Depression and Alcohol Use – Not a Good Combination

Depression and Alcohol Use – Not a Good Combination

Depression and alcohol use are 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. Clinical depression, 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 Institutes of Mental Health, because the combination of untreated depression and drinking can result in a dual diagnosis – having two brain diseases | disorders at the same time.

NIMH Signs and Symptoms, Causes, and 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” feelings
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment

Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors.Depressive illnesses are disorders of the brain. Longstanding theories about depression suggest that important neurotransmitters—chemicals that brain cells use to communicate—are out of balance in depression. But it has been difficult to prove this.

Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behavior appear different. But these images do not reveal why the depression has occurred. They also cannot be used to diagnose depression.

Some types of depression tend to run in families. However, depression can occur in people without family histories of depression too.9 Scientists are studying certain genes that may make some people more prone to depression. Some genetics research indicates that risk for depression results from the influence of several genes acting together with environmental or other factors.10 In addition, trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Other depressive episodes may occur with or without an obvious trigger.

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 first step to getting appropriate treatment is to visit a doctor or mental health specialist. Certain medications, and some medical conditions such as viruses or a thyroid disorder, can cause the same symptoms as depression. A doctor can rule out these possibilities by doing a physical exam, interview, and lab tests. If the doctor can find no medical condition that may be causing the depression, the next step is a psychological evaluation.

The doctor may refer you to a mental health professional, who should discuss with you any family history of depression or other mental disorder, and get a complete history of your symptoms. You should discuss when your symptoms started, how long they have lasted, how severe they are, and whether they have occurred before and if so, how they were treated. The mental health professional may also ask if you are using alcohol or drugs, and if you are thinking about death or suicide.

Once diagnosed, a person with depression can be treated in several ways. The most common treatments are medication and psychotherapy. Click here to read the rest, starting with Medication…

Additional Resources and Information

National Alliance on Mental Illness (NAMI)

Substance Abuse and Mental Health Services Administration (SAMHSA):
Co-Occurring Disorders

Lisa Frederiksen

Lisa Frederiksen

Author | Speaker | Consultant | Founder at
Lisa is the author of hundreds of articles and 11 books, including "If You Loved Me, You'd Stop!," "Addiction Recovery: What Helps, What Doesn't," and "Secondhand Drinking: the Phenomenon That Affects Millions." She is a national keynote speaker with over 25 years speaking experience, consultant, and founder of She has spent more than 14 years studying 21st century brain research in order to write, speak, and consult on substance use disorders prevention, intervention and treatment; mental disorders; addiction (aka substance use disorders) as a brain disease; adolescent addiction treatment vs adult addiction treatment; effective treatment for co-occurring disorders (having both a substance use and mental disorder); secondhand drinking | drugging; help for the family; and related subjects. In 2015, she founded SHD Prevention, providing training and consulting to companies, public agencies, unions, nonprofits and other entities to address the workplace impacts of employee secondhand drinking and alcohol misuse.
Lisa Frederiksen

Latest posts by Lisa Frederiksen (see all)

33 Responses to Depression and Alcohol Use – Not a Good Combination

  1. 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 says:

    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.

  3. 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.

  4. 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!

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

  6. Erin says:

    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).

    • 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. 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!

    • 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:

      Thanks so much for your comment, Carolyn.

  8. 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.

    • 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 says:

    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.

    • 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 says:

    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.

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

  12. Sherie says:

    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!

  13. Sharon O'Day says:

    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.

  14. 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.

  15. Pat Moon says:

    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.

  16. 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.

    • 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 says:

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

Leave a reply