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Updated on September 14, 2023
10 min read

Depression and Drinking

Alcohol and Depression

Alcoholism and depression often go hand in hand. It’s common for someone struggling with depression to engage in alcohol consumption to alleviate symptoms. 

It’s also common for someone struggling with an alcohol use disorder (AUD) to develop substance-induced depression.

Understanding how AUD and depression affect each other can help you or your loved one get the treatment you need to recover from such afflictions.

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Depression and Alcohol Abuse

Depression is a mental health disorder that negatively affects how you think, behave, and act. Someone who is depressed may feel overwhelming sadness, loss of interest, and hopelessness.

Alcohol abuse is the unhealthy consumption of alcohol. Alcohol use disorders can range from mild to severe, including binge drinking and alcoholism. 

Depression and alcohol or drug abuse are often considered co-occurring disorders. Also called dual diagnoses, co-occurring disorders are classified as any combination of substance use disorders and mental disorders that occur simultaneously.

While research can’t effectively pinpoint whether major depressive disorder or alcohol use disorder occurs first, they are among the most prevalent psychiatric disorders diagnosed.

What Is Depression Like?

Depression can come and go throughout your life. During episodes of depression, you may feel constant and ever-present negative symptoms. 

Symptoms of depression include:

  • Irritability, anger, and frustration, even at minor things
  • Feelings of hopelessness, sadness, and emptiness
  • Loss of interest in things that may have been of interest before
  • Low libido
  • Sleeplessness and insomnia
  • Lack of energy
  • Anxiety and restlessness
  • Weight loss or weight gain
  • Reoccurring thoughts of suicide and death
  • Trouble concentrating
  • Feelings of worthlessness or unexplained guilt

The severity of these symptoms varies from person to person. Some may feel major depression symptoms so intensely that they can’t perform daily tasks. Others may exhibit less extreme symptoms. 

Are There Different Types of Depression?

Depression can come in different forms and diagnoses, with some having more symptoms and more severe effects. Below are just a few types:

  • Major depressive disorder: A persistent feeling of sadness and loss of interest affecting daily life
  • Persistent depressive disorder: Depression occurring for more than two years
  • Psychotic depression: Depression that causes reality distortion, manifesting as delusions or hallucinations
  • Seasonal affective disorder: Depression triggered by seasonal changes 
  • Perinatal depression: Depression occurring during or after pregnancy

How Do Doctors Diagnose Depression?

Experts diagnose depressive disorders through screening tools, physical patient examinations, and a psychological evaluation. 

According to the American Psychiatric Association, a depression diagnosis typically adheres to the following symptoms described by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

  • Constant depressed mood daily
  • Significantly diminished pleasure in activities 
  • Significant weight loss or gain from dieting or an increased appetite
  • Daily insomnia or hypersomnia (excessive tiredness during the day)
  • Daily psychomotor agitation
  • Daily loss of energy and persistent fatigue
  • Feelings of worthlessness or inappropriate guilt
  • Indecisiveness and inability to concentrate
  • Recurrent thoughts of death, whether actively suicidal or not

For someone to be diagnosed with major depressive disorder, their symptoms must prove to interfere with social and occupational settings. In addition, the symptoms must fall under depression more than other psychiatric disorders like bipolar disorder.

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How Does Someone Develop Alcohol Use Disorder?

A person might develop an alcohol use disorder due to several factors. These include:

  • If they start drinking at an early age
  • They have a family history of alcohol problems
  • They have mental health conditions leading to addiction
  • They have a history of trauma

A person’s risk for developing severe symptoms of AUD depends on how much and how often they drink.

Symptoms of Alcohol Use Disorder

Similar to major depression, AUD can range in severity. Moreover, signs and symptoms are different in every person. 

Some symptoms of alcohol misuse include:

  • Spending a lot of time drinking or obtaining alcohol
  • Being unable to stop drinking once you’ve started
  • Wanting to cut down on drinking but being unable to 
  • Feeling strong cravings and urges for alcohol
  • Continuing to drink even when it negatively affects your life
  • Developing a tolerance to alcohol
  • Engaging in risky behavior, like drunk driving
  • Experiencing withdrawal when you don't drink

Alcohol Withdrawal

People who struggle with AUD will often experience and worsen withdrawal symptoms when they try to stop drinking without proper guidance. 

Symptoms of withdrawal can be mild to severe, including:

  • Sweating
  • Headaches
  • Vomiting
  • Shakiness
  • Anxiety
  • Seizures
  • Delirium tremens (DTs - shaking frenzy)
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Risk Factors for Co-Occurring Disorders

Co-occurring disorders are often more dangerous than having a single mental health disorder or substance use disorder (SUD). 

