Alcohol affects our brain chemistry, so it’s no wonder that many turn to it when they’re feeling down. But how does alcohol really affect depression?
So many people’s response to stress, anxiety, and depression is, “I need a drink.” We’ve all seen it (or done it). But despite how common that is, most of us also know that alcohol isn’t really the greatest coping tool, even while we’re turning to it. In fact, for millions, alcohol is actually making their depression worse.
What is depression and why does it matter?
A 2017 survey found that 17.3 million adult Americans had suffered from a major depressive episode in the previous year. Because it’s common to say, “I’m so depressed,” in response to everything from a traffic jam to a favorite show being canceled to a loss of a loved one, the true scope of the problem can be unclear. What does depression really mean? The American Psychiatric Association defines a “major depressive episode” as “a depressed mood or loss of pleasure or interest for at least 2 weeks”, along with at least three of the following symptoms:
- weight loss or change in appetite
- Insomnia (not being able to sleep) or hypersomnia (sleeping much more than usual)
- psychomotor retardation (thinking slowly) or agitation (racing thoughts)
- fatigue or loss of energy
- excessive/inappropriate guilt or feelings of worthlessness
- indecisiveness or diminished ability to concentrate or think
- recurrent thoughts of death or suicidal ideation or suicide plan or attempt
Along with all of those symptoms, depression can also make people feel more isolated and less connected to other people. Depression clearly can be serious. It was the second leading cause of disability as of 2013. Those numbers were already huge, and then mental health struggles increased during the pandemic.
Why do people with depression drink?
There are a lot of reasons why people drink, and that also holds true for those with depression. But for many, it’s because they are seeking an escape from the pain of their mental illness. Depression sucks. So a lot of folks try to self-medicate it. Some people feel ashamed of their depression and are trying to hide it. Some have difficulty accessing mental health care. And even for those who do have access to mental health support, a bottle from the liquor store or grocery store might seem cheaper and easier.
At first, alcohol may appear to help. Drinking can create a sensation of euphoria in the brain. It can also blur perception and memory, so it can seem like an easy escape. Unfortunately, drinking can also damage the brain and body, and lead to alcohol use disorder. Nearly a third of people with major depression also have a substance use disorder. We often use the term “dual diagnosis” when someone has a substance use disorder as well as another mental health diagnosis.
Alcohol affects depression in negative ways
The sad fact is that alcohol can make depression worse. You might be thinking, “Sure, but only for those who drink all the time!” Not true. Research suggests that alcohol can make depression worse even for people who don’t drink heavily. But even if you start off drinking moderately, you might not stay that way. Those who drink to manage their depression are much more likely to develop an alcohol use disorder over time.
Alcohol affects your brain chemistry. It’s classified as a central nervous system depressant, which means it depresses the inhibitory centers of the brain, impedes some neural functions, and slows reaction times. In plain terms, it slows down and blocks certain brain functions. Beyond that, it can also hijack the reward system in your brain, making it harder to feel good or even just okay without alcohol.
Drinking can also lead to impulsive decisions, which can cause negative life consequences. These consequences—professional, financial, social, legal, and physical—are a burden that makes situational depression more likely.
Alcohol and treatment for depression
Alcohol isn’t good for depression, and it’s also not good for depression medication. Mixing alcohol and depression meds can make depression worse instead of better. It can even be dangerous for your health. If you are considering drinking while taking anti-depressants, talk to your doctor first, and then follow their guidance.
With some medications, your doctor may okay moderate drinking. If they do, you must know what moderate drinking is and stick to that limit. In general, it means one drink per day for a woman or two for a man. “One drink” means:
- 12 ounces of beer
- 5 ounces of wine
- 1 ounce of hard liquor
Getting an enormous novelty glass and filling it up with booze does not qualify as “one drink.” If you don’t know whether you’ll be able to abide by your doctor’s suggested limits, it’s safest not to drink at all.
If you have a dual diagnosis of alcohol use disorder and depression, make sure your doctor knows about both. It may affect which medication or therapy is most effective for your treatment.
What it boils down to
Not everyone wants to stop drinking. That’s a choice you have to make for yourself! But if you are struggling with your mental health, it’s important to be aware of the ways alcohol is affecting your depression. It might seem to be a coping tool, giving you a way to escape your symptoms. On the contrary, it is actually likely to be making them worse. It might also be adding extra mental and physical damage on top of what you were already dealing with. If you have depression, seek help somewhere other than a bottle.
For those with a dual diagnosis of depression and alcohol use disorder, there are options for treating both. You don’t have to figure it out alone!