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Could Drinking Be Fueling Your Depression?

Anxiety and depression are more common among people with heavy drinking habits

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Malte Mueller / Getty Images

Joining my newly retired friends for dinner over several months, I began to notice happy hour becoming both earlier and more indulgent. Predinner drinks flowed into wine with our meal, followed by after-dinner pours.

During those same months, I observed my friend was spiraling down from her infrequent “blue” moods to much more serious and pervasive “down” moods. “I need help,” she confessed one day over lunch. “I can’t shake this. I’m depressed.”

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The depression and alcohol connection

It’s not unusual for low spirits to accompany heavy alcohol use. In fact, research shows that anxiety and mood disorders commonly co-occur with alcohol use disorder, and depression is the most common among them.

Among people with major depressive disorder, the co-occurrence of AUD ranges from 27 to 40 percent over a lifetime, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

What is alcohol use disorder?

AUD is a medical condition “characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational or health consequences,” according to the National Institute on Alcohol Abuse and Alcoholism. It can be mild, moderate or severe. Binge drinking and heavy alcohol use can increase an individual's risk of alcohol use disorder.

Source: NIAAA

But which comes first?

There’s debate among experts who study the subject. For some, depression hits first and drinking becomes a way to self-medicate. For others, drinking triggers depression.

Whichever comes first, Patrick Fehling, M.D., an addiction psychiatrist at the UCHealth Center for Dependency, Addiction and Rehabilitation in Aurora, Colorado, believes “the real problem is drinking.” And the more a person drinks, research suggests, the more likely they are to develop depression.

Drinking, Fehling says, “puts downward pressure” on our moods. Then people “fall into a kind of loop” of drinking and depression, and the two conditions feed off each other. 

When alcohol hits the brain, it triggers a number of changes, including the release of the body’s feel-good chemicals. This is why, at first, alcohol can make our brain experience relief from distress. But “the rebound effect is that it can actually exacerbate” negative emotional states, says Amy Goodwin, an addiction counselor at UCHealth in Steamboat Springs, Colorado.


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The full impact of drinking too much hits about 72 hours after the alcohol has left the bloodstream. This is when withdrawal symptoms of increased anxiety, irritability, restlessness, agitation and disturbed sleep, among others, are at their peak. 

And because alcohol drains the brain of both dopamine and gamma-aminobutyric acid (our “safety” neurotransmitter), we’re left with “little of our own, natural chemistry to create senses of pleasure or hopefulness,” Goodwin says.

Drinking spikes during COVID

Not helping matters is the fact that heavy drinking has increased in recent years, largely due to the coronavirus pandemic.

When COVID-19 hit — bringing the compound stressors of illness and uncertainty — it threw many individuals into instant, extreme stress. And plenty of people who had been “social drinkers” began drinking more alcohol to cope. In fact, a report led by Harvard researchers affiliated with Massachusetts General Hospital found that excessive drinking in the U.S. increased by 21 percent during the COVID-19 pandemic.

separate survey published in the International Journal of Environmental Research and Public Health found that nearly half of people who reported increased drinking during the pandemic said stress was to blame. Other reasons for the uptick included boredom and availability of alcohol.

In their report, the Harvard researchers estimate that this increase in alcohol consumption for more than a year could result in a significant jump in alcohol-related deaths by 2040, to the tune of 8,000 additional deaths from alcohol-related liver disease, 18,700 cases of liver failure and 1,000 cases of liver cancer. In the shorter term, without intervention to change drinking habits, researchers expect 100 additional deaths and 2,800 additional cases of liver failure between 2020 and 2023. 

spinner image chart showing what a serving of alcohol is for beer wine and liquour
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How much is too much?  

To reduce the risk of alcohol-related harms, the 2020-2025 Dietary Guidelines for Americans defines drinking in moderation as:

  • Two or fewer drinks per day for men on days when alcohol is consumed
  • No more than one a day for women on days when alcohol is consumed

The guidelines caution that people over 60 years of age who should not drink at all are:

  • People taking medications that interact with alcohol
  • Anyone with a medical condition that can worsen with alcohol
  • Anyone recovering from AUD, or those unable to control their consumption
  • Anyone planning to drive a vehicle or operate machinery 

If you don’t drink, the guidelines note, don’t start.

4 tips to cut back on drinking

Dialing back the amount of alcohol consumed to a “safe” level — defined by the Dietary Guidelines for Americans as no more than two drinks a day for men and no more than one drink a day for women — can often be achieved by light or moderate drinkers who have drifted into overindulging during the pandemic by “self-regulating,” Goodwin says.

Here are some tips on how to do just that.

  1. Set your goal. Define what a healthier relationship with alcohol would look like.
  2. Take stock. This step is where Goodwin and Fehling emphasize knowing and accurately recording how much you actually drink — writing down every drink. Denial is pervasive and keeps patients from making progress. The National Institutes of Health has a downloadable tracking tool that can help you log your drinks.
  3. Decide why you want to change your drinking habits. Make a list of items driving you to drink less, such as “to improve my health,” “get fit,” “spend more time with loved ones” or “save money.”
  4. Make a plan of action. This may include avoiding the old triggers that initiated drinking — people, places, habits and lifestyle. It might start with establishing “dry” days, weeks or months.

For most moderate or severe AUD drinkers, however, clinical intervention — including detox and the use of medication — may be the only way to a cure, Fehling notes. And abstinence may be the only path forward.

Concerned about a loved one? Fehling recommends that family and friends of heavy drinkers “build a cohesive message” and unite. Depending on your situation, it may be wise to locate and be in touch with a treatment center in case one is needed immediately. Support groups like Adult Children of Alcoholics and Al-Anon can also be helpful, Fehling says.

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