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The Link Between Alcohol and Depression

Alcohol use disorder (AUD) and depression commonly occur at the same time. This is referred to as a dual diagnosis, which is when a person is diagnosed with both a substance use disorder (SUD) and mental health disorder.

In the U.S., the prevalence of co-occurring disorders is high. Those with depression are more likely to abuse or become dependent on alcohol. Alcoholics also 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.

What is Depression?

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 and decreased self-worth. They often lose interest in activities they once enjoyed.

There is no single cause of depression. The condition can be attributed to a combination of genetic, environmental, and personal factors. The severity of depression also varies from person to person.

There are a few different forms of depression, including:

  • Major depressive disorder (MDD) – severe depression symptoms that interfere with everyday life. People with MDD cycle through depressive and normal states throughout their life.
  • Postpartum depression – this type of depression develops due to hormonal changes in the body after giving birth.
  • Seasonal affective disorder – sunlight decreases during the fall and winter months. This change can cause depression symptoms in certain people.
  • Bipolar disorder – when a person goes through periods of depression and mania.
  • Persistent depressive disorder – this type of depression can last many years or be lifelong.
  • Psychotic depression – when a person experiences psychosis (e.g., hallucinations) and depression symptoms.

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Symptoms of Depression

In addition to the symptoms mentioned above, other signs of depression can include:

  • Negative mood and/or sadness
  • Anger and irritability
  • Decreased productivity
  • Difficulties making decisions
  • Low self-esteem
  • Sleep pattern changes (sleeping too much or insomnia)
  • Changes in appetite (weight loss or weight gain)
  • Loss of energy and interest in activities
  • Tiredness
  • Feelings of guilt
  • 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. A formal depression diagnosis means your symptoms last for more than two weeks at a time.

How Depression Can Lead to Alcohol Misuse

Alcohol misuse is common in people with depression. Many turn to alcohol in order to escape feelings of sadness. Alcohol acts as a central nervous system (CNS) depressant and heavy use can lead to increased depression.

While drinking alcohol may provide an initial feeling of euphoria, it isn’t long-lived. In fact, studies show that alcohol consumption and depression increase the risk of suicidal thoughts and attempts.

Alcohol may create a temporary reduction in depressive symptoms. However, they tend to intensify once the alcohol wears off. Because of this, many people consume more alcohol to continue feeling the effects. This cycle increases the risk of developing an alcohol use disorder (AUD).

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

The National Bureau of Economic Research

How Alcohol Misuse Can Lead to Depression

While many believe that depression leads to an alcohol use disorder (AUD), the opposite is also true.

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. It also disrupts the hormonal systems involved in the development of many mental health disorders. 

Alcohol abuse often leads to:

  • Problems at work
  • Difficulty maintaining relationships
  • Financial troubles
  • Legal troubles

If your depression symptoms continue for over two weeks, a co-occurring disorder may be present.

How Alcohol Use Disorder and Depression Co-Occur

Living with alcoholism and depression increases your risk of experiencing a constant cycle of symptoms. For example, alcohol use may decrease the symptoms of depression for a short time. However, drinking to numb uncomfortable symptoms is very dangerous in the long-term.

Depression is also a common symptom of alcohol withdrawal. 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. It requires a specially focused treatment plan that addresses both conditions simultaneously.

In addition to depression symptoms, other signs of alcohol withdrawal may include:

  • Nausea
  • Vomiting
  • Anxiety
  • Shaking
  • Tremors
  • Headaches

Risks of Drinking Alcohol With Depression

Drinking alcohol if you have depression is very dangerous. On top of the adverse effects that can be experienced by either on their own, the combination could lead to hopelessness and potential self-harm. This is especially true if you are taking antidepressants.

Drinking while on antidepressants is also harmful to your health. Alcohol can increase the side effects of certain medications, including:

  • Dizziness
  • Coordination problems
  • Drowsiness
  • Increased feelings of depression
  • Extreme sedation
  • Decreased alertness
  • Risk of dangerous drug interaction

Treatment for Alcoholism and Depression

A dual diagnosis for alcohol addiction and depression is more difficult to treat at a traditional rehab facility. This is because 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 a long time, sobriety can often make depression worse. When a depressive episode hits, the risk of turning to alcohol to reduce the symptoms increases. This makes relapse more likely.

There are several available options for treating depression and alcohol abuse. Inpatient and outpatient treatment centers are two medically supervised options. Healthcare professionals may also recommend pharmaceutical or cognitive-behavioral therapy (CBT). 

Medical Detoxification for Alcoholism

Treatment in an integrated facility begins with detox in a safe environment. Medical professionals are available to assist with depressive symptoms that occur with 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.

Additional Therapies for Depression

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.

Depression is usually treated with a combination of therapies. This may include:

  • Cognitive-behavioral therapy (CBT)
  • Individual counseling
  • Medications (antidepressants)
  • Support groups
  • Holistic treatment options
  • Other forms of therapy recommended by your doctor

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Resources

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“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.

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