Millions of people in the U.S. struggle with symptoms of clinical depression. As one of the leading causes of disability in the world, depression is a severe mental health condition that can cause significant impairment in a person’s day-to-day functioning. (1)
Depression, when left untreated, can also increase the risk of a person developing an addiction to drugs or alcohol. Excessive alcohol use is a contributing factor in suicidal behavior.
People dealing with the painful symptoms of depression often turn to alcohol for relief from these symptoms. But alcohol is only a temporary solution. Long-term, problem drinking can lead to a host of other problems and health complications.
Below are some potential avenues for supporting a loved one with alcohol misuse and heavy drinking in hopes they stop drinking and receive the proper alcohol treatment.
Alcohol and Depression: The Link Between Alcoholism and Depression
Alcohol and depression often share a complex relationship, with one influencing the other in a cyclical manner. (2) It is important to know and recognize the link between alcoholism and depression to address these issues effectively.
Here’s a breakdown of the key aspects:
1. Bidirectional Influence
Both alcoholism and depression can act as precursors for each other. Individuals struggling with depression may turn to alcohol as a means of self-medication, while excessive alcohol consumption can contribute to the onset or exacerbation of depressive symptoms. (3)
2. Chemical Impact
Alcohol affects neurotransmitters in the brain, such as serotonin and dopamine, which play a significant role in mood regulation. (4) Disruptions in these chemical pathways can contribute to the development or intensification of depressive feelings. When this is the case, seeking the right providers or seeking psychiatric efforts might be beneficial. (4)
3. Coping Mechanisms
Individuals experiencing depression may turn to alcohol as a way to cope with emotional pain or numb their feelings temporarily. However, this reliance on alcohol as a coping mechanism often leads to a vicious cycle, as alcohol can worsen mental health over time. Those with substance abuse disorders or alcohol addiction are likely struggling mentally.
4. Social Isolation
Alcoholism and depression can both contribute to social withdrawal and isolation. This isolation, whether self-imposed or due to societal American stigma, can further intensify feelings of despair and hopelessness. This will then lead to alcohol problems and other substance use disorders.
5. Treatment Challenges
Treating co-occurring alcoholism and depression requires a comprehensive approach. Addressing one without considering the other may lead to a relapse or incomplete recovery. Sometimes, if left untreated, new disorders could occur, such as anxiety disorders or worsened depression.
Integrated treatment plans that focus on both conditions at once tend to yield more positive outcomes for dual diagnosis.
What is Depression?
Depression is a protracted state of pervasive sadness and emotional despondency that endures over an extended period, casting a pervasive shadow over one’s daily life. (5) Unlike transient feelings of melancholy, depression manifests as a persistent and heavy emotional burden, rendering even routine tasks difficult or nerve-wracking.
Comparable to a persistent, overcast cloud, depression obscures the ability to find joy in previously enjoyable activities. It is an involuntary emotional state, extending beyond a mere transient dip in mood, and is not a matter of personal choice. (5)
Depression does not discriminate based on age and can impact individuals across the lifespan.
Types of Depressive Disorders
Depressive disorders encompass a range of conditions characterized by persistent feelings of sadness, hopelessness, and diminished interest or pleasure in activities. (6) Understanding these distinct types of depressive disorders is essential for accurate identification and effective management so there is no increased risk.
Here are some key classifications of this mental health disorder.
1. Major Depressive Disorder (MDD)
This is the most common form of depression. Individuals with major depression experience intense feelings of sadness or a lack of interest in nearly all activities for at least two weeks. Other symptoms may include changes in appetite, sleep patterns, and energy levels. (7)
2. Persistent Depressive Disorder (PDD)
Formerly known as dysthymia, PDD involves a chronic state of depression lasting for at least two years. While the symptoms may be less severe than those of MDD, their prolonged duration can significantly impact daily functioning. (8)
3. Bipolar Disorder
Bipolar disorder involves periods of intense emotional highs (mania or hypomania) alternating with depressive episodes. The depressive phase resembles major depressive disorder but occurs within the context of mood swings. (9) The mental health problems in this type of depression are serious and require medication along with cognitive behavioral therapy.
