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Depression, Anger, and Addiction: The Role of Emotions in Recovery and Treatment

Negative and positive emotions have an impact on the way you act and feel, which means that depression and anger can affect the choices you make and the behaviors you engage in.

Depression, anger, and addiction are issues that are closely related. According to the National Institute on Drug Abuse, people with substance abuse disorders often have co-occurring mental health issues, and vice versa.1 If you or someone you care about is affected by mental health issues and substance abuse, know that addiction treatment can help overcome substance abuse and improve your overall mental health.

How Do Emotions Affect Addiction?

When you feel happy, you are more likely to feel positive and make healthier or more constructive choices, whereas if you feel negative, you may be more inclined to engage in negative behaviors and make poorer choices. People who experience mental wellness can cope with stress and make better decisions, whereas mental illness or poor mental health can lead to problems with thinking, mood, and behavior.2

Poor mental health and addiction are mutually reinforcing—that is to say, when you feel bad, you may feel more inclined to abuse substances. Research has shown that emotional dysregulation (meaning an inability to control your responses to stimuli) can be not only a risk factor for addiction, alcoholism, and depression, but can also cause increased emotional problems; in addition, long-term drug use can impair your ability to deal with intense emotions and cause further emotional dysregulation.3

Research has also shown that alcohol, drugs, and mental health disorders are strongly intertwined; disorders and behaviors such as depression, aggressiveness, and anger are correlated with a higher likelihood of substance abuse and alcohol abuse.4 A recent study found that alcohol and depression are closely linked, with sadness being a strong predictor of addiction.5

Depression and Addiction

How depression and effect addiction.

Everyone feels blue or down from time to time, but that doesn’t necessarily mean that they have depression. Depression is a serious mental health condition that requires medical care because it can worsen if left untreated.6

Depression occurs when you experience obvious negative changes in mood, thought processes, and motivation that last for at least two weeks and affect your ability to function.7 There are different types of depressive disorders, including major depression, postpartum depression, bipolar disorder, and seasonal affective disorder.8

Major depressive disorder is a clinical disorder that involves experiencing symptoms of depressed mood and loss of interest for at least 2 weeks.9 The signs and symptoms of depression include:8

  • Appetite and sleep changes.
  • Fatigue or low energy.
  • Feeling chronically sad, empty, or anxious.
  • Feeling guilty, worthless, or helpless.
  • Feeling hopeless or pessimistic.
  • Feelings of restlessness.
  • Having trouble concentrating or remembering things.
  • Irritability.
  • Loss of interest in activities you once enjoyed.
  • Thoughts of suicide or self-harm.
  • Unexplained aches and pains.

Depression and substance abuse or alcoholism often co-occur, but the exact biological reasons for this are not entirely clear.10 People make choices for different reasons, so the reasons why one person becomes addicted and another doesn’t can vary. Regardless, studies confirm the link between substance abuse and depression; furthermore, depressed people may be more inclined to abuse alcohol.10 Depression symptoms may subside when people stop drinking, but finding the motivation to enter treatment can be difficult.11 

Different types of depression may lead to an increased risk of substance abuse, although clinical studies have demonstrated mixed results.9 In particular, people with major depression are twice as likely to have a substance abuse disorder than people without a mood disorder, and people with bipolar disorder are 7 times more likely to suffer from addiction.9 One study of lifetime prevalence rates showed that, among people who were diagnosed with a mood disorder, 32% had a co-occurring substance use disorder (SUD). Among those who had major depression, 16.5% had an alcohol use disorder and 18% had a drug use disorder; out of those who had bipolar disorder, 56% had a lifetime SUD.9

In addition to underlying genetic factors, depression and addiction may be so closely related because many people self-medicate with drugs or alcohol as a way of managing their depressive symptoms.9 However, instead of making things better, it often only exacerbates the issue, and depression and alcohol use can both spiral out of control.9

Someone who experiences depression and addiction will display symptoms of depression as well as addiction, the combination of which is known as a co-occurring disorder. Additionally, people with co-occurring disorders are at higher risk of suicide attempts.11 Luckily, symptoms of depression and symptoms of addiction can both be effectively addressed in rehab.12

Anger and Addiction

How anger and negative emotions can effect addiction.

Anger is a human emotion that can occur in response to discomfort and is seen as a predictor of aggressive behavior. People with high levels of aggression often display more verbal and physical aggression toward other people and may have higher risks of mental illness.13

Different types of anger can affect you in different ways and cause various signs and symptoms. Some clinicians believe that there are 3 main types of anger which include:14

  • Passive aggression, which means you feel angry but act out your anger in passive ways because you fear confrontation, such as giving people the silent treatment or saying everything is fine when it’s not.
  • Open aggression, which stems from a need to feel in control. In this form of anger, you may lash out because of feelings of rage and become physically or verbally violent and aggressive. You might engage in bullying, yelling, blackmailing, or criticize others.
  • Assertive anger, which is thought to be the healthiest form of anger. You act maturely and respectfully toward others, talk about your feelings, and listen to others instead of acting out.

