It’s often the case that someone coping with depression often abuses alcohol as a way to cope. Or, they become depressed while drinking alcohol to excess. While the immediate effects of drinking may appear to relieve the depressive feelings, the medium and long term effects often, but not always, cause a relapse of the depression. Read on to learn more about alcohol’s impact on depression.
The Relation Between Depression and Alcohol Addiction
The relationship between depression and alcohol addiction is complex. Research suggests a number of viewpoints on this topic [1].
Some studies found that depression was no greater in those with Alcohol Use Disorder (AUD) than the general population. Other studies do not show higher rates of depressive or anxiety disorders in people who subsequently develop AUD. Studies suggest that if there is an association between AUD and anxiety/depressive disorders, it is likely to be found in a relatively small subgroup of those with AUD.
Nonetheless many people with AUD may have symptoms of anxiety or depression that need appropriate care. These problems may contribute to:
- Increased risk of suicide
- More intense withdrawal symptoms
- Possible alcoholism relapse
More recent studies have shown that for those with depression, the risk of being addicted to alcohol is higher than the general population and that depression is more common with alcohol dependence. About half of those who recover from a major depressive episode will have one additional event (depression relapse) in their lifetime. Nearly 80% of those with a history of two events will have another occurrence.
Depression and Relapsing
A major national study in Canada found that there was a 3 times greater risk in those with AUD to have an ongoing or returning major depression episode. In this view, co-occurring AUD and major depressive disorder is one of the strongest risk factors for depression relapse. This creates a vicious circle where if one disorder is treated, but not the other, the risk of AUD or depression relapse would be very high [2].
Can Alcohol Cause Depression?
Yes it can as alcohol is itself a depressant. Depression caused by drinking has a different course of action and is treated much differently from major depressive episodes that are not related to alcohol use. And the former can mimic the latter. In those with both AUD and co-occurring major depression, the depressive episodes are most likely alcohol-induced. They will resolve typically after one week of abstinence, and up to four weeks [3].
There is a wide range of effects of alcohol use on depression, including:
- Increased suicide risk
- Increased irritability and aggressiveness
- Intensified hopelessness
- Progressively worse symptoms over time
- Poorer conforming to treatment
- Reduced or unsuccessful treatment effectiveness
- Increased risk of chronic major depression
Can Depression Cause Alcohol Addiction?
Yes it can. In fact those with major depression have increased lifetime rates of AUD. And many studies show that when people have depressive symptoms while being treated for AUD, their treatment outcomes for the AUD or other measures of health and functioning are as favorable.
A Swiss study found that one year after patients left residential treatment, those with depression relapsed sooner and were less likely to maintain abstinence than those with depression. Other studies, however, found that a depressive episode, whether treated or untreated, did not influence the development of AUD [3].
Depression as a Trigger for Relapse
Major depression may increase relapse risk for those people with AUD as alcohol is also a depressant. This then worsens the depression and in some cases can do so even if the relapse is only for one day. The symptoms of depression tend to worsen over a period of several days after the relapse.
On the other hand, relapses to alcohol use are often associated with stopping antidepressants, although the depressive effects of alcohol will occur even if the person continues to use medication throughout the relapse. And if the person also stops taking the antidepressant it can worsen the effect of the relapse and possibly cause the treatment to fail [4].
Depression and Alcohol Addiction as Co-occurring Disorder
This co-occurring disorder is common. Generally if someone has both an AUD and major depression and they relapse to alcohol again after a sustained period of improvement, it is most likely due to the AUD.
Alcohol Addiction Treatment Approach in Los Angeles
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Sources
[1] Schuckit MA.1995. Alcohol, Anxiety, and Depressive Disorders. Alcohol Health Res World. 1996;20(2):81-85.
[2] Onaemo VN, Fawehinmi TO, D’Arcy C. 2020. Alcohol Use Disorder and the Persistence/Recurrence of Major Depression: Le trouble de l’usage de l’alcool et la persistance/récurrence de la dépression majeure. Can J Psychiatry. 2020 Sep;65(9):652-663.
[3] CAMH. Alcohol Use: Screening for alcohol use and depression.
[4] CAMH. Alcohol Use: Long-term management of co-occurring alcohol use disorder and major depression.
Smith, J. 2024. 12 early signs of a depression relapse and tips for coping. MedicalNewsToday.