Cocaine and Depression

11 Minutes

As one of the most commonly abused illicit drugs, cocaine is particularly famous for its strong, uplifting effects and euphoria. What many do not understand is its effects on mental health may go far beyond the initial high. As opposed to the initial boost in mood, users may also develop depression, one of the lesser-known consequences of cocaine. As the temporary high alleviates, the crash that follows can leave users struggling with emotional lows. The situation worsens as the brain develops a dependency on the drug, worsening the feelings of sadness and hopelessness in individuals who regularly take the drug. Understanding this downward mental health spiral associated with cocaine use is imperative to avoid potentially life-threatening consequences.

How Cocaine Leads to Depression – Exploring the Drug’s Impact Beyond the Initial High

The recreational use of cocaine is primarily because of the burst of energy and euphoria it causes. However, the drug’s effects are far more than the initial high. Research shows its impact on the brain does not stop when the drug wears off, resulting in various mental outcomes. [1] The following is an overview of the way coke works and how it leads to cocaine depression:

Temporary High

Cocaine works by increasing dopamine levels in the brain. Dopamine is the chemical responsible for feelings of pleasure and reward. Its amalgamation in the brain causes euphoria, vigilance, and increased energy that users seek. For a short time, everything feels intensified, such as confidence and physical sensations. However, this dopamine buildup is unnatural, and the body cannot maintain it. As a result, the brain becomes overstimulated, and when the drug’s effects diminish, it makes users feel drained.

Crash

Since the high from coke is short-lived, it goes away after a while, leading to an experience called a crash. During the crash, dopamine levels decrease rapidly, causing the brain to lose its natural chemical balance. The emotional change from a high to a sudden drop can lead to mood swings. Individuals may feel irritable and very anxious as the brain struggles to regain balance, causing emotional numbness or sadness. Coke crash is a crucial part of cocaine’s effects on mental health, as it forms the basis of long-term emotional issues.

Emotional Instability

The longer someone uses cocaine, the more unstable their mood becomes. Persistent cocaine use keeps the brain from regulating its average dopamine production. The lack of regulations makes it difficult for individuals to feel pleasure from everyday activities. This impact of cocaine is known as anhedonia, where activities that were once satisfying no longer provide any reward. As a result, individuals usually feel emotionally empty when not using the drug.

Read Also About Cocaine Induced Psychosis

Anhedonia generally leads to emotional dependence on cocaine. Users may start relying on cocaine to feel normal or to control the feelings of sadness that occur when the drug is not available. This emotional volatility has been shown to worsen over time, making individuals use more cocaine to avoid the lows. [2]

Long-Term Emotional Consequences

According to research, regular use of cocaine to manage the low its causes leads to deeper emotional disturbances. In some people, these lows may evolve into mental disorders like depression. The brain’s inability to regulate mood without the drug leaves users prone to developing chronic mental health issues. What starts as brief emotional lows can turn into cocaine depression, affecting relationships, work, and general health. [3]

How Post-Cocaine Depression Differs from Other Types of the Disorder?

While depression has common symptoms like sadness and loss of interest in everyday life, cocaine-induced depression manifests differently because of its link to drug use. Some of the primary differences are:

• Severity of Mood Swings: In depression secondary to coke, mood swings are usually more extreme. Individuals will quickly alternate between agitation and emotional lows, particularly when the drug is leaving their system. These changes can be much more intense than in typical depression.
• Dependence on Cocaine for Relief: Unlike other types of depression, those with cocaine-induced depression view cocaine use as a necessity to manage the emotional lows temporarily. Consequently, users are unable to stop because stopping feels emotionally unbearable. Ironically, continued drug use also simultaneously worsens depression.
• Shorter Highs, Deeper Lows: The high from cocaine is short-lived, but the low that follows can be profound and last much longer. The crash is usually more intense than the usual depressive episodes seen in non-drug-related depression, making users feel emotionally numb.
• Physical Crashes: While most forms of depression cause fatigue, cocaine depression comes with intense physical exhaustion, specifically after heavy use. The exhaustion can be overwhelming and may include severe physical and mental issues.

Depression after Cocaine Use – Signs and Symptoms

Research shows depression after cocaine use can be hard to distinguish from other types of depression, mainly because it develops gradually. [4] However, specific signs may indicate cocaine depression, including:

Emotional Numbness

One of the primary symptoms of cocaine depression is extreme emotional numbness. This goes beyond typical sadness emotions, extending to a stage where the individual feels entirely disconnected from their sentiments. People with this symptom describe it as feeling hollow, where no negative or positive emotion evokes any emotional response. Activities or relationships that once brought happiness no longer cause reactions, leaving users in emotional limbo. The numbness from depression can persist long after the cocaine has left the body, worsening the depressive state.

