Is Alcohol a Depressant?

Is Alcohol a Depressant? You might drink alcohol to lift your spirits. But ultimately that cocktail, glass of wine or beer will have the opposite effect on your body. "When you first drink it, alcohol can make you feel happier or calmer. But alcohol is a central nervous system depressant. It depresses the activity of the brain," says Dr. Cory Walker, assistant professor at the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine.

How Alcohol Reaches Your Brain

Is alcohol a depressant that goes right to your head? Not quite. Alcohol has a few stops to make first. After you take a swig, alcohol lands in the stomach. At that point, according to the Alcohol Pharmacology Education Partnership, some alcohol (about 20%) can be absorbed into the bloodstream (via capillaries). The rest moves to the small intestine, where about 80% of the alcohol is rapidly absorbed into the blood (again, via capillaries), then moves into the veins and is eventually delivered to all parts of your body, including your brain. The process can take as little as 10 minutes.

The process takes a little longer if there's food in your belly and the "door" to the small intestines (called the pyloric sphincter) is shut tightly. A fatty meal in particular (like a cheeseburger and fries, pasta with Alfredo sauce or enchiladas smothered in cheese and cream sauce) cause a slowdown, since fat takes longer to digest.

Your Brain on Alcohol

Once alcohol reaches your brain, it triggers a number of chemical changes, including:The release of the body's feel-good chemicals, such as dopamine and serotonin.The release of gamma-Aminobutyric acid, or GABA, the body's slowdown chemical.A reduction in the release of glutamate, the body's speedup chemical. The chemical changes lead to physical side effects. "Alcohol slows reflexes and speech, which is why people slur words and the ability to process information when they drink. If you drink too much, it can slow body temperature and breathing. It's poisonous. In all of these ways, alcohol is a depressant," Walker explains.

Is Alcohol a Depressant That Causes Depression?

Since alcohol is a depressant and alters some of the brain chemicals that regulate mood, you may wonder if it can cause depression or anxiety.

Scientists have had observational evidence for decades that suggests an association between alcohol use and mood disorder. For example, a small study in 1991 concluded that depressive episodes after drinking alcohol may be related to reduced levels of serotonin.

Walker says it's a combination of many chemical imbalances (caused by alcohol consumption) that may lead to mood disorder – but it happens over time."If you drink too much in one night, you can deplete the neurotransmitters (brain chemicals) normally associated with feeling content," Walker says. "But you can recover after a night of drinking. If you drink over time, you'll end up with chronic dysregulation."

Does the Mood Disorder Come First?

Scientists also know that alcoholics or people with alcohol use disorder are at an increased risk for having mood disorders. "But the issue is which comes first: the depression or the alcohol use disorder? There are some people whose depression predates alcohol use," Walker points out.

For example, a 2015 review of numerous studies found that among alcohol-dependent patients, 37% suffered from additional mental disorders. Researchers noted that – when compared to people without alcohol dependence – those with alcohol dependence had:Almost four times the risk for depression.More than six times the risk for bipolar disorder.More than four times the risk for generalized anxiety disorder.

Drinking When You Have Mood Disorder

People who are sad may feel a need to reach for a daily drink as a way to self-medicate. But doctors say that can be dangerous. "The risk is that they will develop physical and (psychological) dependence, and over time, the pleasurable effects diminish," says Dr. Eric C. Strain, director of the Center for Substance Abuse Treatment and Research and professor of psychiatry and behavioral sciences at Johns Hopkins University.

In addition, having a mental illness makes treating substance dependence much more difficult. A 2013 study pointed out that when a patient is both depressed and experiencing AUD, treatment outcomes are worse than when each occurs individually.

Part of that is because alcohol can impair the effectiveness of some antidepressant medications and cause other problems. The Mayo Clinic lists several reasons why mixing alcohol and antidepressants is a bad idea:

It can increase feelings of depression or anxiety, making symptoms more difficult to treat.It can worsen a medication's side effects.A class of antidepressant called monoamine oxidase inhibitors, or MAOIs, when combined with certain types of alcohol (and food), can cause a dangerous rise in blood pressure.Combining antidepressants and alcohol may impair physical coordination, judgment and reaction time, which can make driving or other activities more dangerous.Some antidepressants cause drowsiness, as does alcohol. When combined, they can cause extreme sleepiness, which can also be dangerous when driving or working.Patients may stop taking antidepressants or other medications in order to drink. That can make depression worse.

Other Drugs Can Cause Depression

Alcohol isn't the only substance that can lead to depression. Some prescription medications carry risks for depression including:

Isotretinoin, such as Zenatane or Absorica, used to treat severe acne.Alphainterferons, such as Alferon N or Intron A, used to treat cancer.Corticosteroids, such as cortisone or prednisone, used to treat inflammation.Varenicline (Chantix), used to treat smoking addiction.Benzodiazepines, such as diazepam (Valium) or lorazepam (Ativan), used as sedatives. Nonbenzodiazepines, such as zolpidem (Ambien) or eszopiclone (Lunesta), used to help people fall asleep.

"If someone is depressed and taking other prescription medications, you should be aware that some meds can alter mood one way or another," Strain says. He adds that people can also have "idiosyncratic reactions" to prescription drugs that others might not. "If you find a medication has made your mood go down or made you feel very happy or more energetic, it is wise to go back to your physician and tell him about this reaction," he says.

Occasional Drinking

Can someone with depression safely have even the occasional cocktail or glass of wine with dinner? It's certainly possible – but not advisable. "If their symptoms are not controlled, my recommendation would be to abstain," Walker advises.

"If you have a rough day and want a drink, that is understandable, but you need to be careful," Strain says. "Alcoholics say there is always a reason to drink. When something bad happens, you need a drink, and when something good happens, you celebrate with a drink as well. There are healthier ways to cope with a low mood than having a drink." What if you don't have depression and want a drink? "Lots of people can have a glass of wine without it becoming maladaptive," Walker says. "But people have different thresholds. Genetic susceptibility to mood disorder or substance abuse may increase your risk. If you want to be absolutely sure, just don't drink."

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