Introduction and Aims. Heavy drinking is prevalent among undergraduate students and is linked with drinking to cope with depression motives for drinking. Drinking to cope with depression remains poorly understood given that alcohol has been shown to have adverse effects on mood when consumed at high doses. Using semi-structured qualitative interviews, the present study examined the perceived effects of alcohol on depressive symptoms as reported by undergraduate students who endorse high levels of drinking to cope with depression. Design and Methods. Sixteen undergraduate coping-with-depression-motivated (CWDM) drinkers (nine women, seven men), identified using the Modified Drinking Motives Questionnaire-Revised [1], reported on their experiences of drinking to cope with depression. Thematic analysis was conducted to identify themes and subthemes in the data. Results. Undergraduate students reported several effects of alcohol on affective, cognitive and behavioural depressive symptoms. While most of the perceived alcohol effects they described involved relief from depressive symptoms, some perceived effects involved worsening depressive symptoms. Discussion and Conclusions. The study generated several hypotheses to explain drinking to cope with depression, some of which might be testable in future experimental work. Overall, findings suggest the mood-altering effects of alcohol do not fully explain why depression and alcohol use are frequently co-morbid. Indeed, effects of alcohol on cognitive and behavioural depressive symptoms might be particularly reinforcing for CWDM drinkers. Interventions that target co-morbid depression and alcohol use might be improved by teaching CWDM drinkers skills to reduce depressive cognitions and to improve interpersonal interactions outside of drinking contexts. [Couture M-E , Pearson R, Halloran J, Stewart SH. A qualitative study of the perceived effects of alcohol on depressive symptoms among undergraduates who drink to cope with depression. Drug Alcohol Rev 2020;39: [180][181][182][183][184][185][186][187][188]