As a former mental health nurse who also struggled with alcohol abuse and depression, I have a unique take on this subject. In addition to my personal experience, I also watched my father die from alcoholism several years ago. However, I believe that my father died from intractable depression that got worse over the years and led to him abusing alcohol to self-medicate. My personal and professional experiences have given me a deeper insight into the profound link between alcohol and depression.
Most people recognize that alcohol is a depressant, which is why alcohol makes depression worse. But most are unaware of the details of this problem and how extensive it is. I feel that the more people understand the extent of how alcohol interacts with depression, they will be empowered to make informed choices.
Extent of the problem
In a study published in early 2020, just before the pandemic hit its peak, 8.4% of US adults were diagnosed with depression. However, since the pandemic hit, this number has risen drastically. A study from 2021 shows depression now hits about 32.8% of the US adult population. This is a staggering and dramatic increase.
The statistics on alcohol abuse show a positive correlation with depression. What I mean is that as depression rose during the pandemic, so did alcohol abuse. A pandemic-related study shows that alcohol abuse increased for 60% of the study participants. Also, alcohol sales rose by 34% between April and June 2020.
Alcoholism was a problem even before the pandemic as well. A 2019 study shows that 54.9% of study participants drank alcohol in the past month at the time of the study. Concerning dangerous drinking, 25.8% of US adults reported binge drinking in the past month.
Understanding the statistical prevalence of depression and alcohol abuse is essential. As we can see, we are not dealing with minor issues; alcohol abuse and depression are far-reaching, highly common, and seriously problematic for health and wellness. What’s worse is that they are correlated. For example, one study shows that 63% of US alcohol-dependent people had depression.
Why is alcohol abuse particularly dangerous for depression?
It’s hard to know what comes first, depression or alcohol abuse. People who abuse alcohol often do it to self-medicate emotional or even physical pain. However, abuse of alcohol can also lead to the development of depression as well. A 2012 study in ISRN Psychiatry says “individuals, who drink alcohol to reduce emotional stress, may be self-medicating themselves with alcohol, and a link has been shown where depression predicted alcohol use disorder and alcohol use disorder predicted depression.”
I can see this link clearly in myself as I developed worsening depression when my personal alcohol use became seriously addictive and problematic. I also saw this link in my father as well. Pretty soon, it becomes a viscous circle of self-medicating followed by worsening depression, which leads to more drinking and so on.
We know that alcohol has a serious effect on the nervous system, mainly the neurotransmitters that send messages to different parts of the body. The high we get is from the inhibitory effect of the alcohol which makes us feel relaxed and numb. Initially, this feels great. However, with repeated alcohol use, the nervous system has to accommodate the alcohol so it can re-establish balance and that’s when we run into problems. Because as our nervous systems become re-wired, alcohol begins to change the way it responds to stressors.
In particular, repeated alcohol use primes our nervous system for excitation so that when and if we decrease use, our nervous system responds with hyperarousal leading to serious anxiety, tremors, sweating, nausea, and other withdrawal symptoms. This is how depression and anxiety become worse with increasing alcohol use. The more we stress our nervous system with alcohol, the more we alter and disturb the neurotransmitters that are partially responsible for mental health issues.
Another issue is that alcohol is very good at numbing feelings. Unfortunately, this greatly exacerbates depressive symptoms as well as maladaptive thought processes. It even numbs our motivation for wanting to create positive changes in our lives. Because if we can’t feel, then we can’t understand the roots of our depression either.
Often, the root cause of both addiction and depression is unresolved trauma. Trauma itself can re-wire our nervous system and brain making us more susceptible to depression as well as seeking out numbing agents. Trauma causes hyper-vigilance and an increased drive to find safety. This leads to defense mechanisms like dissociation and finding maladaptive ways to comfort ourselves. Alcohol then provides an avenue for continuous dissociation and false comfort. However, it just leads to worsening depression which begins the vicious cycle of self-medicating as we discussed above.
How can we improve alcohol abuse and depression?
One important issue is that while alcohol addiction is present, depression may not respond to antidepressant therapy. This is a very important distinction that the general public needs to be aware of. Dr. Mark Rego, a psychiatrist and author says that many of his clients who abused alcohol “did not benefit from antidepressant therapy. However, once they stopped drinking, the medications began to work and the depression symptoms decreased.” Dr. Rego acknowledges that more stringent studies need to take place in order to understand this phenomenon better.
So if you or someone you know has both depression and alcohol addiction issues, it’s advisable to treat the addiction first or ensure that both conditions are treated simultaneously. However, the good news is that studies show therapy as a highly effective treatment for both addiction and depression. But also, therapy is highly effective for treating trauma as well, which is often the root cause of addiction and depression as stated above. So often, with a good therapist, many of these issues can be treated at the same time.
Unfortunately, access to therapy is limited due to the cost and availability of therapists in many parts of the globe. As such, advocating for better access to therapy should be a top priority in all discussions around improvements to the mental health system and addiction treatment.
The more we talk about this important link the better. Many people have written to me about their personal or family experiences with alcohol and depression. This problematic link is much more common than we care to admit. Clearly, this is an important subject that requires more public discussion, education, and research.