can occur during the use of alcohol or drugs or after stopping the use (during the withdrawal period). This may include amphetamines (stimulating drugs such as cocaine), hallucinogens (drugs that affect thoughts, feelings and senses, such as LSD), sedatives/hypnotics/anxiolytics (calming drugs used to treat anxiety such as Valium or Xanax), opioids used for pain, or other unknown substances. Sometimes, depression is caused by medications that are being used to treat or control other medical conditions. This might include pain, stomach cramps, seizures, high blood pressure, Parkinson's disease, ulcers, and heart disease. It can also be caused by steroids, antidepressants, oral contraceptives (birth control pills), and antipsychotics (used to treat psychotic symptoms such as hallucinations and delusions). In addition, heavy metals and toxins such as gasoline, paint, insecticides, nerve gases, carbon monoxide and carbon dioxide may also cause depressive symptoms.

This diagnosis is used when:

    • depressive symptoms appear during or within one month after using the substance
    • when the symptoms cannot be better explained by another depressive disorder.
    • there is patient history, physical exam, or lab findings that confirm substance use, abuse, intoxication, or withdrawal prior to the start of the depressive symptoms.

Once the substance is stopped, depressive symptoms typically disappear within days to several weeks depending on how long the substance is expected to stay in the bloodstream. If the depression lasts longer than four weeks, it is time to look for other causes of symptoms.

Risks for developing this condition are higher among those who have a history of major depressive disorder, drug-induced depression, or a history of substance use/abuse.

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