Excessive consumption of alcohol can lead to alcohol use disorder (AUD). Alcohol use disorder is defined as problem drinking, and it can cover a large spectrum of people with alcohol issues.

• A lot of time spent drinking
• Recurrence of drinking too much or for too long
• Continually craving alcohol
• Continuing to drink despite negative effects on relationships
• Cutting back on other activities in favor of drinking
• Continued drinking even though it results in depression

The connection between alcohol and depression is undeniable.

Depression

Depression is a mental illness that can be very serious. It is characterized by a persistent sense of sadness in an individual, and it can lead to other diseases and injury. According to the Centers for Disease Control and Prevention (CDC), depression caused an economic burden of more than $210 billion in the year 2010 alone. This figure includes direct costs, workplace costs, and suicide-related expenses.

Depression can permeate every aspect of a person’s life and drastically affect those around them. It often results in problems with friends and family, as well as difficulty in the workplace. It increases the risk of the development of other diseases and puts an individual at greater risk for suicide. It can result in lower income, as workplace absence is commonplace among those battling depression. High-risk behavior is also seen more in individuals dealing with depression than those who are not, and issues like smoking, substance abuse, and eating disorders are more common in this population.

 

According to the American Psychiatric Association (APA), a person can be diagnosed with depression if they exhibit some of these symptoms for at least two weeks:

• Sadness
• Loss of interest in activities
• Erratic sleep patterns
• Fatigue
• Feelings of worthlessness
• Concentration problems
• Suicidal thoughts
• Guilt

Depression is a common condition. According to APA, it affects about one in every 15 people. Though it can arise in any point in a person’s life, it is most commonly seen for the first time during a person’s late-teens to the mid-20s. As far as gender goes, women are at a significantly higher risk for depression than men, and it is estimated that approximately one-third of women will experience a significant episode of depression at some point in their lifetime.

Depression may arise from a multitude of different factors. Some people are genetically prone to depression; for example, a family history of depression makes it more likely that a person will also suffer from depression. Personality can play a role, as those with low self-esteem or who are more likely to be pessimistic are also more likely to develop some level of depression. Environmental factors, especially those early in life, can also play a major role in the development of depression. While all of these factors may contribute to the likelihood of a person experiencing depression, they don’t mean a person will necessarily get the disorder. Many people can exhibit all risk factors and not experience any depression.

 

How Alcohol Abuse Can Factor into Depression

Some people drink alcohol in an attempt to cope with their depression. People can be drawn to the sedative effects of alcohol as a kind of medication, helping to distract from persistent feelings of sadness.

While alcohol may temporarily relieve some of the symptoms of depression, it ultimately serves to worsen depression on a long-term basis. Alcohol abuse brings with it a bevy of negative effects on virtually every aspect of life. As a person begins to experience financial and career consequences as a result of alcohol abuse, and their relationships begin to suffer, their depression worsens. This often leads to a damaging cycle of abusing alcohol in an effort to self-medicate symptoms of depression, and the depression worsening due to the continued alcohol abuse.

Once a person regularly abuses alcohol, physical dependence and addiction can quickly follow. According to the WebMD, about a third of those who suffer from major depression have a co-occurring AUD. It’s understandable that those who suffer from depression may seek out the temporary relief that alcohol can provide; however, again, alcohol abuse simply compounds the depression.

Some people have overlapping genetic predispositions that make them more vulnerable to both alcohol issues and depression, and the onset of one condition can trigger the onset of the other. Hangovers are often accompanied by feelings of depression, and continued alcohol abuse can lead to longer periods of depression.

Those who have been diagnosed with depression and take antidepressants to manage the condition can experience additional ill effects due to alcohol abuse. Alcohol makes antidepressants less effective, and the depressant effects of the alcohol will further worsen the now unmanaged, or less managed, depression.

Alcohol Abuse Leading to Depression

While depression can put a person at greater risk to develop an alcohol problem, the inverse is even more common. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), depression can arise and increase during a battle with alcoholism. This increase in depression can then lead to more drinking, thus perpetuating this cycle from the other angle.

If a person experiences feelings of depression as a result of alcohol abuse, it’s likely that these symptoms will dissipate, at least somewhat, after alcohol consumption has stopped. Since alcohol withdrawal can involve potentially life-threatening withdrawal symptoms after physical dependence has formed, it’s imperative that individuals don’t attempt to stop drinking suddenly on their own. Medical supervision is required.

According to a study published in Addiction, individuals dealing with alcohol use disorder or depression are at double the risk of developing the other condition. This was not simply a correlation, as the study concluded that alcohol use disorders and depression have a causal relationship.

The study found that alcohol abuse is more likely to cause major depression than the other way around, though the causality could go in either direction.

There were links found between the neurophysiological and metabolic changes brought about by alcohol abuse and the mechanisms for depression to occur. The study concluded that abuse of alcohol puts an individual at a significantly greater risk to develop depression than that of a person who is not abusing the substance.

Therefore, it is clear that alcohol abuse can induce depression, and depression can also induce alcohol abuse. This relationship can be cyclical as well, and an individual can get caught going back and forth between abusing alcohol and then using alcohol to try to quell the resulting depression. It can be an extremely challenging set of co-occurring disorders to address, and professional help is needed.

Treatment for Depression and Alcohol Abuse

Treatment for depression often involves some kind of antidepressant medication. These medications can help to modify a person’s brain chemistry in order to stabilize moods. Antidepressants are generally not considered addictive, and they are unlikely to be abused. This is especially helpful when treating a person with concurrent depression and alcoholism, as those with substance use disorders are more apt to attempt to abuse medications.

Some initial effects of antidepressant medications can be experienced rather quickly, usually within a week or two, but their full effect usually takes months to take hold. Most doctors instruct patients to continue taking antidepressants for months even after the depression symptoms have subsided completely. If a person only takes an antidepressant for a few weeks, it’s tough to ascertain whether the medication was a good fit.

CBT has also proven very effective in the treatment of alcohol use disorders, making it a great tool for those suffering from both AUD and depression. CBT is often used as a method to prevent relapse in people with alcohol problems. According to the National Institute on Drug Abuse (NIDA), CBT teaches an individual skills that can help them with problematic behavior. It offers client coping skills and includes the exploration of consequences related to addiction. This strategy attempts to anticipate problems before they happen and prepares an individual with plans on how to react when issues do arise. The skills learned in CBT stay with a person even after they leave treatment, making it an effective tool for long-term recovery.

While either alcoholism or depression can be extremely difficult on a person, experiencing both conditions concurrently can be particularly troubling and often results in significantly worse outcomes. Due to the common co-occurrence of depression and alcohol abuse, many addiction treatment facilities are equipped to treat both disorders simultaneously. This approach of integrated treatment is the most effective way to achieve recovery on all fronts. If only one disorder – either the depression or the alcohol abuse – is treated individually without addressing the other, relapse is highly likely.