4. Seasonal Affective Disorder (SAD)
SAD is a mental illness characterized by recurrent depressive episodes that coincide with specific seasons, particularly fall and winter. Lack of sunlight exposure during these times may contribute to the onset of symptoms. (10)
5. Postpartum Depression
Occurring in new mothers, postpartum depression involves persistent feelings of sadness, anxiety, and exhaustion following childbirth. Hormonal changes, coupled with the demands of caring for a newborn, contribute to this condition. (11)
6. Psychotic Depression
In addition to depressive symptoms, psychotic depression involves features of psychosis, such as hallucinations or delusions. Individuals may experience a break from reality, making this form of depression particularly challenging.
Signs and Symptoms of Depression
- Persistent Sadness: Enduring feelings of profound sadness or a pervasive sense of emptiness that persists for an extended period.
- Loss of Interest or Pleasure: Diminished enjoyment or interest in once pleasurable activities, hobbies, or social interactions.
- Changes in Sleep Patterns: Significant alterations in sleep habits, including insomnia (difficulty falling or staying asleep) or hypersomnia (excessive sleep).
- Appetite and Weight Changes: Noticeable shifts in appetite, leading to significant weight loss or gain based on cravings.
- Fatigue and Low Energy: Ongoing feelings of tiredness, lethargy, or a general lack of energy, even with sufficient rest.
- Difficulty Concentrating: Challenges in focusing, making decisions, or maintaining concentration on tasks, often resulting in decreased productivity.
- Feelings of Worthlessness or Guilt: Persistent negative self-perception, accompanied by unwarranted guilt or feelings of inadequacy.
- Physical Aches and Pains: Unexplained physical complaints, such as headaches, stomachaches, or muscle pains, are often resistant to medical treatment.
- Social Withdrawal: A tendency to isolate oneself from friends, family, or social activities, leading to increased feelings of loneliness.
- Suicidal Thoughts: Persistent thoughts of death or a desire to end one’s life, which necessitate immediate attention and intervention.
Recognizing these signs and symptoms is best for early identification and prompt intervention. (12) If you or someone you know is experiencing these indicators, seeking professional help at a treatment center, whether short-term or long-term, is key.
Why Do People Drink Alcohol When They Are Depressed?
Depression causes an array of different symptoms that can cause distress and impairment in a person’s life. Some of the most common symptoms of depression include those listed above.
Alcohol, however, can alleviate these symptoms, although only temporarily. Drinking can elevate a person’s mood, help them relax, and decrease the urge to socially withdraw.
Still, excessive drinking over a long period of time can lead to alcohol dependence. When a person becomes dependent on alcohol, they experience physical and emotional withdrawal symptoms if they are unable to drink.
Alcohol dependence and excessive drinking can worsen depression symptoms. People who enter rehab for alcohol abuse stemming from depression must be treated for both, also known as co-occurring disorders. (2)
For individuals struggling with alcohol use, not addressing depression and receiving treatment increases the chances for relapse and suicide attempts.
Does Alcohol Abuse Cause Depression, or Are Depressed People More Likely to Abuse Alcohol?
Both scenarios are common, and it can be difficult for patients, loved ones, and clinicians to determine how these two conditions overlap. Alcohol is a depressant, and it can worsen existing depression symptoms.
To put this in perspective, according to a study from the National Institute on Alcohol Abuse and Alcoholism, people suffering from alcohol use disorder, or AUD, are over 2 times more likely to suffer from a major depressive disorder compared to people who do not abuse alcohol. (2)
The study also showed that acute AUD patients were nearly 4 times more likely to suffer from a major depressive disorder and nearly 3 times as likely to suffer from dysthymia, a prolonged mild depression. Dysthymia, when left untreated, can lead to major depressive disorder. (2) (13)
Once diagnosed and receiving treatment for depression, drinking alcohol renders antidepressant medications less effective. But drinking alcohol while taking an antidepressant doesn’t just make the medication ineffective; it can also produce dangerous side effects. For example, MAOI antidepressants mixed with alcohol increase blood pressure and can potentially cause a fatal stroke. (14)
People with depression who drink are at high risk of suicide. Depression, alcohol, and drug abuse are the top three major risk factors for suicide attempts.
Up to 75% of people who commit suicide have drugs and alcohol in their systems at the time of death.
About one-third of those who have clinical depression also have co-occurring alcohol use disorder. It’s common for depression sufferers or sufferers of mental disorders to find relief from their symptoms by drinking.
