It might seem natural for someone who is depressed to use cocaine. The stimulant drug counteracts many of the most painful and debilitating symptoms of depression by boosting mood, energy and confidence. However, these effects are short-lived, leaving people stuck in a cycle of repeated use that can quickly progress to addiction.
Even when people who have depression and use cocaine do not develop a substance use disorder, they ultimately worsen their depression. Chronic cocaine use changes brain chemistry in a way that deepens and prolongs dysphoria and makes it harder to feel happy. When people use cocaine to feel better, they prevent themselves from achieving long-term recovery from depression symptoms.
Does Cocaine Make You Depressed?
Many jokes about cocaine in popular culture emphasize the way the drug can make people feel invincible. Unfortunately, fewer people are aware of the lows that inevitably follow these highs. For people who use cocaine, depression after use is common, even when they do not use it on a regular basis.
The reason cocaine and depression have this relationship has to do with how the brain works. As a stimulant, cocaine activates the sympathetic nervous system, which governs the fight-or-flight response. The state of intensified alertness and surging energy triggered by the release of norepinephrine can’t be sustained for long and will be followed by a crash.
Most of the time, this shift isn’t an issue because people feel relieved to have escaped a threat or to have overcome a stressful challenge and enjoy resting afterward. When substances trigger these changes, however, there is nothing to feel relieved about when their effects wear off. The disappointment people feel as the drug rapidly wears off is one of the ways cocaine can cause depression, especially when people experience it repeatedly.
The primary way cocaine causes depression is by directly changing the brain. In addition to norepinephrine, cocaine also increases serotonin and dopamine levels. When the brain is flooded with higher levels of these chemicals than usual, people feel euphoric. Afterward, the brain enters a recovery period during which these now-depleted neurotransmitters return to normal levels. During this phase, people feel worse than they did before.
Many people are familiar with these short-term effects but aren’t sure about the long-term consequences of cocaine use. Does cocaine cause depression that lasts long enough to require treatment? It can, especially if people progress to cocaine dependence and start experiencing cocaine withdrawal symptoms.
Cocaine Withdrawal and Depression
For people who use cocaine, depression the next day can become part of a familiar and worrisome pattern. This post-cocaine depression is more pronounced for people who are dependent on cocaine, compared to people who are not reliant on it.
According to the Diagnostic and Statistical Manual of Mental Disorders, substance dependence involves the presence of three or more of the following symptoms:
- Tolerance, or needing to use more of the substance to achieve the same effect
- Withdrawal symptoms, or unpleasant physical or mental effects that arise after use
- Taking a substance in larger amounts or over a longer period than intended
- Wanting or making unsuccessful efforts to control or reduce substance use
- Spending a significant amount of time obtaining and using a substance and recovering from its effects
- Giving up important social, work-related or recreational activities because of substance use
- Continuing to use a substance despite knowing it causes or exacerbates a psychological problem
In other words, the clinical definition of drug dependence does not require people to have medical withdrawal symptoms. It merely involves people continuing to use the drugs despite adverse outcomes.
While cocaine does not cause physical withdrawal symptoms as alcohol and opiates do, it can cause lasting and recurring psychological withdrawal effects, including:
- Difficulty concentrating
- Increased appetite
One of the most pronounced and typical effects of cocaine withdrawal is depression. This mental illness may arise because long-term cocaine use causes key neurotransmitters to dwindle to chronically low levels, because using cocaine damages cells in the brain’s pleasure center. Cocaine abuse causes brain cells to “eat themselves.” These changes to the brain can cause people to develop chronic depression or have an acute depressive episode.
The good news is that sustained recovery from cocaine dependence allows the brain to heal and recover its previous level of functioning.
Co-Occurring Treatment for Depression and Cocaine Addiction
It can be intimidating to seek treatment for co-occurring disorders. The effects of addiction and untreated depression can make life seem chaotic, overwhelming and even hopeless. People looking for relief can start to feel like there is no way out.
However, the reality is that both disorders can be successfully treated, often with the same interventions. While addiction requires specific treatment, cocaine depression treatment may be no different from regular depression treatment. In some ways, it may even be easier. For many people, elevated depressive symptoms diminish with continued abstinence from cocaine use.
When depression persists after someone stops using cocaine, many different interventions can help. Cognitive behavioral therapy has been proven to be one of the most effective ways to treat a wide range of mental health conditions and to be especially effective for depression. It can be modified to help people address triggers to use substances at the same time they are learning how to challenge and counteract the distorted thinking that maintains depression.
Research shows that selective serotonin reuptake inhibitor (SSRI) antidepressants can not only improve mood and alleviate the cognitive symptoms of depression but also prevent recurrence of use for people with co-occurring depression and cocaine addiction.
For people who need to treat addiction at the same time as a depressive disorder, many rehab facilities offer evidence-based, integrated treatment programs that address mental health conditions while helping people cope with cravings and avoid triggers. This treatment can allow people to experience immediate relief from painful psychological symptoms while facilitating long-term recovery and restoration of neurotransmitter levels.
Key Points: Depression and Cocaine
- Many people who struggle with depression use cocaine for relief.
- Other people develop depressive symptoms as cocaine use progresses to addiction.
- The way cocaine physically changes the brain can make it hard to feel better even when people improve their lives in other ways.
If you think your cocaine use may have progressed to addiction, you can take this quiz to assess your risk of cocaine addiction. If you know you need help immediately, contact a representative from The Recovery Village today to learn more about integrated treatment options for cocaine addiction and depression. Your journey to recovery can begin today.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.