Major Depressive Disorder, or MDD, can be characterized by a depressed or sad mood, feelings of low self-worth and guilt, thoughts of suicide, poor concentration, low levels of energy and motivation, and sleep and appetite disturbance.                                    

Women are nearly twice as likely to suffer from MDD than men.  Both MDD and SUD need to be identified and addressed concurrently to minimize relapse and improve quality of life and quality of care.  MDD can also increase the risk of suicide.  It is important to note that depressive symptoms may increase or decrease during the phases of substance use (including intoxication, use, and withdrawal).