Should I stop drinking or treat depression first?

Almost always addiction first. Antidepressants fight against the daily depressant effect of alcohol — most people need 2–4 weeks sober before their real mood picture is visible. Don't stop suddenly if you're a heavy daily drinker — do it under medical supervision.

Do antidepressants work while I'm still using?

Poorly. SSRIs are blunted by alcohol and cocaine. Getting sober often halves the antidepressant dose you actually need.

Am I depressed, or is this the drinking?

For most people, both. The only way to know for sure is 4 weeks of abstinence with your GP monitoring mood. A dual-diagnosis rehab can compress that timeline safely.

Depression and addiction

Depression and addiction feed each other. Alcohol, cocaine, cannabis and prescription opioids all worsen depression over time — but they numb it short-term, which is exactly why so many people use them. Treating one without the other rarely holds.

Key signs

Low mood most of the day, most days, for 2+ weeks
Loss of interest in things you used to enjoy
Sleep and appetite changes
Using to cope with the low mood
Suicidal thoughts — needs urgent GP or Samaritans (116 123)

The link to addiction

Alcohol is a chemical depressant. Any daily drinker with depression will not recover on antidepressants alone — the alcohol is fighting the medication. Same logic applies to daily cannabis and benzodiazepines.

UK treatment pathway

Standard UK dual-diagnosis pathway: detox first, antidepressant review after 2–4 weeks of abstinence (the picture usually looks very different), then structured therapy — CBT is the strongest evidence base for depression with addiction.

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FAQs

Should I stop drinking or treat depression first?
Almost always addiction first. Antidepressants fight against the daily depressant effect of alcohol — most people need 2–4 weeks sober before their real mood picture is visible. Don't stop suddenly if you're a heavy daily drinker — do it under medical supervision.
Do antidepressants work while I'm still using?
Poorly. SSRIs are blunted by alcohol and cocaine. Getting sober often halves the antidepressant dose you actually need.
Am I depressed, or is this the drinking?
For most people, both. The only way to know for sure is 4 weeks of abstinence with your GP monitoring mood. A dual-diagnosis rehab can compress that timeline safely.

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