How Alcohol And Depression Are Related
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Depression is common in adults in the US; roughly one in ten people report experiencing symptoms. According to researchers, a large percentage of those people also experience alcohol use disorder at some point in their lives. Whether people drink because they’re experiencing depressive symptoms or if people with a substance use disorder develop depression later may be unique to the individual. Still, experts agree that there is a solid, albeit potentially complicated, connection between the two.
Nature vs. nurture: Potential causes and risk factors
There can be similar risk factors for substance use disorder (SUD) and depression:
Environment
People from families with one or more caregivers who have a depressive disorder or SUD are more likely to develop one as well. It’s also commonly known that people with a history of traumatic experiences are more likely to develop depression or SUD.
Genetics
Some scientists believe alcoholism may be genetic since studies between twins and adoptive parents/children reveal a correlation between genetic makeup and SUD. Other scientists, however, believe that the correlation between SUD and genetics is weak.
Environment and genetics
There's also the theory that alcoholism and depression are epigenetic. This means there may be a gene responsible for the condition but that an external factor (e.g., a traumatic event or the presence of alcohol) must activate it. There are also those who believe that alcohol may trigger a depression gene. While this would explain the high number of people with both alcoholism and depression, more research is needed to reach a definitive conclusion.
Sociological factors
Some experts believe there’s a correlation between SUD and sociological influences such as institutional, professional, and cultural ideologies; gender roles; and socioeconomic factors.
Even with the encouraging volume of research dedicated to determining the relationship between SUD and depression and the causes/risk factors of both, it could be important to remember that there are still many unanswered questions, so more research is needed.
The effects of alcohol on depression
Alcohol is classified as a central nervous system depressant, which may provide a clue into its relationship with depression. But while alcohol can slow down neurological functioning and subsequently inhibit how it communicates with the body, it can also make a person feel more relaxed and uninhibited.
Alcohol in large quantities can cause physical issues like slurred speech, impairments of reaction and movement, and perceptual disturbances. Excessive amounts can result in unconsciousness, respiratory failure, and death.
Psychologically, the effects of mild to moderate alcohol consumption may seem advantageous to someone experiencing depression. Alcohol may create a sense of euphoria and happiness and feel like a means of stress relief. It can also reduce self-consciousness and feelings of anxiety around social situations. It might also help someone temporarily cope with the stress associated with day-to-day difficulties.
Still, the so-called “positive” psychological effects of alcohol are generally short-lived. When the effects wear off, the individual may return to the same mental state as before. This could prompt them to drink again to achieve the same results, which might lead to dependency over time.
Treating SUD and depression comorbidity
Treatment for individuals who have been diagnosed with a combination of depression and SUD may be similar to the treatment of each individual disorder with a few exceptions. Both begin with a thorough examination of the patient’s medical history and family history, a psychological self-assessment via questionnaire, and a preliminary interview. Once the psychologist has referenced their findings with the DSM-5, a dual diagnosis may follow.
Treatment options for depression and alcohol use disorder may include behavioral therapy such as cognitive behavioral therapy and medication. Depending on the severity of the patient’s dependence on alcohol, medication might consist of a combination of anti-depressants and medicines designed to help people stop or reduce their alcohol consumption.
It may be necessary for patients with a chemical dependency on alcohol to undergo a detoxification procedure in a clinic under the care of a physician specializing in addiction. Group therapy and treatment at a rehabilitation center may also be prescribed.
Because comorbidity between depression and SUD is common, it can be easy for one to obscure the other, and either can be overlooked in the process. For this reason, it may be important for people experiencing SUD or depression to seek medical attention from a licensed medical professional. Once a medical doctor determines the patient isn’t in immediate physical danger due to the effects of alcohol, therapy can be the next step.
Benefits of online therapy
Visiting a therapist in person can be difficult for some, especially those experiencing symptoms of depression or using alcohol as a coping mechanism for depression. The stigma sometimes associated with SUD may also prevent people from seeking help.
