Learn more about how to get help if you're struggling with symptoms of depression, a drinking problem, or both.
Did you know that alcohol and depression often go hand in hand?
The relationship appears to go both ways. Research shows the more a person drinks, the more likely they are to develop major depression. People with diagnosed depression are also more likely to develop alcohol use disorder than people without depression.
It's hard to tell which condition most often comes first, but it’s clear that the conditions are intertwined, says Aaron Weiner, PhD, a psychologist and past president of the Society of Addiction Psychology.
“Drinking is a way of disconnecting from that immediate feeling of depression and feeling down,” Dr. Weiner says. “When folks are feeling depressed, they're looking for solutions, and alcohol in the moment can feel like a solution. So depression can lead to alcohol use, and alcohol use can lead to more depression.”
Here’s what to know about how depression and alcohol interact, the risks and warning signs for both depression and alcohol use disorder, and when to get help.
The exact cause of this relationship isn’t entirely known. Some experts believe certain people may be genetically prone to both depression and alcohol use disorder. Environmental or social factors, such as drinking to cope with stress or depressive symptoms, may also play a role.
The link between the two is complex and multifaceted.
Depression Raises the Risk of Alcohol Use Disorder and Vice Versa
As mentioned, the relationship between depression and alcohol use disorder goes both ways. Research suggests that many with depression use substances, such as alcohol, to cope with their symptoms, and have an increased risk of substance abuse disorders like alcohol use disorder.
Studies have found that depression and alcohol use disorder often co-occur, with each disorder worsening the severity and prognosis of the other.
Alcohol Can Make Depressive Symptoms Worse
Many of us have been there — after a bad day or a stressful event, it’s not uncommon to turn to a glass of wine to take the edge off. But making this a regular habit can impede your mental health, especially if you already have depression.
“Some folks drink alcohol as a way to alleviate some of their anxiety and depression, like a reward-seeking or self-medicating type of [behavior],” says Akhil Anand, MD, a psychiatrist at Cleveland Clinic who treats addictions and alcohol and drug withdrawal. “But alcohol itself is a depressant, so while it may help the patient in the short term, it does actually cause depression in the long term.”
Alcohol can affect your brain chemistry. This includes increasing the effect of a brain chemical called GABA, which calms the brain and body, and decreasing the effect of glutamate, which stimulates the brain and body, creating a numbing, less alert feeling.
It can also increase suicide risk, boost feelings of irritability and aggressiveness, increase feelings of hopelessness, and reduce the efficacy of your depression treatment.
The effects of drinking too much can also seep into your daily life and may impact areas like work, finances, relationships and aspects of your physical health like sleep, diet, and exercise, says Dr. Anand. That could lead some people, for example, to turn to drinking to cope with stress caused by these issues.
This can become a cycle, adds Anand. “None of this will help with mood, which precipitates depression. So now you’re also depressed because of your drinking and because alcohol is what you turn to, to feel at least temporarily better, you continue to drink,” Anand says.
Alcohol Can Make Antidepressants Less Effective
Alcoholic beverages can be problematic — even dangerous in some instances — if you’re taking antidepressants. “Whenever we prescribe antidepressants, we really advise against combining them with alcohol and other drugs like cannabis — regardless of the type of antidepressant,” Anand says.
Alcohol not only neutralizes the effectiveness of a lot of medications, including psychiatric drugs, but it can also trigger negative drug interactions. For instance, you need to avoid drinking entirely if you’re taking an antidepressant called a monoamine oxidase inhibitor (MAOI). Combining alcohol and MAOIs can cause a dangerous spike in blood pressure. The following antidepressants are MAOIs:
isocarboxazid (Marplan)
phenelzine (Nardil)
selegiline (Emsam)
tranylcypromine (Parnate)
MAOIs aren’t often prescribed because they’re an older class of antidepressants, but they’re still used in cases when newer options aren’t effective for some patients, Anand says. If you’re taking an MAOI, you should consult with your doctor to understand what’s safe to eat and drink.
Other potential risks of drinking while on antidepressants include becoming sedated or drowsy and having increased depressive symptoms because, as mentioned, the effects of the alcohol can lessen or diminish the benefits of the medication.
There are signs that depression and alcohol dependency may be impacting your or a loved one’s health and well-being, Anand says.
These symptoms often overlap with the warning signs of alcohol use disorder (and addiction in general), including what’s known as the “four Cs”:
Cravings: This includes feeling like you need alcohol or can’t get through the day without a drink.
Loss of control of amount or frequency of drinking: This includes unintentional binge drinking or drinking several days in a row despite committing to yourself or your loved ones that you’d stop. “You always end up drinking more than you actually intend to. It feels out of control,” Anand says.
Compulsion to drink: Weiner asks his patients to consider the purpose of their drinking and whether they’re drinking out of a strong desire to self-medicate. “Are you drinking because you’re trying to deal with stress on a daily basis or is it more social? If you’re drinking to cope, it’s an issue,” he says.
Drinking despite the consequences: If your drinking is interrupting your professional life, increasing your weight, or hurting your relationships, among other consequences, this is a sign you need professional help.
If you’re experiencing any of the symptoms above, your first step is to make an appointment with your family doctor for help. They can refer you to a mental health professional or addiction specialist.
Because it’s often too difficult to tell if the alcohol dependence is induced by depression or vice versa, psychologists and addictions specialists tend to treat both simultaneously, Anand says. Treatment is often a two-pronged approach involving psychotherapy (talk therapy) and medication.
Psychotherapy can involve strategies like group therapy and cognitive behavioral therapy, a type of therapy that helps people identify and change problematic thought and behavioral patterns.
Medications may include antidepressants, as well as medications to help curb alcohol intake. There are three FDA-approved medications to treat alcohol use disorder, says Weiner: disulfiram, naltrexone, and acamprosate.
Alcohol and depression frequently go hand in hand, with research indicating that increased alcohol consumption raises the risk of major depression and vice versa.
If you notice persistent depressive symptoms or suspect you may have alcohol use disorder, talk to your doctor. They can help you find a treatment that helps.
Treatment for both depression and alcohol use disorder typically involves a combination of psychotherapy and medication.