A dual diagnosis can increase your chances of:4-7

  • Homelessness
  • Sexual abuse
  • Suicide
  • Thoughts of death or harming yourself
  • Overdose
  • Additional mental health disorders 
  • Additional alcohol or drug addictions

Effects of Alcohol Use on Depression

Drinking when you're depressed can make a depressive disorder worse.2 Antidepressants often play a significant role in treating depression. Alcohol decreases the effectiveness of these antidepressants.

Alcohol’s other effects on depression include:

  • Mood regulation: Alcohol also affects the same areas of the brain that help regulate your mood; can trigger and heighten mental illness symptoms like depression
  • GABA and dopamine stimulation: Dampens the brain’s ability to produce dopamine and GABA independently
  • Poor sleep quality: Nausea and dehydration can prevent getting restful sleep, affecting your mood and concentration the next day

How Alcohol Withdrawal Affects Depression

When you drink excessive amounts of alcohol, your brain adapts by reducing GABA receptors stimulated by the alcohol. 

When an alcoholic instantaneously quits drinking, there is a sudden insufficient supply of GABA and dopamine (among other things), which drives the brain into an adverse state.3

More severe outcomes from this imbalance in brain chemistry include delirium tremens (DTs) and epilepsy. This adverse state is why heavy drinkers should never quit drinking without the proper medical support.  

Other, more common withdrawal symptoms that many drinkers experience include:3

  • Agitation
  • Anxiety
  • Sweating
  • Shakiness
  • Nervousness
  • Anger
  • Dysphoria (a state of general unhappiness, unease, and restlessness)

How Long Does Alcohol-Induced Depression Last?

Symptoms of alcohol-induced depression can last for any number of days or weeks. It depends on the person.

Alcohol research shows that symptoms improve roughly 3 to 4 weeks after abstaining from alcohol. However, should symptoms persist after receiving treatment for alcohol misuse, studies suggest it’s possible to develop independent depression.10

What To Do If You Feel Depressed Immediately After Drinking

It’s common to feel depressed after alcohol use, even if you don’t have major depressive disorder. If you want to avoid experiencing depressive symptoms after drinking, here are some things you can do:

  • Drink in moderation: According to the National Institute on Alcohol Abuse and Alcoholism, moderate drinking means one drink per day for women and two for men.
  • Eat before drinking: Have a nutritious and balanced meal to keep alcohol from entering the bloodstream too quickly.
  • Know when to stop drinking: If you feel physically sick or emotionally unwell, stop drinking.
  • Ask for help: Talk to someone you trust and ask them to bring you home or keep you company.

Treatment for Concurrent Depression and Alcohol Use Disorder (AUD)

There are several ways to treat co-occurring depression and alcoholism. The best treatment will vary depending on the person, their situation, and the severity of their dual diagnosis. 

Some of the most common treatments for simultaneously occurring depression and AUD include the following:

Therapy

Therapy has been shown to help reduce symptoms of depression.8 

Cognitive behavioral therapy (CBT) is commonly used to treat mental health disorders like depression. CBT focuses on helping you identify and change negative behaviors and thought patterns. 

Additionally, behavioral therapies can help you recover from AUD.9 Cognitive behavioral therapy can help you recognize and change distorted thought patterns, which can cause suicidal behavior and ultimately lead to an AUD.

Rehab

There are two types of rehabilitation options common in treating co-occurring depression and alcoholism:

Outpatient Treatment

Outpatient treatment is a good option for people with moderate to severe alcoholism and depression. This type of treatment works well for people with co-occurring depression and AUDs, yet can live a reasonably normal life. 

Outpatient treatment allows people to continue to go to work and live at home while getting therapy and depression treatment. Moreover, outpatient treatment enables people to maintain relationships, keep up with responsibilities, and uphold a “normal” lifestyle.

Inpatient Treatment

Depending on the level of alcohol misuse, a person may need to seek more serious treatment. 

Inpatient treatment, also called residential treatment, is a form of rehab that requires people to stay at the facility full-time. This treatment is often used when someone has a more severe case of alcoholism or substance abuse.

Additionally, residential treatment can be helpful for someone who needs help detoxing, has an unsafe home life, or is severely addicted. Here, people get around-the-clock, 24/7 care under medical supervision.

Medication

In addition to treatment groups and facilities, a healthcare provider may suggest pharmacological treatments. Psychiatrists might prescribe selective serotonin reuptake inhibitors (SSRIs) for depression.

The most common SSRIs are:

  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Naltrexone
  • Acamprosate
  • Disulfiram
  • Topiramate

Most outpatient and inpatient treatments will have psychiatrists in-house who can prescribe medication to manage anxiety.

Some medications can lower alcohol cravings. These opioid blockers include naltrexone, which blocks the rewarding effects of alcohol, making the substance less addicting. 