With the rise of online therapy, these barriers to treatment may be removed. Online cognitive behavioral therapy provides a feasible solution for logistical issues; there’s no need to leave the comfort of your home to speak to a mental health professional. Online therapy is also effective for treating conditions such as major depression, anxiety, bipolar disorder, and substance use disorder. Also, you don’t have to have a diagnosis of alcohol use disorder to benefit from therapy. Some people who engage in binge drinking or occasional alcohol misuse (formerly called alcohol abuse) may benefit from the support of a therapist.
Takeaway
How does alcohol affect depression?
Alcohol can have complex and bidirectional effects on depression. While some individuals may turn to alcohol as a way to cope with depressive symptoms, clinical and experimental research from the National Institutes of Health shows that excessive alcohol consumption can exacerbate or contribute to the development of depression. Here are some ways in which alcohol can affect depression:
- Depressant Effect: Alcohol is a central nervous system depressant, meaning it slows down brain activity. While some people may initially experience a temporary mood lift or relaxation, excessive alcohol intake can lead to a depressed mood, impaired cognitive function, and increased feelings of sadness.
- Impact on Medication: For individuals who have had depression diagnosed, using alcohol may impact the effectiveness of any antidepressant medications.
- Impact on Neurotransmitters: Alcohol affects neurotransmitters in the brain, including gamma-aminobutyric acid (GABA) and glutamate. Disruptions in these neurotransmitter systems can influence mood management, and chronic alcohol use (formerly called alcohol abuse) may contribute to imbalances associated with depressive symptoms.
- Sleep Disruption: While alcohol may initially induce drowsiness and help some individuals fall asleep, it can disrupt the sleep cycle, leading to fragmented and poor-quality sleep. Sleep disturbances are commonly associated with depression.
- Negative Impact on Coping Mechanisms: Some individuals may turn to alcohol as a way to cope with stress, anxiety, or depression. However, using alcohol as a coping mechanism can become a maladaptive pattern and lead to increased reliance on substances or self-harm instead of healthier coping strategies.
- Social Isolation: Excessive alcohol use can contribute to social isolation and withdrawal from supportive relationships. Social support is crucial for managing depression, and the negative impact on relationships can exacerbate depressive symptoms.
- Increased Vulnerability to Depressive Episodes: Chronic and heavy alcohol consumption is associated with an increased vulnerability to developing or worsening depressive episodes, psychiatric disorders, or Major Depressive Disorder. Individuals with a history of major depression (major depressive disorder), persistent depressive disorder, seasonal affective disorder, psychotic depression, or other mental disorders may find that alcohol exacerbates their symptoms over time.
Does drinking alcohol increase anxiety?
Yes, when you drink alcohol it can increase anxiety for several reasons. While some individuals may initially experience a temporary sense of relaxation or euphoria when consuming alcohol, it is a central nervous system depressant that can have paradoxical effects and severe symptoms. Here are ways in which alcohol consumption may contribute to increased anxiety:
- Disruption of Neurotransmitters: Alcohol affects neurotransmitters in the brain, including gamma-aminobutyric acid (GABA) and glutamate. GABA is an inhibitory neurotransmitter that promotes relaxation, while glutamate is an excitatory neurotransmitter. Alcohol enhances the effects of GABA and inhibits glutamate, leading to a depressant effect. However, as the effects wear off, there can be a rebound increase in excitatory activity, contributing to anxiety.
- Changes in Hormone Levels: Alcohol can affect hormone levels, including cortisol, a stress hormone. While initial alcohol consumption may temporarily reduce cortisol levels, the subsequent rebound effect can lead to increased cortisol production, contributing to heightened stress and anxiety.
- Sleep Disruption: While alcohol may induce drowsiness and help some individuals fall asleep initially, it can disrupt the sleep cycle, leading to fragmented and poor-quality sleep. Sleep disturbances are closely linked to anxiety, and inadequate sleep can exacerbate feelings of tension and worry.
- Negative Impact on Coping Mechanisms: Some individuals use alcohol as a coping mechanism to deal with stress or anxiety. However, relying on alcohol as a way to cope can become a maladaptive pattern, and the temporary relief may be followed by increased anxiety.
