Depression and addiction · Tarzana, CA
Depression and addiction treatment in Los Angeles, when both arrive together.
When depression and addiction arrive together, care has to cover both. At Lumora in Tarzana, depression that comes with substance use is assessed alongside it, and the assessment decides whether a small, private residential setting fits.
Depression and Addiction
Depression and addiction often occur together, and each can make the other worse. Alcohol or drugs may numb low mood for a while, then deepen it. Federal health agencies say both should be assessed and treated at the same time. If someone is thinking about suicide, call or text 988; in immediate danger, call 911.
How depression and addiction feed each other
Depression and addiction feed each other in both directions. People with a mental disorder may use substances to cope, and some mental disorders change the brain in ways that make substances feel more rewarding. The reverse is also true: substance use can bring on brain changes that raise the risk of other mental disorders.
A drink can seem to lift a heavy mood for an evening, but alcohol ultimately makes the problem worse, and sadness, worry and irritability climb during cycles of drinking, withdrawal and craving. The two conditions also share roots, including genes and trauma. Untreated, NIAAA says, the pattern can lead to more returns to drinking, more severe symptoms, more hospital stays and a higher rate of suicide.
At a glance
- Approach
- Both at once Mood and substance use assessed together
- Watch for
- Two weeks Low mood most days, the NIMH threshold
- Crisis
- 988 Call or text at any hour; emergency 911
- Admissions
- 24 hours (818) 422-7772
Which came first
Is it depression, or is it the alcohol or drugs?
It can be either, or both, and the answer usually comes from a timeline rather than a single conversation. Clinicians look at whether low mood is present during long periods without alcohol or drugs.
Mood symptoms caused by a substance tend to ease as the body clears it. A depressive disorder of its own continues through stretches of abstinence, and sometimes began before the drinking or drug use did. Clinicians are advised to ask when mood symptoms started, how long the longest period without drinking has lasted, and how mood behaved during it.
The distinction matters for the plan, not for blame. Either way, treatment is most likely to succeed when both the substance use and the mood are addressed. Families can help a great deal by writing down what they have seen, because a clear history makes the assessment sharper.
Signs
What does depression look like in someone who drinks or uses drugs?
Depression in someone who drinks or uses drugs looks much as it does in anyone else, though the substance can hide it. The core sign is a persistent sad, anxious or empty mood, together with other changes, lasting most of the day, nearly every day, for at least two weeks.
Other common signs are hopelessness, guilt or feelings of worthlessness, losing interest in things that used to matter, fatigue, trouble concentrating or deciding, sleeping too little or too much, changes in appetite, aches without a clear cause, and thoughts of death or suicide. Depression can also show as anger, recklessness, withdrawing from family and friends, and, notably, using alcohol or drugs more often.
That last sign is why the two are so easy to confuse. A family may see only the drinking, when the drinking is partly a response to the mood. Or they may see a flat, tearful person and not know about the drinking or pills behind it.
When the low is part of withdrawal
Some low mood belongs to the withdrawal period itself and is expected to ease. Sometimes it lasts much longer, and sometimes it carries real danger. The substance makes a difference.
Suicide risk
Why is suicide risk higher when depression and addiction occur together?
Suicide risk is higher because depression and substance use are each a risk factor on their own, and together they can make each other more severe. The CDC lists both a history of depression and substance use among the individual risk factors for suicide.
Long-term drinking on top of depressive symptoms is linked with longer mood episodes and a higher risk of suicide, and suicide is a concern for many people who drink heavily even without a diagnosed alcohol problem. The CDC’s list also includes a previous suicide attempt, a sense of hopelessness, and job or financial problems or loss, and MedlinePlus notes that cocaine withdrawal can bring suicidal thoughts in some people.
NIMH lists warning signs that can mean someone is thinking about suicide. Get help quickly if any of them are new or getting worse:
- Talking about wanting to die, great guilt or shame, or being a burden to others.
- Feeling empty, hopeless, trapped or without a reason to live; extremely sad, anxious, agitated or full of rage; or in unbearable pain.
- Doing things such as making a plan, saying goodbye, giving away important things, taking dangerous risks, swinging between moods, or using drugs or alcohol more often.
Treatment
What can treatment for depression and addiction involve?