Anger and substance abuse are strongly correlated. One study of incarcerated adolescents showed that outwardly expressed anger was significantly related to marijuana and alcohol use.15 Another study showed that 40% of cocaine users suffered from different levels of aggression.13

Integrated Treatment and Addiction

Integrated treatment is an effective form of treatment to deal with addiction and co-occurring disorders; meaning mental illnesses, such as depression, schizophrenia, or bipolar disorder, that occur alongside drug or alcohol addiction.

Integrated treatment involves components of cognitive-behavioral therapy (CBT) to help improve interpersonal and coping skills, medication to help treat the addiction and mental health issues with the collaborative efforts of mental health.16

During treatment, you can expect to receive comprehensive medical and psychological care to address your mental and physical health needs. You may participate in a variety of behavioral therapies, including:17

  • Cognitive behavioral therapy, which aims to change harmful beliefs and dysfunctional behaviors.
  • Dialectical behavior therapy, which is designed to reduce self-harming behaviors, such as cutting or other suicidal behavior, and drug use.
  •  Assertive community treatment, which is a form of community-based mental health care designed to address severe mental illness, such as schizophrenia or bipolar disorder, and substance abuse.
  • Contingency management or motivational incentives, which are adjunct forms of treatment that involve providing rewards for positive behaviors.

Addiction Treatment at AAC

American Addiction Centers (AAC), the leading provider of addiction treatment nationwide, specializes in evidence-based treatment and mental health care. AAC can help you overcome anger, depression, and addiction.

Our facilities provide comprehensive care for mental illnesses and substance use disorders through medication and other forms of therapy. We are one of just a few treatment centers that evaluate outcomes and share the results publicly.

Learning more about treatment programs and AAC facilities by giving us a call today at .

If you or someone you care about have a co-occurring disorder, know that help is available. By engaging in a professional treatment program, you can begin the path to happier, healthier, and sober living and learn improved coping skills so you can live a drug- and alcohol-free life.


  1. National Institute on Drug Abuse. (2020). Common comorbidities with substance use disorders: Part 1: The connection between substance use disorders and mental illness.
  2. (2019). What is mental health?
  3. Kober, H. (2014). Emotion regulation in substance use disorders. In J. J. Gross (Ed.), Handbook of emotion regulation (p. 428–446). New York: Guilford Press.
  4. Dorison, C., Wang, K., Rees, V., Kawachi, I., Ericson, K. & Lerner, J. (2020). Sadness, but not all negative emotions, heightens addictive substance use. Proceedings of the National Academy of Sciences of the United States of America, 117(2), 943-949.
  5. Coccaro, E., Fridberg, D., Fanning, J., Grant, J., King, A. & Lee, R. (2016). Substance use disorders: Relationship with intermittent explosive disorder and with aggression, anger, and impulsivityJournal of Psychiatric Research, 81: 127-32.
  6. National Alliance on Mental Illness: California. Directory: Types of mental illness.
  7. National Alliance on Mental Illness. Mental health conditions.
  8. National Institute of Mental Health. (2018). Depression.
  9. Quello, S. B., Brady, K. T., & Sonne, S. C. (2005). Mood disorders and substance use disorder: a complex comorbidityScience & Practice Perspectives3(1), 13–21.
  10. Rappeneau, V. & Bérod, A. (2017). Reconsidering depression as a risk factor for substance use disorder: Insights from rodent models. Neuroscience & Biobehavioral Reviews, 77:303?316.
  11. Tanguay, R. L., Lamba, W., Fraser, R., Mills, P., Azarbar, A., & El-Guebaly, N. (2017). Alcohol use disorder and depression: proposed rewording of Choosing Wisely recommendationCMAJ : Canadian Medical Association journal = Journal de l’Association Medicale Canadienne189(11), E442–E443.
  12. McHugh, R., Sugarman, D., Meyer, L., Fitzmaurice, G. & Greenfield, S. (2020). The relationship between perceived stress and depression in substance use disorder treatmentDrug and Alcohol Dependence. 207:107819.
  13. Zarshenas, L., Baneshi, M., Sharif, F. & Sarani, E. (2017). Anger management in substance abuse based on cognitive behavioral therapy: an interventional studyBMC Psychiatry 17, 375.
  14. Your Life Counts. Dealing with Anger: Types of Anger.
  15. Eftekhari, A., Turner, A. & Larimer, M. (2004). Anger expression, coping, and substance use in adolescent offendersAddictive Behaviors 29(5), 1001?1008.
  16. National Institute on Drug Abuse. (2020). Common comorbidities with substance use disorders » What are the treatments for comorbid substance use disorder and mental health conditions?
  17. Baharvand, P., & Malekshahi, F. (2019). Relationship between anger and drug addiction potential as factors affecting the health of medical studentsJournal of Education and Health Promotion, 8, 157.


Last Updated on June 18, 2021
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