People drink alcohol for many reasons, including consciously or unconsciously trying to address the symptoms of anxiety and depression. It can work temporarily, which is why people continue to do it. Unfortunately, however, it can be counterproductive over time and leave people more anxious and depressed than before they began to drink.
Alcohol, Moods and Neurotransmitters
Much of how we feel at any given time is due to neurotransmitters. Neurotransmitters are chemicals released by neurons, cross the gap between cells, bind to receptors, and send messages to various parts of the body about how to respond to a situation. Although neurotransmitters work in harmony with each other, and no single body chemical is solely responsible for any mood state, one that’s closely tied to anxiety is GABA, and one that greatly affects depression is serotonin. Dopamine is another important neurotransmitter and is associated with teaching people to repeat experiences that have been interpreted as pleasurable or rewarding.
GABA generally causes people to feel relaxed and calm because it blocks certain nerve activity in the brain. Alcohol works in the short term to treat anxiety because it mimics GABA by binding to GABA receptors. It doesn’t directly affect GABA levels, but it produces similar effects by binding to the receptors. If someone drinks too much, the GABA pathways can be overstimulated, which can cause the central nervous system to be overly sedated and produce the symptoms of alcohol overdose.
Drinking can also temporarily boost serotonin levels. Because serotonin is associated with feelings of well-being, higher serotonin generally makes people feel less depressed. Many commonly used anti-depressant medications work to regulate serotonin levels.
Body chemicals interact in complicated ways. A study published in Alcohol Health and Research World notes that many of the effects of alcohol on the brain are probably due to the way serotonin interacts with other neurotransmitters. Alcohol can also cause GABA to interact with different compounds. A study published in the journal Nature Communications reported that drinking enough alcohol to become intoxicated can affect two different proteins (NMDA and FMRP), which may affect the way GABA works and have an anti-depressant effect.
All substances, including alcohol, increase dopamine. The role of dopamine in the body is to teach humans to do things that guarantee survival, such as eat, procreate and form social bonds. Alcohol and other drugs hijack this system, raising dopamine much higher than natural rewards do.
What Goes Up Must Come Down
When people first begin to drink, GABA, serotonin and dopamine levels rise briefly after a drink but then normalize as the alcohol is metabolized. Over time, however, the body begins to sense that things are getting out of balance, so it makes changes in order to adapt to what it sees as a new normal. It begins to alter the structure and function of neurons in a way that affects neurotransmission. The National Institute on Drug Abuse reports that these changes can be significant and long-lasting. This adaptation is a primary way that alcohol impacts anxiety and depression.
When dopamine surges, the body tends to react by reducing the number of receptors. When alcohol causes GABA to rise, it responds by causing GABA receptors to become less sensitive. A similar adaptation occurs with serotonin.
This raising of neurotransmitters and the body’s response underlies alcohol tolerance and dependence. If you drink to raise GABA levels, and the body adapts by making receptors less sensitive, then you’ll have to drink more to get the former effect. If you continue to drink, your body will continue to adapt until neurotransmitters are to some extent only in balance when alcohol is present. Baseline, non-drinking levels will be lower than before. When you stop drinking, the lower levels can contribute to withdrawal symptoms.
People may begin to drink to treat symptoms of anxiety or depression, but the unfortunate result is that it can worsen them over time. Low levels of GABA contribute to anxiety, low levels of serotonin to depression, and low levels of dopamine to certain depression symptoms such as anhedonia (inability to feel pleasure) and lack of motivation.
A study on alcohol and depression published in the journal Addiction found that having either major depression or an alcohol use disorder doubled the risk of having the second condition as well. The authors note that it appears most likely that alcohol use increased the risk of depression rather than the other way around. They state, “The current state of the literature suggests a causal linkage between alcohol use disorders and major depression, such that increasing involvement with alcohol increases risk of depression.”
How Alcohol Indirectly Contributes to Anxiety and Depression
Alcohol can also contribute to anxiety and depression through indirect means. You may feel anxious or depressed, for example, because of things you did when alcohol lowered your inhibitions. You may have done something you were ashamed of or feel anxious about what you might have done during a period that you can’t remember.
