Humans have long understood that there is a link between alcohol and how we feel. Horace, a Roman lyric poet, spoke of wine as a way to forget worries in his famed Odes; ‘the immortal poet’, Li Bai, one of the Tang dynasty’s most famous and celebrated poets, wrote about the companionship that can be found in wine and how it offers a means of escaping worldly concerns and experiencing transient joy; and many of Shakespeare’s characters resorted to drowning their sorrows. There is no doubt that we knew about the positive effects of alcohol –this is a figure of speech and recent studies have proven that no amount of alcohol is safe– but what about the harm?
Although our modern scientific understanding of depression didn’t exist until fairly recently, cultures and religions around the world have connected the idea of a happy and content life with abstaining from alcohol or consuming it in moderation. The Bible asks, “Who has woe, sorrow, and strife?”, then answers that it’s those who drink –“those who tarry long over wine”– and many eastern religions warn against overconsumption as it clouds the way to enlightenment. Films like Leaving Las Vegas, Flight, and A Star is Born beautifully demonstrate our modern cultural understanding of the link between liquor and depression, and act as warnings against drinking your life away.
Despite now understanding these complex and multifaceted links better than ever, alcohol remains one of the most common and popular drugs worldwide. With almost 11 million adults drinking at a level that poses some risk to their health in England alone (Public Health England), raising awareness of the long-term personal and societal costs of alcohol abuse is essential for preventing potentially life-altering depression in millions of individuals.
As with all phenomena dealing with drugs’ biochemical effects on our neurochemistry and their links to our mood and perception – there’s a lot to unpack. After more than half a century of study, researchers from around the world have found a number of links between alcohol and depression.
Correlation: Many studies have shown a strong correlation between regular alcohol use and depression. The National Library of Medicine alone hosts over 42,000 articles relating to alcohol and depression, and there is little to no doubt in the medical community that the correlation is real. The commonly accepted consensus is that individuals with alcohol use disorders are more susceptible to developing depression and other neurological conditions. All that being said, correlation is not causation, and it’s important to further consider other factors that contribute to both alcohol use and depression.
Alcohol misuse and depression positive feedback loop: “Alcohol use disorder (AUD) and depressive disorders are among the most prevalent psychiatric disorders and co-occur more often than expected by chance”, (McHugh and Weiss). This co-occurrence can be attributed to the positive feedback loop that exists between alcohol and depression, whereby an individual feels symptoms of depression, consumes alcohol to seek temporary relief, the alcohol exacerbates the symptoms of depression, leading to more alcohol consumption for temporary relief. Each round of drinking causes more depression, causing more drinking.
Biological and psychosocial links: Biological links between alcohol misuse and depression include factors such as genetic predispositions, neurochemical imbalances, and others that increase one’s odds of becoming alcohol dependent or developing symptoms of depression, either as a result of one another or independently. Developing either depression or alcohol abuse problems could then potentially trigger the above-mentioned positive feedback loop. Psychosocial links include factors such as stress, trauma, and social isolation that are all associated with an increased risk of alcohol abuse and depression (Guinle and Sinha).
Alcohol as a depressant: Alcohol is classified as a depressant-type drug as it acts on the central nervous system to induce relaxation and sedation by slowing down its activity; however, long-term abuse can harm normal brain chemistry and the ability to properly use and regulate neurotransmitters such as dopamine and serotonin (Lovinger). Under attack from prolonged alcohol abuse, our brains simply cannot access the chemicals that regulate our moods.
Other links between alcohol misuse and depression include dual diagnosis, where an individual seeking treatment for alcohol misuse also presents with (possibly unrelated) co-occurring depression; and treatment considerations that address both conditions as integrative treatment.
All of these different links point to the same conclusion: long-term alcohol abuse severely increases the chances of developing depression at some stage in your life. Depression can cause immense harm to your overall well-being, and worryingly, there is a strong correlation between alcohol abuse, depression, and suicide (McHugh and Weiss).
When discussing diagnosis and treatment for depression caused by alcohol misuse, it’s critically important to keep the following three points in mind.
