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The Link Between Alcohol and Depression

Sometimes, a person is diagnosed with both a substance use disorder and mental health disorder. This is called a dual diagnosis.

Alcohol use disorder (AUD) and depression commonly occur at the same time. 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.

It is estimated that major depression occurs in over 24 percent of alcohol-dependent men. It occurs in just under 50 percent of alcohol-dependent women.

National Comorbidity Survey

What is Depression?

Depression is the most common mental health disorder in the U.S.

Some facts about depression include:

  • It affects over 16 million adults in the United States.
  • There is no single cause of depression. It varies from person to person.
  • People with depression suffer from feelings of sadness and decreased self-worth.

Depression is often characterized by the loss of interest in activities once enjoyed. The condition can be attributed to a combination of several factors such as:

  • Genetic
  • Environmental
  • Personal

There are a few different forms of depression, including:

  • Major depressive disorder (MDD) – severe depressive symptoms that interfere with everyday life. People with MDD cycle through depressive and normal states throughout their life.
  • Postpartum depression – this 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 depressive 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 depressive symptoms.
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Symptoms of Depression

In addition to the symptoms mentioned above, other depressive symptoms 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 depressive 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. Studies show that alcohol consumption and depression increase the risk of suicide.

Alcohol temporarily reduces depressive symptoms, but they intensify once the alcohol wears off. Ultimately, people consume more alcohol to continue feeling the effects. This increases the risk of developing AUD.

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

The National Bureau of Economic Research
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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 common in people with a genetic predisposition to, and a family history of, depression.

When you suffer from AUD, alcohol consumption is a regular part of life.

Heavy alcohol use:

  • Affects brain function
  • Alters brain chemicals
  • Disrupts the hormonal systems

Alcohol misuse can also intensify mental health conditions such as:

  • Anxiety
  • Bipolar disorder
  • Major depressive disorder
  • Post-partum depression

Alcohol abuse often leads to:

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

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

How Long Does Alcohol-Induced Depression Last?

Alcohol-induced depressive symptoms typically resolve 3-4 weeks after your last alcoholic drink. However, this also varies from person to person.

Research suggests that alcohol or substance-induced depression can turn into independent depression. When this happens, depressive symptoms persist despite cessation of alcohol or substance use.

How Alcohol Use Disorder and Depression Co-Occur

Living with alcoholism and depression increases your risk of experiencing a constant cycle of symptoms.

Alcohol use may temporarily reduce depression symptoms. 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 alcohol consumption.

This vicious cycle can be difficult to overcome. It requires a focused treatment plan that addresses both conditions simultaneously.

In addition to depressive 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. This is on top of the adverse effects caused by either on their own.

The combination of drinking alcohol while depressed could lead to hopelessness and potential self-harm.

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

  • 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 presents unique challenges. It is more difficult to treat at a traditional rehab facility.

Treating only one condition often leads to relapse. If a physician treats someone with depression for AUD alone, they may successfully detox.

However, sobriety can often make depression worse. This happens when you have been masking symptoms of depression with alcohol for a long time.

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 substance abuse. These include:

  • Inpatient treatment centers
  • Outpatient treatment centers
  • Medication-assisted therapy (MAT)
  • 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. This usually happens after several days or weeks of abstinence.

Additional Therapies for Depression

If there is an underlying depressive disorder, the following can help:

  • Counseling
  • Pharmacotherapy
  • Regular mental health therapy after rehab

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

Resources

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Alcohol and Depression: How to Treat Co-Occurring Issues.” Alcohol.org.

Alcohol Use, Abuse, and Depression: Is There a Connection?WebMD, WebMD, 12 Nov. 2018.

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.

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.

Depression and Addiction.” Dual Diagnosis.

DeVido, Jeffrey J, and Roger D Weiss. “Treatment of the Depressed Alcoholic Patient.” Current Psychiatry Reports, U.S. National Library of Medicine, Dec. 2012.

Digital Communications Division. “Does Alcohol and Other Drug Abuse Increase the Risk for Suicide?HHS.gov, 13 May 2016.

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.

Major Depression.” National Institute of Mental Health, U.S. Department of Health and Human Services.

Mental Illness and Substance Abuse.” The National Bureau of Economic Research.

Pompili, Maurizio, et al. “Suicidal Behavior and Alcohol Abuse.” International Journal of Environmental Research and Public Health, Molecular Diversity Preservation International (MDPI), Apr. 2010.

Wasson, Anne. “Alcohol Worsens Depression; Depression Worsens Alcohol Abuse.” AFMC, 17 Apr. 2018.

"What Is Depression?" American Psychiatric Association.

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