Speakers - 2026

Title: Depression and substance use disorders: From self medication to resilience integrating clinical practice and neuroscientific insights

Abstract

Depression and substance use disorders (SUDs) are two of the most prevalent and disabling conditions worldwide. Recent meta-analyses demonstrate a high comorbidity rate between major depressive disorder (MDD) and substance use, resulting in more severe clinical outcomes, higher suicide risk, and poorer therapeutic response. This presentation explores the bidirectional mechanisms linking depression and addiction, emphasizing their neurobiological, psychological, and social determinants, as well as practical approaches for integrated intervention.

Drawing upon both empirical research and clinical experience, this work discusses the self-medication hypothesis(Khantzian, 1997) as a key conceptual model to understand the emotional regulation function of addictive behaviors. Neuroimaging studies (Volkow et al., 2016; Koob & Le Moal, 2008) highlight the dysregulation of dopaminergic reward circuits and the overactivation of the hypothalamic-pituitary-adrenal (HPA) stress axis, which perpetuate both craving and anhedonia. From a psychosocial perspective, substance use often compensates for underlying social anxiety, affective dysregulation, or early trauma.

The presentation will feature a clinical case study (Mr. B.L.), illustrating the trajectory from initial self-soothing through substances (alcohol, cannabis, MDMA, cocaine) to a chronic depressive collapse. Through this case, I will demonstrate how integrative psychotherapeutic work—combining Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), and Acceptance and Commitment Therapy (ACT)—can restore meaning, agency, and resilience.

Finally, evidence-based recommendations will be presented:

1. Early integrated screening and treatment of comorbid depression–SUD.
2. Psychosocial interventions tailored to anxiety, motivation, and emotion regulation.
3. Systematic suicide risk management within addiction services.
4. Reinforcement of resilience through acceptance- and mindfulness-based approaches.
5. Community-based programs to reduce stigma and promote social reintegration.

This contribution aims to bridge scientific knowledge and clinical practice, fostering a multidisciplinary dialogue on how to humanize and optimize treatment for dual-diagnosis patients.

Audience take away from presentation:

• Understand current neuroscientific and psychological models explaining the depression–addiction link.
• Recognize early signs of comorbidity and risk factors for chronicity.
• Apply integrated therapeutic principles (CBT, MI, ACT) in clinical settings.
• Enhance collaboration between addiction and mental health professionals internationally.