Alcohol can cause a long list of other potential problems which can indirectly contribute to anxiety and depression, including the following:
The National Institute on Alcohol Abuse and Alcoholism lists some of alcohol’s effects on the body. The heart can be damaged by alcohol, putting people at higher risk of high blood pressure, an irregular heartbeat and stroke. The liver can also be damaged and lead to cirrhosis, fibrosis, fatty liver and alcoholic hepatitis. Effects on the pancreas can lead to pancreatitis and associated digestive problems.
Drinking weakens the immune system, making you more likely to contract pneumonia, tuberculosis or another infectious disease. It can also damage nerves and lead to numbness, tingling or pain. Michigan Health notes that sometimes alcohol causes neuropathy and is the second-leading cause of it.
Alcohol consumption is also associated with a long list of cancers, including liver cancer, breast cancer, colon cancer and cancers of the esophagus, head and neck. In a publication on alcohol and cancer, the National Cancer Institute reports that even light drinkers have an increased risk of some cancers. They report that 3.5% of cancer deaths in the US may be related to alcohol.
Alcohol has many effects on the brain beyond those related to anxiety and depression. It damages neurons in a way that makes it harder for parts of the brain to communicate with each other. This damage can cause a range of symptoms, including memory impairment. The NIAAA reports that memory problems can be detected after only a few drinks and that the problems continue to grow with the amount of alcohol consumed. Blackouts (when people are unable to remember events or key details about them) aren’t uncommon. They can happen to anyone, but it appears that women may be at higher risk of experiencing them.
Drinking can be a large source of strife and arguments within relationships. When people are under the influence of alcohol, they may behave hurtfully and uncharacteristically; this can be as simple as saying something unkind or as serious as infidelity or domestic violence. Family members may be concerned about the amount of money spent on alcohol, or the amount of time spent drinking.
A very significant downside to drinking is the risk of becoming addicted. Although no one is immune, the risk seems to be higher for those with mood disorders. The question, “Does alcohol effect anxiety and depression?” can certainly be answered in the affirmative, and the cycle of drinking to relieve moods, then having those moods worsen over time, can be an unfortunate precursor to alcohol addiction. A study published in the Journal of Affective Disorders found that 6% of people without anxiety and depression suffered from alcohol dependence, but 20% of people with combined anxiety and depression did.
Unfortunately, people often don’t realize that their drinking has become an addiction due, in part, to alcohol’s effect on memory. Memory impairments may keep people from connecting their drinking to its negative consequences. Alcohol also affects the prefrontal cortex of the brain, which makes it harder to think clearly. A study on alcohol treatment published in the journal Psychiatric Services found that fewer than one in nine people who needed treatment for an alcohol use disorder perceived their need.
Integrated Treatment for Alcohol Addiction, Depression, and Anxiety
When people have both mental health and substance use disorders, it’s important to treat them together in an integrated and coordinated way. Because the conditions interact with each other, practitioners need to monitor symptoms closely so they can adjust treatment as needed. An article in the journal Alcohol Research notes that alcohol withdrawal and depressive disorders share symptoms, such as insomnia and psychomotor agitation, that can make diagnosis challenging.
Treatment needs to be individualized to be most effective. It’s likely to involve both medication and psychotherapy. You may receive cognitive-behavioral therapy, which helps identify untrue or unhelpful thoughts that affect your emotions and behaviors. You may have unconscious beliefs, for example, that you’re a failure or that things will never change. Learning to recognize and address those beliefs can be a powerful tool in addressing all three issues—anxiety, depression and alcohol dependence.
Another important aspect of treatment is learning to recognize and address your relapse triggers. Stress is a common one, so you’ll learn practices and coping skills that help turn down your body’s stress response. You’ll learn to understand your history and motivations and how your personal story can be both a challenge and a source of strength.
Although there are many treatment options, residential treatment is often a wise choice for people with multiple conditions to address. It can remove the environmental triggers for alcohol use and help people focus their attention on recovery without the distractions and stressors of everyday life.
We want you to find hope, healing, peace and joy. Let us help you find the path that will lead you there. Call us today at 1.844.675.1022 and let us talk to you about anxiety treatment or depression treatment options. Your new life can start right now.