Increased Risk-Taking Behavior

Depression due to cocaine does not always present as withdrawal or avoidance, as seen in many other forms of depression. Instead, some individuals may participate in high-risk-taking activities or behavior as an attempt to end emotional numbness. As a result, they may make impulsive decisions such as spending large amounts of money, participating in unsafe sexual activities, and others. These behaviors are generally linked to the desperate need to feel anything to end the numbness that comes with cocaine depression. The high risk-taking state often leads to further self-destructive behavior, worsening depression, and other mental health struggles.

Compulsive Drug Seeking

Another feature of depression due to cocaine use is the need to continue using the drug despite knowing that it is worsening the emotional lows. For many, this behavior manifests into a strong urge to obtain cocaine to control the feelings of despair and numbness. Unlike other types of depression, where individuals avoid stimuli, those with cocaine depression feel that the only way to relieve their issues is by continuing to use the drug.

Episodes of Panic or Anxiety

In addition to emotional numbness and risk-taking behavior, individuals with cocaine depression have increased anxiety and panic attacks. Unlike general feelings of anxiety commonly present in depression, studies show cocaine-induced panic episodes can happen suddenly and more intensely. Small or even nonexistent stimuli can also easily trigger it. This state can further lead to irrational fears or paranoia, worsening the individual’s mental health. [5]

Loss of Appetite or Weight Changes

Depression causes various physical changes, such as loss of appetite or significant weight changes. When combined with depression, the effect can be even more extreme. Individuals may lose interest in food altogether, paving the way for rapid weight loss. Conversely, they may overeat as a way to deal with emotional distress. These alterations in appetite and weight are common symptoms of a worsening depressive state associated with cocaine use.

Who is at Higher Risk of Cocaine Depression?

Some individuals are more likely to have depression as a result of cocaine use. The following are some factors that contribute to the chances of developing cocaine depression:

• Frequent or Heavy Cocaine Users: Those who use cocaine regularly or in large amounts are more likely to have depression. Persistent exposure to the drug significantly disturbs the brain’s natural dopamine production, which results in severe emotional lows and issues.
• Individuals with a History of Mental Health Issues: People who already have mental health disorders like anxiety or previous episodes of depression are more prone to cocaine-induced depression. The drug worsens existing mental health issues, making them more challenging to manage.
• Younger Users: Adolescents and young adults are at a higher risk of having depression from cocaine use because of the ongoing development of their brains. The impact of the drug can interfere with cognitive function and emotional issues, resulting in lasting mental health problems.
• Those with High Stress Levels: Individuals with high stress levels, whether from personal relationships or work, may resort to cocaine as a form of self-medication. This can have the opposite effect, as the drug adds to hopelessness and emotional exhaustion over time.
• Polydrug Users: People who mix cocaine with other substances, such as alcohol or prescription medications, have more chances of having depression. The interaction between multiple substances can exacerbate the adverse mental health effects of each drug.
• Family History of Depression: Individuals with a genetic predisposition to depression are at a higher risk of developing mental health issues when using cocaine. The drug can cause depressive episodes that may not have surfaced otherwise.

How is Cocaine Depression Treated – Primary Treatment Options

Treatment of cocaine-induced depression requires an extensive approach that addresses both the substance use and the mental health issues it creates. Some treatment options that can be effective in managing this situation include the following:

Medical Detox

The first step in treating cocaine depression is detoxification. Medical detox assists individuals in safely withdrawing from cocaine under professional guidance. The process helps to stabilize the body and manage withdrawal symptoms as well as any health issues that may arise, preparing the individual for further treatment.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy is among the most used interventions for treating substance use and depression. It helps individuals identify thought patterns and behaviors that contribute to their cocaine use and depression. Through CBT, individuals can learn strategies to manage their sentiments without relying on drugs.

Medication-Assisted Treatment (MAT)

In some cases, medicines may manage the symptoms of depression and control cravings for cocaine. For instance, antidepressants can regulate mood swings, while other medications can decrease the urge to use coke. Such an approach typically works well with therapy for better health outcomes.

Group Therapy

Group therapy provides a supportive space where individuals can share their experiences and difficulties with others who have had similar issues. Such a setting reduces the feelings of being isolated that come with depression and provides peer support throughout the recovery.

Inpatient Rehabilitation Programs

For those with severe substance abuse and depression, inpatient rehabilitation programs are the most beneficial. These programs offer intensive treatment in a controlled space and include medical care, counseling, and support services to help individuals focus on their recovery without any triggers or distractions.

