Alcohol and depression have a complex relationship. In some cases, alcohol use can lead to depression. In other cases, depression can lead to drinking problems. Once alcohol use escalates into an alcohol use disorder (AUD), a person may suffer from a co-occurring disorder, also called dual diagnosis. This complicates treatment because clinicians must address and treat both conditions at the same time to be effective.
Understanding Alcohol Abuse And Depression
Legal and acceptable, drinking alcohol is commonplace in the United States. People drink to relax, socialize, or celebrate. Alcohol has a strong effect on people, and the intensity of the effects depend on a variety of factors. These include:
- family history
- how much you drink
- how often you drink
- mental/physical health status
When someone drinks alcohol despite harmful consequences, they may suffer from an alcohol use disorder (AUD). AUD is a relapsing brain disease characterized by compulsive drinking and lack of control. However, heavy or regular drinking may be just as harmful if a person suffers from depression.
Depression, also called major depressive disorder or clinical depression, is a common mood disorder. It causes symptoms that affect thought, feeling, behavior, and overall health. Some symptoms of depression include:
- decreased energy or fatigue
- feelings of hopelessness and guilt
- lack of interest in favorite activities
- persistent sad or empty mood
- suicidal thoughts
Symptoms must generally persist for at least 2 weeks for a clinical diagnosis of depression. To understand the relationship between alcohol and depression, it’s important to consider how one can lead to the other.
Can Alcohol Use Lead To Depression?
There are two main reasons alcohol use can lead depression, and the first is social. If a person starts drinking alcohol too much, they may start to experience problems in their life. Drinking can cause damage to relationships, legal problems, loss of employment, and other consequences. These troubling situations can cause negative emotions, which could develop into a major depressive disorder.
The second reason is more biological. While drinking alcohol may initially feel good because of the euphoric effect, alcohol use changes chemical functioning in the brain. Alcohol is a central nervous system (CNS) depressant, which means it slows brain activity. Long-term alcohol use can severely affect the production of the brain chemical serotonin, which is said to be related to clinical depression and other mood disorders.
People with prior history of an alcohol use disorder may be more likely to feel symptoms of major depression, even when they no longer drink alcohol.
Can Depression Lead To An Alcohol Use Disorder?
Although difficult to determine, it’s possible depression can lead to an alcohol use disorder (AUD). Research shows that almost a third of people with depression also suffer from a drinking problem. In an attempt to self-medicate, people may think alcohol can help with depression to alleviate their symptoms. Because of how alcohol affects the brain, drinking can make depressive symptoms even worse.
Many people with depression also have genetic risk factors for alcohol use disorders. Family history or brain development problems can make people with depression more susceptible to alcohol dependence. A Yale University study compared alcohol use disorders among depressed and nondepressed persons, finding people with depression are more likely to suffer from AUD throughout their lifetimes.
A person with clinical depression and an alcohol use disorder suffers from a co-occurring disorder.
Co-Occurring Disorders – Depression And Alcohol Use Disorder
Co-occurring disorders are diagnosed when a person suffers from mental illness and a substance use disorder. Also called dual diagnosis, co-occurring disorders are difficult to diagnose and even more difficult to treat. For example, depression and alcohol withdrawal can have similar symptoms, like anxiety and fatigue, making it difficult for clinicians to differentiate one disorder from another.
Further complicating matters, treatment providers may need to initially know which disorder came first. Did drinking lead to depression, or did depression lead to drinking? This question is usually best answered when the person stops drinking alcohol. Research shows depressive symptoms go away after abstaining from alcohol for a few weeks. If depressive symptoms persist, treatment can focus on depression, which may also help the alcohol use disorder.
However, receiving treatment for one disorder, and not the another, may worsen each condition. In order for treatment to be effective, both conditions must be treated at the same time.
Alcohol And Depression Treatment
Both clinical depression and an alcohol use disorder are generally treated with a combination of behavioral therapy and medications. Many inpatient treatment centers, also called residential rehab, provide specialized programs for people with co-occurring disorders.
Certain intensive behavioral therapies, like cognitive behavioral therapy (CBT) and motivational interviewing (MI), have shown positive results for dealing with depressive and alcohol use disorders. Medications, like antidepressants, can be used to treat depression. Other government approved medications are successful for reducing alcohol cravings, but won’t be effective for treating depression.
Integrated treatment, or a collaboration of services among professionals in the mental health and addiction treatment fields, is likely most effective. People with co-occurring disorders have a low rate of completing treatment, making an integrated approach essential for their success in recovery.
Contact us today and learn more about treatment options for depression and AUD.
National Institute on Alcohol Abuse and Alcoholism—Overview of Alcohol Consumption
National Institute of Mental Health—Depression
Research Institute on Addictions—Alcohol and Depression
U.S. National Library of Medicine—Alcohol Use Among Depressed Patients