Alcohol and Depression

Do you drink every day? Is low mood a constant experience that impacts other areas of your life? A negative relationship with alcohol is very hard to live with in a society where drinking is legal, socially acceptable and encouraged.

Giving up alcohol can be extremely tough. It often feels as though it’s in every shop and at every establishment and event that you go to. Alcohol and depression have long been recognised as being connected.(1)

According to research, 595,131 people were reported as having alcohol dependence in 2019 in the UK.(2) As with the age old question of the chicken or the egg, identifying whether an alcohol problem or depression came first is often impossible to tell. Why is this?

Firstly, people drink for various reasons and regular drinking can lead to depression. On the other hand, people drink to ease depression. In many cases the two are inextricably linked and exacerbate each other.

When the two are present, they’re often referred to as a comorbid condition or are given a dual diagnosis status. When professionals guide people through treatment for this condition it’s incredibly important to identify and diagnose both the alcoholism and depression.

How alcohol affects your mind and body

Your brain

Alcohol slows down the Central Nervous System (the brain and spinal cord). Prolonged regular drinking destroys brain cells.(3)

When a person drinks a large amount of alcohol regularly it causes unnatural spikes and drops in brain chemicals called serotonin and dopamine. This has the effect of causing depression and anxiety in many people. It’s also one of the factors contributing to dependence as the brain and body start to “need” alcohol in order to “function normally”.

Short term effects

But what about where it all began? There’s a reason alcohol is so popular in the first place. When young people drink, the vast majority are experimenting with it and drink socially, or to enhance situations.(4) It’s important to acknowledge that when first discovered alcohol makes people feel good.

This is due to the release of “happy chemicals” just mentioned. In the short term this can influence mood making a person feel relaxed, confident, even euphoric.

Beyond this point, alcohol begins to dull reactions, it slows down speech and causes people to lose balance. Later still? Over-consumption can lead to dizziness, sickness, black-outs. And the next day? The foggy-headed feeling and loss of memory is extremely common.

Long term effects

Alcohol can cause many issues for people, not only in terms of the physical and psychological, but also in terms of external repercussions. Long-term drinking can affect a person’s life by causing the following:

Reduced motivation to participate in interests and hobbies.
Mood swings, depression, anxiety.
Inflamed skin, weight gain.
Difficulties in romantic, familial and social relationships.
Housing and financial problems.

When a person becomes dependent on alcohol and drinks every day for many years. The following consequences are common:

Dementia Korsakoff’s Syndrome which is characterised by amnesia as well as cognitive and behavioural dysfunction.(5)
Psychosis that can include hallucinations such as hearing voices, music, and seeing things that aren’t there.(6)
Damage to vital organs, which can cause heart disease, liver disease, stroke, and cancer.

Sadly, alcohol dependency is also the cause of death for around 3 million people a year throughout the world according to the World Health Organisation (WHO).(7)

What does self-medicating mean?

People with mental health issues, such as depression, are more likely to self-medicate.(8) This means using alcohol or illicit drugs to manage negative mental health symptoms.(9) The reason behind this is to try and regulate mood: small amounts of a substance can ease symptoms and feelings of depression initially.

Being a depressant, alcohol has a sedative effect that might ease a person’s feelings of stress, worry, or low moods. However, the issue with self-medicating is that over time the amount of alcohol a person drinks usually increases. This is due to alcohol tolerance building up and a person not having found other coping strategies.

Regular drinking as a way to self-medicate symptoms of depression and can therefore become a deep-rooted problem.

How are alcohol and depression linked?

It’s commonly acknowledged throughout medical, psychiatric, and psychological teams that there is a connection between alcoholism and depression. There is much research to support this. WHO states that “there is a causal relationship between harmful use of alcohol and a range of mental and behavioural disorders”.(10)

Some studies report over 80% of alcoholics having experienced “mood disturbances” in their lives.(11) This is why it’s important that the comorbid nature of the two need to be considered in order for the most efficient treatments to be identified and put in place.

Do you have a drink problem?

Sometimes it can be hard to tell whether or admit that you have a problem with alcohol. Even when symptoms are glaringly obvious to those around you, it can be easy to ignore them due to drinking being socially accepted. You might also be afraid or worried about what being honest with yourself will mean.

Being honest with yourself, though, can have positive effects in the long-run. Facing addiction and its underlying causes can revolutionise your life for the better and improve relationships with others.

Here are some symptoms that you might suffer with when alcohol abuse or dependency exists:

You drink to cope or when stressed.
Drinking or craving a drink causing mood swings.
Insomnia.
An increase in tolerance and needing more alcohol.
Negative effect on relationships.
Negative impact on work.
Feelings of regret after drinking.
Shaking when you haven’t had a drink for a while.

