Alcohol & Depression: The Connection & Dual Treatment Near Me
Simultaneous treatment for alcohol use disorder and a depressive disorder can help you or your loved one take back control of your mental health, physical wellbeing, and overall happiness. Know that you’re not alone and help is available.
Ways to Get in Contact With Us
If you believe you or someone you love may be struggling with addiction, let us hear your story and help you determine a path to treatment.
There are a variety of confidential, free, and no obligation ways to get in contact with us to learn more about treatment.
Everyone feels blue or down from time to time, and people often say that they feel “depressed” during these temporary bouts of sadness. But clinical depression isn’t just a matter of feeling the occasional ups and downs or periodic sadness caused by issues of daily life.
Major depressive disorder, persistent depressive disorder, and other depressive disorders are treatable mental health disorders that are characterized by symptoms of sadness, emptiness, or irritable mood that affects a person’s body and mind, specifically the ability to function. Although researchers have identified several risk factors for depressive disorders, they can occur in anyone. Not everyone who experiences risk factors will develop a depressive disorder, but risk factors can play a role in its development. These risk factors include:1,2,3,4,5
- Genetics and heritability. Genes are not destiny, but a family history of depression is considered a risk factor. First-degree family members of individuals with major depressive disorder have a risk two- to four-times higher than the general population.
- Biological factors and illness. This includes your physical health, such as having a serious illness like cancer, diabetes, or heart disease, as well as your levels of neurotransmitters (brain chemicals), which can become imbalanced and influence depression.
- Stress, major life changes, and exposure to trauma. Any of these can be a risk factor, but particularly if you experienced them in childhood.
- Taking certain medications. Some of the side effects of medications can cause or contribute to depressive symptoms.
- Low socioeconomic status. While socioeconomic status can play a role at any point in your lifespan, it can be a particular risk factor early in life.
- Using illicit substances or alcohol. Different substances can increase your risk of developing depression.
There are several types of depressive disorders with somewhat different presentations. These disorders include:1,5,6
- Major depressive disorder. This causes severe symptoms that must be present for at least 2 weeks to receive the diagnosis. Symptoms affect your ability to work, sleep, eat, study, and function.
- Persistent depressive disorder, also known as dysthymia. This causes less severe symptoms than major depression, but symptoms tend to last longer (at least 2 years in most cases).
- Postpartum depression, also known as perinatal depression. This is a type of major depression that can occur to women during pregnancy or after they give birth.
- Seasonal affective disorder. People can experience depressive symptoms due to seasonal changes, such as lack of exposure to daylight. While it can occur any time of year, it typically begins in the fall or early winter and goes away in the spring or summer.
- Psychotic depression, also known as depression with psychosis. This is a severe form of depression where people experience hallucinations (seeing, hearing, feeling, or smelling things that aren’t there) or delusions (believing things that aren’t true).’
- Bipolar disorder, which is different from depression, however, a person with bipolar disorder experiences episodes of low or irritable moods that meet the criteria for major depressive disorder.
- Medication- or substance-induced depression. This is a type of depression where depressive symptoms emerge during or soon after exposure to a substance (i.e., intoxication) or medication or while experiencing withdrawal symptoms from a substance or medication.
Signs and Symptoms of Depression
To be diagnosed with major depressive disorder or another depressive disorder, people typically need to display symptoms almost every day for at least 2 weeks. The symptoms are severe enough that they cause significant stress and impairment in social, occupational, or other important areas of functioning.5 While the specific types of depressive disorders can look a bit different, they tend to share common symptoms that include:1,5,6
- A persistent low mood, feelings of sadness, and/or feeling anxious or empty.
- Feeling hopeless or pessimistic.
- Irritability, frustration, or restlessness.
- Feeling excessively or inappropriately guilty, worthless, or helpless.
- Losing interest or pleasure in activities or hobbies you once enjoyed.
- A lack of energy or fatigue.
- Moving or talking more slowly than usual.
- Difficulty thinking, remembering, or making decisions.
- Changes in sleep, such as trouble falling or staying asleep (insomnia) or sleeping more than usual (hypersomnia).
- Changes in appetite with significant weight loss or weight gain (e.g., a change of more than 5% of body weight).