- Interference with Medication: For individuals who have medications to manage anxiety, alcohol can interfere with the effectiveness of these medications. It may counteract the benefits of the medication or amplify its side effects.
- Social Consequences: Alcohol misuse can have social consequences, including impaired judgment and increased vulnerability in social situations. This may contribute to feelings of social anxiety or unease.
Why is alcohol bad for anxiety?
Alcohol can be detrimental to individuals with anxiety for several reasons. While some people may initially turn to alcohol to alleviate stress or anxiety symptoms, it often has counterproductive and negative effects on mental health. Here are reasons why alcohol is considered bad for anxiety:
- Disruption of Neurotransmitters: Alcohol affects neurotransmitters in the brain, including gamma-aminobutyric acid (GABA) and glutamate. Initially, alcohol enhances the effects of GABA, promoting relaxation. However, as the effects wear off, there can be a rebound increase in excitatory activity (glutamate), contributing to heightened anxiety.
- CNS Depressant Effect: Alcohol is a central nervous system (CNS) depressant, meaning it slows down brain activity. While some individuals may experience a temporary mood lift, excessive alcohol consumption can lead to a depressed mood, impaired cognitive function, and increased feelings of anxiety.
- Sleep Disruption: Although alcohol may induce drowsiness and help some individuals fall asleep initially, it disrupts the sleep cycle. This can result in fragmented and poor-quality sleep, which is closely linked to anxiety symptoms.
- Negative Impact on Coping Mechanisms: Some individuals use alcohol as a way to cope with stress or anxiety. However, relying on alcohol as a coping mechanism can become a maladaptive pattern, and the temporary relief it provides may be followed by increased anxiety.
- Interference with Medication: For individuals taking medications to manage anxiety, alcohol can interfere with the effectiveness of these medications in depression treatment. It may counteract the benefits of the medication or amplify its side effects.
- Increased Risk of Panic Attacks: Excessive alcohol consumption is associated with an increased risk of panic attacks, which can be particularly distressing for individuals with anxiety disorders.
- Social Consequences: Alcohol use can have social consequences, including impaired judgment and increased vulnerability in social situations. This may contribute to feelings of social anxiety or unease.
- Emotional Dysregulation: Chronic alcohol use can lead to emotional dysregulation, making it more challenging for individuals to manage and regulate their emotions. This can contribute to increased anxiety symptoms.
How does alcohol affect the brain and behavior?
Alcohol affects the brain and behavior by interacting with neurotransmitter systems, altering neural activity, and influencing cognitive and motor functions. Here are some key ways in which alcohol affects the brain and behavior:
- Neurotransmitter Modulation: Alcohol affects several neurotransmitter systems in the brain. It enhances the effects of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that promotes relaxation. Additionally, it inhibits the effects of glutamate, an excitatory neurotransmitter. The combined effect leads to a general slowing down of brain activity.
- Central Nervous System Depression: Alcohol is a central nervous system (CNS) depressant. It suppresses neural activity in the brain, leading to sedation and a decrease in alertness. This depressant effect is responsible for the relaxation and euphoria often associated with moderate alcohol consumption.
- Impaired Cognitive Function: Excessive alcohol consumption can impair cognitive functions such as attention, memory, and decision-making. This can result in poor judgment, reduced inhibitions, and impaired reasoning, contributing to risky behaviors.
- Disruption of Balance and Coordination: Alcohol affects the cerebellum, a brain region involved in motor control and coordination. This can lead to impaired balance, coordination, and motor skills, increasing the risk of accidents and injuries.
- Changes in Mood and Emotion: While alcohol can initially induce a sense of euphoria, excessive consumption can lead to changes in mood, including irritability, aggression, and emotional instability. Chronic alcohol use is also associated with an increased risk of mood disorders.
- Impact on the Reward System: Alcohol activates the brain's reward system by increasing dopamine levels. This reinforcement contributes to the pleasurable effects of alcohol and may contribute to the development of dependence in some individuals.