Treatment for depression and addiction can involve talk therapy, medicines, care coordination, or a combination, chosen for the person. Behavioral therapies used for co-occurring conditions include cognitive behavioral therapy, contingency management and motivational interviewing.
In practical terms, an integrated plan can mean cognitive behavioral therapy (CBT) aimed at the drinking and at the depression, with skills for both taught in the same sessions or in alternating ones. One meta-analysis found small but clinically significant drops in both depressive symptoms and drinking when CBT and motivational interviewing were combined, compared with usual care.
Where medicine fits
Medicines can treat addiction to opioids and alcohol and can ease the symptoms of many mental disorders; medicines for opioid use disorder during a residential stay are explained separately. Pairing an antidepressant with a medicine for alcohol use disorder can treat both conditions, and clinicians need not wait for sobriety to start an antidepressant when there is evidence of need. NIAAA advises against as-needed benzodiazepines for anxiety, mood instability or sleep in people with alcohol use disorder, because of their potential for misuse and overdose; see when a sedative prescription becomes part of the problem. Any choice of medicine is made by a prescriber for that person, with interactions checked. A residential stay is one stage; how therapy and psychiatry continue afterward belongs in the plan for mood and recovery support after discharge.
When a hospital comes first
Severe depression can become life-threatening, NIMH notes, for example when someone has stopped eating or drinking or is at high risk of suicide, and some depression comes with psychosis. Lumora is not a psychiatric hospital. When the risk is acute, the first call is 911 or 988 and hospital care comes first; residential substance use treatment can follow once the person is stable.
At Lumora
Depression and addiction in Los Angeles: where Lumora fits
Lumora is a small, private house on a quiet street in Tarzana, in the San Fernando Valley, where co-occurring mental health conditions are assessed alongside substance use.
The assessment covers mood as well as every substance being used, and it decides whether a residential setting is the right fit. When withdrawal has to come first, detox happens in the same house and leads into residential treatment without a transfer; how detox at Lumora leads into treatment explains that stage, and what a residential stay in the house involves covers the next. On the harder days there is the wellness room with its living green wall, or the covered gazebo in the garden.
Depression rarely arrives with only one substance. Our pages on treatment for alcohol use disorder once withdrawal is over and cocaine treatment and the evidence behind it go deeper on those drugs. Low mood also often travels with worry and with old trauma; see anxiety alongside drinking or drug use and trauma and PTSD alongside substance use, and the wider picture on the dual diagnosis overview.
If another setting would serve the person better, admissions will tell you plainly, and can talk through whether residential or outpatient care suits the situation. You can also read about the people and the house behind Lumora. Start with a confidential call about mood and substance use.
What to do
What should you do if someone may be thinking about suicide?
If someone may be thinking about suicide, ask them directly, stay with them, make dangerous things harder to reach, and connect them with 988. These are NIMH’s five action steps.
Ask
“Are you thinking about suicide?” NIMH says asking does not increase suicidal thoughts.
Be there
Listen without judgment. Talking about it may reduce suicidal thoughts.
Keep them safe
Ask if they have a plan, and make highly lethal items or places harder to reach.
Help them connect
Call or text 988 together, and reach a trusted relative, friend or clinician.
Follow up
Keep in touch after the crisis and after any discharge from care.
If they have already taken something, have hurt themselves, or you cannot keep them safe, call 911 now and do not leave them alone. For the wider work of persuading someone to accept help, see how families can help when low mood and drinking or drugs come together.
Safety first
Thoughts of suicide, with drinking or drugs involved: call or text 988.
If you or someone you love is thinking about suicide, call or text 988 to reach the Suicide and Crisis Lifeline at any hour, or chat at 988lifeline.org. Stay with the person. Call 911 if they are in immediate danger, have taken an overdose or have harmed themselves.
Go deeper
The detail, if you want it
What will the assessment ask about mood and substance use?
