A Tangled Web: Navigating Depression and Co-Occurring Alcoholism

I just need it to calm my nerves. I need to wind down from a stressful day. I’m more fun socially when I have a few. I want something to help me through this breakup. Drinking helps me forget my problems. I just need a little escape.

You wake up after a night of drinking with your mind spinning and head pounding. Your tongue is like sandpaper and nausea grips you hard. As you gain consciousness, you are overcome by a feeling of emptiness, a dull sadness that sweeps through you. The thought of getting up to face the world, much less have a productive workday, is too overwhelming to bear. You decide to call in sick. As you lie there, staring at the ceiling, your thoughts begin racing–what if you get fired? Why did you do this again? What’s wrong with you?

Is this just a hangover? Or are your depressive symptoms breaking through after the temporary relief offered by alcohol, revealing your true psychological state? Drinking can mask depression, both while you are intoxicated by numbing your pain, and during the hangover stage by providing an alternative narrative to explain away your feelings. Alcohol enables you to stay in denial about your mental health disorder, creating a dangerous cycle of increasing self-destruction as both your addiction and co-occurring psychological illness progress. It can also hide your depression from others, as they too assume that your emotional state is the result of your drinking, and focus their concern solely on your alcohol consumption. Without personal insight and social support for your depressive illness, it remains in the shadows, flourishing from neglect.

You finally realize you have a problem with alcohol. You seek treatment, dry out, go to 12-step meetings; you do everything right. You are a model of recovery. And yet the feelings of emptiness and despair remain. You are desperate for comfort and, because humans are creatures of habit, you turn to the relief you know best: drinking. A few drinks turn into many, and before you know it you are right back where you started–dependent not just physically, but addicted psychologically. The consequences of your alcoholism–fractured relationships, professional failures, overspending, health problems–further exacerbate your depression, which leads to an increased desire to drown out your pain.

People who experience depression with co-occurring alcohol addiction need specialized treatment in order to provide meaningful intervention for both disorders simultaneously. Without this multi-pronged therapeutic approach, your risk of relapse for both conditions increases significantly. If only your addiction is treated, the underlying impetus for your drinking remains, its roots firmly planted and threatening to draw you back in. If only your depression is treated, your physical and psychological reliance on alcohol are still there and your addictive behavioral patterns are not broken. The neural pathways that fuel your addiction stay wide open and drinking remains your first instinct when faced with stressors. Even when depression is managed effectively, the emotional burdens of everyday life can quickly trigger your alcoholism, which in turn unravels the hard work you have done to cope with your mental health disorder by disrupting your healing process, interfering with antidepressant medications, and reintroducing instability to your life.

It is vital that you connect with a treatment program with the expertise to address the full scope of your distress and support you through the recovery process. It is only through a sophisticated, nuanced understanding of depression, alcoholism, and the complex relationship between the two that you can truly begin to move forward toward a healthy, stable, and fulfilling life.

Bridges to Recovery has the resources to treat depression with co-occurring alcohol abuse. Contact us for more information about our program and how we can help you or your loved one start on the journey to healing.