Alcohol Use, Abuse, and Depression: Is There a Connection?

A number of studies have found evidence of a persistent association between alcohol use disorders and major depression, even after controlling for confounding factors [14, 15]. Both depression and alcohol use disorder are treatable medical conditions. Some people may feel unsure about seeing a doctor, but the right treatment can ease symptoms and help a person live a better, happier life. On the other hand, Pettinati et al. illustrated that a combination of sertraline, an SSRI, with naltrexone as a treatment for alcohol dependence would result in higher alcohol discontinuation rates and a significant reduction in depression symptoms, with acceptable incidence of side effects [22]. As for depression co-existing with SUD, opioids were the most commonly studied agents. Brenner et al. showed that substance abuse could lead to a doubled risk of treatment-resistant depression than non-abusers.

Treatment for Depression and AUD

The disorder often develops when individuals are in either their twenties or thirties. Similarly, major anxiety disorders usually are apparent before age 30, and although major depressive disorders often have a later onset, they too are frequently observed before age 30. Although these studies raise important questions, researchers cannot draw definitive conclusions about the association between alcoholism and psychiatric disorders alcohol and depression for a number of reasons. The major problem encountered in these studies involved the use of research methods that failed to address several important issues that might have explained the observed relationships (Allan 1995; Schuckit and Hesselbrock 1994). Specifically, some studies focused on drinking patterns rather than on alcohol dependence or described mood/anxiety symptoms rather than true psychiatric disorders.

Depression and Alcohol Use Disorder: Are They Connected?

• The “burst” of energy from alcohol can be a welcome relief against some symptoms.
• Some data are also available on stimulant agents and benzodiazepines [6].
• You don’t have to battle the depression alone and relying on alcohol to make you feel better will only cause further pain.
• Adults who met criteria for alcohol use disorders also had a higher risk for depression.
• Having an extra drink or two once in a while doesn’t automatically translate to heavy drinking.

Finally, the etiology, course, and treatment of both AUD and depression differ substantially by gender. Women have been underrepresented in much of the research on co-occurring AUD and depressive disorders, particularly in the early research on this topic. The research needs more representation of women to increase understanding of the sex differences and to better characterize the mechanisms underlying women’s heightened vulnerability for depressive disorders. These populations experience disparities in access to care for AUD and depressive disorders but are underrepresented in studies of these disorders.

Treatment of Co-Occurring AUD and Depressive Disorders

Both the P.I and the CBHW reports on the drinking status of the participants were compiled weekly. Any discrepancy between the two structured reports was confirmed by a home visit by the CBHW. https://ecosoberhouse.com/ Several studies, including a 2013 study that used a nationally representative sample, have found that people who drink to manage a psychiatric condition are more likely to abuse alcohol.

Major Depressive Disorder (MDD)

• According to Kennedy, for those taking antidepressants, combining them with alcohol can reduce their efficacy.
• If you have a mental disorder, like depression, schizophrenia, anxiety, or bipolar disorder, it’s common to have trouble with substances including alcohol.
• It can affect many aspects of a person’s life and can even be debilitating.
• Depression can also be directly caused by alcohol in the case of a substance-induced disorder.
• Majority (60.5%) of the participants had begun drinking alcohol before the age of 18years, with the mean AUDIT score being 28.6 for male and 26.6 for females.

If you tend to rely on alcohol to ease anxiety in social situations, for example, you might never address the underlying causes of your discomfort. Namely, it interferes with the release of neurotransmitters linked to mood regulation, including serotonin and norepinephrine. Being around others who are experiencing the same challenges can help you feel connected and reduce feelings of isolation. You might also want to consider natural supplements such as tyrosine, 5-HTP, and ashwagandha to help rebalance your brain’s neurotransmitters.

Relieving depression linked to drinking

In addition it may explain why antidepressants have been shown to moderately benefit patients with both depression and alcohol use disorders [7]. Fortunately, several important ongoing studies will help answer some remaining questions regarding the treatment of coexisting depressive or anxiety disorders in the context of alcoholism. The COGA investigation will gather more data regarding potential alcoholic subtypes and will continue to explore possible genetic linkages between alcohol dependence and major depressive and major anxiety disorders. Certain ongoing treatment studies also are further evaluating the potential usefulness of buspirone, some specific anti-depressants, and other medications that affect brain chemicals as potential components for treating alcoholism.

This may imply that depression in alcohol dependence is as a result of effects of chronic alcohol intoxication and is related to the recent episode of drinking. Most clinicians and researchers would agree that alcoholics experience high rates of anxiety and depressive symptoms and that these problems must be addressed early in treatment (Brady and Lydiard 1993). Increased debate, however, has focused on whether the depressive and anxiety disorders precipitated the patients’ alcoholism—in which case, longer term intensive treatments aimed at these psychiatric conditions might be required to ensure the optimum chance of recovery from alcoholism. Disagreement also exists about whether longer term independent treatment for depressive or anxiety diagnoses is required for the alcoholic person to achieve a normal level of life functioning. As previously mentioned, it is possible that many depressed or anxious alcoholics demonstrate mood or nervousness conditions caused by intoxication or withdrawal from alcohol; these psychiatric states are likely to improve markedly during the first several weeks to 1 month of abstinence. Thus, long-term psychiatric treatment does not appear to be required for alcohol-induced psychiatric conditions to be resolved (Brown and Schuckit 1988; Schuckit and Hesselbrock 1994).

The prevalence of depression at intake before detoxification was 63.8% (120 participants). Three participants were referred for treatment of major depression within the period of the study. Furthermore, in a large study by Albrecht et al., the risk of traumatic brain injury was evaluated in patients with alcohol dependence and depression. The study showed that females, patients with anxiety, or those with Alzheimer’s disease were at a higher risk of traumatic brain injury.

Stick to moderate drinking

People may turn to alcohol as a way to cope with mood problems, but drinking alcohol can also contribute to symptoms of depression. Alcohol use can also affect how antidepressants work, which can affect depression treatment. An alcohol-dependent person who demonstrates such psychological symptoms needs more intense intervention and support than may otherwise be provided, and if not appropriately treated, the symptoms may carry a worse prognosis for alcohol-related problems. High levels of depression are especially worthy of concern, because the risk of death by suicide among alcoholics, estimated to be 10 percent or higher, may be most acute during these depressed states. In fact, people who are depressed often find that cutting out alcohol entirely for just four weeks makes a clear difference in how they feel.15,16 It’s important to keep it up in the longer-term too – because the drinking and depression are linked, going back to high risk drinking can bring the symptoms back. The data pertaining to the combination of antidepressants and either disulfiram or acamprosate with the specific intent to treat co-occurring AUD and depressive symptoms is even more limited, with no data available to support or refute these particular treatment approaches.

A better understanding of the heterogeneity within this population will inform more personalized treatment approaches and might ultimately improve treatment response. In summary, none of the three types of studies conducted (i.e., family studies, prospective investigations, and studies involving COA’s) proves an absence of a relationship between long-term anxiety or depressive disorders and alcoholism. As briefly discussed earlier in this article, the family studies are far from definitive because of difficulties in the methodologies used. It is also important to remember that some studies indicate a potential relationship between alcoholism and anxiety/ depressive disorders. In addition, alcoholism and these psychiatric disorders may operate together within some families, or individual instances may occur whereby a person develops alcoholism as a direct reflection of a preexisting psychiatric syndrome.