The relationship between alcohol and depression can be both intricate and bidirectional. Clinical and experimental research suggests that heavy alcohol consumption can disrupt important systems in the brain, altering mood regulation and heightening your vulnerability to depressive symptoms. Conversely, individuals grappling with depression often resort to alcohol as a means of temporary solace, attempting to alleviate the heavy emotional pain that depression can bring. Moreover, the concurrent presence of these conditions can fuel an ongoing cycle, where each condition exacerbates the other.[1]
In today’s blog, Clear Behavioral Health will explore how excessive alcohol consumption can contribute to depressive symptoms, and vice versa, shedding light on the complexities of this connection for those facing these challenges or supporting loved ones who are struggling.
What is Depression?
Depression commonly refers to a mental health disorder characterized by persistent feelings of sadness, hopelessness, and a loss of interest in activities that you once enjoyed. It can vary in severity from mild to severe and gets in the way of your ability to function normally in daily life.[2]
Some common symptoms of depression can include:
- Persistent sad, anxious, or “empty” mood
- Feelings of hopelessness or pessimism
- Irritability or restlessness
- Loss of interest in activities or hobbies once pleasurable
- Fatigue or decreased energy
- Difficulty concentrating, remembering details, or making decisions
- Changes in appetite or weight
- Insomnia or oversleeping
- Physical symptoms such as headaches, digestive issues, or chronic pain that do not respond to treatment
- Thoughts of death or suicide, or suicide attempts[2]
Depression can be caused by a combination of genetic, biological, environmental, and psychological factors. It can affect anyone, regardless of age, gender, or background, and often requires treatment such as therapy, medication, or a combination of both to improve.[3]
What’s the Difference Between Clinical and Non-Clinical Depression?
Both clinically significant depression and non-clinical depression are terms often used to distinguish between the kinds of depression that meet the criteria for a clinical diagnosis and depression that may not, be milder in severity, or that we all experience in life from time to time, such as when things are hard.
Clinical Depression
Clinical depression refers to depression that meets the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), commonly as major depressive disorder. It typically involves experiencing a certain number of symptoms (such as persistent sadness, loss of interest, changes in appetite or sleep, feelings of worthlessness, etc.) for a specific duration (usually at least two weeks), and these symptoms must significantly impair the person’s ability to function in daily life.[4] In severe cases, individuals may feel like they are too depressed to work, function, or do anything.
Non-Clinical Depression
Non-clinical depression may refer to experiences of sadness, low mood, or other depressive symptoms that do not meet the full criteria for a clinical diagnosis of depression. This could include milder forms of depression or depressive symptoms that are temporary and do not significantly impair your ability to engage in daily life. Non-clinical depression can still cause distress, but it may not reach the threshold for a formal diagnosis of depression.[5]
Some people may experience depressive symptoms in response to specific life stressors or events, such as grief, relationship difficulties, or job loss, which may not necessarily qualify as clinical depression but still warrant both attention and support.
It’s also important to note that non-clinical depression can sometimes progress to clinical depression if left untreated or if its underlying factors worsen. As such, it’s essential for individuals experiencing any level of depressive symptoms to seek support and professional guidance if needed.
What is Alcohol Use Disorder?
Alcohol use disorder (AUD) is a chronic, relapsing condition that is characterized by compulsive alcohol use, a loss of control over your alcohol intake, alcohol dependence, and a negative emotional state when not using alcohol:
- Compulsive alcohol use: Individuals with AUD often find it difficult to control their alcohol consumption despite negative consequences. They may continue to drink excessively even when it causes problems in their personal relationships, work, or health.
- A loss of control: People with AUD may find themselves unable to stop drinking once they start, even if they initially intended to have only one or two drinks. This loss of control is a hallmark symptom of the disorder.
- Physical dependence: With prolonged and heavy alcohol misuse, physical dependence can develop. This means the body has adapted to the presence of alcohol and experiences withdrawal symptoms when someone doesn’t drink alcohol or reduces their intake.
- Tolerance: Individuals with AUD often develop a physical and psychological tolerance to alcohol, meaning they need to drink larger amounts to achieve the desired effects. This can contribute to a cycle of escalating drinking habits.
- Negative emotional state: When not drinking, individuals with AUD may experience negative emotions such as anxiety, depression, or irritability. Alcohol may be used as a way to alleviate these unpleasant feelings, perpetuating the cycle of dependence.
