Depression and Alcohol Use – Not a Good Combination

Depression and alcohol use is often not a good combination. Both cause changes in the brain, and both can make the other condition worse.

Depression and the Alcohol Use Connection

Depression and the alcohol misuse connection is not generally understood.

Depression and the alcohol misuse connection is not generally understood. Both cause brain changes.

Suffering from depression and its accompanying feelings of sadness, loneliness, restlessness and the like is often a reason a person elects to drink in the first place. Alcohol triggers the brain’s dopamine reliant pleasure/reward pathways, which are the pathways that facilitate a person’s ability to experience joy, happiness, pleasure. Unfortunately, alcohol is also a depressant. Thus the alcohol can exacerbate the symptoms a person feels as a consequence of their depression. Not only that, but mental illness, such as depression, is one of the key risk factors for developing an addiction and the road to addiction (alcoholism) is a progression, moving from alcohol use to abuse to dependence (an addiction to alcohol). [To understand the progression, check out this link, “Alcoholism is a Disease and It’s Not Alcohol Abuse.”]

As with the stigma and shame that surrounds drinking too much and not being able to control or cut back on one’s drinking, depression carries a huge amount of stigma and shame, as well. Often, friends and family will chide a loved one who seems depressed to get up, get going, get out, do something. Often friends and family will chide a loved one who drinks too much to stop, to cut back, to only drink on holidays, to get it under control. Depression (explained below), alcohol abuse and alcoholism all cause brain changes – they actually change the way the brain works. For this reason, it’s impossible for the person experiencing either or both to “Just Do It!” until they “fix” their brain – in other words, treat their depression, truly change their drinking patterns to fall within low-risk limits and/or treat their alcoholism. In all three cases – the earlier treatment (change) is begun, the better.

For these reasons, I thought it would be helpful to share some of the facts about depression from the National Institute on Mental Health, because the combination of untreated depression and drinking can result in a Co-Occurring Disorders – having two brain diseases (disorders) at the same time.

Co-occurring disorders in the brain is similar to one body having both cancer and diabetes. Medical practitioners do not stop treating the diabetes while they treat the cancer. They know they must do both or that body will likely not survive.

NIMH Signs and Symptoms, Risk Factors, Diagnosis and Treatments of Depression

Quoting from NIMH’s Publication – Depression:

Signs and Symptoms

People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness.
Signs and symptoms include:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness or pessimism
  • Irritability, restlessness
  • Feelings of guilt, worthlessness or helplessness
  • Loss of interest in activities or hobbies  
  • Decreased energy or fatigue
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering or making decisions
  • Difficulty sleeping, early-morning awakening or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without clear physical cause and/or that do not ease even with treatment

Risk Factors

Depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors.

Depression can happen at any age, but often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although it sometimes presents with more prominent irritability than low mood. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children.

Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.

Risk factors include:

  • Personal or family history of depression
  • Major life changes, trauma, or stress
  • Certain physical illnesses and medications

Diagnosis and Treatments

Depression, even the most severe cases, can be effectively treated. The earlier that treatment can begin, the more effective it is.

The earlier that treatment can begin, the more effective it is. Depression is usually treated with medicationspsychotherapy, or a combination of the two.Click here to read the rest, starting with Medication…

Additional Resources and Information

Lisa Frederiksen

Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com
Lisa Frederiksen is the author of hundreds of articles and 12 books, including her latest, "10th Anniversary Edition If You Loved Me, You'd Stop! What you really need to know when your loved one drinks too much,” and "Loved One In Treatment? Now What!” She is a national keynote speaker with over 30 years speaking experience, consultant and founder of BreakingTheCycles.com. Lisa has spent the last 19+ years studying and simplifying breakthrough research on the brain, substance use and other mental health disorders, secondhand drinking, toxic stress, trauma/ACEs and related topics.
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33 Comments

  1. Explode Your Business ONLINE @Norma Doiron on March 18, 2013 at 11:36 am

    Having worked in medical offices for several years, I always found so amazing how many people are on depressive medication. Wowsers! Unreal…

  2. Tom H on March 18, 2013 at 3:08 pm

    Thanks for sharing this information, depression seems to be slightly epedemic right now and many folks don’t have appropriate resources to manage their condition.

