Alcohol & Health
Treatment
Helping Alcoholics
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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 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.
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:
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.
Depression can come in different forms and diagnoses, with some having more symptoms and more severe effects. Below are just a few types:
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):
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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A person might develop an alcohol use disorder due to several factors. These include:
A person’s risk for developing severe symptoms of AUD depends on how much and how often they drink.
Similar to major depression, AUD can range in severity. Moreover, signs and symptoms are different in every person.
Some symptoms of alcohol misuse include:
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:
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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
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:
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
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
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:
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 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.
There are two types of rehabilitation options common in treating co-occurring depression and alcoholism:
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.
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.
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:
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 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:
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:
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
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
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.
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