- Sleep Disruption: Although alcohol may induce drowsiness, it disrupts the sleep cycle, leading to poor-quality sleep. This can contribute to feelings of fatigue and impaired cognitive functioning.
- Dehydration: Alcohol is a diuretic, promoting increased urine production and potentially leading to dehydration. Dehydration can contribute to physical symptoms such as headaches and fatigue.
- Negative Impact on Inhibitions: Alcohol can lower inhibitions and impair judgment, leading to behaviors that an individual might not engage in when sober. This can include risky sexual behavior, aggression, or other impulsive actions.
- Tolerance and Dependence: With regular and chronic alcohol use, the brain can develop tolerance, requiring larger amounts of alcohol to achieve the same effects. Dependence may also develop, leading to withdrawal symptoms when alcohol consumption is reduced.
- Risk of Addiction: Persistent and excessive alcohol use can lead to alcohol use disorder (AUD), which is characterized by a loss of control over drinking, continued use despite negative consequences, and a preoccupation with alcohol.
Does quitting alcohol help anxiety?
Yes, quitting alcohol can help alleviate anxiety. While alcohol may provide temporary relief, especially for those dealing with stress or social anxiety, it can exacerbate anxiety symptoms in the long run. Alcohol is a central nervous system depressant that can disrupt neurotransmitter balance, impact sleep quality, and contribute to emotional dysregulation. Abstaining from alcohol allows the brain and body to recover, leading to improved mental clarity, better sleep, and a more stable emotional state. Quitting alcohol may also provide individuals with the opportunity to develop healthier coping mechanisms and address the underlying factors contributing to their anxiety, fostering long-term well-being.
Why do I get emotional when I drink?
Drinking alcohol can have varied effects on emotions, and individual reactions can differ based on factors such as personality, mood, and the context in which alcohol is consumed. Alcohol is a central nervous system depressant that affects neurotransmitter systems in the brain, including gamma-aminobutyric acid (GABA) and glutamate. While initial consumption might induce relaxation and euphoria, excessive drinking can lead to emotional dysregulation and intensified feelings. Alcohol can also dampen inhibitions and lower self-awareness, making individuals more prone to expressing or experiencing heightened emotions.
How long does alcohol anxiety last?
The duration of alcohol-induced anxiety can vary widely among individuals and is influenced by factors such as the amount of alcohol consumed, individual tolerance, overall health, and any underlying mental health conditions. Alcohol-induced anxiety is often associated with the hangover phase, which typically occurs after the immediate effects of alcohol wear off.
Hangover symptoms, including anxiety, can last anywhere from several hours to a full day, depending on the severity of the hangover and individual differences. In some cases, individuals may experience anxiety as part of acute alcohol withdrawal, commonly known as the "hangxiety" phenomenon.
Is alcohol like an antidepressant?
While alcohol might initially produce feelings of relaxation and euphoria, it is not a true antidepressant and should not be used as a substitute for proper mental health treatment. Alcohol is a central nervous system depressant that affects neurotransmitters in the brain, including gamma-aminobutyric acid (GABA) and glutamate. It may temporarily alleviate symptoms of stress or anxiety, leading some individuals to perceive it as having antidepressant-like effects. Over time, alcohol may increase symptoms of depression.
How much alcohol is OK daily?
It's important to note that the definition of "moderate" alcohol consumption can vary based on factors such as individual health, age, and medical conditions. The Centers for Disease Control and Prevention (CDC) and other health organizations define moderate drinking as follows:
For men: Up to two standard drinks per day
For women: Up to one standard drink per day
A standard drink is typically defined as containing about 14 grams of pure alcohol. This is roughly equivalent to:
12 ounces of beer with about 5% alcohol content
5 ounces of wine with about 12% alcohol content
1.5 ounces of distilled spirits (e.g., whiskey, vodka) with about 40% alcohol content
It may be important to recognize that exceeding these guidelines, even on occasion, can have health risks and may impact mental illness. Excessive alcohol consumption is associated with a range of negative health effects, including liver disease, cardiovascular issues, increased risk of accidents and injuries, and mental health problems.
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