What is Depression?
Feelings of sadness, lack of energy or trouble sleeping can be common occurrences that individuals experience in their daily lives. Losing a job, the death of a loved one or the end of a relationship can naturally cause feelings of grief. And often, people may use the word “depressed” as a way to verbalize how they are feeling.
In the case of individuals who are diagnosed with depression, these low moods and feelings of sadness are often much more severe and occur for longer periods of time.1 Depressive disorders can affect a person’s ability to function in many areas of their life and tends to be persistent.1 Symptoms can affect every aspect of their life including how they think, feel and handle daily activities such as eating, exercising or working.2
Across the globe, depression affects more than 264 million people of all ages and is a leading cause of disability worldwide.3 Between 2013 to 2016, 8.1% of American adults aged 20 and over had depression within a 2-week period.4 While there is no single cause leading to depression, there are many factors that may contribute to its development including genetics, personality traits, environment, various life stressors, and substance use such as alcohol.1,2
It is common to see alcohol use disorders (AUDs) co-occurring in individuals struggling with depression.5 Research has indicated that having either AUD or a depressive disorder roughly doubles a person’s chances of developing the other.5 Thankfully, with psychological and pharmacological treatments, both disorders can be managed and treated effectively.3,5
Types of Depression
When it comes to depression, some depressive disorders are more serious than others. Additionally, while many have similarities, each disorder has its own set of unique symptoms.2 A depressive episode can be categorized as mild, moderate, or severe depending on the severity and number of symptoms being experienced.3
A person may suffer from:2
- Persistent depressive disorder: Depression lasting more than 2 years.
- Peripartum depression: Depression occurring during or after pregnancy, impairing a woman’s ability to care for her child.
- Psychotic depression: Depression experienced with a distortion of reality, such as hallucinations or delusions.
- Seasonal affective disorder: Depression generally occurring during fall and winter months and is linked to a lack of natural light.
- Bipolar disorder: Although it is not classified as a depressive disorder, individuals with bipolar disorder experience extremely low moods that fit the criteria for major depression, while also going through periods of mania or extreme highs.
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Signs and Symptoms of Depression
While many people may feel down or sad from time to time, a depression diagnosis would mean experiencing the below symptoms for at least two weeks.1 The signs and symptoms of depression include: 2,6
- Feelings of hopelessness.
- Sad moods lasting most of the day/week.
- Frequent crying spells.
- Loss of appetite, or greatly increased appetite.
- Inability to sleep, or excessive sleeping.
- Feelings of worthlessness and guilt.
- Suicidal thoughts.
- Loss of interests in hobbies and other activities.
- Inability to fulfill roles in life, such as parenting or working.
- Extreme fatigue.
- Inability to concentrate or make decisions.
- Moving very slowly or unable to do things at a normal pace.
Alcohol Addiction and Depression
It can be difficult to know which one comes first—AUD or depression, but research has shown that regardless of the order, both issues are among the most prevalent psychiatric disorders and co-occur often.5 Studies have also indicated that this dual diagnosis, or comorbidity, is associated with greater severity and a worse prognosis for both disorders.5
Two possible explanations exist for the increased risk of developing an AUD or major depression: common underlying genetic and environmental factors, and the causal effect with each disorder that increases the risk to develop the other.7
For example, because those abusing alcohol spend a substantial amount of time drinking, it may also hide an underlying genetic predisposition to depression.8 At times, having depression can lead a person to “self-medicate” by drinking alcohol in an attempt to feel better. And drinking alcohol, which depresses the central nervous system, can lead to more depressed feelings in those already suffering from depressive and other mood disorders. 7 In the end, it creates a vicious cycle.
What is Alcoholism?
Not everyone who struggles with alcohol abuse is addicted to it, but it can be helpful to understand warning signs and symptoms that put you at risk of developing an AUD. Alcoholism is when a person can no longer control their alcohol use, compulsively abusing it despite its negative ramifications, and/or experiences emotional distress when they are not drinking.9
AUD is diagnosed based on an individual meeting criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To be diagnosed with AUD, a person must meet at least 2 of the following criteria within a 12-month period: 6
- Drinking more alcohol than intended.