    • Lisa Frederiksen on March 18, 2013 at 3:15 pm

      You’re welcome, Tom, and thank you for adding your comment!

  3. Alexandra McAllister on March 18, 2013 at 4:05 pm

    Thanks, Lisa for sharing this post and the resources. Depression is an epidemic and not everyone knows how to handle it, until it is too late! Bless you for bringing awareness to this challenge.

    • Lisa Frederiksen on March 18, 2013 at 4:21 pm

      Thank you so much, Alexandra – I’m glad it helps raise awareness. Thank you for adding your comment!

  4. Leslie Yerger on March 18, 2013 at 8:21 pm

    Thank you Lisa for sharing this insightful information. It helped my understand why so often times depression goes along with another issue. You are a real wealth of knowledge. Please don’t stop sharing it!

    • Lisa Frederiksen on March 18, 2013 at 9:43 pm

      Thank you so much for the kind words, Leslie, and I’m glad you found the information helpful!!

  5. Meryl Hershey Beck on March 18, 2013 at 10:11 pm

    Lisa, the resource you provided is comprehensive and informative. Depression can effect not only the individual but the family as well.

    • Lisa Frederiksen on March 19, 2013 at 7:38 am

      Very good point, Meryl, and especially if it’s not understood or healthily discussed without stigma, shame or blame – thanks for raising this important point!

  6. Erin on March 19, 2013 at 3:39 am

    Thanks for sharing this information! I’m always curious to read about stuff like this as depression seems to be quite an epedemic. Too many folks don’t have the resources to manage their condition in an appropriate manner (or they are in denial of it altogether).

    • Lisa Frederiksen on March 19, 2013 at 7:48 am

      You’re so right – and often it goes unacknowledged for what it is (people telling themselves it’s stress or a phase or not enough hours in the day…) because, as you say, they don’t have the resources to pay the cost to see a doctor for a professional evaluation or they are not aware of the symptoms to understand it could really be a problem. And of course, there’s still such stigma surrounding mental illness as if it’s a bad choice instead of the brain changer it is. Thanks for your comment, Erin!

  7. Carolyn Hughes on March 19, 2013 at 5:51 am

    Having suffered with both depression and alcoholism, I can now see how they were linked. I drank because I was depressed, but then I became more depressed because of the drinking. What amazes me now is that no doctor pointed this out to me (okay I may not have listened!) but it wasn’t until I was in treatment that I learnt that the drinking could have made my addiction worse and vice versa.
    Thank you for the information Lisa!

    • Lisa Frederiksen on March 19, 2013 at 8:01 am

      It’s amazing how many doctors don’t understand addiction. In the U.S., for example, only 1200 out of the 985,000 doctors are trained in treating addiction. When they don’t understand it as a brain disease and are unable to take the time in the short visits they have with a patient (time controlled by our health care system / health care costs) to fully flesh out the reason for the depression, the patient is often medicated, without addressing the root cause for their drinking, which is often a trigger (cue) for which the brain has wired alcohol as the go-to-relief answer to ease the emotional pain triggered by the cue.

      This is a huge, complicated issue, to be sure. Hopefully, raising awareness can help people better see their story and have the strength (armed with knowledge) to fight for the kind of help they need for their depression and to do whatever it takes to wrest control of their drinking. I say wrest control as it may be alcohol abuse (in which case, they may be able to learn to “re-drink” in moderation) or it may be alcoholism (in which case, they cannot drink any amount if they want to treat their brain disease of addiction). For readers of this comment, this short video further explains the difference: http://www.youtube.com/watch?v=2zADTxr5QDE

      Thanks so much for your comment, Carolyn.

  8. Martha Giffen on March 19, 2013 at 7:07 am

    Good info! Depression can be contagious. If one person in a family goes untreated, the dark mood spreads to all involved. It’s weird that way.

    • Lisa Frederiksen on March 19, 2013 at 8:02 am

      You’re right, Martha – the malaise, hopeless, sometimes antagonistic feelings others take on as a consequence of their inability to “help” or their frustration with the person for not “snapping out of it” can spread. Thanks so much for your comment!

