Substance-Induced Mood Disorder

When Alcohol, Drugs or Medications Make You Feel Worse

Sad woman looking out window

EMS-FORSTER-PRODUCTIONS / Getty Images 

Table of Contents
View All
Table of Contents

Substance-induced mood disorder is a kind of mood disorder that is caused by using alcohol, drugs, or medications. Substance/medication-induced mood disorder is the diagnostic name for alcohol or drug-induced depression.

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 Mood Disorder?

The irony of substance-induced depression is that most people take drugs to feel better, yet those same drugs make them feel worse. People sometimes don't realize that it is alcohol, drugs, or medications that are causing the way that they are feeling because they only associate those substances with positive emotions.

Types of Substance-Induced Mood Disorders

There are several specific types of substance-induced mood disorders. In addition to substance/medication-induced depressive disorder, there is also:

  • Substance/medication-induced bipolar or related disorder
  • Substance/medication-induced anxiety disorder
  • Substance/medication-induced obsessive-compulsive or related disorder
  • Substance/ medication-induced psychotic disorder

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.

Signs of Substance-Induced Mood Disorders

Substance- or medication-induced mood disorders cause symptoms that are the same or similar to those of mood conditions such as depression, anxiety, bipolar disorder, OCD, or psychosis.

Substance-induced depressive disorder, for example, can lead to symptoms such as:

  • Low mood
  • Loss of interest in previously enjoyed activities
  • Feelings of helplessness or hopelessness
  • Irritability
  • Low energy and fatigue
  • Changes in sleep patterns
  • Changes in appetite
  • Difficulty concentrating
  • Feelings of guilt or worthlessness
  • Thoughts of death or suicide

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Other symptoms that may occur with other types of substance- and medication-induced mood disorders include mania, psychosis, anxiety, or uncontrollable recurring thoughts.

When Does a Substance-Induced Mood Disorder Start?

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 using on the drug or medication. 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 abstaining from alcohol, drugs, or medication.

Diagnosing Substance-Induced Mood Disorders

To be diagnosed with a substance/medication-induced mood disorder, people must display prominent mood disturbances after substance/medication use or withdrawal. These symptoms lead to significant distress or impair a person's ability to function in important areas of their life.

For the diagnosis of substance/medication-induced depressive disorder to be given, for example, there have to be severe symptoms that are not related to intoxication or withdrawal, which require clinical evaluation.

For instance, there may be a significant change in mood that impacts people’s lives, causing, perhaps, a great deal of distress or impairing some aspect of their life, such as their social life, their employment situation, or another part of their life that is important to them.

Drugs That Cause Substance-Induced Mood Disorders

A wide variety of psychoactive substances can cause substance/medication-induced mood disorders. These include:

  • Alcohol
  • Phencyclidine and other hallucinogens
  • Inhalants
  • Opioids
  • Sedatives
  • Hypnotics
  • Anxiolytics
  • Amphetamines and other stimulants
  • Cocaine

Many medications are known to cause substance-induced depression. The following disorders are recognized:

  • Steroid-induced depressive disorder
  • L-dopa-induced depressive disorder
  • Antibiotic-induced depressive disorder
  • Central nervous system drug-induced depressive disorder
  • Dermatological agent-induced depressive disorder
  • Chemotherapeutic drug-induced depressive disorder
  • Immunological agent-induced depressive disorder

Specific Medications That Can Cause Depression

There are also a number of specific medications that have been implicated in medication-induced depression through surveillance studies, retrospective observational studies, or case reports. Some of these 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)
  • Immunological agents (interferon)

Treatment for Substance/Medication-Induced Mood Disorders

Treatment for substance/medication-induced mood disorders involves stopping the exposure to the substances or medications causing the condition.

However, you should always talk to your doctor before you stop taking a medication. Some substances, such as alcohol or benzodiazepines, can lead to potentially dangerous withdrawal symptoms.

For some substances, your doctor may be able to prescribe medications that can minimize your withdrawal symptoms or reduce drug cravings. Your doctor may also prescribe certain medications to help manage the symptoms you are experiencing, such as antidepressants or antipsychotics.

Psychotherapy can also help treat symptoms of mental disorders and help you stop using the substances that caused your mood disorder. Types of therapy that can be helpful include cognitive-behavioral therapy (CBT), family therapy, or motivational enhancement therapy (MET)

4 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

  2. Dakwar E, Nunes EV, Bisaga A, et al. A comparison of independent depression and substance-induced depression in cannabis-, cocaine-, and opioid-dependent treatment seekers. Am J Addict. 2011;20(5):441-6. doi:10.1111%2Fj.1521-0391.2011.00148.x

  3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, fifth edition, DSM-5. American Psychiatric Association, 2013.

  4. Revadigar N, Gupta V. Substance-induced mood disorders. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Updated October 5, 2020.

Additional Reading
  • American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, fifth edition, DSM-5. American Psychiatric Association, 2013.

By Elizabeth Hartney, BSc, MSc, MA, PhD
Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada.