Alcohol use disorders are among the most common substance use issues in the United States. Alcoholism is also closely tied to mental health issues, especially depression. Depression and alcohol use disorders can feed of off each other, each one making the other one worse. Treating co-occurring disorders can be difficult, but it can be effectively managed with the right help and therapy options. Learn more about alcoholism, depression, and how the two can be treated together.
How Alcohol Works in the Brain
To understand what alcohol does to your emotions and psychology, it’s important to understand how it works in the brain. Alcohol is in a large class of drugs called central nervous system depressants, which affect the chemical messaging systems in your nervous system. Depressants work to limit excitability in the nervous system, causing you to slow down and relax. When you drink alcohol, it is metabolized and absorbed into your intestines quickly and makes its way to your liver. Your body can use the carbs in beer and the other nutrients in the ingredients that come with mixed drinks, but it has no use for alcohol.
In fact, unlike fats and sugars, the body has no way to store alcohol. Because of that, it prioritizes the processing of alcohol above other substances. After alcohol makes it into your bloodstream, it’s filtered out by your liver. If you only have one drink every two hours, your liver can successfully remove alcohol from your blood before it gets to your brain. Drinking more than that can overwhelm your liver and alcohol makes its way to the brain and starts to have an effect.
Once it’s in the brain, we don’t know everything about how it works to cause the effects we are familiar with, but we do know some things. Alcohol is GABAergic, which means that it affects a natural chemical messenger in the brain called gamma-aminobutyric acid (GABA). GABA is an important chemical that’s responsible for regulating excitability in the nervous system. When you are awake, alert, anxious, or otherwise amped up, GABA can help calm you down when it’s time to rest. Like other depressants, alcohol has the ability to enhance the effects of GABA in the brain, causing more intense effects.
The Link Between Alcohol and Depression
Depression and alcoholism are common co-occurring disorders. In fact, addiction and other mental health problems are commonly related. A 2017 review found that 7 percent of people in the U.S. have an alcohol use disorder, and more than 20 percent of that group also had been diagnosed with a major depressive disorder.
What is Self-medication?
Self-medication is when someone with a psychological, emotional, or biological problem use alcohol or other drugs to cope without consulting a doctor.
In some cases, it’s a conscious decision to drink in order to forget a painful memory or to mask general depressive symptoms. In other cases, it’s subconscious. Social drinking leads to drinking to improve your mood. Before long, you are no longer drinking with friends or even for recreation. Instead, you begin drinking to maintain a sense of normalcy.
Self-medication is a dangerous but common form of alcohol abuse. It’s common to hear “I need a drink” in response to a stressful situation on TV, in movies, or even in social situations. However, this is a culturally accepted attitude that’s closely tied to self-medication. The phrase normalizes turning to alcohol for anxiety, stress, or depression to relieve. In reality, alcohol is not a good remedy for mental health issues or stress in general. Rather than treating the problem, it’s temporarily masked. Plus, depression can be ultimately worsened by alcohol in your system.
Does Alcoholism or Depression Come First
It’s difficult to determine what causes substance use disorders and depression definitively. In most cases, these issues are caused by a variety of problems, including genetic, environmental, and developmental factors. For the same reason, it’s difficult to pinpoint whether alcoholism is caused by depression and vice versa. In some cases, alcohol abuse precedes depression. That could be because alcohol worsened mild or latent depression issues. Alcoholism may follow depression because of self-medicating behavior (more on that later).
The two issues may also develop at the same time or close to the same time as a result of overlapping risk factors like genetic predispositions to addiction and depression.
Dual Diagnosis Treatment
According to the National Institute on Drug Abuse (NIDA), effective addiction treatment will address multiple needs, directly and indirectly, related to a substance use disorder. Addressing depression and other mental health issues is a major part of addiction treatment, and it’s necessary to facilitate a lasting change. Dual diagnosis is a method of addiction treatment that addresses mental health issues alongside substance use issues. It’s important to treat both issues simultaneously because they often feed off of each other. Treating one can be made more difficult, and results may be short-lived if the other problem is ignored.
Behavioral therapy, individual therapy, and group therapy (among others) can all help to address both disorders at the same time. If depression is based on other issues like trauma, specific therapies can be used to treat those problems. Effective treatment should be personalized, considering your specific medical, psychological, and social needs.