Alcohol and Depression: How They’re Linked

Did you know that alcohol and depression often go hand in hand?

It's hard to tell which condition most often comes first, but it’s clear that the conditions are intertwined, says Aaron Weiner, PhD, a psychologist and past president of the Society of Addiction Psychology.

“Drinking is a way of disconnecting from that immediate feeling of depression and feeling down,” Dr. Weiner says. “When folks are feeling depressed, they're looking for solutions, and alcohol in the moment can feel like a solution. So depression can lead to alcohol use, and alcohol use can lead to more depression.”

Here’s what to know about how depression and alcohol interact, the risks and warning signs for both depression and alcohol use disorder, and when to get help.

The link between the two is complex and multifaceted.

Depression Raises the Risk of Alcohol Use Disorder and Vice Versa

Alcohol Can Make Depressive Symptoms Worse

Many of us have been there — after a bad day or a stressful event, it’s not uncommon to turn to a glass of wine to take the edge off. But making this a regular habit can impede your mental health, especially if you already have depression.

“Some folks drink alcohol as a way to alleviate some of their anxiety and depression, like a reward-seeking or self-medicating type of [behavior],” says Akhil Anand, MD, a psychiatrist at Cleveland Clinic who treats addictions and alcohol and drug withdrawal. “But alcohol itself is a depressant, so while it may help the patient in the short term, it does actually cause depression in the long term.”

The effects of drinking too much can also seep into your daily life and may impact areas like work, finances, relationships and aspects of your physical health like sleep, diet, and exercise, says Dr. Anand. That could lead some people, for example, to turn to drinking to cope with stress caused by these issues.

This can become a cycle, adds Anand. “None of this will help with mood, which precipitates depression. So now you’re also depressed because of your drinking and because alcohol is what you turn to, to feel at least temporarily better, you continue to drink,” Anand says.

Alcohol Can Make Antidepressants Less Effective

Alcoholic beverages can be problematic — even dangerous in some instances — if you’re taking antidepressants. “Whenever we prescribe antidepressants, we really advise against combining them with alcohol and other drugs like cannabis — regardless of the type of antidepressant,” Anand says.

• isocarboxazid (Marplan)
• phenelzine (Nardil)
• selegiline (Emsam)
• tranylcypromine (Parnate)

MAOIs aren’t often prescribed because they’re an older class of antidepressants, but they’re still used in cases when newer options aren’t effective for some patients, Anand says. If you’re taking an MAOI, you should consult with your doctor to understand what’s safe to eat and drink.

Other potential risks of drinking while on antidepressants include becoming sedated or drowsy and having increased depressive symptoms because, as mentioned, the effects of the alcohol can lessen or diminish the benefits of the medication.

There are signs that depression and alcohol dependency may be impacting your or a loved one’s health and well-being, Anand says.

• Persistent feelings of sadness, anxiety, hopelessness, or pessimism
• Feelings of irritability, frustration, helplessness, or restlessness
• Feelings of guilt or worthlessness
• Lack of energy or fatigue
• An increase or decrease in appetite, leading to weight gain or loss
• Problems concentrating, remembering things, or making decisions
• Sleep problems
• Unexplained physical pains
• Increased drug or alcohol use
• Social withdrawal
• Suicidal thoughts or behaviors

• Cravings: This includes feeling like you need alcohol or can’t get through the day without a drink.
• Loss of control of amount or frequency of drinking: This includes unintentional binge drinking or drinking several days in a row despite committing to yourself or your loved ones that you’d stop. “You always end up drinking more than you actually intend to. It feels out of control,” Anand says.
• Compulsion to drink: Weiner asks his patients to consider the purpose of their drinking and whether they’re drinking out of a strong desire to self-medicate. “Are you drinking because you’re trying to deal with stress on a daily basis or is it more social? If you’re drinking to cope, it’s an issue,” he says.
• Drinking despite the consequences: If your drinking is interrupting your professional life, increasing your weight, or hurting your relationships, among other consequences, this is a sign you need professional help.

If you’re experiencing any of the symptoms above, your first step is to make an appointment with your family doctor for help. They can refer you to a mental health professional or addiction specialist.

Because it’s often too difficult to tell if the alcohol dependence is induced by depression or vice versa, psychologists and addictions specialists tend to treat both simultaneously, Anand says. Treatment is often a two-pronged approach involving psychotherapy (talk therapy) and medication.

• Alcohol and depression frequently go hand in hand, with research indicating that increased alcohol consumption raises the risk of major depression and vice versa.
• If you notice persistent depressive symptoms or suspect you may have alcohol use disorder, talk to your doctor. They can help you find a treatment that helps.
• Treatment for both depression and alcohol use disorder typically involves a combination of psychotherapy and medication.