The link between depression and alcohol use disorder is complex. With the right treatment, it’s possible to manage both disorders.

Alcohol use disorder (AUD) can occur alongside depression and vice versa. It can also be hard to tell which disorder is worsening the other.

If you live with both depression and AUD, you’re not alone. A 2019 review reveals that depressive disorders are the most common mental health disorders in people with AUD.

People with AUD and depression often experience the most symptom relief when they receive treatment for both disorders at the same time.

The link between depression and AUD is complex.

The two conditions often co-occur with anywhere between 33% and 63.8% of people with AUD also having depression. People who have both tend to have more severe symptoms than those who have only one disorder.

Some people with underlying depression may start using alcohol to find relief from their symptoms. Over time, this can develop into AUD. For others, alcohol use itself can cause depression symptoms.

Additionally, genetics may influence how likely you are to develop depression and a substance use disorder (SUD).

Sometimes it’s difficult to determine the cause-and-effect dynamic between alcohol and depression.

Does alcohol use activate or worsen depression or the other way around? Or do they exist side-by-side?

2019 research suggests that depressive disorders are more common in people with alcohol dependence than in those who engage in alcohol misuse, like binge drinking. However, both alcohol dependence and alcohol misuse fall under the AUD umbrella.

The most studied types of depression in AUD are:

  • major depressive disorder (MDD)
  • persistent depressive disorder (PDD)
  • alcohol-induced depression

Major depressive disorder

Major depressive disorder (MDD) is the most common mental health disorder in people with AUD. This may be because MDD is one of the most common conditions in the general population.

People with AUD are 2.3 times more likely to have had MDD in the previous year.

And people with alcohol dependence are 3.7 times more likely to have had MDD in the previous year.

To get a diagnosis of MDD, you need to have had at least five of the following symptoms, including depressed mood or loss of interest in favorite activities, for at least 2 weeks:

  • appetite changes
  • sleep problems
  • fatigue or loss of energy
  • lack of concentration
  • poor decision-making
  • restlessness

Persistent depressive disorder

Persistent depressive disorder (PDD) has milder symptoms than MDD but lasts longer. It’s often called high-functioning depression and involves having a low mood for at least 2 years.

People with AUD are 1.7 times more likely to have had PDD in the previous year. Those with alcohol dependence are 2.8 times more likely to have had PDD in the previous year.

Alcohol-induced depression

Sometimes, alcohol use itself triggers depressive symptoms.

Alcohol-induced depressive disorder is a depression-like condition that happens only when drinking alcohol and shortly after withdrawal. It typically goes away after 3 to 4 weeks of not drinking.

Alcohol-induced depression is uncommon. In people with a substance use disorder, less than 1% with depressive disorders had substance-induced symptoms.

However, evidence suggests that more than 25% of people in treatment have experienced a substance-induced depressive episode in their lifetime.

Still, many people who receive a diagnosis of substance-induced depression are later re-diagnosed as having depression because symptoms continue after they stop drinking.

Several medications and behavioral treatments can help with both depression and AUD.

Your doctor may prescribe:

  • Antidepressant medication can help with symptoms of depression and some symptoms of AUD.
  • Naltrexone helps limit alcohol cravings and may ease depression symptoms by boosting endorphins.
  • Disulfiram is an alcohol deterrent and causes unpleasant symptoms if you drink alcohol.
  • Acamprosate can help restore balance to your brain’s neurotransmitters and may help you abstain from alcohol.

Behavioral therapies for AUD and depression may include:

  • Cognitive-behavioral therapy (CBT). CBT teaches you to replace the negative thoughts and behavioral patterns that can cause or worsen depression and AUD.
  • Motivational interviewing (MI). MI may help you find the internal motivation to quit alcohol. Many people with AUD have only a low or moderate desire to quit, despite the negative consequences. It may be helpful to combine MI and CBT to treat depression and AUD.
  • Dialectical behavior therapy (DBT). This is a type of CBT that can help you practice acceptance and change. Mental health professionals may recommend DBT to help reduce self-harm and suicidal behaviors.
  • Behavioral activation. This is an effective therapy for both AUD and depression. It targets reward dysfunction by teaching you how painful life events and behaviors affect mood. Your therapist will encourage you to take an active approach to improve your mood with positive experiences.
  • LETS ACT. Life-enhancement treatment for substance use, or “LETS ACT,” is a type of behavioral activation therapy for people with substance use disorders.

Recovering from depression and AUD is difficult because the disorders can worsen one another. Often, people turn to alcohol to help relieve their depression symptoms.

In addition, attempting to stop drinking and going through withdrawal can worsen depression, making it even harder to quit.

Whether depression is a stand-alone diagnosis or caused by drinking, alcohol often worsens symptoms. However, depression symptoms can improve after abstaining from alcohol for about 3 to 4 weeks. And, having more severe depression doesn’t necessarily mean you’ll have a more challenging time recovering from AUD.

Once you begin your healing journey, it’s important to engage in self-care. Consider looking into holistic therapies such as yoga or meditation.

In one 2018 study, 60 people who recently detoxed from alcohol experienced fewer depressive symptoms after participating in Sudarshan Kriya Yoga for just 2 weeks.

You might also want to consider natural supplements such as tyrosine, 5-HTP, and ashwagandha to help rebalance your brain’s neurotransmitters. Just check with your doctor before trying these, especially if you’re taking medication.

It’s also important to have a strong support network. You might consider joining a 12-step program like Alcoholics Anonymous (AA) or a non-12-step group like SMART recovery.

Being around others who are experiencing the same challenges can help you feel connected and reduce feelings of isolation.

Experiencing both depression and AUD can be a difficult road, but recovery is possible. Many people have been where you are and have successfully treated their depression and alcohol use disorder.

There are many support systems in place to help you begin your journey. And research continues to produce better medications and therapies to help you detox more comfortably and effectively treat depression symptoms.