Can alcohol cause depression?

How does alcohol affect your mood?

Alcohol is a central nervous system (CNS) depressant. The central nervous system, consisting of the brain, spinal cord, and meninges, impacts all bodily functions.

Alcohol use affects the brain's natural body chemistry, including the neurotransmitters that play integral roles in feelings of happiness. While initially, alcohol may seem to increase positive feelings these feelings soon dissipate.

The depressant effects of alcohol on the brain initially cause reduced feelings of anxiety. These effects also reduce inhibitions, impulse control, and other critical thinking skills.

Alcohol can make difficult emotions, like anger and frustration, more pronounced and unmanageable because of its negative effect on executive functioning. Minor annoyances while drinking can result in angry outbursts or other behaviors that a person would not otherwise engage in.

These out-of-character behaviors often lead to feelings of shame or guilt after the alcohol has worn off.

This damaging cycle further intensifies depression and anxiety, often resulting in even more heavy drinking for those who believe their alcohol use helps reduce those feelings.

Alcohol can also cause feelings of anxiety, including panic attacks, as its effects wear off ^[5].

Alcohol reduces the quality of sleep due to reducing the amount of rapid eye movement (REM) sleep ^[5]. Poor sleep contributes to mood disorder symptoms, irritability, trouble concentrating, and memory deficits.

When used responsibly in small quantities alcohol can produce relaxing, euphoric outcomes. Excessive, frequent alcohol abuse leads to worsened mental health.

Can alcohol use disorder lead to depression?

Many people with alcohol use disorders believe that alcohol helps them manage feelings of depression or anxiety.

A long-term 40-year study found no evidence of pre-existing depression or anxiety symptoms among participants that developed alcohol use disorders ^[6]. Findings such as these call into question the subjective statements of people's experiences with alcohol and depression.

Some research even suggests that alcohol use can cause feelings of depression. Experts accept that alcohol use disorders undoubtedly make symptoms of depression worse overall. 

Dependence and tolerance to alcohol develop the more that it is used. This means that as the body adjusts to having alcohol in the system, larger and larger amounts of it are required to achieve effects.

Again, alcohol is a CNS depressant that affects the brain's natural feel-good chemicals in the brain. Continued alcohol use changes how the brain operates even when not under the influence.

As alcohol dependence develops, the more likely alcohol itself becomes a contributing factor to feelings of depression.

Clinical depression symptoms include ^[2]:

• Frequent low mood
• Feeling sad, or hopeless
• Low motivation or frequent fatigue
• Thoughts of self-harm
• Changes in appetite, weight fluctuations
• Sleep changes

Studies on binge drinking, or consuming large amounts of alcohol in a short period, demonstrate that frequent binge drinking can affect emotions and emotional regulation. It also reduces the ability to identify one's own emotions as well as the emotions of others ^[3].

The relationship between alcohol and depression is complex and differs across individuals. While alcohol leads to definitive effects and changes in physiological functioning, psychological components also play a role in destructive patterns that arise.

People who consume alcohol to cope with painful feelings have limited opportunities to learn healthier coping strategies. The more they become reliant on alcohol to cope with those feelings, the stronger those feelings may become.

Alcohol use disorders impact relationships with others and limit functionality in everyday life, exacerbating feelings of depression and frustration.

Drinking to alleviate negative feelings may work for people short term, or feel as though it is working, but once sobering up there are often even more difficult feelings to deal with such as guilt, shame, or regret.

These feelings further perpetuate the cycle of alcohol use disorders.

How to deal with alcohol and depression

Dealing with alcohol and depression can be difficult, especially without support. The good news is that there is help available and millions of people have been able to break the harmful patterns of alcohol and depression.

Experts often recommend starting by reducing or eliminating the use of alcohol before tackling depression symptoms. Many find that depressive symptoms are alleviated or significantly reduced by eliminating alcohol for at least 4 weeks ^[1].

Before stopping alcohol use, consultation with a medical provider is important. The withdrawal symptoms from alcohol can potentially be life-threatening depending on the severity of the dependence.

Alcohol withdrawal symptoms may include ^[2]:

• Increased sweating
• Increased pulse rate
• Hand tremors
• Insomnia
• Gastrointestinal symptoms
• Hallucinations
• Psychomotor agitation
• Anxiety
• Seizures

The doctor will consider how long alcohol use has occurred, the amount and frequency of alcohol, and overall mental and physical health. They may recommend working with a medical team while detoxing from alcohol in a residential or hospital setting.

The medical doctor may prescribe medication to manage or prevent more difficult withdrawal symptoms.

Avoiding people, places, and things that trigger drinking episodes is imperative while starting to stop alcohol use. Keeping track of alcohol use and identifying triggers can help to plan for when they occur ^[1].

Support is key to successfully stopping alcohol use. Support can come through family, friends, or more formal support such as a mental health professional, peer support group, or alcohol treatment program.

Psychotherapy or substance use treatment programs may be necessary for those experiencing alcohol use and depression. Psychotherapy approaches such as cognitive-behavioral therapy can help with identifying triggers, unhelpful thought patterns, and alternative coping strategies to manage depression.