- Having thoughts of self-harm, death, or suicide, or making suicidal attempts.
- Aches, pains, headaches, cramps, or digestive problems that aren’t easily explainable and do not improve with treatment.
How Alcohol Abuse Can Factor into Depression
Can alcohol cause depression or vice versa? Research has shown that there seems to be a bidirectional relationship between alcohol use disorder (AUD) and depressive disorders; both disorders can exist together, each disorder increases the risk for the other disorder, and each disorder can worsen the other.7 Regardless of the order of which came first, AUD or a depressive disorder, both issues are among the most prevalent psychiatric disorders and co-occur often.7,8,9,10
Are you in need of substance abuse and co-occurring mental health treatment? Plenty of American Addiction Centers locations across the nation offer specialized co-occurring disorder treatment. Call our admissions navigators today to discover your treatment options.
The pathways leading to the development of co-occurring AUD and a depressive disorder are complex and intertwined. Some individuals may be genetically susceptible to both. For others, symptoms of a depressive disorder can influence the development of an AUD. One possible contributor to cooccurrence is that people may alleviate symptoms of a depressive disorder with substances like alcohol. People who experience major depressive symptoms may start to rely on alcohol to ease their symptoms and feel better, but over time, this can develop into a full-blown alcohol use disorder.10 Even in instances where a person doesn’t develop an AUD, self-medication may not be helpful long-term, as it is associated with increased psychiatric comorbidity, higher stress levels, and lower health-related quality of life.3,10 Research also has associated AUD with a risk not only for the onset of depressive symptoms but also depressive disorders.
It’s important to note that the co-occurrence of AUD and depressive disorders, specifically major depressive disorder and persistent depressive disorder, is associated with greater severity and worse prognosis than either disorder alone. This includes a heightened risk for suicidal behavior.7
It’s a vicious pairing that can be difficult to overcome, however, treatment can be effective.
Does Alcohol Cause Depression?
A study in JAMA Psychiatry points out that there may be a direct cause and effect association between alcohol abuse and dependence and major depressive disorder in certain instances.9 Alcohol can not only lead to depressive symptoms, it may also worsen depressive symptoms in people who already experience depressive symptoms or in those who may be genetically vulnerable to depressive disorders. If depressive symptoms are caused by drinking alcohol, they may stop after significantly reducing or stopping alcohol use.11 However, research also suggests that substance-induced depression may turn into independent depression should symptoms persist following cessation of alcohol or other substances of abuse.12
Can Alcohol Make Depression Worse?
Yes, alcohol can exacerbate depression and depressive symptoms. In addition, a clinical review in the journal, Professional Psychology: Research and Practice explains that drinking can interfere with recovery from depression. Depressed study participants who were heavy drinkers displayed worse outcomes from depression treatment; furthermore, even mild to moderate amounts of alcohol appeared to worsen depression, with depressed patients who drank low levels of alcohol (less than 1 oz per day) experiencing worse outcomes from pharmacological treatments.13
Alcohol use disorders may be more prevalent in people who also have depression than they are in the general population. The occurrence of alcohol use disorder and a depressive disorder are associated with greater severity and a worse prognosis for both disorders.
How Long Does Alcohol-Induced Depression Last?
The duration of alcohol-induced depression can vary widely. Generally speaking, depressive symptoms associated with alcohol-induced depression have been shown to improve significantly after you’ve abstained from alcohol for a certain amount of time, typically 3-4 weeks in many cases.11 However, research also suggests that substance-induced depression can turn into independent depression should symptoms of depression persist following cessation of alcohol or other substances of abuse.
Take Our “Am I an Alcoholic?” Self-Assessment
Take our free, 5-minute “Am I an Alcoholic?” self-assessment below if you think you or someone you love might be struggling with an alcohol use disorder (AUD). The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of an AUD. The test is free, confidential, and no personal information is needed to receive the result.
Treatment for Co-Occurring Depression and Alcohol Use Disorder
Treatment often includes an integrated approach to simultaneously address both alcohol use disorder and depression..
