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Updated on December 8, 2022
6 min read

Depression and Drinking

Alcoholism and depression often go hand in hand. It’s common for someone struggling with depression to start drinking alcohol to alleviate negative symptoms. It’s also common for someone struggling with an alcohol use disorder (AUD) to develop depression.

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

What is the Connection Between 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 (AUDs) can range from mild to severe, including binge drinking and alcoholism. 

Depression and alcohol abuse often go hand in hand, which is why they’re 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.

Alcohol can temporarily suppress symptoms of depression, but not for long. Drinking alcohol will likely make your depression worse over time. 

Alcoholism can also cause depression. In this case, alleviating alcoholism may rid you of your depression, but alleviating depression may not relieve you of your AUD.

Symptoms of Depression

Depression can come and go throughout your life. While some people may only experience depression once, most have multiple episodes. 

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 depression symptoms so intensely that they can’t perform daily tasks. Others will notice less extreme symptoms. 

Symptoms of Alcohol Abuse

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

Some symptoms of alcohol abuse 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 symptoms when you don't drink

People who struggle with AUD will often experience withdrawal symptoms when they try to stop drinking. 

Symptoms of withdrawal can be mild to severe and include:

  • Sweating
  • Headaches
  • Vomiting
  • Shakiness
  • Anxiety
  • Seizures
  • Delirium tremens (DTs), which can be deadly
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Why Do People Drink When They’re Depressed?

It’s not uncommon for people to drink to drown out unwanted feelings of mental illness, physical pain, and emotional turmoil. 

Drinking alcohol can ease feelings of anxiety, stress, or sadness. Additionally, drinking a few alcoholic beverages can make you sleepy and relaxed. This mood shift can help ease symptoms of depression temporarily. 

Nearly 63.8% of alcoholics are depressed.1 This statistic shows just how intertwined alcohol and depression are. In turn, alcohol can decrease the effectiveness of the antidepressant medication.2 

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 yourself6
  • Overdose
  • Additional mental health disorders 
  • Additional drug or alcohol addiction

Effects of Alcohol Use on Depression

Drinking when you're depressed can make depression worse.2 This is due to a few reasons. 

For one, alcohol decreases the effectiveness of antidepressants. Antidepressants often play a significant role in treating depression. 

Secondly, alcohol affects the same areas of the brain that help to regulate mood. When you drink, your brain chemistry changes, triggering and heightening mental illness symptoms like depression.

Alcohol influences dopamine and receptors for the brain neurotransmitter GABA (gamma-aminobutyric acid). GABA produces calming effects, while dopamine produces pleasure, motivation, and satisfaction. 

Alcohol stimulates GABA receptors and dopamine, which dampens the brain’s ability to produce them independently. 

How Alcohol Withdrawal Affects Depression

When you drink excessive amounts of alcohol, your brain adapts by reducing GABA receptors that are being fulfilled by drinking. 

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

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

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

  • Agitation
  • Anxiety
  • Sweating
  • Shakiness
  • Nervousness
  • Anger
  • Dysphoria
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Treatment for Co-Occurring Depression and Alcohol Use Disorder (AUD)

There are several ways to treat co-occurring depression and alcoholism. The best form of 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 the most commonly used to treat mental health disorders like depression. CBT focuses on helping you identify and change negative behaviors and thought patterns. 

Additionally, CBT can help you recover from AUD.9 Cognitive behavioral therapy can help you recognize and change distorted thought patterns, which can influence 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 dealing with moderate to severe alcoholism and depression. In addition, this type of treatment works well for people with co-occurring depression and AUDs who can live a reasonably normal life. 

That's because outpatient treatment allows people to continue to go to work and live at home while getting therapy and 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 use, 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 like a psychiatrist may suggest starting on antidepressant medication. 

Psychiatrists often prescribe selective serotonin reuptake inhibitors (SSRIs) for depression. The most common SSRIs used are escitalopram (Lexapro), fluoxetine (Prozac), and sertraline (Zoloft).

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

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Summary

  • Depression and alcohol abuse often go hand in hand, which is why they’re considered co-occurring disorders.
  • Depression can cause someone to have an alcohol use disorder (AUD), and AUDs 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 depression and alcohol use disorder includes therapy, rehab, and medication.
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Updated on December 8, 2022
9 sources cited
Updated on December 8, 2022
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 MW, et al. “The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence.” ISRN Psychiatry, 2012.
  2. Ramsey SE, et al. “Alcohol Use Among Depressed Patients: The Need for Assessment and Intervention.” Prof Psychol Res Pr, 2005.
  3. Huys, Quentin. “The unhealthy mix between alcohol and mental health.” Camden and Islington NHS Foundation Trust.
  4. Schütz, Christian G.,  et al. “Living With Dual Diagnosis and Homelessness: Marginalized Within a Marginalized Group.” Journal of Dual Diagnosis, 2019.
  5. Chen LP, et al. “Sexual abuse and lifetime diagnosis of psychiatric disorders: systematic review and meta-analysis.” Mayo Clin Proc, 2010.
  6. Sher L. “Dual disorders and suicide during and following the COVID-19 pandemic.” Acta Neuropsychiatr, 2021.
  7. van Draanen J, et al. “Mental disorder and opioid overdose: a systematic review.” Soc Psychiatry Psychiatr Epidemiol, 2022.
  8. Driessen E, et al. “Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators.” Psychiatr Clin North Am, 2010.
  9. McHugh RK, et al. “Cognitive behavioral therapy for substance use disorders.” Psychiatr Clin North Am, 2010.

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