Alcohol and depression often go hand in hand, and each can make the other worse. Alcohol is a depressant, so heavy drinking can cause or deepen low mood, and people with depression are more likely to develop alcohol use disorder. The good news is that treating both conditions together can help people feel better and drink less.
If you have been drinking to cope with sadness, or you feel worse emotionally the more you drink, this guide can help you understand what is happening. We explain how the two conditions are connected, how clinicians tell them apart and what effective treatment looks like.
If you are having thoughts of suicide or self-harm, please reach out now. You can call or text 988 to reach the 988 Suicide & Crisis Lifeline. In an emergency, call 911.
How Alcohol and Depression Are Connected
Researchers describe the link between alcohol use disorder (AUD) and depression as a two-way street. A 2019 review in Alcohol Research: Current Reviews explains that depressive disorders increase the risk of AUD, and AUD increases the risk of depressive disorders.
The overlap is large. According to that review, people with AUD are 2.3 times more likely than people without AUD to have had major depressive disorder in the past year. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that among people with major depressive disorder, between 27% and 40% will have AUD at some point in their lives.
Drinking to Cope
Many people drink to numb painful feelings, fall asleep or get through a hard day. Alcohol can bring brief relief, but it does not treat the underlying problem. As the effects fade, low mood, guilt and poor sleep can return, which can lead to more drinking.
How Alcohol Worsens Depression
Alcohol slows down brain activity. Over time, heavy drinking can cause depressive symptoms on its own. NIAAA notes that long-term alcohol use alongside depressive symptoms may lead to a more severe course, with longer mood episodes, poorer thinking and memory, and a higher risk of suicide.
Alcohol-Induced Depression vs. Independent Depression
Not all depression in people who drink heavily is the same. Clinicians often try to tell the difference between two situations:
- Alcohol-induced depressive disorder: The 2019 review describes this as depressed mood or loss of interest that occurs only during or shortly after intoxication or withdrawal and goes away after 3 to 4 weeks without alcohol.
- Independent depression: Depression that began before heavy drinking, or that continues well after a person stops drinking. This needs its own treatment.
This is one reason a thorough assessment matters. Some people find their mood lifts a great deal after a few weeks of sobriety, while others need ongoing mental health care. Either way, it is important not to wait it out alone if you are struggling.
Signs of Depression to Watch For
The National Institute of Mental Health (NIMH) explains that depression can cause severe symptoms that affect how you feel, think and handle daily activities like sleeping, eating or working. NIAAA lists the symptoms of major depressive disorder as five or more of the following for at least two weeks:
- Low mood
- Low energy
- Loss of interest or pleasure in most activities
- Irritability
- Sleeping too little or too much
- Significant changes in weight or appetite
- Trouble concentrating
- Feelings of guilt or worthlessness
- Thoughts of death or suicide
Many of these can also be caused by heavy drinking or withdrawal, which is why it helps to talk to a professional who understands both.
Alcohol, Depression and Suicide Risk
This is the most serious part of the connection. A 2019 review on alcohol and suicidal behavior found that the odds of suicidal behavior are about three times higher among people with AUD than among those without it. The same review notes that AUD is the second most common mental health condition found among people who die by suicide worldwide, after mood disorders. Drinking heavily in the moment also sharply raises the risk of a suicide attempt.
There is hope in this research, too. The review reports that starting treatment for AUD has been shown to lower the risk of a later suicide attempt among veterans. Getting help makes a difference.
If you or someone you love is in crisis, call or text 988, or call 911 in an emergency. Our guide on what to do in a mental health crisis has more steps.
Treating Alcohol and Depression Together
Because the two conditions feed each other, treating only one often is not enough. Research points to integrated care:
- Integrated therapy: The 2019 depression review notes that integrated cognitive behavioral therapy (CBT) for depressive and substance use disorders was associated with a greater reduction in alcohol use.
- Medication: The review found antidepressants are more effective than placebo at reducing depression symptoms in people with both conditions. NIAAA adds that combining an antidepressant with an AUD medication can be an integrated and effective approach.
- Combined care: NIAAA states that integrated treatment of AUD and co-occurring mental health conditions tends to lead to better results than fragmented approaches.
Learn more about medications for alcohol use disorder and the types of antidepressants. Anxiety often shows up alongside both conditions; our article on alcohol and anxiety explains that connection. When care addresses more than one condition at once, it is called dual diagnosis treatment.
Frequently Asked Questions
Can alcohol cause depression?
Yes. Heavy drinking can cause depressive symptoms. When depression is caused by alcohol, it often improves after 3 to 4 weeks without drinking, but some people have depression that continues and needs its own treatment.
Why do I feel more depressed after drinking?
Alcohol is a depressant. As it wears off, low mood, anxiety and poor sleep can follow, and repeated heavy drinking can make depression last longer.
Should I stop drinking if I’m on antidepressants?
Talk with your prescriber about alcohol use. They can explain how drinking may affect your medication and mood. If you drink heavily, do not stop suddenly without medical guidance, because alcohol withdrawal can be dangerous.
Is treatment different when you have both conditions?
Yes. The most effective care treats alcohol use and depression at the same time, often with therapy, medication and peer support.
Get Help for Alcohol and Depression in Lancaster, PA
You deserve care that treats the whole picture. The Ranch Pennsylvania Outpatient Services offers integrated dual diagnosis care in Lancaster, with CBT, DBT, psychiatric evaluation and medication management. Explore our addiction partial hospitalization program or mental health partial hospitalization program, and learn more about depression and alcohol addiction. Verify your insurance in minutes. Our admissions team is available 24/7, and calls are free and confidential.
