Consuming alcohol isn’t just common, it’s also widely accepted and promoted as a way to relax, let go, and have a good time.
While plenty of people use alcohol moderately, there are many others for whom this is not so easy. Some may even develop an addiction to alcohol, becoming entangled in a cycle that is difficult to break.
The toll that alcohol dependence takes on one’s physical and mental health is undeniable. Research shows numerous health risks associated with alcohol use and alcoholism. Among the most common is a strong link between alcohol and depression.
The Connection Between Depression and Alcohol Abuse
What exactly is the relationship between alcohol and depression? Does alcohol cause depression? Or is it depression that leads to alcohol abuse?
It’s a classic “chicken vs egg” dilemma, and it may work both ways. Research suggests that the occurrence of one doubles the chance of developing the other.
Depression is more common than you might think. According to the American Psychiatric Association (APA), depression affects approximately one in 15 people. Symptoms can affect every aspect of a person’s life, and can range from mild to severe. The following are some common symptoms of depression:
- Feeling sad
- Experiencing a depressed mood
- Loss of interest in activities one typically enjoys
- Difficulty sleeping (not sleeping enough or sleeping too much)
- Loss of energy/fatigue
- Feelings of guilt or worthlessness
- Trouble concentrating
- Suicidal thoughts
Alcohol abuse is also more common than many people realize. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), over 14 million adults in the U.S. (5.8 percent of this population) suffer from alcohol use disorder.
Depression and Drinking
Have you ever noticed that a couple of drinks can help lift your mood when you’re feeling out of sorts?
You’re not alone.
People commonly use alcohol as a way to escape reality, and suppress the dull, empty emotions associated with depression. In fact, there are countless people worldwide who turn to alcohol as a way to manage their depression. This is commonly referred to as “self-medication.”
Over time, many people come to believe that alcohol is helping them cope, helping them sleep, and taking the edge off feelings of sadness, restlessness, and irritability. However, while alcohol might provide momentary feelings of well-being when someone is struggling, in the big picture it can actually make things worse.
Alcohol and the Brain
To better understand how alcohol can cause depression, let’s have a look at how alcohol works in the brain.
In a 2012 study published in Science Translational Medicine, researchers found some reasons why alcohol might temporarily make a person feel “better.” It appears that alcohol consumption releases endorphins in certain areas of the brain, specifically the nucleus accumbens and the orbitofrontal cortex.
The nucleus accumbens plays a key role in the brain’s reward circuit. Its action is mainly based on two primary “feel good” chemicals in the brain, serotonin and dopamine.
The orbitofrontal cortex is associated with expectation, sensory integration, and decision making. Research shows that feelings of depression (specifically low self-esteem and loss) are linked to orbitofrontal cortex function.
Considering the way alcohol affects these two brain regions, it makes sense that it could help one temporarily feel better. Anyone who has drank alcohol to escape feelings of depression, however, knows that this feeling doesn’t last.
How Alcohol Makes Depression Worse
Alcohol has several adverse health effects that can contribute to depression:
Alcohol Decreases Serotonin Levels
Drinking alcohol temporarily boosts serotonin levels, which is why so many people feel “better” after having a few drinks. In the long term, however, excess alcohol consumption does the exact opposite.
Low serotonin levels are linked to feelings of depression and low energy. They can also lead to symptoms of anxiety, decreased self-esteem, difficulty sleeping, aggression, and more.
The more you drink, the lower your serotonin levels become overall. So if you already suffer from depression, drinking can intensify these feelings.
Excessive Drinking Can Increase Stress Hormone Levels
Research indicates that heavy and long term drinking can put significant strain on the body, and lead to an increase in the stress hormone cortisol.
Because of its role in our “fight-or-flight” response, increased levels of cortisol can result in feelings of chronic stress. This continual state of “high alert” can cause neurotransmitters such as serotonin to stop functioning correctly, which can in turn lead to depression.
People with depression tend to have higher levels of cortisol in their bloodstream to begin with. Excessive alcohol consumption can exacerbate these chronically high cortisol levels, causing feelings of depression to become worse.