“57.3% of adults with alcohol dependence wish to reduce their drinking”.(2) Perhaps this might be on your mind. If you’re experiencing any of the above mentioned symptoms around drinking, you could be misusing alcohol.

Later in the article, there will be guidance on what to do if you’re in this situation.

What is Depression?

The Royal College of Psychiatrists describes depression as having three levels: mild, moderate, and severe.(12)

It outlines various symptoms that include regularly feeling down and unhappy, lack of enjoyment and interest in hobbies or seeing friends, having low self-confidence, feeling negative, and some may experience suicidal thoughts.

Other symptoms include feeling tired, agitated, change in weight, and self-neglect.

There are various types of depression which include (but aren’t limited to):

Dysthymia
Seasonal affective disorder
Prenatal depression
Postnatal depression

Throughout the world, depression is a leading cause of disability. The effects are often severe and often present with other physical and psychological issues.(13)

What causes a dual diagnosis of alcoholism and depression?

People drink for many different reasons. Mental health issues arise from all manners of circumstances. Each individual is unique and (especially on the surface) lives can look very different.

There are many reasons that contribute to a person developing a dual diagnosis featuring both alcoholism and depression. There are, however, some common factors that are usually apparent in people with dual diagnosis and these regularly include the following:

Genetics. Alcoholism, like depression, can run through families.
Mental health issues that instigate self-medication.
Traumatic events, such as abuse or bereavement.
Environment, memories, triggers.
A person’s personality and outlook on life.

It should be noted that developing mental health issues and turning to drink is very human. However, living with a dual diagnosis brings its own set of problems and this in itself can make life more challenging.

To begin a healing path where mental health and drinking misuse is prioritised and controlled in a healthy and empowering way, treatments are available.

What treatments are available?

In order to begin recovery, a holistic approach is essential. This is because a person is made of different parts: the physical, the psychological, and the emotional. All three are interconnected. The most effective way to recover is through working on each area.

The physical

For people addicted to alcohol, dependency can develop. Dependency is signified by physical symptoms during the withdrawal phase. Symptoms include:

Sweating.
Tremors.
Blurred vision.
Nausea.
Hallucinations.

In order to detox from alcohol a medically monitored detox is essential. Doctors and nurses as well as experienced substance misuse workers should be present to ensure your health and safety. Medication, such as Librium, can be prescribed and support is given throughout the process to make you feel as comfortable as possible given the process. A detox lasts 7 days.

Detox facilities and support are available at local rehab clinics.

In terms of managing depression going forward, antidepressants can be prescribed so long as a patient is totally alcohol-free. This would take place under careful monitoring as in the case of a relapse, alcohol and antidepressants can be a dangerous combination.

The psychological

Now, the psychological aspect of recovery for people experiencing alcohol misuse and depression is incredibly important. Just as a person requires doctors and medicinal treatments for physical ailments, professionals and treatments are necessary for psychological ailments.

This is where psychiatrists and therapists support a person through the mental aspect of symptoms. Various treatments are available in order to provide people with the tools to manage their thought processes in a healthy way. By facing thoughts and learning how to take control of them, recovery can really begin to take place.

The psychological aspect of recovery can be uncomfortable as it requires the person to be truly ready for change and healing. This is where honesty, determination, and self-compassion are vital.

Treatments include:

Cognitive Behavioural Therapy.
Motivational Interviewing.
Contingency Management.

Willingness and total participation in recommended treatments provide the best chance for recovery.

The emotional

Finally, the emotional aspects of recovery are critical and for some people in recovery this can provide the toughest area to face.

When facing emotional causes for depression and alcohol misuse many haunting and distressing emotions can arise. There are also the emotions that will surface due to removing alcohol and its numbing effect. This in itself can feel traumatic. With the right support and courage, it is possible to take control of emotional recovery as well.

Emotional treatments include:

Dialectical Behavioural Therapy.
Mindfulness training.
Attending 12 Step groups and practising the 12 Steps.
Participating in holistic art and music therapies.

As with lifestyle changes, choosing to face emotions might be difficult to begin with but the more this happens, the more equipped a person becomes to manage their responses.

How do you access help around drinking and depression?

If you’d like to find out more about available treatments you can contact us or your local GP for information on local alcohol services. There will be both inpatient and outpatient options to you.

Final thoughts…

Alcoholism and depression are widely recognised as having a high correlation between the two. The nature of drinking to relieve symptoms of depression is very common. This is despite the fact that regular, long-term drinking further deteriorates mental health.

Recovery is possible. Thousands of people throughout the UK access treatment services every day to begin and continue on their path to healing.

By being shown strategies to manage thoughts and emotions, a person is able to take control of their behaviour. The process can be very uncomfortable, but with the right support, treatments, and attitude, it’s truly possible for a person to quit drinking and to learn to manage depression.