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A mood disorder can be classified as substance-induced if its etiology can be traced to the direct physiologic effects of a psychoactive drug or other chemical substance, or if the development of the mood disorder occurred contemporaneously with substance intoxication or withdrawal. Also, an individual may have a mood disorder coexisting with a substance abuse disorder. Substance-induced mood disorders can have features of a manic, hypomanic, mixed, or depressive episode. Most substances can induce a variety of mood disorders. For example, stimulants such as amphetamine, methamphetamine, and cocaine can cause manic, hypomanic, mixed, and depressive episodes.

Alcohol-induced mood disorders Edit

High rates of major depressive disorder occur in heavy drinkers and those with alcoholism. Controversy has previously surrounded whether those who abused alcohol and developed depression were self-medicating their pre-existing depression. But recent research has concluded that, while this may be true in some cases, alcohol misuse directly causes the development of depression in a significant number of heavy drinkers. Participants studied were also assessed during stressful events in their lives and measured on a Feeling Bad Scale. Likewise, they were also assessed on their affiliation with deviant peers, unemployment, and their partner’s substance use and criminal offending. [1][2][3] High rates of suicide also occur in those who have alcohol-related problems.[4] It is usually possible to differentiate between alcohol-related depression and depression that is not related to alcohol intake by taking a careful history of the patient.[3][5][6] Depression and other mental health problems associated with alcohol misuse may be due to distortion of brain chemistry, as they tend to improve on their own after a period of abstinence.[7]

Benzodiazepine-induced mood disorders Edit

The long-term use of benzodiazepines, such as Valium and Librium, may have a similar effect on the brain as alcohol, and are also implicated in depression.[8] Major depressive disorder can also develop as a result of chronic use of benzodiazepines or as part of a protracted withdrawal syndrome. Benzodiazepines are a class of medication commonly used to treat insomnia, anxiety, and muscular spasms. As with alcohol, the effects of benzodiazepine on neurochemistry, such as decreased levels of serotonin and norepinephrine, are believed to be responsible for the increased depression.[9][10][11][12] Major depressive disorder may also occur as part of the benzodiazepine withdrawal syndrome.[13] In a long-term follow-up study of patients dependent on benzodiazepines, it was found that 10 people (20%) had taken drug overdoses while on chronic benzodiazepine medication despite only two people ever having had any pre-existing depressive disorder. A year after a gradual withdrawal program, no patients had taken any further overdoses.[14] Depression resulting from withdrawal from benzodiazepines usually subsides after a few months but in some cases may persist for 6–12 months.[15][16]

See alsoEdit


  1. Fergusson DM, Boden JM, Horwood LJ (March 2009). Tests of causal links between alcohol abuse or dependence and major depression. Arch. Gen. Psychiatry 66 (3): 260–6.
  2. Falk DE, Yi HY, Hilton ME (April 2008). Age of Onset and Temporal Sequencing of Lifetime DSM-IV Alcohol Use Disorders Relative to Comorbid Mood and Anxiety Disorders. Drug Alcohol Depend 94 (1–3): 234–45.
  3. 3.0 3.1 Schuckit MA, Smith TL, Danko GP, et al (November 2007). A comparison of factors associated with substance-induced versus independent depressions. J Stud Alcohol Drugs 68 (6): 805–12.
  4. Chignon JM, Cortes MJ, Martin P, Chabannes JP (1998). [Attempted suicide and alcohol dependence: results of an epidemiologic survey]. Encephale 24 (4): 347–54.
  5. Schuckit MA, Tipp JE, Bergman M, Reich W, Hesselbrock VM, Smith TL (July 1997). Comparison of induced and independent major depressive disorders in 2,945 alcoholics. Am J Psychiatry 154 (7): 948–57.
  6. Schuckit MA, Tipp JE, Bucholz KK, et al (October 1997). The life-time rates of three major mood disorders and four major anxiety disorders in alcoholics and controls. Addiction 92 (10): 1289–304.
  7. Wetterling T, Junghanns K (December 2000). Psychopathology of alcoholics during withdrawal and early abstinence. Eur Psychiatry 15 (8): 483–8.
  8. Semple, David; Roger Smyth, Jonathan Burns, Rajan Darjee, Andrew McIntosh [2005] (2007). "13" Oxford Handbook of Psychiatry, United Kingdom: Oxford University Press.
  9. (2003) "4" Oxford Handbook of Clinical Specialties, 6, Oxford University Press.
  10. Professor Heather Ashton (2002). Benzodiazepines: How They Work and How to Withdraw.
  11. Lydiard RB, Laraia MT, Ballenger JC, Howell EF (May 1987). Emergence of depressive symptoms in patients receiving alprazolam for panic disorder. Am J Psychiatry 144 (5): 664–5.
  12. Nathan RG, Robinson D, Cherek DR, Davison S, Sebastian S, Hack M (1 January 1985). Long-term benzodiazepine use and depression. Am J Psychiatry 142 (1): 144–5.
  13. Lader M (1994). Anxiety or depression during withdrawal of hypnotic treatments. J Psychosom Res 38 (Suppl 1): 113–23; discussion 118–23.
  14. Professor C Heather Ashton (1987). Benzodiazepine Withdrawal: Outcome in 50 Patients. British Journal of Addiction 82: 655–671.
  15. Ashton CH (March 1995). Protracted Withdrawal From Benzodiazepines: The Post-Withdrawal Syndrome. Psychiatric Annals 25 (3): 174–179.
  16. Professor Heather Ashton (2004). Protracted Withdrawal Symptoms From Benzodiazepines. Comprehensive Handbook of Drug & Alcohol Addiction.

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