The Complex Relationship Between Alcohol and Depression
Alcoholism and depression can co-occur, but the relationship between the two isn’t always black and white.
About a third of people with major depressive disorder also have an alcohol use disorder. People with depression are more likely to develop an alcohol addiction, and sometimes alcohol is used in an attempt to relieve the immediate symptoms of a depressive episode. Turning to drinking every time you feel sad or hopeless can be a sign that you have an alcohol use disorder.
People with both alcoholism and depression should get treatment for both conditions concurrently to help reduce the chances of a relapse. Treating depression could make it easier to escape from addiction, but treating only the alcohol use disorder is unlikely to reduce depression without concurrent treatment.
What happens to the brain when you drink?
Drinking alcohol affects the brain in a few ways. While alcohol is classified as a nervous system depressant, this isn’t because it causes depression. Drugs classified as depressants are those that decrease activity of the central nervous system. Depressants such as alcohol interfere with the neurotransmitters that regulate your moods and control physical reactions. Many people report feeling happy while drinking because alcohol causes the brain to release more serotonin and dopamine, neurotransmitters related to pleasure. Alcohol also reduces anxiety for some people and can lower inhibitions, which can appeal to those with depression.
The depressant effects of alcohol also limit your brain’s ability to coordinate physical movements, speak clearly and react quickly. This combination of reduced physical ability and feel-good chemicals often leads people to engage in risky behaviors while drinking. This could include driving while intoxicated or trying dangerous things while your inhibitions are lowered. People who have been drinking might also act without considering the consequences. You might empty your bank account without thinking about the fact that you need the money for bills later in the month or skip work without realizing that you could lose your job for the unexcused absence.
Someone who has been drinking might also feel sleepy, which can seem appealing if you’ve been experiencing insomnia due to depression or anxiety. Alcohol may also inhibit the effects of medication, including antidepressants, so it can hamper efforts to treat depression. Someone who frequently drinks to reduce depression symptoms may feel even more depressed once the effects of alcohol wear off.
Can moderate alcohol use cause depression?
Moderate alcohol use, generally defined as one drink per day or less for women and two drinks or less a day for men, is not typically considered a cause of depression. This doesn’t mean there’s no link between moderate alcohol consumption and depression, though. Someone who already experiences symptoms of depression may notice changes in their symptoms when drinking, and using small amounts of alcohol to self-medicate for depression can easily lead to a tolerance that leads to heavier drinking.
Some people are more prone to developing both depression and alcohol use disorders. Factors that can increase the likelihood of both depression and alcoholism include:
- Genetic factors, such as a family history of substance abuse or major depressive disorder
- Concurrent mental health conditions, including previously unidentified issues
- Exposure to adult or childhood trauma
- Environmental effects such as childhood poverty
Does depression lead to drinking?
People who experience depression often drink to minimize their symptoms. The feel-good chemicals your brain releases in response to alcohol can temporarily lift the sad mood and fogginess of depression. Unfortunately, this effect changes over time as your brain develops a tolerance to alcohol. More alcohol is required to get the same effect, and the normal processes of dopamine production are disrupted.
This means that your body has more difficulty feeling pleasure and joy naturally while simultaneously becoming less able to achieve those emotional states using alcohol. People with depression often drink more and more as they chase the high that moderate drinking once provided.
Depressive symptoms may be hard to identify, and depression often goes untreated for a while before an official diagnosis. Recognizing the signs of depression helps you determine whether you might have concurrent alcohol use and mental health issues. Depression symptoms can include:
- Persistent feelings of sadness and hopelessness
- A loss of interest in formerly pleasurable activities
- Sleep disorders, including sleeping too much or experiencing insomnia
- Major changes in appetite and significant weight gain or loss in a short period of time
- Difficulty focusing and concentrating
- Recurrent thoughts of suicide or self-harm
The Long-Term Effects of Alcohol on Depression
In addition to the buildup of alcohol tolerance over time, alcohol also affects people with depression by reducing overall serotonin levels. Low serotonin levels can cause more feelings of depression when you aren’t drinking, which creates a cycle that’s hard to break. Once stuck in this cycle, people with both depression and alcohol use disorder often experience feelings of guilt and hopelessness.
Major depressive disorder isn’t the only form of depression, either. Some people experience Seasonal Affective Disorder, also known as SAD, which occurs during particular times of the year. People with SAD may feel depression symptoms during the winter months and be more cheerful and optimistic during the spring and summer.
Persistent depressive disorder includes ongoing depressive symptoms over two years or more, though the symptoms may seem milder than those experienced during major depression. Psychotic depression is a severe form of depression that involves severe mood swings, paranoia, hallucinations and delusions in addition to feelings of low self worth and persistent sadness. Alcohol use paired with any form of depression can be problematic, especially if the individual is using alcohol as a way to control or manage the depressive symptoms.
When should you get help for alcohol addiction?
