Depression is one of the most common mental illness in the United States, affecting some 17.3 million people each year, or some 7.3% of all U.S. adults. One in 5 of us will experience a depressive period at some point during our lives, and this period will last an average of 2-6 months. For others, chronic major depression will reoccur and last for their entire life, impacting every aspect of their lives. Persons with depression and chronic depression are significantly more vulnerable to alcohol abuse and alcohol use disorder, thanks to a complex range of factors including mutual vulnerabilities, genetics, and causation.
If you or a loved one is struggling with substance abuse, binge drinking, and depression, the two might be linked. If you have a dual diagnosis, you likely need special treatment to ensure that all of your symptoms are treated. And, it’s important that you understand how the two can feed into and impact each other, making both worse.
Is there a Connection Between Alcohol and Depression?
The Substance Abuse and Mental Health Services Administration (SAMHSA) releases a yearly National Survey on Drug Use and Health, In 2019, this survey showed that individuals with depression and similar mental disorders are significantly more likely to struggle with alcohol-related disorders than people without any issues at all.
SAHMSA shows that 25.3% of individuals with no diagnosed mental disorder binge drink. These numbers rise to 31.3% of individuals with Any Mental Illness and 32.3% of individuals with a Severe Mental Illness. In adolescents, or children under the age of 18, 4.1% of those without a diagnosis binge drink, but 8.4% of individuals with a mental illness do. Further studies show that lifetime prevalence of major depression among persons with alcohol use disorder is about 24.3% for men and 48.5% for women.
In addition, some 15.7% of the general population is likely to have a substance use disorder. 36.7% of persons with any mental illness, or 49.4% of persons with a severe mental illness are likely to have a co-occurring substance use disorder.
This data is important because it shows that persons with a mental illness such as depression are significantly more at risk than the general population. While many are more likely to abuse prescription drugs such as benzodiazepines, alcohol is accessible, often used to self-medicate, and often cheap.
When most of us think of depression or major chronic depression, we don’t think of childhood, genetics, epigenetics, or environment. But, mental illnesses are caused by a complex array of factors, often known as “risk factors”. Many of these directly overlap with the risk factors for addiction and substance abuse.
Recent or previous trauma
Quality of childhood exposure to childhood trauma
Exposure to traumatic events
Recent illness or chronic pain
Here, one of the most important studies is the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) study, which tracked the development and health of over 17,000 people over several years. The data showed that individuals who experienced adversity as children were significantly more likely to struggle with mental and physical health and significantly more vulnerable to substance use disorders.
The overlap of risk factors can mean that substance abuse and depression may develop independently and may be unrelated. However, depression and substance abuse often impact the same parts of the brain, and one may exacerbate problems leading to the other.
Overlapping Symptoms and Causes
Depression is heavily linked to serotonin imbalances in the brain (although it is significantly more complex and there are many other factors and chemicals involved). Treatment for depression often involves selective serotonin reuptake inhibitors, which function on the basis of preventing the brain from absorbing serotonin as quickly, leaving more of it in the brain for function. Serotonin is one neurotransmitter in the brain’s reward system, functioning alongside dopamine. Where dopamine creates a “Desire” or “stimulus” for an action or choice, serotonin creates both a motivation and a reward. The chemical is commonly linked to the reward system and can be found in the brain during feelings of pleasure such as when you fall in love, eat something delicious, or take a large hit of alcohol. Serotonin is a “reward” chemical and having too much or not enough of it means that the reward system is thrown out of balance.
Alcohol abuse results in the same sorts of fluctuations. Binging on alcohol means that the brain produces a great deal of serotonin. You feel good. When you constantly drink alcohol, you develop tolerance. The brain adjusts to having “too much” serotonin and produces less of it on a daily basis. Individuals struggle with depression-like symptoms and emotional blunting, where they are less interested in emotions, social interaction, or previous hobbies.
So, an individual with depression may drink because they are depressed and want to feel better, resulting in worsening symptoms. An individual with substance use disorder may feel depressed because they drink too much.
Self-medication is an incredibly common phenomenon among people of all ages. Persons with depression are significantly likely to use alcohol or another drug to self-medicate or attempt to alleviate symptoms of depression. In the short-term, this often means having a drink after a particularly trying day. However, self-medication almost always escalates, because chronic depression doesn’t go away, individuals are highly likely to continue taking something that worked before, and alcohol tolerance increases, forcing the individual to take more and more to achieve the same result.
Self-medication can quickly result in dependence and addiction, especially when the individual uses on a daily basis or develops a behavioral dependency (I need to drink or I will be depressed). However, it can manifest in several ways:
Someone who drinks to cope, typically on their own, in secret. This can start out as casually having a drink after work or after a stressful incident but might lead to drinking at work, before or during driving, or in other inappropriate situations
Someone who drinks to “blow off steam”. This person will normally drink and have a good time a few times a week, usually to the point of excess. They may black out, have memory issues, and/or spend more than they can afford on alcohol.
Self-medication almost always backfires, because alcohol is a depressant and long-term, it will worsen symptoms of depression.
Millions of people struggle with alcohol use disorder and depression. These two disorders overlap in numerous ways, and it’s sometimes difficult to tell if one caused the other or they developed independently. In most cases, the two exacerbate each other, and it’s critical to treat both at the same time. An individual seeking out treatment for alcohol use disorder will go right back to using if their depression isn’t treated.
If you or a loved one is struggling with alcohol abuse, it’s crucial to seek out help. Today, many rehab facilities offer dual diagnosis treatment, where treatment is designed around the individual and their specific needs and priorities. Call (800) 931 9884 for Help Today.