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Heavy Alcohol Use and Depression

Updated: Aug 11, 2023

Numerous studies show a link between heavy alcohol use and depression. Among hazardous drinking men and women there are lower levels of positive affect and higher levels of depression and anxiety. Depressive symptoms are associated with numerous drinking variables. Especially, drinking to get drunk, frequency of intoxication or consuming higher amounts of alcohol per occasion. Heavy drinkers are more likely to be depressed, compared to light drinkers.

Possible Mechanisms

Heavy alcohol consumption may aggravate or generate depressive symptoms through various possible mechanisms:

  • The direct pharmacological effects of alcohol use may decrease the availability of tryptophan, a precursor to serotonin. Reduced level of serotonin has been linked to depression,

  • Heavy alcohol use can indirectly generate or aggravate depressive symptoms by influencing the psychosocial functioning of the person. Low self-esteem, feeling of guilt and hopelessness may result from alcohol-related negative repercussions.

  • Heavy alcohol use may lessen the possibility that a person seeks treatment for depression,

  • Excessive alcohol consumption can negatively impact cognitive functioning and prevent from choosing more adaptive coping methods. People who rely on drinking as a way of coping with negative affect tend to have higher alcohol dependence and more drinking problems.

There are very limited studies that identify the level of alcohol consumption that is disadvantageous for treatment of depression. The level at which alcohol use negatively affects depressive symptoms and treatment of depression will most likely vary depending on the person.


Motivational Interviewing is a collaborative, non-confrontational method to address a person’s ambivalence towards behaviour change. Motivationally focused interventions have shown success also among drinkers not seeking treatment for drinking problems. A brief intervention involves elements of:

  • Feedback about a person’s drinking,

  • Responsibility for committing to change,

  • Advise to change behaviour,

  • Menu of options for implementing a change strategy,

  • Empathy,

  • Self-efficacy.

Facets such as personalised feedback on the consequences of drinking on depressive symptoms and consideration of alternative options may encourage a person to make meaningful changes.

Asking about pros and cons of the current drinking levels helps to address ambivalence directly. It also helps to understand the link between heavy drinking and depressive symptoms and can contribute in motivating a person to make change in their alcohol use.

A depressed and heavy drinking individual who realise that their current drinking pattern jeopardises depression treatment would be more likely willing to change, in comparison to a person who does not see a connection between the two.

Another crucial principle of motivational interviewing is reinforcing self-efficacy. This could involve strategies such as expressing confidence in a person’s ability to change, affirming responsibility or identifying the resources such as mental health treatment. It is crucial to express empathy, avoid judgment, shaming and argumentation.

Heavy alcohol use and depression. Iremia Counselling


Sher, L. (Ed.). (2008). Comorbidity of depression and alcohol use disorders.

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