Alcohol and Depression: What’s the Link? -

The exact cause of this relationship isn’t entirely known. Some experts believe certain people may be genetically prone to both depression and alcohol use disorder. Environmental or social factors, such as drinking to cope with stress or depressive symptoms, may also play a role.

The link between the two is complex and multifaceted.

Depression Raises the Risk of Alcohol Use Disorder and Vice Versa

As mentioned, the relationship between depression and alcohol use disorder goes both ways. Research suggests that many with depression use substances, such as alcohol, to cope with their symptoms, and have an increased risk of substance abuse disorders like alcohol use disorder.

Studies have found that depression and alcohol use disorder often co-occur, with each disorder worsening the severity and prognosis of the other.

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.”

Alcohol can affect your brain chemistry. This includes increasing the effect of a brain chemical called GABA, which calms the brain and body, and decreasing the effect of glutamate, which stimulates the brain and body, creating a numbing, less alert feeling.

It can also increase suicide risk, boost feelings of irritability and aggressiveness, increase feelings of hopelessness, and reduce the efficacy of your depression treatment.

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.

Alcohol not only neutralizes the effectiveness of a lot of medications, including psychiatric drugs, but it can also trigger negative drug interactions. For instance, you need to avoid drinking entirely if you’re taking an antidepressant called a monoamine oxidase inhibitor (MAOI). Combining alcohol and MAOIs can cause a dangerous spike in blood pressure.

The following antidepressants are MAOIs:

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.

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