The PMHNP is conducting an evaluation on a 45-year-old divorced man who has a history of depression and substance use disorder. He wants to know if the substance use disorder caused the depression, or if the depression caused the substance use disorder. What is the most appropriate response?

“It doesn't really matter. We'll treat both conditions.”

“Many clients experience both, and it was most likely a combination of many factors that led to the development of each condition.”

“It was most likely the depression that caused the substance use disorder.”

“It was most likely the substance use disorder that caused the depression.”