The assessment will ask about the order of events: when the low mood began, when the drinking or drug use began, and how each behaved while the other changed. They are the questions used to tell the two apart, with notes on what a family can bring.
| The question | Why clinicians ask it | What a family can note beforehand |
|---|---|---|
| When did the low mood start, and when did the drinking or drug use start? | Mood problems that came first may be a depressive disorder of their own; mood that followed heavy use may be driven by the substance. | Rough ages or years for each, even if they are estimates. |
| What was the longest stretch without alcohol or drugs? | A long period off the substance shows how mood behaves without it. | When it was, how long it lasted and what ended it. |
| How was mood during that stretch? | Depression that persists through abstinence points to a separate condition that needs its own treatment. | Whether they seemed lighter, the same, or lower. |
| Has there ever been talk of suicide, or an attempt? | Clinicians are told to ask about current and past suicidal thoughts and attempts, and to involve a psychiatrist where there is such a history. | Anything said or done, and when. Say it on the call even if it feels disloyal. |
| Do mood problems or addiction run in the family? | Family history of mood disorders, alcohol problems, psychiatric hospital stays and suicidality is among the questions to ask. | Relatives with depression, bipolar disorder, alcohol or drug problems, or a death by suicide. |
| Which substances, how much, and how recently? | Withdrawal itself can bring depressed mood, and recent heavy use changes what symptoms mean. | Every substance, prescribed medicines included, and the date of last use. |
Questions drawn from NIAAA’s guidance for clinicians on alcohol use disorder and co-occurring mental health conditions. Bring the same details for any drug use. A family’s notes support the assessment; they never replace it.
How do alcohol, cocaine and meth affect mood after stopping?
Alcohol, cocaine and methamphetamine can each leave depressed mood behind when they stop, on different timelines.
Alcohol
Depression, anxiety and mood swings are common withdrawal symptoms, and sleep changes, rapid changes in mood and fatigue may last for months.
Cocaine
Withdrawal brings depressed mood; craving and depression can last for months after long-term heavy use, and suicidal thoughts can come with it.
Methamphetamine
Withdrawal symptoms, depression included, peak two to three days after last use, and low mood, anxiety and craving may continue after that acute phase.
A longer low after stopping is not a sign that treatment has failed. It is a reason to keep watching mood closely, and to plan for it. Stopping heavy drinking also carries physical risks of its own, explained in the medical dangers of quitting alcohol abruptly. The stimulant pages go deeper on the low mood of the cocaine comedown and on the long flat stretch after meth, and treatment for meth itself is covered in meth treatment paced for mood and memory.
Why should depression and addiction be treated at the same time?
Depression and addiction should be treated at the same time because each one undermines recovery from the other. Integrated treatment leads to better health outcomes for people with both, according to the National Institute on Drug Abuse (NIDA).
People with a substance use disorder and another mental disorder usually find it harder to stay in treatment, and substance use can make some medicines less effective. On the alcohol side, stopping drinking often improves mental health, but treating psychiatric symptoms alone is generally not enough to reduce drinking. Leaving either condition for later tends to leave both worse off.
Integrated care means mental health and substance use treatment combined, so that care is coordinated in one place. Its first step is an accurate diagnosis by clinicians experienced in both, because the symptoms overlap.
What should you ask a program about depression and addiction?
Ask how any program handles mood alongside substance use before you commit. Each question rests on federal guidance, and we expect to be asked them too.
- Is depression assessed at the same time as the substance use? Screening for one condition in anyone seeking help for the other, and treating both together, is the recommended approach.
- Who on the team is experienced in both mental health and addiction? Accurate diagnosis depends on clinicians experienced in both, because the symptoms overlap.
- How is suicide risk checked at admission, and how often after that? Clinicians are advised to ask about current and past suicidal thoughts and attempts.
- How do you tell withdrawal low mood from depression of its own? The guide is a timeline of mood during periods with and without alcohol.
- Can existing prescriptions continue, and who reviews them? Some medicines interact with alcohol and need a prescriber’s review.
- Which therapies address the mood and the drinking or drug use together? CBT can be aimed at both conditions, in the same or alternating sessions.
- What happens if the depression becomes too severe for your setting? Some people need a psychiatric hospital first. A program should say where it would send them.
- Who provides therapy and psychiatry after discharge? Ongoing contact after a crisis or a discharge can play an important role in suicide prevention.
FAQ
Questions families ask
Does drinking make depression worse, even if it seems to help at first?
It often does. NIAAA explains that people commonly drink to cope with symptoms of a mental health condition, even though alcohol ultimately makes those problems worse. Low mood and irritability also tend to rise and fall with cycles of drinking, withdrawal and craving.