In addition, it reduces heavy drinking but is most effective when an individual stops drinking before starting medication. 

Most healthcare providers prescribe naltrexone orally, though it is also available as a monthly injection administered intramuscularly.

Support Groups

Support group programs like Alcoholics Anonymous (AA) provide a safe space to discuss alcohol problems while maintaining your privacy. 

Commitment to discussions can reduce the chances of engaging in high-risk behaviors and encourage individuals to push forward in the sobriety process.

Below are a few alternative support groups and 12-step programs for substance-dependent patients:

  • SMART Recovery
  • LifeRing
  • Secular Organizations for Sobriety (SOS)
  • Women for Sobriety (WFS)
  • Moderation Management

Lifestyle Changes

Making positive changes in various areas of your life can reduce the risk of mood disorders, depression, alcohol dependence, and substance use disorder worsening. 

Lowering stress can subsequently improve immune responses and mental health and put individuals in a better mindset to manage mental health conditions.

Some lifestyle changes individuals can apply to manage a severe form of depression, AUD, and symptoms:

  • Eat a well-balanced diet that supports the immune system, cell regeneration, and vital organ functioning
  • Engage in exercise to improve physical health and get better-quality sleep
  • Create structure and daily routines for predictability
  • Engage in relaxing activities like meditation, creativity, or spa treatments
  • Develop connections with like-minded people
  • Explore new hobbies by attending a class or joining a group

Frequently Asked Questions

Why do people drink when they’re depressed?

Drinking alcohol can relieve feelings of anxiety, stress, or sadness. When you drink alcohol, you become sleepy and relaxed, helping ease symptoms of depression temporarily.
 
It’s not uncommon for people to drown out unwanted feelings of mental illness, physical pain, and emotional turmoil by drinking. Nearly 63.8% of alcoholics are depressed.1

While someone with depression may feel the short-lived effects of alcohol, it can decrease the effectiveness of the antidepressant medication in the long run.2 

Does alcohol dependence cause major depression?

Alcoholism can cause depression. Drinking will likely worsen symptoms of depression over time because it’s a central nervous system depressant.

While research remains limited, findings do see a prevalence of depression in frequent drinkers. A 2012 study demonstrated that higher drinking levels are associated with severe depression.11

Does genetics make you more susceptible to comorbid alcohol dependence and major depression?

While genes don’t guarantee that an individual will develop either disorder, a family history of these conditions is considered a risk factor. For example, those with nuclear family members with major depressive disorder are up to four times more likely to develop the same condition.

Environmental influences are more likely to cause depressive disorders. Being raised in poverty or an abusive household is a significant factor. Children who develop major depressive disorder are also more likely to drink earlier in life.

Summary

  • Major depression and alcohol misuse often go hand in hand, so they’re considered concurrent disorders. Depression can cause someone to have an alcohol use disorder (AUD), and AUD can make people depressed.
  • Often, people drink to find temporary relief from symptoms of depression. However, drinking only makes depression worse.
  • Treatment for co-occurring major depression and alcohol misuse includes therapy, rehab, lifestyle changes, and medication.
Updated on September 14, 2023
11 sources cited
Updated on September 14, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. Kuria et al. “The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence.” ISRN Psychiatry, 2012.
  2. Ramsey et al. “Alcohol Use Among Depressed Patients: The Need for Assessment and Intervention.” Professional Psychology Research and Practice, 2005.
  3. Huys, Q. “The unhealthy mix between alcohol and mental health.” Camden and Islington NHS Foundation Trust.
  4. Schütz et al. “Living With Dual Diagnosis and Homelessness: Marginalized Within a Marginalized Group.” Journal of Dual Diagnosis, 2019.
  5. Chen et al. “Sexual abuse and lifetime diagnosis of psychiatric disorders: systematic review and meta-analysis.” Mayo Clinic, 2010.
  6. Sher, L. “Dual disorders and suicide during and following the COVID-19 pandemic.” Acta Neurologica Journal, 2021.
  7. van Draanen et al. “Mental disorder and opioid overdose: a systematic review.” Social Psychiatry Psychiatric Epidemiology, 2021.
  8. Driessen, E., and Hollon, S.D. “Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators.” Psychiatric Clinic North America, 2010.
  9. McHugh et al. “Cognitive behavioral therapy for substance use disorders.” Psychiatric Clinic North America, 2011.
  10. McHugh, R.K. “Alcohol Use Disorder and Depressive Disorders. Alcohol research.” 2019.
  11. Geisner et al. “An Examination of Depressive Symptoms and Drinking Patterns in First Year College Students.” 2012.
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All content created by Alcohol Rehab Help is sourced from current scientific research and fact-checked by an addiction counseling expert. However, the information provided by Alcohol Rehab Help is not a substitute for professional treatment advice.
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