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What’s the Connection Between Depression and Alcohol Use?

“After the day I’ve had, I need a drink.” It’s a line a character in a movie might say after the breakup of a bad relationship, the loss of a job, or the death of a parent.

It’s not at all uncommon for movies to mirror real life, and here, writers are tapping into the myth that a sip of alcohol can make feelings of sadness or depression fade away.

In reality, depression and alcohol abuse have a complicated relationship.

Rather than helping to ease ongoing sadness, alcohol abuse might make feelings of depression worse.

Alcohol abuse might, in some cases, even cause depression.

Doctors are adept at untangling this relationship and designing programs that can help people to feel at ease. Understanding how alcoholism and depression intertwine could also be useful for you, as the knowledge might help you recognize a problem and get appropriate care.

DEPRESSION AND DRINKING GO HAND IN HAND 

Research cited in an article published in Current Psychiatry Reports makes the link between depression and drinking quite clear. Here, researchers report that 16.9 percent of people diagnosed with a substance use disorder in the past year also had depression within that same year. Also, those with a depressve episode were 22 percent more likely to experience symptoms of substance abuse, compared to only 7.9 percent of those who did not have depression.

Statistics like this make it clear that depression and the use of alcohol are closely tied together. That relationship might be due, in part, to genetic influences.

Modern researchers are combing through genetic data, looking for genes that can influence behavior. In preliminary research published in the journal BioRxiv, researchers claim there is evidence to support the role of genes in the development of major depression and alcohol abuse happening within the same person.

This makes intuitive sense. Feelings of depression can originate within brain cells. The brain relies on a constant stream of chemicals to communicate with other brain cells, and some of those chemicals are meant to identify an episode of happiness or pleasure. When those chemicals are present, the brain is aware that something positive is happening.

People with depression can have deficiencies in the production or uptake of these pleasure chemicals. When that happens, people cannot experience high levels of joy, even when something wonderful happens. Their altered brain chemistry is to blame.

Alcohol can seem like a panacea, as it can reduce overall electrical activity within the brain while stimulating the release of pleasure chemicals. Alcohol can seem like a solution to depression, as it is altering the brain at the cellular level.

Unfortunately, alcohol offers a temporary fix that leads to damage. Brain cells become accustomed to the presence of alcohol, and they can downregulate the production of pleasure chemicals, preparing for the next drink to arrive. That can lead to feelings of sadness that will not abate until the next drink appears. In time, people might need to drink more and more alcohol to feel the pleasure that once came from a single drink, due to this regulating ability.

Alcohol abuse and depression are also linked due to timing. As researchers writing in the journal Addictive Behaviors Reports point out, depression tends to develop during young adulthood. Alcohol abuse also tends to become more common during young adulthood, as people come of age and can purchase alcohol independently. At times, both conditions seem to spontaneously appear in the same person at the same time, and unraveling the roots of the issue can be difficult.

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WHEN DOES DEPRESSION COME FIRST? 

According to Mental Health America, one in three people with depression also has some form of substance abuse or dependence. Unfortunately, alcoholism symptoms can be similar to the symptoms of depression, and that can mean some people with depression are simply unaware that they are attempting to regulate a mental health problem with alcohol.

Depression can develop independently of an alcohol abuse issue, and it is not uncommon for people to experience an episode of depression due to an underlying health issue, such as cancer or heart disease. People may also experience depression due to an emotional shock, such as the death of a loved one. Depression can also run in families, meaning that children of parents who experienced depression can also have episodes of their own.

For those who develop depression before alcoholism, they may be able to point to a time in which they were feeling low, upset, or hopeless before they began drinking to make things better. That period may be incredibly brief, as alcohol is so plentiful and it is commonly thought of as a mood booster; however, the presence of a time in which depression symptoms were available without the use of alcohol could indicate that the depression was in place first.

WHEN DOES ALCOHOL ABUSE COME FIRST?

For some people, alcohol abuse was the trigger that sparked the depressive episode.

For example, in a study published in the journal International Scholarly Research Notices Psychiatry, researchers followed 156 people for six months after they entered a detoxification program.

Researchers found that 30.2 percent still had depression at the end of the study. This seems to suggest that the others had feelings of depression that resolved when they stopped their drinking habit.

Someone like this may have started drinking during a time of happiness and stability. They may have thought their drinking was meant to enhance their happiness, or they may have used drinks to celebrate their successes. In time, as drinking deepened, they may have felt upset while drinking. Later, they may have felt upset almost all the time.