Can drugs or alcohol cause depression in someone who never had it before?
They can. NIMH notes that substance use can change the brain in ways that raise the risk of other mental disorders. Depressed mood is also a listed symptom of withdrawal from alcohol, cocaine and methamphetamine. Whether the depression will outlast the substance is a question the assessment tries to answer.
Will the depression lift once they stop drinking or using?
For many people mood improves with time off the substance. NIAAA says quitting drinking on its own often leads to clinical improvement of co-occurring mental health disorders. If low mood stays through a long stretch without alcohol or drugs, that points to depression of its own, which needs its own treatment.
Should the depression be treated first, or the addiction?
Usually both together. NIDA says integrated treatment leads to better health outcomes than treating the conditions separately. NIAAA adds that treating psychiatric symptoms alone is generally not enough to reduce drinking, and that which one gets more emphasis at first depends on the person.
Can someone take an antidepressant while they are still drinking?
Sometimes, and the decision belongs to a prescriber. NIAAA guidance says clinicians do not need to wait for sobriety to start an antidepressant when there is evidence of need, but should check for interactions with alcohol. Never start or stop a medicine without medical advice.
If they start an antidepressant, how soon should they feel better?
Not straight away. NIMH says antidepressants usually take four to eight weeks to work, and that sleep, appetite and concentration often improve before mood does. NIMH also notes the FDA’s advice to watch people of all ages closely in the first weeks, because people under 25 may have more suicidal thoughts at first.
Will asking about suicide put the idea in their head?
No. NIMH says studies show that asking someone whether they are suicidal does not increase suicidal thoughts or behavior. Asking plainly, “Are you thinking about suicide?”, opens the conversation that can lead to help.
My partner said they wanted to die after a night of drinking. Was it just the alcohol talking?
Treat it as real. NIAAA notes that suicide is a concern for many people who drink heavily, whether or not they have a diagnosed alcohol problem. Call or text 988 to talk it through with a trained counselor, stay close, and call 911 if they are in immediate danger.
How many people live with depression and an addiction at the same time?
Millions. SAMHSA’s 2025 national survey found that 7.3 million adults in the United States, 2.8% of adults, had both a major depressive episode and a substance use disorder in the past year. Young adults aged 18 to 25 had the highest rate, at 5.7%.
Can Lumora help with depression when there is no drinking or drug use?
No. Lumora is a residential substance use program, and mental health care here is for conditions that occur alongside substance use. Someone whose need is depression alone is better served by a mental health program, and admissions will say so on the first call.
Other ways we help
Care at Lumora
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Medical detox
Medically supervised withdrawal in the residence, leading straight into residential treatment.
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Residential treatment
Living at Lumora for the length of the program, rather than going home each night.
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Dual diagnosis care
Mental health conditions that occur with substance use, treated together with it.
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Eating disorder support
Coordinated planning for eating disorders alongside substance use, including referral when that is safer.
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Aftercare planning
A plan for life after Lumora, pointing to step-down care, sober living or therapy near home.
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Tour the residence
Bedrooms, lounges, the wellness room and the garden.
Admissions, 24 hours a day
Depression and addiction, talked through on one call.
Admissions answers day and night. Describe the low mood and the drinking or drug use together. We will say plainly whether Lumora is the right setting, or where would be safer to start.
Last updated
Sources
- NIAAA, Mental Health Issues: Alcohol Use Disorder and Common Co-occurring Conditions (Core Resource on Alcohol)
- NIMH, Depression (publication, revised 2024)
- NIMH, Finding Help for Co-Occurring Substance Use and Mental Disorders
- NIDA, Co-Occurring Disorders and Health Conditions
- SAMHSA, Key Substance Use and Mental Health Indicators: Results from the 2025 National Survey on Drug Use and Health
- NIMH, Warning Signs of Suicide (revised 2025)
- NIMH, 5 Action Steps to Help Someone Having Thoughts of Suicide
- CDC, Risk and Protective Factors for Suicide
- MedlinePlus, Alcohol withdrawal
- MedlinePlus, Cocaine withdrawal
- NIDA, Methamphetamine
- NIMH, Suicide Prevention
- 988 Suicide and Crisis Lifeline
This page is for information and is not a substitute for medical, legal or insurance advice. Sources checked October 11, 2026.