You can get help for alcohol addiction at any point, but the earlier you get help, the easier it may be to break free of the addiction. Alcohol addiction typically occurs in three stages:
1. The Early Stage
During this early stage of alcohol addiction, you may participate in occasional binge drinking. When social drinking starts to affect everyday life or cause problems with relationships, this can be a sign that it has shifted into alcoholism or alcohol abuse.
2. The Chronic Stage
During Stage 2 of alcoholism, drinking becomes chronic. Daily drinking is a habit and you may show signs and symptoms of alcohol addiction or abuse, such as an increased tolerance to alcohol and engaging in risky behaviors while drinking. People in this stage have trouble quitting even though they might want to stop drinking.
3. The Danger Stage
Stage 3 is the most dangerous stage of alcohol addiction because it includes the development of chronic health issues related to alcohol use. This can include liver disease or seizures. People in Stage 3 of alcohol addiction may experience severe withdrawal symptoms when they try to quit drinking. Severe alcoholism requires a detox period before recovery from addiction can begin, and people detoxing from alcohol should be medically monitored for dangerous withdrawal side effects.
Symptoms’ Slow Creep
The positive feelings associated with alcohol use can make it hard to identify when drinking becomes a problem. Symptoms can also develop slowly. Someone with a mild or moderate alcohol use disorder may have two or three identifiable symptoms, while someone with severe alcoholism may present with four or five different symptoms.
Some of the common signs and symptoms of alcohol abuse and addiction include:
- Engaging in high-risk behaviours while drinking, such as driving, fighting, unsafe sexual practices and operating heavy machinery
- Drinking behaviours that affect your daily life, including school, work, romantic relationships and friendships
- Refusing to stop drinking despite the negative effects on your life
- Developing a tolerance to alcohol that makes you drink more to get the same effect a small amount once provided
- Experiencing cravings or withdrawal symptoms when you try to stop drinking
Quitting alcohol cold turkey can be dangerous, especially for people who have reached stage 3 of alcohol addiction. Withdrawal symptoms can include deadly seizures, so a doctor or nurse must be present to watch for these types of potentially deadly events. Trying to stop drinking on your own can be difficult even in the earliest stages, especially when depressive symptoms occur in conjunction with the cravings for a drink. Learning to avoid alcohol and finding other ways to cope with depression or other mental health disorders is essential for long-term recovery.
Can you be addicted to alcohol without symptoms?
Sometimes alcohol addiction develops slowly and subtly, and this can be especially true in people with other mental health disorders, including depression. The signs and symptoms of depression could mimic or hide the symptoms of alcohol abuse. People with hidden alcoholism may limit their drinking to times when they are alone.
While most people who develop an alcohol problem have easy-to-identify symptoms, some can maintain their regular activities despite having a drinking problem. High functioning alcoholism can develop when someone has a problem with drinking but doesn’t experience the typical problems associated with alcohol abuse.
People can also have high functioning depression, formally known as persistent depressive disorder, in which they hide the symptoms of depression that would otherwise indicate a need for intervention. Someone with high functioning alcoholism and high functioning depression may appear cheerful and happy to the outside world but have hidden symptoms that others don’t see.
Even if you don’t experience the typical symptoms of alcohol use disorder, drinking while depressed could still be a problem. Some things to consider when trying to determine if you need to seek help include:
- How often you drink
- Why you choose to drink
- How you feel during and after drinking
- The times and places when you tend to drink
EHN Canada can help for alcohol use and depression
Treatment for concurrent depression and alcohol use disorder involves a coordinated approach. After a detox period to get all alcohol out of your system and medically monitored withdrawal to watch for potentially dangerous withdrawal symptoms, rehabilitation and mental health care are handled simultaneously to maximize the chances of a full recovery without future relapses.
Some approaches used in treatment include individual therapy, group therapy, peer group sessions, family therapy to rebuild relationships damaged by alcohol use, and medication to reduce the symptoms of depression. Cognitive behavioral therapy is one type of counseling you might take part in to help with both co-occuring disorders. During CBT, you learn to identify the triggers that set off a drinking episode or depressive thoughts and develop strategies to deal with triggering events.
Because symptoms of both depression and alcohol use disorder can recur, ongoing therapy and treatment for these disorders is recommended once you leave an inpatient rehab program. During the inpatient program, you learn ways to deal with temptation and resist cravings, and an outpatient aftercare program helps reinforce these things as you re-enter society.
How to reach out for help
If you think you might have a problem with alcohol use and have been diagnosed with clinical depression, contact EHN today. Treatment for both depression and alcohol use disorder can be completed concurrently, helping you get back on track. Our lines are open 24/7 to get you the help you need. Give us a call at one of the numbers listed below to learn more:
EHN Canada has locations across Canada that specialize in addiction and mental health treatment. If and when you’re ready, please reach out to begin your recovery journey.
Outpatient Services (Multiple locations): 1-888-767-3711