Substance-Induced Mood Disorder

When Alcohol, Drugs or Medications Make You Feel Worse

Sad woman looking out window


Substance-induced mood disorder is a kind of depression that is caused by using alcohol, drugs, or medications. Substance/medication-induced depressive 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 Depression?

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.

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.

For the diagnosis of Substance/Medication-Induced Depressive Disorder to be given, 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.

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 disorder
  • Phencyclidine-induced depressive disorder
  • Other hallucinogen-induced depressive disorder
  • Inhalant-induced depressive disorder
  • Opioid-induced depressive disorder
  • Sedative-induced depressive disorder
  • Hypnotic-induced depressive disorder
  • Anxiolytic-induced depressive disorder
  • Amphetamine-induced depressive disorder
  • Other stimulant-induced depressive disorder
  • Cocaine-induced depressive disorder
  • Other substance-induced depressive disorder
  • Unknown substance-induced depressive disorder

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 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).

3 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. 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

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

  3. 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.