Depression and Alcohol

Alcohol abuse and depression are commonly connected among patients who receive a dual diagnosis. This is when a person is diagnosed with both a substance use disorder (SUD) and mental health disorder. In the U.S., the prevalence of these co-occurring disorders is high. Those with depression are more likely to abuse or become dependent on alcohol. Inversely, those that abuse alcohol have a higher risk of developing depression.

The National Comorbidity Survey estimates that major depression occurs in over 24 percent of alcohol-dependent men and just under 50 percent of alcohol-dependent women.

Depression Symptoms

Depression is the most common mental health disorder in the U.S., affecting over 16 million adults. People with depression suffer from feelings of sadness, decreased self-worth, and a loss of interest in activities that they once enjoyed. Additional symptoms of depression can include:

  • Negative Mood
  • Low Self-Esteem
  • Sleep Pattern Changes – too much sleeping or insomnia
  • Changes in Appetite
  • Loss of Energy
  • Feelings of Worthlessness
  • Problems with Concentration and Thinking
  • Slowed Speech
  • Thoughts of Death or Suicidal Thoughts

Everyone experiences ups and downs in life, which can include short periods of depression. However, receiving a depression diagnosis means your symptoms last for more than two weeks at a time.

Depression and the Risk of Alcohol Abuse

Unfortunately, alcohol abuse is common in people with depression. Many turn to alcohol in order to escape feelings of sadness. While drinking alcohol may provide an initial feeling of euphoria and temporarily lift spirits, it isn’t long-lived. Alcohol acts as a central nervous system (CNS) depressant and heavy use can lead to increased depression.

alcohol

Alcohol Abuse and Depression Create a Dangerous Circle of Symptoms

While alcohol may create a temporary reduction in depressive symptoms, they tend to intensify once the alcohol wears off. Because of this, many increase their alcohol consumption to continue feeling the effects, increasing their risk of developing an alcohol use disorder (AUD). Studies also show that alcohol consumption and depression increase the risk of suicidal thoughts and suicide attempts.

People with current mental health disorders consume 38 percent of all alcohol.

The National Bureau of Economic Research

Alcohol Abuse Can Contribute to Depression

While many believe that depression leads to an alcohol use disorder (AUD), the opposite is also true. In fact, alcohol abuse significantly increases the risk of developing depression. This is especially true if you have increased risk factors for depression, such as family history and genetic predisposition.

When you suffer from AUD, alcohol consumption is a regular part of life. Heavy alcohol use directly affects brain function and alters various brain chemicals and hormonal systems known to be involved in the development of many mental disorders. 

Alcohol abuse often leads to problems at work, difficulty maintaining relationships, financial troubles, and/or legal troubles. When these occur, periods of depression are likely. If this depression continues for over two weeks, many receive a diagnosis of both disorders.

Co-Occurring Alcohol Use Disorder and Depression

Living with both alcohol addiction and depression increases your risk of experiencing a constant cycle of symptoms. Drinking helps to improve your mood and decrease your symptoms of depression for a short time. 

Depression is a common symptom of alcohol withdrawal so when the alcohol wears off, depressive symptoms can return. As the depression increases, so does the alcohol consumption. This vicious cycle can be difficult to overcome and requires a specially focused treatment plan that addresses both conditions simultaneously.

Treating Depression and Alcohol Abuse

The co-occurrence of both disorders is highly prevalent in the U.S. Unfortunately, when both occur together, they are often associated with poor outcomes through traditional rehab facilities. Treatment for people with both disorders presents unique challenges.

Treating only one condition often leads to relapse. For example, if a physician treats someone with depression for their alcohol use disorder alone, they may successfully detox. However, when you have been masking symptoms of depression with alcohol for so long, sobriety can often make depression worse. Therefore, when a depressive episode hits, the risk of turning to alcohol in order to reduce the symptoms of depression increases, making relapse likely.

When it comes to treating both conditions, an integrated treatment approach is best. Rehab facilities with programs for a dual diagnosis go farther than just simple alcohol detox.

treatment

Integrated Treatment Centers Focus on Dual Conditions

Treatment in an integrated facility begins with detox in a safe environment. Medical professionals are available and ready to assist with depressive symptoms that commonly occur with alcohol withdrawal. After detox, professionals evaluate for symptoms of depression.

 If the depression is alcohol-induced, symptoms typically resolve on their own after several days or weeks of abstinence. However, if there is an underlying depressive disorder, counseling and pharmacotherapy can help reduce symptoms. Regular mental health therapy after rehab is essential in order to reduce the risk of relapse.

Resources

“Alcohol and Depression: How to Treat Co-Occurring Issues.” Alcohol.org, https://www.alcohol.org/co-occurring-disorder/depression/.

“Alcohol Use, Abuse, and Depression: Is There a Connection?” WebMD, WebMD, 12 Nov. 2018, https://www.webmd.com/depression/guide/alcohol-and-depresssion#1.

“Alcoholism and Co-Occurring Disorders-Alcohol Alert No. 14-1991.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, https://pubs.niaaa.nih.gov/publications/aa14.htm.

Conner, Kenneth R, et al. “Meta-Analysis of Depression and Substance Use among Individuals with Alcohol Use Disorders.” Journal of Substance Abuse Treatment, U.S. National Library of Medicine, Sept. 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864601/.

“Depression and Addiction.” Dual Diagnosis, https://dualdiagnosis.org/depression-and-addiction/.

DeVido, Jeffrey J, and Roger D Weiss. “Treatment of the Depressed Alcoholic Patient.” Current Psychiatry Reports, U.S. National Library of Medicine, Dec. 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712746/.

Digital Communications Division. “Does Alcohol and Other Drug Abuse Increase the Risk for Suicide?” HHS.gov, 13 May 2016, https://www.hhs.gov/answers/mental-health-and-substance-abuse/does-alcohol-increase-risk-of-suicide/index.html.

Dongier, Maurice. “What Are the Treatment Options for Comorbid Alcohol Abuse and Depressive Disorders?” Journal of Psychiatry & Neuroscience : JPN, U.S. National Library of Medicine, May 2005, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1089782/.

“Major Depression.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/statistics/major-depression.shtml.

“Mental Illness and Substance Abuse”, The National Bureau of Economic Research https://www.nber.org/digest/apr02/w8699.html.

Pompili, Maurizio, et al. “Suicidal Behavior and Alcohol Abuse.” International Journal of Environmental Research and Public Health, Molecular Diversity Preservation International (MDPI), Apr. 2010, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872355/.

Wasson, Anne. “Alcohol Worsens Depression; Depression Worsens Alcohol Abuse.” AFMC, 17 Apr. 2018, https://afmc.org/afmc-healthspot/alcohol-worsens-depression-depression-worsens-alcohol-abuse/.

What Is Depression?, https://www.psychiatry.org/patients-families/depression/what-is-depression.

Updated on: September 2, 2020
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Alcohol Rehab Help Writing Staff
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Annamarie Coy,
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