What Makes Someone Vulnerable to Depression and Co-occurring Alcohol Use Disorder?
There is no single cause for either depression or alcohol abuse and addiction. A combination of specific genetic, physiological, and environmental factors can increase someone’s risk of developing these comorbid conditions.
One condition can trigger the other, making matters even murkier for patients and clinicians alike. Which condition typically comes first is different for both men and women.
Studies show that men tend to report drinking problems before experiencing depression symptoms. Women, on the other hand, are more likely to be depressed before turning to larger amounts of alcohol to alleviate their symptoms. (15)
When Should Someone Get Help for Depression and Alcohol Use Disorder?
Depression and drinking make both problems worse, and it’s dangerous to drink while taking antidepressants. For people with comorbid depression and alcohol use disorder, they must receive comprehensive, integrated treatment for both diseases. Treating one, but not the other, increases the chances of relapse for either depression or alcoholism.
Depressed patients who need rehabilitation for alcohol use disorder can benefit from a combination of therapy, medical detox, antidepressants, and attending support groups like alcoholics anonymous and 12-step programs. (16)
What Should Someone Do if They Are Concerned About a Loved One’s Drinking and Depression?
First, it’s important to recognize the symptoms of depression and problem drinking. Problem drinking is defined as more than one drink per day for women and more than two drinks per day for men. Binge drinking for women is four or more drinks in one sitting for women and five or more drinks in one sitting for men. (17)
If a loved one is missing work or school, having trouble fulfilling obligations, and engaging in problematic behavior when drinking, these are all symptoms of alcohol use disorder.
For depression, the signs to look for in a loved one include:
- Feelings of shame or guilt
- Excessive sadness and tearfulness
- Anger and irritability
- Changes in sleeping patterns
- Changes in eating habits
- Lethargy
- Fatigue
- Problems engaging in self-care
- Problems fulfilling normal obligations
- Withdrawal symptoms
- Loss of interest or pleasure in things or activities that once brought joy
- Suicidal threats, self-harm, and suicide attempts
When confronting a loved one about depression and alcohol abuse, it’s important to avoid placing blame on the loved one. Before speaking to someone about these concerns, it’s critical to have a plan in place before the intervention.
The steps for helping a loved one with comorbid depression and alcoholism include: (18)
- Getting support from clinicians, social workers, mental health professionals, and drug rehabilitation counselors.
- Helping the person with self-care
- Having a treatment option ready for the individual to explore
- Staging an intervention
- Participating in the treatment plan
Get The Help You Need, Today
Alcohol and depression are lifelong illnesses that need ongoing care, maintenance, and support from trusted family and friends. But with healthcare treatment, people can go on to live a life of sobriety, free from the painful symptoms of depression.
If you’re concerned about your or a loved one’s depression and alcohol use, call the Zinnia Health drug addiction hotline at (855) 430-9439.
Citations
- https://www.who.int/news-room/fact-sheets/detail/depression
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6799954/
- https://www.sciencedirect.com/science/article/abs/pii/S0165032724000156
- https://www.matclinics.com/matclinics-blog/what-alcoholism-does-to-the-brain
- https://www.psychiatry.org/patients-families/depression/what-is-depression
- https://www.ncbi.nlm.nih.gov/books/NBK430847/
- https://www.nimh.nih.gov/health/statistics/major-depression
- https://www.health.harvard.edu/a_to_z/dysthymia-a-to-z
- https://www.medicalnewstoday.com/articles/bipolar-3
- https://www.nhs.uk/mental-health/conditions/seasonal-affective-disorder-sad/overview/
- https://www.jogc.com/article/S1701-2163(16)35240-9/pdf
- https://www.healthline.com/health/depression/recognizing-symptoms
- https://www.researchgate.net/publication/7928414_The_prevalence_and_impact_of_alcohol_problem_in_major_depression_A_systematic_review
- https://www.ncbi.nlm.nih.gov/books/NBK539848/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519357/
- https://www.ncbi.nlm.nih.gov/books/NBK64815/
- https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683830/
Related Articles
- Alcohol Use Disorder Treatment
- Is Alcoholism Genetic? Here’s What You Need to Know
- Alcohol Poisoning: Symptoms, Causes, Treatment, & Prevention