Alcohol and Depression
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Individuals who suffer from depression are more likely to abuse or become dependent on alcohol. Depression is a mental health condition that involves continually experiencing feelings of sadness and hopelessness. Over time, these emotions influence how people think and act. This can affect many aspects of life, including professional responsibilities, personal goals and relationships with family members and friends.
For those struggling with depression, alcohol is sometimes used to suppress symptoms related to their condition, such as irritability, loss of interest, anxiety, restlessness and insomnia. Drinking becomes a way to escape reality and relax. Unfortunately, using alcohol as a way to self-medicate depression can significantly impact physical and emotional well-being.
Heavy alcohol consumption alters the brain’s neurotransmitters. Chemicals such as serotonin and dopamine will fluctuate rapidly with alcohol consumption. Serotonin helps balance a person’s mood, whereas dopamine controls the brain’s reward system. Unusually high or low levels of these chemicals can trigger symptoms of depression, among other health problems.
Without proper treatment, self-medicating depression with alcohol increases the risk of severe bodily injury, and even suicidal behaviors. Learn about rehab programs designed to treat co-occurring conditions, such as alcoholism and depression, by talking with a treatment specialist today.
Types of Depression
There are several different types of depression that are commonly diagnosed in individuals suffering from alcoholism. While some forms of this mental illness are less severe than others, depression can quickly take control of a person’s life.
Seasonal Affective Disorder (SAD)
This type of depression is linked to changes in light stemming from a shift in seasons. Typically, symptoms of SAD start to emerge in the fall and gradually worsen during the winter. Research shows that a lack of light during the winter months contributes to a case of the “winter blues”. Oftentimes, these gloomy moods shift to optimistic spirits through spring and summer. For a formal diagnosis, SAD symptoms must present themselves for at least the last two consecutive years.
Symptoms of SAD include:
- Feeling sad and irritable most days
- Gaining or losing more weight than usual
- Experiencing changes in appetite
- Having a “heavy feeling” in arms and legs
Alcohol can be used to achieve a temporary sense of pleasure during dreary months. However, frequent and excessive drinking can lead to a full-blown addiction that lingers long after fall and winter. This is because the body becomes dependent on the chemicals released by alcohol to achieve feelings of happiness. As a result, a person will begin to crave alcohol in order to achieve a feeling of satisfaction.
A more severe form of depression, psychotic depression involves hallucinations, paranoia or delusions. This type of depression can cause individuals to hear voices or make them believe that someone is out to harm them.
Some signs of psychotic depression are:
- Extreme mood swings
- Staying awake all night and sleeping all day
- Neglecting self-care, such as bathing
- Incoherent speech
Combining drinking with psychotic depression can be extremely dangerous to one’s health and well-being, as well as those around them. Rather than providing a sense of calmness, alcohol actually exacerbates the symptoms of psychotic depression. A person’s paranoia intensifies dramatically while under the influence, resulting in bizarre behavioral outbreaks, mania and thoughts of suicide.
Over time, a person can become dependent on alcohol and rely on it to get by. However, if an individual suffering from psychotic depression and alcoholism tries to quit drinking cold turkey, their body may go into shock. This can result in serious health complications. Because of this, a co-occurring disorder should only be treated under the care of medical professionals.
Persistent Depressive Disorder
Individuals who suffer from persistent depressive disorder, or dysthymia, have recurring symptoms of depression for at least two years. However, symptoms are rarely uniform. Some weeks and months may include minor signs of depression, while other times they are much more severe.
Symptoms of persistent depressive disorder include:
- Low self-esteem and feelings of worthlessness
- Distressing over making decisions
- Difficulty concentrating
- Avoiding social gatherings and hobbies
Persistent depressive disorder greatly increases the likelihood of developing a substance use disorder, such as alcoholism. Co-occurring depression and alcoholism can take a toll on a person’s physical and emotional health, as well as their relationships with loved ones. The more alcohol an individual consumes, the stronger their dependency will become over time.
No one should suffer in silence from the harmful effects of co-occurring alcoholism and persistent depressive disorder. Alcohol treatment programs are the safest and most effective way to overcome co-occurring conditions. These programs provide the tools necessary for staying in recovery long-term.
The most serious type of depression is major depression. This occurs when depression symptoms, such as feelings of sadness and worthlessness, interfere with a person’s daily life. Roughly 20 to 25 percent of U.S. adults will experience a major depressive episode at some point during their lives.
