Alcoholism and Depression

Alcoholism and metal health researchers have known for quite some time that alcoholism and depression tend to occur together and that both disorders may run in families. 

In fact, previous research studies of twins and adopted siblings have implied that there are genes in common underlying alcoholism and depression and that both of these disorders take place in families.  Indeed, a family history of either alcoholism or depression puts an individual at increased risk for developing either illness.

Important Facts About Alcoholism and Depression

The following list represents some key facts that researchers have uncovered regarding the relationship between alcoholism and depression:

• Alcoholism and depression are frequently associated, leading to a high potential for alcohol-antidepressant interactions.

• The use of alcohol and drugs can complicate the diagnosis and treatment of depression.

• According to U.S. research, most people with depression do not seek treatment, although the great majority of individuals, even those whose depression is extremely severe, can be helped with professional treatment.

• Frequently, the reasons for depression are not clear.  That is, there may not be just one "cause," but a variety of contributing factors that accumulate over time and make people feel defeated, helpless, demoralized, hopeless, and depressed.

• Alcohol triggers depressive symptoms, increasing both their frequency and severity.

• Psychotherapy alone is not recommended as the only treatment for severe depression or for bipolar (manic-depressive) illness.

What is Depression?

Depression is a mental state typified by a despondent lack of activity and a pessimistic feeling of inadequacy.  When a person is depressed, he or she usually feels hopeless, exhausted, helpless, and worthless.

It is important to point out the fact that while "normal" depression is associated to any downturn in mood that might be relatively short-term and even triggered by something relatively trivial, "clinical depression," conversely, is correlated with symptoms that last two weeks or more and are so severe that they interfere with daily functioning and living.

Alcoholism and Depression: Symptoms

U.S. mental heath researchers have discovered the fact that some of the dynamics that are involved in producing the symptoms of reduced appetite, poor sleep, low mood, and anxiety that are characteristic of depression are also affected by alcohol. 

The following represents some of the major facts about the symptoms of alcoholism and depression:

• Among U.S. alcoholics entering treatment, approximately two-thirds of them have symptoms that resemble anxiety disorders.

• Approximately 5 to 10 per cent of U.S. individuals with depression also have symptoms of alcohol abuse or alcoholism.

• Since symptoms of depression are likely to develop during the course of alcoholism, some patients with mood disorders may increase their drinking when undergoing a mood change, fulfilling criteria for secondary alcoholism.

• The symptoms of depression in U.S. alcoholics are significantly reduced after three to four weeks of sobriety. 

• According to U.S. research, if a drinker has never experienced alcohol problems, he or she will tend to not have symptoms of depression.

• Since symptoms of depression associated with alcohol are the most sever when a person first stops drinking, recovering alcoholics with a history of depression should be carefully monitored during the entire alcohol withdrawal process and especially during its early stages.

• The strongest relationship between alcoholism and severe anxiety takes place in the context of alcohol withdrawal.

• In the U.S., up to 40 per cent of individuals who drink excessively have symptoms that resemble depression.

• When depressive symptoms are secondary to alcoholism, they are likely to disappear within a few days or weeks of abstinence, as the alcohol withdrawal symptoms decrease.

Depression and the Elderly

Some individuals have the mistaken belief that it is normal for the elderly to feel depressed.  U.S. research, however, shows that people who experience alcohol problems both before and after age 60 have the highest rates of depression.  In fact, seniors who suffer from depression and alcoholism are at an increased risk of suicide.

According to U.S. alcohol abuse statistics, since depression and alcohol abuse or alcoholism are related to suicide, and given the high rate of suicide in older people, health care professionals need to be sensitive to the presence of suicidal ideation in older patients. 

In short, clinicians must not only raise their awareness about depression and alcoholism in older adults but they should also refrain from confusing these disorders with "normal aging."

Alcoholism and Depression: Suicide

Alcohol impairs judgment, a fact that goes a long way in explaining its relationship with suicide.  Additionally, due to the fact that alcohol abuse and alcoholism can intensify depression and increase impulsiveness, a person suffering from major depression and from alcoholism has a much higher risk of attempting and succeeding at taking his or her own life.

Because of the risk of suicide, it is imperative that individuals suffering from major depression and alcoholism or alcohol abuse receive prompt medical attention.

Alcoholism and Depression: Treatment

Regrettably, many individuals, including health practitioners, tend to perceive alcoholism and depression as separate problems when in fact they are associated with one another.  Consequently, the positive relation between alcohol abuse or alcoholism and depression argues strongly for a more comprehensive approach to treatment. 

This means not only paying close attention to the "drinking problem" but also taking into consideration the treatment of depression - which can require anti-depressant medications or psychotherapy.  Stated differently, when a person exhibits drinking problems and depression, both medical conditions need to be addressed and treated. It almost goes without saying that this type of extensive treatment approach will help ensure a more appropriate and effective outcome for the patient.

According to many researchers and mental health practitioners, the clinical assessment of current and past alcohol abuse and alcohol-related disorders should be established as a routine part of all medical or psychiatric evaluations.

Moreover, all depressed patients should be frequently asked about their alcohol and drug use throughout the course of their treatment and advised to abstain from drug and alcohol abuse. 

In sum, when alcoholism or alcohol abuse occurs with depression, both the substance abuse and the mood disorder require immediate and professional treatment.

Alcoholism and Depression: Conclusion

Alcoholism and depression have a high comorbidity.  This means that alcoholism and depression occur in the same individuals at a rate higher than they would normally occur if both disorders were not interrelated.  The relationship "link" can biological, social, psychological, genetic or most likely a combination of these and other factors.

The bottom line is this:  when alcoholism or alcohol abuse occurs with depression, both the "drinking problem" and the mood disorder require prompt, quality treatment.

Message to Alcoholics

Don't just sit there and think things are going to get better and that your drinking problems are going to vanish. Addiction doesn't get better. It gets worse until somebody dies. You need to take appropriate action by getting professional treatment and you need to take action now!