Alcohol and Depression
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Consuming alcohol is widely accepted and promoted as a way to relax and take the edge off difficult emotions. But when it comes to alcohol and depression, does having a few beers help or hurt? Can consuming alcohol help you manage your condition, or is it the opposite: Can drinking cause depression?
It appears that depression and alcohol have a complicated relationship, and may actually reinforce each other. Below, we’ll cover the reasons why, and what you can do to take care of yourself if you suffer from either or both conditions.
Learn more: Alcohol and Mental Health
Table of Contents
Is Alcohol Linked To Depression?
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 struggling with one doubles the chance of developing the other.
Alcohol abuse is 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 (AUD).1
Depression is also 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.2
Common symptoms of depression:
- Feeling sad
- 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
Does Alcohol Make Depression Worse?
The short answer is yes. But the effects of alcohol can be deceptive. In fact, countless people worldwide turn to alcohol to help manage the above symptoms. This is commonly referred to as “self-medication.”
This may lead a person to wonder, “does alcohol help depression?” In reality, although alcohol might provide momentary relief when someone is struggling, it often makes things worse in the big picture. But if that’s true, you might ask, “why does alcohol make me feel less depressed?”
Why Alcohol Might Make You Feel Better
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:3
- The nucleus accumbens, which 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, connected to expectation, sensory integration, and decision making. Research shows that feelings of depression (specifically low self-esteem and loss) are linked to orbitofrontal cortex function.4
By stimulating these two regions, alcohol can make you feel more relaxed, confident, at ease, and positive overall. If you’ve ever drank alcohol to escape feelings of depression, however, you’ve probably noticed these feelings don’t last. In fact, as the effects of alcohol recede, you may actually feel more depressed.
3 Ways Alcohol Makes Depression Worse
Can drinking too much alcohol cause depression? If so, why can alcohol make you depressed? Here are three ways drinking can make things worse in the long run.
1. Decreased Serotonin Levels
Drinking alcohol temporarily boosts serotonin levels, which can improve your mood in the moment.5 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 overall serotonin levels become, making underlying feelings of depression worse.
2. Increased Stress Hormones
Does drinking every day make you depressed? Heavy and long-term drinking can put significant strain on the body, leading to an increase in the stress hormone cortisol.6 Because of its role in our “fight-or-flight” response, increased levels of cortisol can cause feelings of chronic stress. This continual state of “high alert” can also affect your serotonin levels, increasing depression.
People with depression tend to have higher levels of cortisol in their bloodstream to begin with. Excessive alcohol consumption can exacerbate this, causing feelings of depression to become worse.
3. Decreased GABA Production
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.7 Decreased GABA levels may also lead to increased anxiety, which can increase feelings of depression as well.
In summary, does alcohol make you depressed? If you drink it frequently, yes. And if you already struggle with depression, alcohol can aggravate that underlying condition.
Facts and Statistics on 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.8
- 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.9
- 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. Fifty percent were experiencing major depression at the time of suicide.10
How Long Do The Depressive Effects of Alcohol Last?
Can alcohol make you depressed for days, or longer? The answer depends on how much you drink, and how often.
As discussed above, alcohol temporarily increases levels of “feel-good chemicals” like dopamine and serotonin. The next day, as these neurotransmitters return to their usual levels, you may feel depressed for a day or so. If you don’t drink regularly, your system should return to normal after this.
If you drink heavily on a regular basis, however, the depressive effects of alcohol may become a part of your daily life. And you may experience them even more acutely if you quit. Alcohol withdrawal leads to decreases in dopamine function.11 If you’re in recovery, and depression is a drinking trigger for you, this can make things especially difficult. Your system will eventually recover, but it can be helpful to have long-term support.
How To Treat 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.12
No matter which came first, 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.13
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 are shown to increase some people’s desire to drink.14 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.
Read more: Medication for Alcohol Use Disorder
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 equals removing 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.
Read more: Treating Depression and Alcohol Addiction: A Psychiatrist’s Perspective
How To Help Someone With Depression and Alcohol Abuse
If your loved one is struggling with both depression and alcohol, it can feel overwhelming. To overcome these patterns, a person must be ready to change of their own accord. But if you think they will be receptive, approach the problem with empathy and nonjudgement, and be prepared to offer solutions. If they are ready, help them research their options, and discuss the best ways for you to be supportive.
Depending on the person, depression may resolve quickly as they overcome their addiction. For other, including those who might have begun drinking to manage depression, it can take months or longer to improve. Your loved one may need treatment for depression in addition to treatment for alcohol use disorder. If possible, help them find a treatment program that includes counseling. This may make it easier for them to get care for their underlying depression.
For more tips on helping a loved one, check out our resources for family and friends.
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 in-network with many insurance providers.
Our approach has a high success rate: On average our members reduce their drinking by 75% within the first year. Learn more about how it works or get started with us today.