People with major depression are typically only able to see the negative in various personal and professional situations. This mental health condition can take a toll on overall well-being, including how a person sleeps, eats and thinks.
Signs of major depression include:
- Excessive crying
- Low energy and motivation every day
- Insomnia or hypersomnia
- Recurring thoughts of suicide
Alcohol and drugs should be avoided with major depression. Drinking can heighten the symptoms of depression, which can have life-threatening implications. This is because alcohol impacts the same areas of the brain that help regulate mood. Drinking can alter the brain’s chemical levels, which can trigger the symptoms of a mental health illness, such as depression.
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How is Depression Diagnosed?
Doctors use a physical exam, lab tests and a psychological evaluation to diagnose depression. These tests help determine the type of depression present, as well as eliminate the possibility of certain health conditions like thyroid problems and viruses. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is commonly used by physicians and psychologists to reach a formal diagnosis.
Questions that may be asked during the psychological evaluation include:
- In the past several weeks, how often have you felt hopeless, sad or depressed?
- Have you had thoughts about self-harm or harming another person when you’re feeling down?
- How much uninterrupted sleep do you get each night?
- Do you drink alcohol or use any recreational drugs?
- How do your symptoms interfere with your personal and professional responsibilities?
- Does your mood fluctuate? If so, how often?
After the evaluation is complete and a diagnosis has been made, a doctor will discuss their findings with the patient and talk about treatment options. In the case of co-occurring conditions, a health provider may refer their patient to a treatment specialist who is able to help them recover from both disorders simultaneously.
Alcohol and Depression Treatment
Even the most severe forms of alcoholism and depression can be treated. However, the earlier a person seeks treatment, the better.
Due to the nature of co-occurring conditions, it is highly recommended that individuals receive treatment from a rehab facility specializing in alcoholism and depression. These programs are not only safe and effective, but they also help people prepare to acclimate back into everyday life. Many centers are also able to provide aftercare recommendations to help ensure sobriety after rehab.
The most common therapies used to treat alcoholism and depression are:
This type of therapy involves the use of prescription drugs to ease a person’s withdrawal symptoms and reduce cravings. There are four types of medications typically used to reduce impulses to drink: benzodiazepines, naltrexone, acamprosate and disulfiram.
A treatment specialist may also prescribe an antidepressant to balance mood swings and other symptoms of depression. While medications can be extremely beneficial during recovery, they should only be used alongside other forms of treatment.
Cognitive behavioral therapy (CBT)
A type of psychotherapy, cognitive behavioral therapy helps people learn how to replace negative thoughts with positive and uplifting feelings. This is an essential part of the recovery process. CBT helps teach people how to identify potential triggers, find ways to cope with urges to drink and set realistic goals. Cognitive behavioral therapy generally starts in a rehab setting and can be continued after treatment with the help of an alcohol counselor.
During treatment, group therapy is used as a way to meet and facilitate discussion among peers working to overcome similar co-occurring disorders. Depending on the program you choose, sessions are usually held one to two times each week. Group therapy provides an outlet for people to openly discuss the highs and lows of their addiction, as well as offer advice to others going through challenging times. Many aftercare programs offer various types of group therapy so that patients can continue working on their recovery.
Deciding to seek help for alcoholism and depression is the first step to taking back control of your life. While rehab facilities help treat addiction, not all will offer the services you may need for overcoming a co-occurring condition. For example, some facilities may specialize in certain conditions and offer therapies tailored to specific addictions. Other programs are more generalized, providing services to a wide range of addictions.
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With so many treatment options available, it can be challenging to find the right one for you. Our treatment specialists are here to answer any questions you may have and help you along the way.
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- Author — Last Edited: August 7, 2018
National Institute of Mental Health. (2015). Depression. March 2017. https://www.nimh.nih.gov/health/publications/depression-what-you-need-to-know/index.shtml
Mayo Clinic. (2016). Depression (Major Depressive Disorder). March 2017. http://www.mayoclinic.org/diseases-conditions/depression/basics/definition/con-20032977
Shivani, Goldsmith, Anthenelli. (2002). Alcoholism and Psychiatric Disorders. March 2017. https://pubs.niaaa.nih.gov/publications/arh26-2/90-98.htm
Mayo Clinic. (2015). Persistent Depressive Disorder (dysthymia). March 2017. http://www.mayoclinic.org/diseases-conditions/persistent-depressive-disorder/symptoms-causes/dxc-20166596
U.S. National Library of Medicine. (2016). Major Depression. March 2017. https://medlineplus.gov/ency/article/000945.htm