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Why Drinking Makes Your Depression Worse

Woman with curly hair and glasses sitting by the bed depressedImage via Claudia Wolff/Unsplash

Contrary to what we’re conditioned to believe, alcohol and depression do not mix. Though the media and even those closest to us might encourage us to “drown our sorrows” in alcohol, the reality is that drinking can worsen depression. It might also delay the overall process of emotional healing by preventing us from finding healthy coping mechanisms and treatments earlier. 

It’s important to understand that most people when they tell you to drink to take away your feelings of sorrow, angst, loneliness, or hopelessness might not understand that depression and sadness are two completely different things. And while alcohol might seem like a good option, depression and alcohol can be a dangerous combination. The first step is recognizing depression and seeking out medical help to manage it.

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Recognizing Depression

Dr. Sally Chung, a board-certified clinical psychologist, says, “Sadness comes and goes, like all feelings, but depression is an illness that impacts the way someone functions and moves through life.” 

Depression, which affects over 13 million US adults each year, is more than feeling sad. When people are unable to recognize the severity of their mental health struggles, due to denial, stigma, or lack of awareness, they may find destructive ways to self-medicate like abusing alcohol instead of seeking professional help. The National Institute of Mental Health reports about a third of adults living with major depression do not receive treatment

“Depression affects you emotionally, physically, and mentally,” explains Dr. Chung. “It can last for weeks, or months, or even years. It impacts your ability to perform at work or school, engage or stay connected to friends and family, and think positively about your future.”

Alcohol is a Depressant

Researchers found that even casual alcohol use showed an adverse effect on depression and reduced the effectiveness of treatment for depression, while heavy alcohol users responded worst to depression treatment and medication. Though alcohol is clinically classified as a depressant, it is shown to have a stimulating effect before the sedation kicks in. This dual effect of alcohol feeds cultural misunderstandings about how drinking impacts us mentally and emotionally. Initially, alcohol induces a spike in dopamine and serotonin levels but then the “feel-good” chemicals dip immediately afterward, as soon as the body begins to break down the alcohol, exacerbating depression.

“Using alcohol as a coping mechanism runs the risk of needing more over time,” adds Dr. Chung, because chronic alcohol use will cause the brain to default to producing lower levels of these chemicals, causing a person to feel more depressed. 

Alcohol Blocks the Effectiveness of Depression Medications

Using alcohol and mental health medications together should be avoided to maximize the effectiveness of depression treatment. SSRIs (Selective Serotonin Reuptake Inhibitors) are the most common group of medications used to treat depression and anxiety. These medications work to increase and regulate the amount of serotonin in the body. Alcohol disrupts serotonin levels by producing unpredictable highs and lows, which prevents the medication from working to treat depression. 

Dr. Chung warns that mixing alcohol with monoamine oxidase inhibitors (MAOIs), a different class of antidepressants, can also be dangerous and have serious health consequences

Alcohol Impairs Sleep

Ninety percent of people with depression experience sleep issues. Though sleep issues were viewed as a symptom of depression in the past, research now suggests sleep issues often appear before depression symptoms. Treating sleep issues is now a vital part of depression treatment. The less quality sleep a person gets, the more their mood is negatively impacted, worsening depression. Though alcohol may allow people to fall asleep faster, research finds drinking before bed causes a reduction in REM sleep, the most restorative stage of sleep, and causes more sleep disruptions.

Alcohol should never be mixed with sleep aid medications due to not only a high, potentially fatal, risk of drug interactions but also an increased risk of addiction. 

What are Some Healthy Ways to Manage Depression?

  • Therapy. Dr. Chung says because symptoms of depression include decreased motivation and a loss of pleasure in things previously enjoyed, treating depression can be tricky. Therapists can help patients: 
    • Re-examine beliefs about their depression as well as mental health in general. “Oftentimes, people feel guilty or ashamed because they don’t believe there’s anything to be depressed about, other people have it worse, or they can’t snap out of it,” explains Dr. Chung. “It is important to talk about how depression is an illness and isn’t something under a person’s control. There isn’t always a trigger, it is not always the same constellation or severity of symptoms, and duration can vary. It is a medical issue and I’ll compare it to having a cold or having a chronic health condition, like diabetes. Depression has nothing to do with mental fitness or your willingness to be happy. The brain literally can’t ‘do positive’ when it is depressed.” 
    • Identify and challenge depressive (or anxious or negative) thoughts so that they can be adjusted to be more accurate. Therapy can offer different perspectives that help reframe things to be less hopeless or dark. 
    • Create a safe space to process stressful or painful situations in life. In fact, therapy might be that safe space.
    • Track changes in mood and other symptoms as well as help monitor whether medications are working. 
    • Start a positivity journal by listing 3-5 things that range from neutral to positive every day. The brain has trouble generating positive thoughts when depressed, thus the journaling is an intentional exercise to create neural connections for positive thoughts. The assignment also serves as a priming event, where the brain starts noticing neutral to positive things during the day so they can be written down that night. 
    • Develop other coping strategies so that drinking isn’t the first or only stress management skill in the toolbox. Therapists can help a person explore the reasons for drinking and address the root causes in addition to harm reduction.
  • Medication taken as prescribed by a qualified doctor, can reduce symptom severity and is especially effective in treating depression when combined with therapy. (To reiterate, alcohol and mental health medications don’t mix as alcohol prevents mental health medications from working properly.) 
  • Practice Self-Care. “Self-care is something that is simultaneously so simple and so challenging,” says Dr. Chung.  Drinking enough water, getting sufficient sleep, exercising, taking a shower or a bath, and eating regularly are all important, incremental ways to manage depression and wellness.
  • Create a daily to-do list of simple tasks, including self-care activities. Crossing them off each day can help provide structure and a sense of accomplishment.
  • Quit Drinking. Choosing sobriety can be an important form of self-care because alcohol and depression are negatively linked, compounding one another’s destructive effects. TEMPEST is a powerful tool to help people quit drinking online. 

If you have depression and are still drinking, now might be the time to take a break from alcohol to see if it helps at all. It also might be a good time to seek medical advice about whether or not it’s time to quit altogether. Likewise, if you’re not sure you’re ready to quit drinking yet but are looking for some support as you evaluate your relationship with alcohol, an online recovery program like Tempest might be able to help.

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