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Can Cocaine Use Cause Depression?

Written by Jonathan Strum

& Medically Reviewed by Dr. Jessica Pyhtila, PharmD

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Last Updated - 8/15/2022

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Updated 08/15/2020

Doctors are still debating the reasons behind why depression often occurs in people who use cocaine.

Cocaine is strongly linked to depression. One study shows that nearly half of people who struggle with cocaine use and mental health issues are depressed. Doctors have debated whether the drug itself causes depression or if people with depression are more likely to use it.

Other doctors have pointed out that a cocaine use disorder itself can cause depression, due to the stress of living with an addiction. Although the debate is ongoing, evidence shows that people who struggle with cocaine are more likely to be depressed.

Depressive Effects of Cocaine

Although cocaine is a stimulant that can cause euphoria, the drug is also linked to depressive symptoms. One study showed that people who struggled with cocaine use were more likely to be depressed after using it, as opposed to being depressed before use.

Doctors are not completely sure why this happens. One explanation may be that cocaine overstimulates the brain’s pleasure center, leading to eventual depression. Doctors have also noticed that certain areas in the brain are involved in both cocaine addiction and depression. These include the limbic system and the nucleus accumbens.

Effect on Neurotransmitters

Cocaine causes euphoria by creating an excess of dopamine, the brain’s “feel-good” chemical. Cocaine also increases levels of the brain chemical serotonin, which is involved in depression. Doctors have found that chronic cocaine use may prevent cells in the brain from using dopamine as well as they should. Doctors think this may cause some symptoms of depression, such as the loss of pleasure.

These changes to how the brain uses dopamine may be permanent. However, researchers are studying chemicals in the brain to find new therapies that treat both cocaine addiction and depression.

Cocaine Comedown

Cocaine causes a rush of feel-good brain chemicals, including:

  • Norepinephrine: causes energy
  • Dopamine: causes euphoria
  • Serotonin: causes confidence

During chronic cocaine use, the brain adapts to having extra amounts of these chemicals. If cocaine use suddenly stops and the increased chemical levels are no longer available, withdrawal symptoms begin. These symptoms often include depression.

Depression During Cocaine Withdrawal

Depression is a common side effect of cocaine withdrawal and often lasts for several days. In severe cases, however, it can last for months. It is especially common in people who have more extreme highs on cocaine, and it may also be more common in women than men. In addition to depression, other symptoms like exhaustion and sleep often occur.

Cocaine Dependence

Some people with depression may begin to take cocaine to self-treat their symptoms. If they stop taking cocaine, the symptoms may recur. Because of changes to brain chemistry from cocaine, the recurring depression symptoms may also be worse than before.

Dual Diagnosis Treatment

In dual diagnosis treatment, substance use disorders and mental health issues are treated at the same time. Treating both cocaine addiction and depression simultaneously is important. People with depression who are in treatment for cocaine use tend to have more cravings than those who are not depressed. Further, they have a higher risk of relapse. Because of this, addressing depression as well as cocaine use is important to rehab success. Fortunately, therapy has been shown to help the depressive symptoms of people who struggle with cocaine.

If you struggle with cocaine use and depression, The Recovery Village Palm Beach at Baptist Health is here to help. Contact us today to learn more about treatment programs that can help you recover from a substance use disorder and co-occurring mental health condition.

View Sources

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Conner, Kenneth; et al “Meta-analysis of Depression and Substance Use and Impairment Among Cocaine Users.” Drug and Alcohol Dependence, November 1, 2008. Accessed October 6, 2019.

Lister, Jamey; et al. “Causal Pathways Between Impulsiveness, Cocaine Use Consequences, and Depression.” Addictive Behaviors, February 2015. Accessed October 6, 2019.

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Creed, Meaghan; et al. “Convergence of Reinforcing and Anhedonic Cocaine Effects in the Ventral Pallidum.” Neuron, October 2016. Accessed October 6, 2019.

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