Alcohol & Depression

In 2018, researchers examined published studies about depression and AUD. They identified 22 studies that met their criteria and found that 21.9% of people with depression self-medicated with alcohol.[3]

In 2022, researchers writing for the journal Alcohol identified 13,753 people with depression. They found that those who self-medicated with alcohol were more likely to experience suicidal thoughts than those who did not use alcohol this way.[16]

The good news is that with proper awareness, understanding, and treatment, it is possible to break this cycle and pave the way toward a healthier, happier, and more fulfilling life.

How Are Alcohol & Depression Linked?

People with depression may turn to alcohol as a quick pick-me-up in the hope that it will provide momentary relief from their emotional struggles.[4] This temporary “fix” can quickly spiral into a dangerous cycle of depressive episodes and alcohol abuse. 

The Effect of Alcohol & Depression on the Brain

The interplay of alcohol and depression is complicated. Depression already contributes to an imbalance in the brain, and alcohol can worsen this imbalance. Even if the person feels better in the moment, the after-effects often include worsened depression symptoms.

Alcohol is classified as a depressant, which means that the chemical imbalance that causes depression is worsened by the use of alcohol. This happens on a small scale with a single session of alcohol use. Over time, ongoing alcohol abuse disrupts the balance of neurotransmitters, making depression even more intense.[4]

Additionally, when alcohol takes control of the brain, inhibitions drop and judgment becomes fuzzy. This means that the feelings of sadness and hopelessness that come with depression can be amplified under alcohol’s influence. It’s a dangerous combination that can increase the risk of impulsive behavior, self-harm, and other choices that can worsen their relationships and life circumstances, contributing further to feelings of depression.[5,6]

Biological Processes Involved in Alcohol & Depression

Alcohol interacts with key brain chemicals involved in regulating your mood. Those changes could make depression symptoms worse.

Researchers say alcohol works on two key receptors:[17]

• Serotonin: This neurotransmitter is known for promoting feelings of happiness and well-being. Low serotonin levels can contribute to depression.
• Dopamine: This neurotransmitter is associated with pleasure, motivation, and reward. While alcohol may initially increase dopamine levels, it’s depleted later and makes depression worse.

In short, alcohol disrupts the brain’s natural reward system and mood regulation, leaving you feeling more low and sad in the long run.

Depression & Alcohol Abuse Statistics

Here are some of the top statistics on the interplay of depression and alcohol abuse, including AUD:

• About a third of people with major depression disorder (MDD) also have alcohol use disorder (AUD) at some point in their lives.[7] 
• People who are dependent on alcohol are 3.7 times more likely to have MDD and 2.7 times more likely to have a milder form of depression in the prior year.[2]
• People with either MDD or AUD are likely to self-medicate emotional issues with alcohol or drugs. The prevalence of this self-medication practice ranges from 21.9% to 24.1%.[3]
• People with depression are more than four times as likely to develop alcohol dependence compared to their peers who aren’t depressed.[8] 
• Men are more likely to experience AUD before developing depression, while women are more likely to develop depression first and then develop AUD.[9]
• The presence of both depression and alcohol use increases the risk of engaging in impulsive behaviors, such as self-harm and suicidal ideation.[10-12]

Are Certain Types of Depression Worse for Alcoholism?

Certain types of depression may pose greater challenges when it comes to alcohol use. 

People with MDD, sometimes referenced as clinical depression, have a higher likelihood of developing AUD.[13] This type of depression can cause persistent feelings of sadness and lack of interest in things that were previously enjoyed, making it challenging to cope with life’s ups and downs. 

While all types of depression, including mild depression or dysthymia, are linked to higher rates of alcohol abuse, the link is strongest for MDD.

Bipolar disorder, which includes bouts of depression mixed with periods of mania, is also linked with AUD.[14] Drinking can worsen the clinical progression or cycle of bipolar disorder, greatly complicating the treatment process.

Understand the Cycle of Alcohol & Depression Over Time

The cycle of alcohol use and depression is complex, but many people tend to follow a typical series of steps. They include the following:

1. Depression begins. Someone has feelings of sadness and hopelessness.
2. Self-medication starts. People use alcohol in an attempt to lift their mood. The drinks increase dopamine levels and lead to a temporary mood boost.
3. Consequences start. As the alcohol wears off, serotonin and dopamine levels are depleted and depression begins.
4. Problems deepen. People drink more frequently to ease their mood, which is worse due to drinking.
5. Consequences deepen. People feel ashamed of their habits, and they may become socially isolated.
6. The problems become entangled. The person may experience withdrawal symptoms if they try to stop drinking, making it even harder to break the cycle. Depression and dependence worsen each other, creating a powerful and difficult situation to overcome.

What Treatment Options Are Available for Depression & AUD?

When depression and AUD occur in the same person at the same time, treatment for co-occurring disorders is needed. If only one condition is treated, relapse will likely occur quickly for the condition that is treated. The only way to effectively treat either condition is with treatment for both disorders.

Standard treatment for co-occurring depression and AUD includes both medications and therapy. Here is what to expect:[15-18]

Medications

Antidepressants are commonly used to manage depressive disorders. Antidepressants work by increasing the neurotransmitters serotonin and noradrenaline. These chemicals are linked to mood and emotion, and when they’re shifted, they can ease depression too. They can come with a range of side effects, but they tend to improve as the body gets used to the medication.[18]

In addition, medications may be prescribed to manage AUD, such as the following:[19,20]

• Acamprosate: This medication helps to prevent people from drinking alcohol, but it doesn’t prevent withdrawal symptoms. Side effects can include diarrhea, insomnia, and anxiety.
• Naltrexone: This medication blocks the euphoria associated with drinking. Side effects can include nausea, vomiting, and headache.
• Disulfiram: This medication makes people feel sick when they drink even a small amount of alcohol.

Therapy

In therapy, clients will identify issues that contribute to both their depressive symptoms and their alcohol abuse. They’ll develop coping mechanisms to better deal with triggers without drinking, and they’ll learn healthy habits that can boost their overall well-being and ability to stay sober.

Social Support

Support is a key part of recovery from both AUD and depression. Peer support groups can help members see that they are not alone in their challenges, and they can learn from the experiences of others. There are various support groups dedicated to those dealing with alcohol abuse, those with depression, and those with co-occurring disorders.