Are Depression and Cannabis Use Linked?

I regularly look at depression news as relates to substance use. As a former addictions counselor, I have remained interested in the inter-relationships between drug use and mental health disorders.

It has been well documented that using cannabis during adolescence increases the risk of psychosis, especially in vulnerable youth (i.e., those whose genetics include the risk for mental illness with psychosis such as schizophrenia.) Now a recent study indicates using marijuana regularly during adolescence is associated with depression in the young adult years. There is a risk of changing neurological development by the frequent intoxication from THC during years when brains are rapidly growing and changing.

As I reflected on the importance of that information, I recalled a recent conversation with a man in his early 20s about how hard it is to rein in his constant marijuana smoking. He suffers depression and he feels as if the substance use is somehow making it worse even though he feels less depressed when high. He is right. The outcome of smoking for him lowers motivation and especially lowers his productivity and that makes him feel worse and more depressed. He openly says he has an “addiction to pot”, i.e., cannabis use disorder, and he is struggling to find the path out of this dilemma.

Is marijuana use linked to depression?

Source: BraunS/Kaboompics

But there may be more to this situation. This particular young man suffered depression during much of his adolescence. He smoked a lot of marijuana throughout high school and college years as an escape. I wondered, “Was this a chicken-egg problem? What came first?” So I looked for other information and discovered research that indicates cumulative experiences of depression during adolescence can influence the later development of cannabis use disorder, which this man certainly is experiencing. He and I will evaluate how this intertwined as we work to deal with both disorders because the answer to the chicken-egg problem could influence how he responds to treatment suggestions/methods/decisions about managing both depression and cannabis use.

Knowing about risk factors and educating young people is more important than ever.

It seems that there may be a bi-directional influence of depression during adolescence influencing cannabis use and using cannabis with regularity during adolescence increasing risk of depression. This may seem manifestly obvious, but with cannabis becoming legal throughout the USA and Canada, knowing about risk factors and educating young people is more important than ever. So many people regard THC consumption in various forms as innocuous, and for many people that may be true. So how does one decide whether using it is a potential health risk?

It is most necessary to look at family history for mental illness and addiction, because, without question, those conditions increase the risks for children to develop depression or become addicted to substances or behaviors, e.g., porn use, video-gaming, gambling. Family members can share that information. If a parent is an alcoholic it is logical to assume the children are at higher risk for alcoholism if they begin to drink alcohol, and that risk is much higher if they start to drink alcohol in adolescence. The same is true for nicotine. And beginning cannabis use in early-mid adolescence increases the risk of cannabis use disorder.

The adolescent years are years of brain growth and change, and because of that process called “blossoming and pruning” (through which brain function becomes more efficient) what were only vulnerabilities may become realities. Substance use challenges healthy development, especially during early adolescence, so the less altered the brain, the lower the risk that mental health disorders will emerge, such as psychosis, depression, bipolar and schizophrenia. This is not to say that complete abstinence from drugs will prevent such conditions, but rather, frequent use of mood-altering drugs raises the risk those conditions may occur, especially when the adolescent has a family with a history of mental illness or addiction.

The “which came first” chicken-egg question might be averted with careful attention to mood disorder and THC use.

Here are 10 ideas to help:

Know the signs of depression in youth: more than a brief bout of being down or sad, depression often brings with it lethargy, loss of interest in normally interesting activities, sleep disturbance, irritability and overt feelings of helplessness, worthlessness or even suicidal ideation. When these symptoms last longer than 2 weeks or have nothing to do with a situational loss (like a break up with a boyfriend) it is time to seek help.

Helping adolescents cope with depressive episodes might be the single best prevention against developing marijuana use disorder. A talk with a school counselor might help parents decide whether to seek psychotherapy for their teen. There are many good books and apps for cognitive therapy self-help.

Consider options other than medication first: psychotherapy works! AND it teaches people how to cope, providing skills to respond to life’s challenges, which medication does not do.

Be willing to consider medication if psychotherapy is ineffective. Utilizing every means of preventing depression recurrence is good prevention of later substance use problems.

Rather than simply telling a teen that pot is bad, or lecturing about gateway drugs, learn about what the adolescent’s interest is in getting high. You might spot incipient depression in an urge to escape and find other pathways to relieve the depression.

Depression Essential Reads

When the Brain Has Difficulty Listening to the Heart

Understanding Depression and Managing It Effectively

Find out what the adolescents’ sources of information are and what they know factually about marijuana (or other substances). Talking reasonably about the positives and negatives of using ANY substance during the vulnerable years can help a curious adolescent to make healthy choices.

“Just say no,” did not work before and it won’t work now. Help adolescents to develop assertiveness and plan for how to handle circumstances in which they might be interested in or pressured to use drugs.

Monitor the frequency of use. Daily pot users incur risks beyond mental health problems, and those include poor academic performance, impaired driving accidents, and relationship problems. Noting the connection between using and consequences is an early stage intervention that might increase motivation to decrease use.

Remember that occasional substance use, as opposed to frequent use, does not seem to carry the same risk for later depression, so try to stay realistic about experimental uses.

The signs of addiction are similar to those of depression, so if you see them, do not delay to seek addiction recovery help for any substance abuse during adolescence.