Alcohol and depression: how are they linked?

When you drink alcohol in moderation, it can help you to unwind, become more social and reduce anxiety and stress. However, if it's drunk to excess, the opposite can become the case. Alcohol abuse and mood disorders like depression are intrinsically linked, with evidence showing that one often leads to the other.

We have outlined the common reasons why alcohol and depression become connected, and the steps you can take if you’re struggling.

How does alcohol affect mood?

Following the initial, relatively short-lived phase of relaxation and mood enhancement, alcohol is actually a depressant that, over time, depletes levels of the neurotransmitter, serotonin. In your brain, serotonin levels are linked to mood – too little can result in a downturn in how you're feeling. Regular or excessive drinking can increase the likelihood of negative emotions taking over, regardless of how you felt when you started drinking. Eventually, these emotions may impact your thoughts, feelings, actions and overall mental (as well as physical) health.

Regular excessive or even episodic binge drinking can also lead to various negative life consequences. Drinking severely affects all aspects of sleep, creating a cycle of waking up feeling ill, agitated, jittery and guilty. In the long-term it can also affect your physical health, damaging your wellbeing further. It might also lead to bad decision making, negatively affecting your job, financial situation or personal relationships. This can further worsen your mood, all combining into a downward spiral that could develop into depression.

There's also a relationship between heavy drinking and an increased risk of self-harm and suicide, as disinhibition and impaired judgement through alcohol can lead to feelings of hopelessness as well as impulsive, risk-taking behaviours.

Generally, it’s common for alcohol to feed into depression in these ways. To really understand this connection, it’s important to review the key signs of alcoholism:

• Anxiety
• Mood swings
• Paranoia
• Secretive or dishonest behaviour
• Avoiding contact with loved ones

If you find yourself experiencing these symptoms, it’s likely that your drinking is affecting your mood and wellbeing – a cycle that can lead to depression. With many people who suffer from depression, excessive alcohol use is involved at some stage, exacerbating their symptoms or leading to negative changes in their life.

Studies have confirmed the link between alcohol use disorders and major depression, suggesting that greater alcohol consumption increases your risk of developing depression (source).

Does depression cause alcoholism?

Just as alcohol use can contribute to someone developing depression, people who already suffer from depression may develop alcoholism. The key symptoms of depression can point towards the relationship between the two:

• Intense feelings of sadness and guilty
• Feelings of hopelessness and/or worthlessness
• Irritability
• Fatigue
• Suicidal thoughts

If you’re experiencing the above symptoms, you may reach for alcohol to improve your mood, cope with anxiety or suppress any symptoms of depression. You might also wish to block out or cope with painful life experiences.

Again, this highlights the overlapping nature of depression and alcohol use. The causes of depression and alcoholism are often complex and differ on an individual basis. It’s not always clear whether depression causes someone to drink, or vice versa. For someone to develop depression and/or alcoholism, additional factors are often at play too, such as:

• Genetics – while more research is needed, it’s widely accepted that genes play some role in your likelihood of developing depression or alcoholism. If you have a close relative who has struggled with depression or alcoholism, the chances of you doing so may increase
• Trauma – experiencing trauma, especially during childhood, is a common factor in someone developing depression or turning to excessive drinking
• Lifestyle – many aspects of your lifestyle could combine to make it more likely you'll develop depression. Poor diet, lack of sleep, and a lack of exercise are all linked with a decrease in mood. Changes in your life, such as divorce or bereavement, are common triggers for some people developing a problem with alcohol

The connection between life events, depression and alcohol misuse is well-established in relevant scientific studies. Childhood trauma, and the depressive symptoms that come from it, have been found to lead to a higher likelihood of alcoholism in adulthood (source). A relationship between drinking and past trauma has also been established in young adult veterans, who are all at greater risk of alcohol misuse, depression and post-traumatic stress disorder (PTSD) (source).

How can I stop drinking so much alcohol?

If you find that you’re drinking too much, or you’re feeling depressed and find yourself drinking to relieve symptoms, removing or reducing alcohol from your life will likely improve your mood and overall wellbeing. This may seem daunting right now, but taking small steps can quickly make a big difference in your life.

Here are some strategies that might help you stop drinking as much alcohol, or cut it out altogether:

• Set goals – setting targets and achieving goals can be a major motivator when you’re trying to cut down on your drinking. Whether it’s a budget-based limit or a limit on the number of drinks you have per week, set a target and stick to it
• Have a ‘get out’ plan – social events are one of the more difficult hurdles you’ll have to overcome. Have a plan ahead of any event so you can keep alcohol at a level you’re happy with. Set a strict budget or pre-book a taxi so you can be home before you’ve had too much to drink
• Keep busy – boredom can easily lead to you grabbing a drink or two when you don’t even really want one. You could try taking up a new hobby or organising an alcohol-free event with your friends. Anything that keeps your mind away from drinking will help in the long run
• Swap alcohol for alternatives – sometimes when you feel you need a drink, it can be enough to reach into the fridge and grab an alcohol-free alternative. The action of doing this is all you need to de-stress after a hard week at work. Try out the wide range of alcohol-free alternatives available today – you probably won’t even notice the difference

Diagnosis and treatment of depression and alcoholism

If you’re struggling with depression or alcohol addiction, know that both conditions are treatable and recovery is possible.

Your first step is to seek out a potential diagnosis. You could make an appointment with your GP, or contact Priory and make use of our world class private healthcare services, where we help sufferers of depression and alcohol addiction get their lives back on track. Our experts can assess your symptoms, make a medical diagnosis for depression or alcoholism, and outline your treatment options.

Depending on your circumstances, a combination of the following treatments for depression and alcohol addiction may be appropriate.

Alcohol treatment programme

Alcohol addiction is commonly treated through our intensive alcohol rehab programmes, which take place residentially at one of numerous hospital sites across the UK.

Therapy

Therapy, such as cognitive behavioural therapy (CBT), is an effective way to treat sufferers of both depression and alcohol addiction. A CBT therapist will work with you to identify negative or irrational thoughts and behaviours, and work to replace them with a healthier, more positive outlook.

Therapy can be delivered as part of an inpatient or outpatient treatment programme. Recovery is also possible from the comfort of your own home with our online therapy service.

Medication

Alongside therapy, our expert psychiatrists may prescribe you effective antidepressant medication. Medication can help to relieve symptoms of depression and reduce your need to drink, allowing you to make the most of your therapy sessions and improve your wellbeing in the long-term.

For people entering an alcohol treatment programme with us, it might also be appropriate for you to go through a monitored detox programme, where we may prescribe medications such as diazepam or oxazepam. These will help you to cope with the alcohol detox process and alleviate any discomfort that you're experiencing.