In a study highlighted by Science Direct, researchers found that a third of men with major depression had their symptoms only while they were drinking heavily. When these men stopped their drinking habits, their symptoms disappeared.

Stressed man with his hands on his head sitting on some steps

Research like this suggests that alcohol abuse is responsible for at least some episodes of depression.

WHAT ARE THE RISKS?

Depression is more than a fleeting bad mood. People with depression can feel isolated, helpless, and hopeless. They may need support from the people they love to get better, but their depression can make communicating with others difficult. Alcoholism can augment this problem.

People with a drinking problem can seem incredibly selfish, as they might:

  •  Spend family money on alcohol.
  •  Isolate themselves so they can drink.
  •  Say or do inappropriate things while drunk.
  •  Ruin family events or workplace gatherings due to drunkenness.
  •  Lose their jobs, wreck their cars, or cause the family other forms of financial distress.

All these issues can serve to make a family pull away from someone with alcoholism, and that can make feelings of isolation yet more extreme. People with depression are often incapable of thinking clearly, and in time, people with depression can be tempted to commit suicide to make the pain stop.

Alcohol can reduce inhibitions, and that can make the risk of suicide even more significant. While people without depression may realize that suicide is a permanent solution to a temporary problem, and it can cause intense harm to those left behind, people in the midst of depression may be unable to make that connection. Combining desperation with impulsivity can lead to disaster.

“According to the Arkansas Foundation for Medical Care Inc., about 75 percent of people who died by suicide had one or more drugs in their bodies. It’s clear that depression and alcoholism play a role in making this loss of life seem like a viable option.”

Arkansas Foundation for Medical Care Inc.

HOW DOCTORS SCREEN FOR DEPRESSION AND ALCOHOLISM 

When someone has symptoms of depression and alcoholism, doctors can do a great deal to make things better. Sometimes, they attempt to unravel which condition came first.

In an article published in Psychiatric Times, experts say they might look for these signs to determine that the depression came first:

  •  Feelings of depression that started before heavy drinking began
  •  Symptoms of depression that are severe
  •  Feelings of sadness that persist, even if the person stops drinking for a month

The authors of this article admit that this can be subjective and that some doctors cannot accurately predict which problem came first. There is no blood test or brain scan that can identify depression or separate it from alcoholism. But doctors do their part of understanding how the symptoms developed in their patients so that they will know what to do to help.

In the journal American Family Physician, experts also say they might ask their patients to describe how often they engage in episodes of binge drinking. Those who are attempting to regulate their mood might be likely to drink a great deal at once, and that could indicate that depression is playing a role.

Sources

(December 2013). Treatment of the Depressed Alcoholic Patient. Current Psychiatry Reports from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712746/

(September 2018). Evidence of Causal Effect of Major Depression on Alcohol Dependence: Findings from the Psychiatric Genomics Consortium. BioRxiv from https://www.biorxiv.org/content/early/2018/09/09/412098

(December 2018). Examining Co-Patterns of Depression and Alcohol Misuse in Emerging Adults Following University Graduation. Addictive Behaviors Reports from https://www.sciencedirect.com/science/article/pii/S235285321830052X

Co-Occurring Disorders and Depression. Mental Health America from http://www.mentalhealthamerica.net/conditions/co-occurring-disorders-and-depression

(November 2011). The Association Between Alcohol Dependence and Depression Before and After Treatment for Alcohol Dependence. International Scholarly Research Notices Psychiatry from https://www.hindawi.com/journals/isrn/2012/482802/

(February 2013). Alcohol Abusers’ Depression Often Related to Drinking. Science Daily from https://www.sciencedaily.com/releases/2013/02/130212075432.htm

(January 2016). Alcohol Worsens Depression; Depression Worsens Alcohol Abuse. AFMC from https://afmc.org/afmc-healthspot/alcohol-worsens-depression-depression-worsens-alcohol-abuse/

(June 2011). Comorbid Depression and Alcohol Dependence. Psychiatric Times from http://www.psychiatrictimes.com/major-depressive-disorder/comorbid-depression-and-alcohol-dependence/page/0/1

(May 2004). Routine Screening for Depression, Alcohol Problems, and Domestic Violence. American Family Physician from https://www.aafp.org/afp/2004/0515/p2421.html

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