For many decades, scientists have researched the effects of cocaine on the human brain, including its correlation with mental illnesses such as depression. While there’s no certain proof that cocaine usage can actually cause depression, there is some pretty compelling evidence linking the two.

Cocaine is a fairly common illicit drug used among addicts in the United States today, and it’s a highly addictive stimulant. While cocaine differs from other addictive substances in that consumption typically results in high levels of energy, the effects it has on the reward center of the brain are quite similar to other drugs out there.

Once consumed, dopamine is released from the brain, resulting in an intense euphoria. If you haven’t studied up on your common bodily neurotransmitters recently, here’s a reminder of what dopamine is and what it does: dopamine is a friendly little chemical that the brain releases to reward us when we experience something positive. These can include activities like going for a jog, falling in love, or eating a big, juicy hamburger. It makes us feel good and is our brain’s way of reinforcing behaviors that it wants us to repeat. But after repeated cocaine usage, the brain adapts to the excess dopamine produced by the drug and stops its own natural production of it.

While rates of depression are significantly higher among chronic cocaine abusers compared to the general population, scientists haven’t quite been able to pinpoint exactly why that is. Some researchers believe that long-term cocaine use can cause permanent damage to neurons in this particular area of the brain by killing the brain cells that make it possible to experience feelings of pleasure. But the problem with these studies is that scientists are not able to confirm whether those brain cells were killed off by drug abuse or were already dormant due to a pre-existing case of depression.

It really all boils down to a “chicken or the egg” type of situation: there’s a clear, evident correlation between cocaine usage and depression, but it’s been quite a challenge for researchers to identify which condition presented itself first in each subject. That’s why many addiction treatment facilities are now treating patients for coexisting disorders, rather than their addiction alone. It becomes necessary to treat both depression and addiction simultaneously, as it is unclear which condition may have influenced the other.

While this has proven to be one of the most effective treatment perspectives to date, researchers continue to investigate this link between cocaine usage and depression, with hopes that a breakthrough—and a more effective treatment—might be just over the horizon.

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