Alcoholism Depression

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Mental health and alcoholism researchers have known for quite some time that alcoholism and depression tend to occur together and that both disorders often occur in families. 

In fact, previous studies of adopted siblings and twins have suggested that there are genes in common underlying alcoholism and depression and that these disorders do in fact seem to take place in families.  Indeed, a family history of either alcoholism or depression puts a person at increased risk for developing either illness.

Some Important Facts About Alcoholism and Depression

• When individuals abuse alcohol and/or drugs, depression can develop.
• Even though research has not shown that depression actually causes alcoholism, the two disorders are commonly seen in the same patients at the same time.
•  Depressed people often turn to alcohol in the belief that it has the ability to ease their symptoms.  Not all heavy or long time drinkers, however, will become depressed. 
• Without treatment, a major depressive episode can last up to 6 to 12 months or longer.
• To relieve the pain of depression, some people resort to alcohol or drug abuse.
• Alcohol triggers depressive symptoms, increasing both their frequency and severity.
• Alcoholism may cause a relapse in patients with depression.  This suggests that a gene or genes might predispose some individuals to depression (which may be alcohol induced) and others to alcoholism.
• Many depressive conditions are associated with the excessive use of alcohol and drugs.
• A lot of depressed individuals, especially teenagers, also have problems with alcohol or other drugs.  These individuals are therefore more likely to develop a dependency on alcohol or other drugs than non-depressed individuals.
• People with depression cannot simply "pull themselves together" and feel better.

What is Depression?

Depression is a mental state characterized by a despondent lack of activity and a pessimistic sense 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 with any downturn in mood that may be relatively transitory and even triggered by something trivial, "clinical depression," conversely, is related to symptoms that last two weeks or more and are so severe that they interfere with daily functioning and living.

Alcoholism and Depression: Symptoms

Mental heath scientists have discovered the fact that some of the factors that are involved in producing the symptoms of low mood, reduced appetite, anxiety, and poor sleep that are characteristic of depression are also affected by alcohol. 

The following represents some of the key symptoms of alcoholism and depression:

• The symptoms of depression in alcoholics are greatly reduced after three to four weeks of sobriety.
• The strongest correlation between alcoholism and severe anxiety takes place during the alcohol withdrawal process.
• If a drinker has never experienced alcohol problems, he or she will tend to not have symptoms of 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.
• About 5 to 10 per cent of people with depression also have symptoms of alcoholism or alcohol abuse.
• Since symptoms of depression related to alcoholism are the greatest when a person first stops drinking, recovering alcoholics with a history of depression should be carefully monitored during the early stages of the alcohol withdrawal protocol.
• Among alcoholics entering treatment, roughly two-thirds of them have symptoms that resemble anxiety disorders.
• Due to the fact that 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.
• Up to 40 per cent of people who drink excessively have symptoms that resemble depression.  

Depression and the Elderly

Some people have the misconception that it is "normal" for the elderly to feel depressed.  Research, however, shows that people who experience alcohol problems both before and after the age of 60 have the highest rates of depression.  In fact, seniors who experience depression and alcoholism are at an increased risk of suicide.

Since depression and alcohol abuse are correlated with suicide, and given the high rate of suicide in older individuals, substance abuse treatment professionals and other health care practitioners need to be sensitive to the presence of suicidal ideation in older patients.  In short, clinicians must raise their awareness about depression and alcoholism in older adults and they should not confuse these disorders with “normal aging.” 

Alcoholism and Depression: Suicide

Alcohol impairs a person's judgment, a fact which to a great extent explains its association with suicide.  Moreover, due to the fact that alcohol abuse and alcoholism can intensify depression and increase impulsiveness, a person suffering from major depression and who abuses alcohol has a much higher risk of attempting and succeeding at taking his or her own life.

Because of the risk of suicide, it is critical that individuals suffering from major depression and alcohol abuse receive immediate medical attention.

Alcoholism and Depression: Treatment

Sadly, many people, including health care professionals, tend to view alcoholism and depression as separate problems when in fact, they are strongly associated to one another.  As a result, the positive correlation between alcohol abuse or alcoholism and depression argues strongly for a comprehensive approach to treatment.  This means not only paying attention to the problem of alcohol, but also taking into account the treatment of depression - which can require psychotherapy and/or anti-depressant medications.  It is claimed that this type of extensive treatment approach will help ensure a more productive and effective outcome for the client. 

There is general agreement in the psychiatric community that alcoholic individuals are at increased risk for bipolar illness and depression and that depressed people are at increased risk for alcoholism and alcohol abuse.  According to some researchers and clinicians, therefore, the clinical assessment of current and past alcohol abuse and alcohol-related disorders should be considered an essential aspect of all psychiatric or medical evaluations.

In addition, all depressed patients should be frequently asked about their drug and alcohol use and abuse all through the course of their treatment and advised to abstain from alcohol and drug abuse.  Since relapse prevention is one of the most critical factors in the treatment of depressed patients with a past history of alcoholism, it is critical to maximize the chance of long-term sobriety in clients with depression.

In a word, when alcoholism or alcohol abuse occurs with depression, both the "drinking problem" and the mood disorder demand professional treatment.

Famous People Who Had Depression

Abraham Lincoln is perhaps the most noted person to successfully cope with depression. Another famous person, Winston Churchill, the British Prime Minister, successfully managed his depression that he referred to as his "black dog."  Leaders in other fields like film (Woody Allen and Jim Carrey), sports (Terry Bradshaw), television (Dick Cavett and Mike Wallace), and any number of scientists, doctors, educators, lawyers, and nurses have experienced depression and moved forward to live successful and productive lives.  These "success stories" should remind others who suffer from depression that this illness need not be a crippling blow to the ways in which they live their lives.

Alcoholism and Depression: Conclusion

Alcoholism and depression have a high comorbidity.  Stated differently, alcoholism and depression occur in the same people at a rate higher than they would occur if both disorders were not associated.  The "link" can be genetic, social, biological, psychological, or most likely a combination of these and other factors. 

Individuals who are alcoholic and who also suffer from depression deserve the same kind of comprehensive care as a diabetic patient with glaucoma or a cancer patient with pneumonia.  The bottom line is this:  when alcohol abuse or alcoholism occurs with depression, both the "drinking problem" and the mood disorder require immediate and professional treatment.

If individuals can be made aware of the strong relationship between alcoholism and depression AND made aware of some great people in history who battled through depression and lived highly successful lives, some of them may be more able to cope with depression without resorting to alcohol abuse or alcoholism. 

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