Long Term Exposure to Alcohol Leads To Decreased GABA Levels
GABA is a neurotransmitter responsible for blocking impulses between nerve cells in the brain. When GABA is at its optimal level, this neurotransmitter is believed to improve mood and help relax the central nervous system.
Long term heavy drinking seems to reduce GABA levels in the brain, which research suggests can ultimately make depression worse. Decreased GABA levels may also lead to increased anxiety, which can increase feelings of depression as well.
Facts and Statistics About Depression and Alcohol
In the 2010 National Survey on Drug Use and Health, nearly one sixth of U.S. adults who met the criteria for substance abuse disorder reported at least one major depressive episode in the same period of time.
- People who experienced a major depressive episode in the past year were also more likely to report problems with substance abuse or dependence.
- The majority of people struggling with both depression and substance abuse reported that alcohol was their most used substance.
- Struggling with either depression or alcohol abuse can double a person’s risk of developing the other issue.
- Individuals experiencing both major depression and alcohol use disorder have an increased risk of suicide. One study found that blood alcohol concentration was above or at the legal limit in 30 percent of suicide deaths. 50 percent were experiencing major depression at the time of suicide.
Treatment Options for Alcoholism and Depression
If you’ve been suffering from depression, and have been attempting to drink your blues away, you’re certainly not alone.
Research shows that most people who abuse alcohol and enter treatment have high scores on depression rating scales. For many, these ratings tend to decline after a few weeks of abstinence from alcohol. For others, depression may continue to be an issue, especially if their alcohol abuse developed from an attempt to self-medicate.
No matter which came first, however, an increasing number of health professionals believe it’s best to treat alcohol use and depression at the same time. An integrated model of treatment—which includes both pharmacological and psychological therapy—is often seen as the most effective way to do this.
Prescription Medication for Depression
There are several FDA-approved drugs for the treatment of depression. Selective serotonin reuptake inhibitors (SSRIs) are among the most popular, and often help to lift a person’s mood.
If you’re being treated for both depression and alcohol abuse at the same time, however, you should be careful about combining antidepressants and alcohol. SSRIs have been shown to increase some people’s desire to drink. Alcohol can also worsen the side effects of antidepressants, which include dizziness, drowsiness, insomnia, blurred vision, headaches, and more.
This interaction is rarely life-threatening. But if you’re struggling with depression, and also trying to cut back on your drinking, you may want to discuss alternatives with your doctor.
Prescription Medication for Alcohol Abuse
There are also prescription drugs that can help a person reduce or stop drinking. FDA-approved medications for the treatment of alcohol use disorder include:
Several other drugs are considered effective “off-label” medications for alcohol abuse. This means they are FDA approved for another purpose, but deemed safe for alcohol addiction treatment. These include:
Some of these medications also help with anxiety and depression. But once again, since everyone is different, consult with your doctor before trying any of these. In rare cases, some of these drugs can make depression much worse.
Therapy and Support
Aside from medication, most people struggling with both alcohol and depression benefit from some type of therapy or behavioral health support. This can mean joining a support group, such as Alcoholics Anonymous or SMART Recovery. It can also mean finding a personal therapist, or a recovery coach.
Removing alcohol from the equation often means the removal of a coping mechanism. If you’re also struggling with depression, having experienced peers or a trusted professional to talk to can make a big difference. A therapist or recovery coach can help you learn new ways of managing cravings and difficult emotions, while joining a group can make you feel less isolated.
Either way, strong mental health support makes a big difference in overcoming depression and alcohol.
New Solutions for Alcohol Use and Depression
The connection between alcohol and depression is well documented. Experts agree that where there is one, the other often appears.
Fortunately, there seems to be an answer. Treating both problems at once with a combination of medication and therapy has shown very positive results. This is especially true when treatment is flexible to the unique needs of the individual.
Ria Health is one program that strives to make this approach easier to access. We offer both medication and coaching for alcohol addiction via telemedicine. Treatment plans are customized to each person’s needs through online meetings with our medical team. Our program is 100 percent accessible through your smartphone or personal device, and is even in-network with many insurance providers.