A person’s genetic make-up influences the risk of developing problems with drinking, drug use and depression. These problems can overlap; the link between depression and substance abuse and dependence is strong:

Abusing alcohol or drugs is linked to brain damage, stroke, liver disease, heart disease, digestive problems and cancer. People who use alcohol and drugs are more at risk of car accidents, drowning and falling. They may engage in unsafe sex, which exposes them to illnesses such as HIV/AIDS and herpes. Any alcohol- or drug-related problems can contribute to depression.

Substance abuse also can wreak havoc on your personal life. Relationships become tense. The risk of divorce and domestic violence increases. School or work performance may be poor. Initially, people may turn to alcohol or drugs as an escape from painful emotions. The substances, though, tend to amplify rather than reduce problems.

Depression and substance use/abuse feed each other. No matter which problem comes first, it is important to treat both the depression and the substance problem. (Sometimes substance abuse is a hidden reason why depression treatment fails.)

Treatment often involves a combination of psychotherapy, group support (such as Alcoholics Anonymous) and drug treatment. Your doctor can help to determine whether you have any associated medical problems that need to be treated.