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 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.
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.
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:
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.
Similar to depression, AUDs can range in severity. Moreover, signs and symptoms are different in every person.
Some symptoms of alcohol abuse include:
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:
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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
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 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.
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
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 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.
There are two types of rehabilitation options common in treating co-occurring depression and alcoholism:
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.
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.
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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