Alcohol and Depression: Understanding the Connection

Medically reviewed by Geralyn Dexter, PhD, LMHC

There is a strong link between alcohol use and depression, a mental health condition that includes feelings of hopelessness, emptiness, fatigue, loss of interest, and more. But does regular drinking lead to depression, or are people with depression more likely to drink too much alcohol? Both are possibilities.

This article covers everything you need to know about the connection between alcohol and depression.

Does Depression Drive You to Drink Alcohol?

Depression can lead some people to drink more alcohol. One study of 421 people found that 25% had both alcohol misuse and depression.

People with depression may use alcohol as a form of self-medication. Drinking alcohol can become a coping mechanism to deal with feelings of hopelessness, numbness, guilt, and worthlessness.

However, alcohol can make these feelings and other symptoms worse over time, perpetuating the cycle of alcohol consumption and depression.

Another way that depression could lead someone to drink alcohol is through changes in their brain as a result of depression. These changes can heighten the physiological "rewards" of alcohol and increase the likelihood that they will continue their pattern of drinking.

Related: How Signs of Depression Feel and Look

Does Drinking Too Much Make You Depressed?

Likewise, excessive alcohol consumption can also contribute to depression.

One study by the National Institute on Alcohol Abuse and Alcoholism found that people with alcohol use disorder (AUD) were 2.3 times more likely to have major depressive disorder than people who did not have AUD.

Alcohol consumption can lead to feelings of depression due to chemical reactions. In the short term, drinking alcohol can make you feel good, sociable, and even euphoric. This is due to a rush of the "feel-good" chemical dopamine.

However, this response is short-lived. Over time, your brain's reward pathway builds tolerance and requires more and more dopamine (via alcohol) to feel pleasure. This can lead to addiction and feelings of depression in the absence of the rewarding substance.

Excessive alcohol drinking can also cause problems socially, such as issues with family, school, employment, and friends. This could have a carryover effect on depression since loneliness and lack of social support are linked to depression.

Related: Symptoms of Alcohol Withdrawal: Timeline and Signs of Danger

How Long Does Alcohol-Induced Depression Last?

Substance-induced depression is different from major depressive disorder and, by definition, should improve once a person stops consuming substances (such as alcohol).

One study of people with both AUD and depression undergoing treatment for both conditions found that the majority of symptom improvement for both conditions happened during the first three weeks of treatment.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), if depression symptoms persist after one month without consuming alcohol, then a different depressive disorder diagnosis would apply.

Is It Genes or Lifestyle?

Researchers agree that alcohol and depression have a bidirectional relationship, meaning that depression can cause overuse of alcohol, but overuse of alcohol can also cause depression.

However, there is a third explanation for why alcohol and depression occur together so frequently: shared risk factors. In short, this means that the things that might predispose someone to depression or AUD overlap with one another.

For example, having a family member with an alcohol use disorder is a risk factor for both depression and alcohol use disorder. Emerging research has found that there is a genetic link between AUD and depression.

What You Can Do to Manage Alcohol and Depression

If you have depression and drink too much alcohol, then you may be wondering if there are any treatments or lifestyle changes for someone in your situation.

The following treatments are beneficial for co-occurring AUD and depression, but keep in mind this is a developing area of research:

• Antidepressants: Medications that are typically used to treat depression; little is known about their impact on alcohol use.

• Naltrexone: A prescribed medication used to treat alcohol use disorder.

• Cognitive behavioral therapy (CBT) and motivational interviewing (MI): A form of therapy (CBT) and specific technique (MI) within treatment that is useful in treating both conditions.

• Behavioral activation: A therapy to treat both conditions by retraining reward pathways.

• Mutual support groups (such as Alcoholics Anonymous): A form of social support found to be effective in treating alcohol use and depression.

Summary

There is a lot that we still need to understand about the link between alcohol and depression, and this is an emerging area of research. Existing research indicates that depression can cause alcohol overuse, and alcohol overuse can cause depression. On the other hand, both conditions also share certain risk factors, such as genetics and social isolation. Having either depression or alcohol use disorder increases your risk of developing the other condition. Talk to a healthcare provider about possible treatments.

Read the original article on Verywell Health.