Alcohol & Depression: Understanding the Link Between Both

Studies have shown a significant prevalence of self-medication with alcohol or drugs among those with depression and AUD.[3] Because alcohol is itself a depressant, it becomes a self-perpetuating cycle. 

The link between depression and alcohol is significant and can have devastating effects on the person struggling with the disorders, their families, and society as a whole. 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]

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.

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, and they work best when used in conjunction with therapy. In addition, medications may be prescribed to manage AUD, such as acamprosate, naltrexone, or disulfiram. Other medications may be prescribed on an as-needed basis to manage specific symptoms of withdrawal.

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.