- A negative impact on health and functioning: AUD can have severe consequences for physical health, mental health, and overall functioning. It can lead to liver disease, cardiovascular problems, neurological impairments, psychiatric disorders, relationship difficulties, job loss, and legal issues.[6]
AUD exists on a spectrum, with mild, moderate, and severe qualifiers. A formal diagnosis is typically made based on criteria outlined in the DSM, which include factors such as the amount and frequency of alcohol consumed, unsuccessful efforts to cut down or control drinking, and the presence of withdrawal symptoms.[6]
When Does Alcohol Use Become Problematic?
Alcohol use can become problematic when it starts to negatively impact various aspects of a person’s life, including their physical health, mental well-being, relationships, and daily functioning:
- Regular and excessive consumption: Drinking alcohol excessively and regularly, especially to the point of intoxication, can be problematic. This may involve binge drinking or consuming more than the recommended guidelines for moderate drinking, which is generally defined as up to one drink per day for women and up to two drinks per day for men.
- Negative consequences: Problematic alcohol use often leads to negative consequences in various areas of life. This can include health problems (such as liver disease, cardiovascular issues, or neurological impairments), relationship problems (such as conflicts with family members, friends, or colleagues), legal issues (such as DUIs or public intoxication charges), and financial difficulties.
- Interference with responsibilities: When alcohol use starts to interfere with one’s ability to fulfill responsibilities at work, school, or home, it becomes problematic. This may manifest as absenteeism, poor performance, neglect of duties, or inability to meet obligations.
- Tolerance and withdrawal: Developing tolerance to alcohol (needing to drink more to achieve the same effects) and experiencing withdrawal symptoms when not drinking are signs of problematic alcohol use. Withdrawal symptoms can include anxiety, tremors, sweating, nausea, and agitation.
- Negatively impacting your mental health: Problematic alcohol use often co-occurs with mental health issues such as depression, anxiety, or substance use disorders. Alcohol may be used as a way to self-medicate, exacerbating underlying mental health problems.
- Trying to quit and not being able to: If someone repeatedly tries and fails to quit drinking or cut down on their alcohol consumption despite recognizing its negative effects, it suggests problematic use.[7]
It’s important to note that even if someone doesn’t meet the criteria for a diagnosis of AUD their alcohol use may still be causing harm and therefore warrant further attention. This is especially true in the case of high-functioning alcoholics who may seem put together externally, however, struggle internally with mental health, physical health, and maintaining relationships.
How can Depression and Alcohol Use Be Related?
Depression and alcohol use often intertwine, forming a complex relationship that can exacerbate both conditions. Many individuals with depression may turn to alcohol as a means of self-medication, seeking temporary relief from their symptoms of sadness, anxiety, or hopelessness. While alcohol may initially offer a sense of escape, it ultimately compounds the problem, disrupting brain chemistry and worsening depressive symptoms over time. This creates a detrimental cycle wherein depression leads to alcohol use, which in turn exacerbates depression.[8]
Biological Factors
Biologically, both depression and alcohol use disorder involve alterations in neurotransmitter systems, such as serotonin and dopamine, which play key roles in regulating mood and reward pathways. Shared genetic vulnerabilities may also contribute to the co-occurrence of these conditions. Furthermore, depression can lead to social isolation and withdrawal, increasing the likelihood of alcohol use as a coping mechanism to alleviate loneliness or to feel more socially connected in social situations.[9]
Impaired Judgment and Impulsivity
Conversely, excessive alcohol consumption can impair judgment and increase impulsivity, making individuals more prone to engage in risky behaviors. Depression can exacerbate this impairment, further compromising decision-making abilities and exacerbating alcohol use. Moreover, both depression and alcohol use disorders are significant risk factors for suicidal behavior. The presence of both conditions simultaneously can heighten the risk, as alcohol can lower inhibitions and increase impulsivity, making individuals more susceptible to acting on suicidal thoughts.[10]
Treating Alcoholism and Depression Equally
Addressing every struggle including depression, alcohol use disorders, and any other mental health condition concurrently is essential for effective treatment. Integrated approaches that target both conditions, such as cognitive-behavioral therapy (CBT) or medications for depression alongside therapy and support for alcohol use disorders, can be particularly beneficial. Seeking professional help from mental health professionals or addiction specialists is crucial for managing the interconnected challenges of depression and alcohol use disorders and promoting long-term recovery and well-being.
What Can I Do if I Need Help With Depression and Alcohol Use?
If you’re grappling with co-occurring depression and alcohol use then it’s important to remember that help is available. Taking proactive steps can make a significant difference in your journey toward recovery.
Reach Out for Support
Reaching out to your friends and family for support can provide invaluable encouragement and guidance. Involving your loved ones in your recovery process can strengthen your support network and foster a sense of connection and belonging, both of which are essential aspects of the healing process.