  9. Shari on March 19, 2013 at 8:56 am

    Dual diagnosis is a huge problem in the U.S. and there are few dedicated resources to address it. It can be absurdly difficult to get access to effective, empirically validated treatment. Thanks for bringing attention to this major issue, Lisa.

    • Lisa Frederiksen on March 19, 2013 at 9:05 am

      It really is, Shari. And for the addict|alcoholic with a dual diagnosis, if the treatment is not truly treating both brain diseases/disorders at the same time, it’s like taking away their medicine – thus it’s very likely they’ll return to their substance of choice because their brains have wired it as the “thing” that makes them feel better. Thanks for your comment!

  10. MamaRed on March 19, 2013 at 12:13 pm

    Dealing with the shame that comes from being depressed was huge when I was initially diagnosed. Fortunately it didn’t turn to alcoholism and it did a real number on my life and I can only imagine how much harder it must be with a dual diagnosis.

    • Lisa Frederiksen on March 19, 2013 at 12:33 pm

      Thank YOU, MamaRed, for sharing your own experience with depression. It really helps others know there is a way out – it truly can get better.

  11. Daniele Holmberg on March 19, 2013 at 6:16 pm

    Thank you for sharing this! Many people do not understand the severity of alcoholism and depression..it is so unfortunate. Thank you for raising awareness;)

    • Lisa Frederiksen on March 19, 2013 at 6:56 pm

      You’re so welcome, Daniele. I appreciate your comment!!

  12. Sherie on March 19, 2013 at 7:00 pm

    Lisa,so glad that you are raising awareness of the link between depression and alcoholism. Both are rampant and you are doing such a wonderful service, my dear! Excellent post!

    • Lisa Frederiksen on March 20, 2013 at 8:20 am

      Thanks so much, Sherie – appreciate you reading and adding you comment!

  13. Sharon O'Day on March 19, 2013 at 7:15 pm

    I read an article like this and just count my lucky stars. I often think of the fact that my mother had four children. We’re far from perfect … but we’ve escaped both addiction and major depression. Thank you for the clarity you bring to this massive challenge, Lisa.

    • Lisa Frederiksen on March 20, 2013 at 8:21 am

      That’s wonderful, Sharon!! – and thanks for adding your comment.

  14. Moira Hutchison on March 20, 2013 at 9:25 am

    Thanks for getting this information out there Lisa! Depression is such an often overlooked issue and awareness is such a key allowing for change and support.

    • Lisa Frederiksen on March 20, 2013 at 10:25 am

      It really is – thanks for adding your comment and support, Moira!

  15. Pat Moon on March 23, 2013 at 1:28 pm

    Depression has such a broad range of causes. One that I see so much is involved in nutrient deficiencies. So many people have horrific diets full of processed foods and especially sugar. Were you aware that sugar is as additive as heroin? So many times nutrient deficiencies are covered up with anti-depressant drugs instead of really addressing the problem. A vicious cycle can involve eating junk food and that contributes to depression which leads to more bad eating habits. Breaking out of the cycle can be tough. Also consumption of quality fats is very beneficial in keeping the brain healthy. Thanks for this good info on depression and addiction.

    • Lisa Frederiksen on March 23, 2013 at 1:36 pm

      EXCELLENT points, Pat. Thank you so much for sharing your wealth of knowledge about nutrition and health – especially as it relates to brain health!!

  16. Helena Bowers on March 25, 2013 at 4:55 am

    Thanks so much Lisa for getting the word out about depression and how harmful it is. It really bothers me that doctors seem to go one of two ways: they either tell you to suck it up, you’re not depressed, or they go straight for the prescription pad. Neither one addresses the why of depression, and until you can get to what triggers it, I don’t see how you can really treat it.

    • Lisa Frederiksen on March 25, 2013 at 7:46 am

      I couldn’t agree more, Lena — although sometimes a person may need the medication to help get to a point where they can accept treatment, but the two must go hand-in-hand. Plus, it’s important doctors and therapists keep in mind the other brain healers that can help supplement treatment – such as exercise, mindfulness, nutrition and sleep – but it’s a composite of healing the brain, which requires dealing with underlying issues – the whole picture has to be addressed. Thanks so much for your comment!

  17. Yvonne on March 25, 2013 at 2:03 pm

    I should forward that…Unluckily that person is not in a space were she listens….

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