Drinking has a firm foot in our culture, and it seems to fit any occasion.
Having a birthday and turning 21, 30, or 50? Have a round on the house!
Getting married? Crank up Rihanna’s “Cheers (Drink to That)” and throw one (or five) back while grooving on the dance floor into the wee hours of the morning.
Going on a first date? Why not meet at the bar for a classy cocktail or glass of wine?
Had a hard day at work, bad week, or even a rough month when you just can’t seem to shake that sinking feeling? Nothing a drink to lift the spirits can’t solve…
And that’s where we begin to run into trouble — self-medicating our depression through alcohol consumption.
The Relationship Between Alcohol and Depression
Though a drink or two on occasion may not be cause for concern, the research is clear: drinking is making you depressed — and vice versa.
“The worst thing you can do if you’re depressed is to drink,” Dr. Howard Samuels, CEO/founder of The Hills Treatment Center, tells Talkspace. “A lot of people are drinking because they’re depressed and then that makes their depression 10 times worse.”
Drinking for self-medication leads to a circular pattern where drinking causes the depression, which increases the need for self-medication, which means more drinking, and so on. This leads to dependency for many. The link between alcohol use disorder (ACU) and depression is very strong.
According to the National Institute on Alcohol Abuse and Alcoholism, studies suggest that “30 percent to 50 percent of people with alcohol issues (at any given time) are also suffering from a major depressive disorder.” A similar study found that those who are alcohol-dependent are nearly four times more likely to have suffered from depression in the previous year than those without drinking issues. In 2011, an Addiction journal article revealed that living with either alcoholism or depression doubled the chances of developing the other disorder.
Further, the University of Buffalo’s Research Institute on Addictions reports that those with ACU and depression generally experience more severe forms of both diagnoses, which are more difficult to treat. Women are more likely to develop depression first, then an alcohol problem, whereas men usually develop an alcohol dependency followed by depression. In addition, per Dr. Mark Jacob’s report for Psych Central, “alcoholism may cause a relapse in patients with depression.”
Alcohol’s Effects on the Brain
To understand alcohol’s relationship with depression, let’s examine how alcohol affects our brain chemistry.
While it’s commonly referred to as a depressant, that’s not all alcohol does for us. When it enters the bloodstream and ultimately the brain, it increases both our feelings of pleasure and dampens our mood.
As blood alcohol content rises during the initial stages, drinking acts like a stimulant, making you feel better. This happens thanks to an increase in “feel good” neurotransmitters such as dopamine, triggering the brain’s “reward center.” Initially, alcohol can feel like an effective way to treat the blues.
However, as blood alcohol content decreases, more of its suppressive qualities start to take hold. Alcohol dampens excitatory neurotransmitters that regulate energy levels such as glutamate, taking things down a notch. Meanwhile, alcohol also reaches the primary inhibitory neurotransmitter GABA, which slows down the system, resulting in the “downer” feeling that can follow drinking.
“By jacking up dopamine levels in your brain, alcohol tricks you into thinking that it’s actually making you feel great — or maybe just better if you are drinking to get over something emotionally difficult,” writes David DiSalvo in Forbes. “The effect is that you keep drinking to get more dopamine release, but at the same time you’re altering other brain chemicals that are enhancing feelings of depression.”
Dangers of Depression and Alcohol Abuse
One of the other well-known side effects of alcohol is its ability to remove inhibitions — dancing wildly all night long or slipping between the sheets for a night of casual fun. We have reduced inhibitions because, according to Dr. Joshua Gowin writing in Psychology Today, the prefrontal and temporal cortex areas of the brain experience a decrease in activity. The prefrontal cortex controls decision making and logical thinking. While under the influence, this area of the brain allows for less inhibited actions.
This loss of inhibition has a dark side when drinking while depressed. Research shows that those who consume “heavy” amounts of alcohol have a “five-fold higher risk of suicide than social drinkers,” according to a 2010 article in the International Journal of Environmental Research and Public Health. Further, the Substance Abuse and Mental Health Services Administration found that in 2008, almost one-third suicides across 16 reporting states involved alcohol.
Dr. Howard Samuels puts it frankly — the combination of depression and alcohol is much more likely to be lethal due to lowered inhibitions, increasing the risk of suicide. “It will make you feel better when you take that first shot of scotch,” he says, “and then you’ll drink more and more and more and…your depression will turn into suicidal ideation the next day.”
Considering Proper Medication
While some depression is situational — feeling down for a period of time after losing a loved one or being laid off from the job — for many, depression also has a chemical component best managed by medication. Drugs used to treat depression and other mental illnesses and alcohol also do not mix.
“If you drink, then you’re countering the effects of the antidepressant,” says Samuels. At that point, any benefits the meds may provide are nullified, and can even intensify the negative effects of alcohol use.
When alcohol is mixed with selective serotonin reuptake inhibitors (SSRIs), a common class of drug used to treat mood disorders, the result can be a loss of coordination, motor skills, reaction time, and alertness, which makes ordinary tasks risky at best. Drinking while taking monoamine oxidase inhibitors (MAOIs), another class of medication used to treat mental health conditions, can cause dangerously high blood pressure.
Benzodiazepines, often prescribed to reduce anxiety, target the same GABA neurotransmitter that alcohol does. This means drinking and taking these meds at the same time amplifies the sedative quality of both chemicals, which DiSalvo reports “can slow your heart rate and respiratory system down to dangerous levels.”
Despite the alarming connection between drinking and depression, there is also good news. Jacob writes that depression symptoms are “greatly reduced” in about a month after letting alcohol go. Keep in mind depression may get worse before it gets better, especially while going through the withdrawal period of sobering up. Once you’ve stopped drinking, it’s easier to address the root causes of depression, whether a tough life situation or a chemical imbalance.
“Drinking and depression aren’t a good combo. If you’re having trouble with either or both, ask for help,” writes Huffington Post blogger Hannah Sentenac, who previously used drinking as a “socially acceptable method for feeling better.” “You’re not alone, trust me. These problems are much more prevalent than most people realize.”
In addition, awareness and advocacy about co-existing disorders, such as depression and ACU, increases daily. Programs that address both substance use and mental health conditions have become more widely available, including therapy solutions. Help is out there, and once you take the courageous step to reach out, there is also hope.