Many treatments can help co-occurring depression and AUD. Some of these can include:14,15,16
- Detox. This is usually the first step in the recovery process followed by entry into a formal drug rehabilitation program. Detox helps you safely and comfortably withdraw from alcohol.
- Antidepressants/Medications. You may receive antidepressants, which can help treat both the depression and some symptoms of AUD. In addition, you may receive naltrexone, a medication that helps people stop drinking and reduces depressive symptoms, disulfiram, which is used as an alcohol deterrent (it causes unpleasant symptoms if you drink alcohol), or acamprosate, which is used to help maintain abstinence from alcohol.
- Behavioral therapies. These can include:
- Cognitive-Behavioral Therapy (CBT). This helps you learn positive coping mechanisms to replace the thought and behavioral patterns that can contribute to or worsen AUD and depression.
- Dialectical Behavior Therapy (CBT). This is mainly used to help reduce self-harm and suicidal behavior.
- Behavioral Activation. This is a type of behavioral therapy that is effective for both AUD and depression. It involves developing an understanding of how negative life experiences and behaviors influence your mood and emotions and encourages you to take an active approach to increase your positive life experiences.
- Mutual support groups, which include 12-step groups like Alcoholics Anonymous (AA) and non-12-step groups like SMART Recovery. These groups are effective both as treatment and as aftercare for both AUD and depression. You’ll benefit from the support of others who know what it’s like to be in your shoes, which can lessen feelings of isolation and help you feel connected.
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Other Frequently Asked Questions Regarding Alcohol & Depression
- National Institute of Mental Health. (2018). Depression.
- Çakıcı, M., Gökçe, Ö., Babayiğit, A., Çakıcı, E., & Eş, A. (2017).
- Kaltenboeck, A. & Harmer, C. (2018). The neuroscience of depressive disorders: A brief review of the past and some considerations about the future. Brain and Neuroscience Advances, 2.
- Kwong, A., López-López, J. A., Hammerton, G., Manley, D…& Pearson, R. M. (2019). Genetic and Environmental Risk Factors Associated With Trajectories of Depression Symptoms From Adolescence to Young Adulthood. JAMANetwork Open, 2(6), e196587.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Obeid, S., Akel, M., Haddad, C., Fares, K…& Hallit, S. (2020).
- McHugh, R. K., & Weiss, R. D. (2019). Alcohol Use Disorder and Depressive Disorders. Alcohol research : current reviews, 40(1), arcr.v40.1.01. https://doi.org/10.35946/arcr.v40.1.01.
- National Institute of Mental Health. (2021). Depression.
- Fergusson, D. M., Boden, J. M., & Horwood, L. J. (2009). Tests of causal links between alcohol abuse or dependence and major depression. Archives of general psychiatry, 66(3), 260–266.
- Turner, S., Mota, N., Bolton, J., & Sareen, J. (2018). Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and anxiety, 35(9), 851–860.
- American Society for Addiction Medicine (ASAM) Principles of Addiction Medicine, Sixth Edition (2 hard copies in our department library. Online access available—ask Scot for login credentials)
- Nunes EV, Liu X, Samet S, Matseoane K, Hasin D. Independent versus substance-induced major depressive disorder in substance-dependent patients: observational study of course during follow-up. J Clin Psychiatry. 2006 Oct;67(10):1561-7. doi: 10.4088/jcp.v67n1010. PMID: 17107247.
- Ramsey, S. E., Engler, P. A., & Stein, M. D. (2005). Alcohol Use Among Depressed Patients: The Need for Assessment and Intervention. Professional Psychology: Research and Practice, 36(2), 203–207.
- McHugh, R. K., & Weiss, R. D. (2019). Alcohol Use Disorder and Depressive Disorders. Alcohol Research: Current Reviews, 40(1), arcr.v40.1.01.
- National Institute on Drug Abuse. (2020). Common Comorbidities with Substance Use Disorders Research Report: What are the treatments for comorbid substance use disorder and mental health conditions?
- National Alliance on Mental Illness. (2020). Substance Use Disorders.
- National Institute on Alcohol Abuse and Alcoholism. (2008). Genetics of Alcohol Use Disorder.
- National Alliance on Mental Illness. (2021). Medication Frequently Asked Questions.