To summarise these three points: Alcohol dependency and depression are serious, complex, and difficult to deal with. With the stakes this high, Gladstones Clinic cannot strongly enough recommend that an individual on the path towards chronic alcohol abuse or depression seek help from trained and experienced medical practitioners.
The biggest factor that determines the treatment and therapy of alcohol misuse and related depressive symptoms will be whether one goes at it alone (often with support from family or friends), or enters a rehab facility. A number of factors could affect this decision, including the severity of both conditions, financial means, the individual, etc. It’s also not uncommon for people to seek psychiatric help or group therapy (e.g., Alcoholics Anonymous) for one or both conditions while staying in their own homes during recovery.
As mentioned earlier, dedicated rehabilitation facilities offer the best chance at a full and long-term recovery. Residential facilities that physically remove you from familiar places and situations where one usually drinks (or abuses other substances) and restrict access to it, have the facilities and means to medically ease the pains of withdrawal symptoms, and then offer integrative in-house primary care for both alcohol misuse and depression are in the optimal position to provide the best possible patient outcome. Integrative primary care refers to professional treatment that addresses both alcohol dependency and depression. This includes a detailed look into the root causes of both conditions and developing strategies for dealing with them.
While the exact therapies used might vary between facilities –especially alternative therapies such as acupuncture or yoga–, modern evidence-based rehabilitation centres typically make use of a combination of individual and group therapies, Cognitive and Dialectical Behavioural Therapies (CBT & DBT Therapy), and transactional analysis. Depending on the situation, SSRIs (selective serotonin reuptake inhibitors) and other dependence medications might be prescribed.
Gladstones Clinic is committed to providing holistic, integrative, and personalised treatment for individuals facing the challenges of drug or alcohol misuse and depression. With over 20 years of experience in addiction recovery, our team understands the complex nature of both of these conditions and has guided hundreds towards lasting healing and recovery.
Our residential facilities located in London and the Cotswolds offer peaceful and comfortable accommodation surrounded by everyone and everything you need for recovery. Once checked in, you can expect to have a trained, experienced, and licenced team of medical professionals by your side 24/7 as you go through a medically supervised detox and start primary care. All of our always-small-group residential patients receive individualised care and psychiatric therapy (CBT & DBT) while simultaneously reaping the time-proven benefits of group therapy.
At Gladstones, we prefer to use the disconnection model of addictive behaviour as opposed to the more outdated chemical-hook model. This approach emphasises unique and personalised care to uncover and address the factors that contribute to alcohol dependency and depression instead of just focusing on normalising brain chemistry. Identifying these factors and creating strategies to deal with them on a patient-to-patient basis helps us achieve our goal of long-term patient recovery.
At Gladstones Clinic, our compassionate team is here to provide the information, support, and advice you need to embark on a journey of healing and transformation. Let us be your partner in reclaiming your life and embracing a brighter, healthier future.
Alsheikh, AM, et al. “Treatment of Depression With Alcohol and Substance Dependence: A Systematic Review.” Cureus, vol. 12,10, 2020. National Library of Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592633/. Accessed 29 06 2023.
Guinle, Maria Isabel Barros, and Rajita Sinha. “The Role of Stress, Trauma, and Negative Affect in Alcohol Misuse and Alcohol Use Disorder in Women.” Alcohol research : current reviews, vol. 40,2, 2020. National Library of Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431322/. Accessed 29 06 2023.
Lovinger, DM. “Serotonin’s role in alcohol’s effects on the brain.” Alcohol health and research world, vol. 21,2, 1997, pp. 114-20. National Library of Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826824/. Accessed 28 06 2023.
McHugh, RK, and RD Weiss. “Alcohol Use Disorder and Depressive Disorders.” Alcohol research : current reviews, vol. 40,1, 2019. National Library of Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6799954/. Accessed 29 6 2023.
Public Health England. “Health matters: harmful drinking and alcohol dependence.” GOV.UK, 21 January 2016, https://www.gov.uk/government/publications/health-matters-harmful-drinking-and-alcohol-dependence/health-matters-harmful-drinking-and-alcohol-dependence. Accessed 29 June 2023.