- Unsuccessful attempts to cut back or stop drinking.
- Experiencing symptoms of withdrawal when they stop drinking.
- Developing a tolerance for alcohol, which requires them to drink more and more to achieve the same level of intoxication as before.
- Drinking and engaging in risky behaviors, such as driving.
- Drinking even though they know it makes a physical or emotional problem worse.
- Engaging in the use of alcohol, even when it increases family conflict.
- Drinking to the point that the person cannot fulfill their roles at home or work.
- Giving up activities they previously enjoyed to drink.
- Spending a significant amount of time drinking or recovering from drinking.
- Strong cravings to use alcohol.
Treatment for Depression and AUD
Treatment for co-occurring depression and AUD can be challenging, but integrated approaches that address both disorders can be effective.5 Studies have shown that treating both depression and AUD results in better outcomes for patients who did not also receive treatment for depression.10 An integrated approach focuses on both disorders within the same sessions or interactions and uses specific therapeutic techniques and strategies within a comprehensive, individualized treatment plan.
Effective treatment for alcoholism and co-occurring depression may include a mix of therapies include private and group counseling, behavioral therapies, medications to ease alcohol withdrawal symptoms or treat symptoms of depression, and long-term aftercare planning to help maintain sobriety.2,7,11 Before entering an inpatient or outpatient setting, a person seeking rehab treatment will need to go through a detox phase. Because detoxing from alcohol can be uncomfortable—or life-threatening for those who’ve developed a severe physical dependence—a medically-monitored detox setting is recommended.12
Following a successful detox, an inpatient or outpatient treatment setting may be advised depending a variety of factors determined via a substance abuse assessment conducted by a medical professional. Inpatient treatment allows for 24/7 monitoring and care in a hospital or other treatment facility.
Outpatient settings offers much of the same programming as inpatient treatment but is relatively less time intensive. Patient are able return home or to other living situations outside of treatment hours. Outpatient treatment may only be an option if a person’s current level of physical dependence does not necessitate the need for inpatient treatment.
How to Seek Treatment
If you’re ready to seek treatment for alcoholism and/or are struggling with depression, American Addiction Centers (AAC) can help. Alcohol.org is a subsidiary of AAC which includes a nationwide portfolio of rehab centers equipped to treat co-occurring disorders.
AAC’s therapeutic staff will address the comorbidity and can tailor your mental health and recovery treatment plans to offer you a comprehensive approach to manage your symptoms and start you on a path toward recovery. If you’re interested in learning more about your treatment options, our admissions navigators are available to chat with you 24/7. Call our hotline at 1-888-685-5770 to get started today.
. Anxiety and Depression Association of America. (2018). Depression.
. National Institute of Mental Health. (2018). Depression.
. World Health Organization. (2020). Depression.
. Centers for Disease Control and Prevention. (2018). Prevalence of Depression Among Adults Aged 20 and Over: United States, 2013–2016.
. McHugh, R. K., & Weiss, R. D. (2019). Alcohol Use Disorder and Depressive Disorders. Alcohol Research: Current Reviews, 40(1).
. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing; 155, 490-491.
. Kuria, M. W., Ndetei, D. M., Obot, I. S., Khasakhala, L. I., Bagaka, B. M., Mbugua, M. N., & Kamau, J. (2012). The association between alcohol dependence and depression before and after treatment for alcohol dependence. ISRN Psychiatry. 2012, 1-6.
. National Institute on Alcohol Abuse and Alcoholism. (2002). Is There a Genetic Relationship Between Alcoholism and Depression? Research Update, 26 (3), 233-240.
. National Institute on Alcohol Abuse and Alcoholism. (2018). Alcohol Use Disorder.
. DeVido, J. J., & Weiss, R. D. (2012). Treatment of the depressed alcoholic patient. Current psychiatry reports, 14(6), 610-618.
. National Institute on Drug Abuse. (2019). Treatment Approaches for Drug Addiction.
. MedlinePlus. (2019). Alcohol withdrawal.