Can MDMA Cause Depression?

MDMA pill being handed to a person

Recreational club drug users who pop ecstasy or Molly pills expect to experience euphoric highs that last several hours and transport them to another world. They may feel emotional warmth, a distorted sense of time and space, and increased energy and pleasure.

However, what they don’t expect to feel is depression, a mental health disorder that is estimated to affect 16 million adults in the United States and 300 million people across the globe.

Nonetheless, feeling down in the dumps is a common side effect of using MDMA, particularly after the highs have passed and use of the drug has stopped.

How mdma affects the brain

MDMA is the abbreviation for 3,4 methylenedioxymethamphetamine. It is an illegal, synthetic, psychoactive drug chemically similar to stimulants and psychedelics. MDMA affects the brain’s serotonin levels, causing users to feel intense sensations of euphoria and general well-being.

Chronic MDMA use can permanently change the brain’s production and use of serotonin, the neurotransmitter chemical responsible for reducing depressing and regulating anxiety, among other bodily functions. Because of this, long-term use is believed to raise risks of developing depression and leave users susceptible to stress, anxiety, and other emotional disturbances.

There is research about how drugs such as MDMA can become treatments for depression for people who have post-traumatic stress disorder and other conditions. Studies are ongoing about the drug’s potential therapeutic benefit, and the effects of MDMA use still make it a dangerous one to take outside of a therapeutic setting.

Users risk high blood pressure, nausea, muscle tension, increased appetite, sweating, and high body temperatures. Failing to drink sufficient amounts of water can lead to dehydration. Heart failure, kidney failure, and irregular heartbeat are also problems that result from MDMA use.

Why depression often follows mdma use

Depression that results from MDMA use is reportedly mild and can last one or two days. However, some people who use MDMA frequently or in large amounts report experiencing longer periods of depression. offers two possible physiological reasons why MDMA use can appear to cause depression. They also could experience negative moods and feel irritable or tired.

Temporary depletion of serotonin

MDMA’s effects on the brain cause it to release large amounts of serotonin, which could deplete the brain’s supply, and the brain will need time to restore what was lost. This period could be when users feel down in the dumps. Research shows this process can take anywhere from two days or a week or more.

Serotonin Receptors Take Longer To Regulate

The brain’s serotonin receptors down-regulate, or turn off, when they are flooded with too much serotonin. The brain’s ability to regulate the receptors helps it maintain balance. Once the body processes excess serotonin, receptors may turn on again or they may remain shut off for a time that could last for a few days to a few months, depending on the person and their situation.

Some MDMA Users Could Already Have Depression

Sometimes using substances bring out conditions that already existed before the person started using. That is also the case with MDMA. Some people may already struggle with depression but was not diagnosed or properly diagnosed before their substance use began. People in this group might be using ecstasy to medicate themselves as they manage the symptoms of their condition.

Dual diagnosis drug addiction treatment is most beneficial for substance users who also have a mental health disorder. It addresses drug use and the disorder at the same time to give users a chance at overcoming their dependence and addiction.

MDMA Addiction

Feelings of depression are also among the symptoms of ecstasy withdrawal. Those who have stopped taking the drug for a time may feel tempted to restart their ecstasy use just so they can keep negative moods, irritability, and fatigue away. Use also may be restarted to attempt to re-create the feelings that were experienced when using MDMA was new. Some will find that it is hard to achieve these effects because MDMA has exhausted the brain’s serotonin supply. The synthetic drug can only release the neurotransmitter that already exists; it cannot create more.

Increased, regular use of MDMA means users will build a high tolerance for the drug, which usually means they will use more of it to achieve the high they are seeking. This practice is dangerous for it can lead to MDMA-related emergencies, such as an accidental overdose, heat stroke, or an addiction that can be never-ending until professional drug treatment is received.

According to the National Institute on Drug Abuse, there are no specific medical treatments for MDMA addiction. Some people who enter treatment for their addiction benefit from behavioral therapy. Treatment can also give recovering MDMA users life strategies to help them live without addictive substances.

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