Unlike the transient feelings of sadness that are normal and that everyone experiences, or even the temporary hangover or “crash” that often gets people the morning after alcohol or drug use, when substance-induced depression hits, it feels considerably worse for much longer. For some people, it involves a complete loss of interest or enjoyment in life.
What Is Substance-Induced Depression?
The irony of substance-induced depression is that most people take drugs to feel better, yet those same drugs make them feel worse. When doctors or psychologists give a diagnosis of substance/medication-induced depressive disorder, they check to make sure that the depression wasn’t there before the use of alcohol, drugs, or medications thought to be responsible. This is because there are different types of depressive disorders, and if the symptoms were there before the substance use, it isn’t the substance/medication-induced type of depression.
How Soon After Taking the Drug Can Depression Be Induced?
In some cases, almost immediately. There is even a category “with onset during intoxication,” which means that depressive episode actually begins when the individual is high on the drug. It can also occur during withdrawal, during which symptoms of depression are common. However, with depression which is simply a symptom of withdrawal, the person’s mood will usually pick up within a few days of ceasing to take the drug, while with substance-induced depression, it can start during withdrawal, and continue or get worse as the person moves through the detox process. Generally, the diagnosis isn’t given if the person has a history of depression without substance use, or if the symptoms continue for more than a month after the person becomes abstinent from alcohol, drugs, or medication.
Which Drugs Cause Substance/Medication-Induced Depressive Disorder?
A wide variety of psychoactive substances can cause substance-induced depression. The following disorders are recognized:
Alcohol-induced depressive disorderPhencyclidine-induced depressive disorderOther hallucinogen-induced depressive disorderInhalant-induced depressive disorderOpioid-induced depressive disorderSedative-induced depressive disorderHypnotic-induced depressive disorderAnxiolytic-induced depressive disorderAmphetamine-induced depressive disorderOther stimulant-induced depressive disorderCocaine-induced depressive disorderOther substance-induced depressive disorderUnknown substance-induced depressive disorder
Many medications are known to cause substance-induced depression. The following disorders are recognized:
Steroid-induced depressive disorderL-dopa-induced depressive disorderAntibiotic-induced depressive disorderCentral nervous system drug-induced depressive disorderDermatological agent-induced depressive disorderChemotherapeutic drug-induced depressive disorderImmunological agent-induced depressive disorder
Specific medications that have been implicated in medication-induced depression through surveillance studies, retrospective observational studies, or case reports, which are prone to difficulty in determining the actual cause, include antiviral agents (such as efavirenz), cardiovascular agents (such as clonidine, guanethidine, methyldopa, reserpine), retinoic acid derivatives (such as isotretinoin), antidepressants, anticonvulsants, anti-migraine agents (triptans), antipsychotics, hormonal agents (corticosteroids, oral contraceptives, gonadotropin-releasing hormone agonists, tamoxifen), smoking cessation agents (varenicline), and immunological agents (interferon).