Withdrawal Management
Accessing professional help can assist you in assessing your situation comprehensively and give you access to guidance tailored to your individual recovery needs. If you’ve become physically dependent on alcohol, managed withdrawal under medical supervision may be necessary to safely begin the treatment process. This process should ideally take place in a supervised medical setting to ensure your safety and comfort.
Medication
Depending on your individual needs, medication may also be recommended to help manage symptoms of depression and support your recovery from alcohol use disorder. It’s essential to adhere to your provider’s recommendations and attend regular follow-up appointments for medication management.
Mental Health and Addiction Treatment
Enrollment in a residential treatment program, also known as inpatient rehab, may be beneficial in addressing depression and substance abuse issues simultaneously. These programs provide intensive care and support in a structured environment, offering a combination of therapy, medical monitoring, and holistic interventions designed to address both depression and alcohol use disorders. Following the completion of a residential program, transitioning to outpatient programs can provide ongoing therapeutic engagement and support to help you maintain sobriety and manage depression while reintegrating back into your daily life.
Community and Aftercare
Many quality treatment programs also offer continuing linkage to your treatment providers and recovery community with aftercare programs, allowing you to stay connected and supported in your journey toward sustained recovery and better health.
Above all, remember that recovery is a journey, and your progress may not always be linear. Be patient with yourself, stay committed to your treatment plan, and lean on your support network for encouragement and guidance. With the right support, resources, and determination, it is possible to overcome depression and alcohol use disorders and embark on a path toward a fulfilling, sober life.
There’s One Clear Choice for Your Co-Occurring Treatment and Recovery Needs
If you’re ready to take the first step towards healing and reclaiming your life, Clear Behavioral Health is here to support you every step of the way. With a wide array of treatment options and a full spectrum of care for mental health, addiction, and co-occurring concerns, our dedicated team is committed to providing personalized support tailored to your unique needs. From your initial contact with us through your journey into aftercare, we’ll be by your side, offering comprehensive services and compassionate guidance to help you achieve lasting recovery and wellness.
Don’t wait another day to seek the help you deserve—reach out to Clear Behavioral Health today to learn more about our detox, withdrawal management, and residential rehab in a home-like setting as well as our outpatient programs for co-occurring disorders. If depression and mental health are your main struggles, we also offer residential mental health treatment for more severe mental health issues and outpatient mental health programs for ongoing support. Our passionate team is always available to walk you through your treatment options and help you take the first step into a brighter tomorrow.
References:
- National Institute on Alcohol Abuse and Alcoholism. (2022). Alcohol and the Brain: an Overview | National Institute on Alcohol Abuse and Alcoholism (NIAAA). Www.niaaa.nih.gov. https://www.niaaa.nih.gov/publications/alcohol-and-brain-overview on February 19, 2024
- Torres, F. (2020, October). What is depression? American Psychiatric Association. https://www.psychiatry.org/patients-families/depression/what-is-depression on February 19, 2024
- National Institute of Mental Health. (2023, September). Depression. National Institute of Mental Health; National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/depression on February 19, 2024
- O’Connor, E. A., Whitlock, E. P., Gaynes, B., & Beil, T. L. (2009, December). Table 1, Primary DSM-IV depression disorders, criteria for adults. Nih.gov; Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK36406/table/ch1.t1/ on February 19, 2024
- Situational depression vs clinical depression: Difference and diagnosis. (n.d.). Www.medicalnewstoday.com. https://www.medicalnewstoday.com/articles/314698 on February 19, 2024
- National Institute on Alcohol Abuse and Alcoholism. (2021, April). Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5 | National Institute on Alcohol Abuse and Alcoholism (NIAAA). Nih.gov. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-use-disorder-comparison-between-dsm on February 19, 2024
- National Institute on Alcohol Abuse and Alcoholism. (2021). The Cycle of Alcohol Addiction. Www.niaaa.nih.gov. https://www.niaaa.nih.gov/publications/cycle-alcohol-addiction on February 19, 2024
- Schuckit, M. A. (1996). Alcohol, Anxiety, and Depressive Disorders. Alcohol Health and Research World, 20(2), 81–85. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6876499/ on February 19, 2024
- Nunes, E. V. (2023). Alcohol and the Etiology of Depression. American Journal of Psychiatry, 180(3), 179–181. https://doi.org/10.1176/appi.ajp.20230004 on February 19, 2024
- McHugh, R. K., & Weiss, R. D. (2019). Alcohol Use Disorder and Depressive Disorders. Alcohol Research: Current Reviews, 40(1). https://doi.org/10.35946/arcr.v40.1.01 on February 19, 2024