Lifestyle Changes

Lifestyle changes like exercise, a balanced diet, and adequate sleep can significantly improve mental and physical well-being. Exercise, in particular, has been shown to improve mood and regulate the brain’s reward system without cocaine use. Therefore, it can be an effective strategy to use with other forms of treatment for best results.

Ongoing Mental Health Counseling

After the early stages of treatment, ongoing counseling is necessary to manage cocaine depression and lower the chances of relapse. Long-term therapy helps individuals work through underlying issues, develop better coping mechanisms, and maintain sobriety without resorting to drug use.

What happens when Cocaine Depression is Left Untreated?

When cocaine depression is left untreated, the health outcomes can be severe and, sometimes, irreversible. The following are the significant issues that may emerge due to delay in treatment: 

• Chronic Depression: Without intervention, cocaine depression can worsen over time. The emotional lows become more frequent and intense, causing a consistent state of despair. This can develop into a depressive disorder that may last for years.
• Worsening Substance Use: Depression leads to further cocaine use as individuals attempt to self-medicate their emotional numbness. This creates a situation in which substance use intensifies, making it difficult to stop. The longer this continues, the more severe the substance use becomes, leading to addiction and multiple health issues.
• Severe Cognitive Decline: Untreated cocaine depression can cause permanent damage to cognitive functions. Individuals may experience memory loss and difficulty in focusing. Over time, cognitive decline can impact daily functioning and decrease quality of life.
• Relationship Breakdown: Depression and cocaine use usually lead to social withdrawal and issues with loved ones. Untreated depression can also cause the breakdown of personal relationships as users become more isolated. This isolation can further contribute to their mental health problems.
• Increased Risk of Suicide: One of the most significant risks of untreated cocaine depression is the increased likelihood of suicidal ideation. The intense feelings of hopelessness and substance abuse can cause individuals to self-harm or even attempt to end their lives.
• Long-Term Physical Health Problems: Continued cocaine use results in severe physical health issues, such as heart disease and stroke. When combined with depression, the deterioration of both mental and physical health can cause irreversible complications and even death.

Conclusion

Cocaine depression is a complex and dangerous mental health issue that goes beyond the drug’s immediate impacts. It results in worsening psychological issues, encouraging further cocaine use as a coping strategy. Identifying the signs and getting early treatment is vital for managing these issues. It is possible to recover effectively with the right interventions, such as therapy, pharmacotherapy, and lifestyle changes. Addressing the emotional and physical toll of both cocaine use and depression is necessary to restore mental health and build a healthier future.

FAQs

Can cocaine cause depression even if used only a few times?

Yes, even the occasional use of cocaine can lead to depressive symptoms. While the chances increase with regular use, some individuals may have emotional lows, anxiety, or depressive episodes after just a few uses, specifically during the crash that follows the initial high.

Does quitting cocaine automatically resolve depression?

Contrary to the widespread assumption, quitting cocaine does not automatically resolve depression. While stopping use is an essential first step in recovery, the consequent depression may continue because of the brain’s altered chemical balance. Professional treatment, which includes medication and therapy, is essential to treat the underlying depression fully.

Is there a higher risk of overdose in people with cocaine-induced depression?

Individuals suffering from cocaine depression are at higher risk of overdose. The emotional stress and desperation for relief may push them to use larger or more regular doses, which significantly contributes to the chances of an accidental overdose. Overdose is a serious situation that requires immediate medical attention. If you or someone you know is having symptoms of overdose, call emergency services as soon as possible to avoid further complications.

References

[1] Nestler EJ. The neurobiology of cocaine addiction. Science & practice perspectives. 2005 Dec;3(1):4.

[2]  Morton WA. Cocaine and psychiatric symptoms. Primary care companion to the Journal of clinical psychiatry. 1999 Aug;1(4):109.

[3] Fonseca F, Mestre-Pintó JI, Gómez-Gómez À, Martinez-Sanvisens D, Rodríguez-Minguela R, Papaseit E, Pérez-Mañá C, Langohr K, Valverde O, Pozo ÓJ, Farré M. The tryptophan system in cocaine-induced depression. Journal of clinical medicine. 2020 Dec 19;9(12):4103.

[4] Alías-Ferri M, García-Marchena N, Mestre-Pintó JI, Araos P, Vergara-Moragues E, Fonseca F, González-Saiz F, Rodríguez de Fonseca F, Torrens M. Cocaine and depressive disorders: When standard clinical diagnosis is insufficient. Adicciones. 2021 Jul 1;33(3):193-200.

[5] Conner KR, Pinquart M, Holbrook AP. Meta-analysis of depression and substance use and impairment among cocaine users. Drug and alcohol dependence. 2008 Nov 1;98(1-2):13-23.