Depression and Alcoholism

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Research scientists have known for quite some time that depression and alcoholism tend to occur together and that both disorders may occur in families. In fact, previous studies of adopted siblings and twins have suggested that there are genes in common underlying depression and alcoholism and that the two disorders seemingly take place in families.

Indeed, a family history of either depression or alcoholism puts an individual at increased risk for developing either illness.

Some Key Facts About Depression and Alcoholism

The following represents some key information that researchers have discovered about depression and alcoholism:

To relieve the pain of depression, some individuals resort to drugs or alcohol.
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.
Up to 40 per cent of people who drink excessively have symptoms that resemble "clinical depression."
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.
Psychotherapy alone is not recommended as the only treatment for severe depression or for bipolar (manic-depressive) illness.

Beer is the drink most commonly consumed by people stopped for alcohol-impaired driving or involved in alcohol-related crashes.

What is Depression?

image: teenager depressed over his alcoholic behavior Depression is a mental state typified by a despondent lack of activity and a pessimistic sense of inadequacy. When an individual is depressed, he or she usually feels helpless, exhausted, worthless, and hopeless.

It is important to point out that while "normal" depression is associated with any downturn in mood that might be relatively transitory and perhaps due to something trivial, "clinical depression," however, refers to symptoms that last two weeks or more and are so severe that they interfere with daily living and functioning.

Depression and Alcoholism: Symptoms

Alcoholism researchers have uncovered the fact that some of the factors that are involved in producing the symptoms of low mood, reduced appetite, poor sleep and anxiety characteristic of depression are also affected by alcohol. The following represents some of the key factors regarding the symptoms of depression and alcoholism:

The symptoms of depression in alcoholics are greatly reduced after three to four weeks of stopping alcohol intake.
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.
About 5 to 10 per cent of people with a depressive illness also have symptoms of alcoholism or alcohol abuse.
When depressive symptoms are secondary to alcoholism, they are likely to disappear within a few days or weeks of abstinence, as withdrawal symptoms decrease.
The depressive symptoms from alcohol are greatest when a person first stops drinking, so recovering alcoholics with a history of depression should be carefully monitored during the early stages of withdrawal.
If a drinker has never experienced alcohol problems, he or she will tend to not have symptoms of depression.
Among alcoholics entering treatment, about two-thirds have symptoms that resemble anxiety disorders.
The strongest correlation between alcoholism and severe anxiety symptoms occurs in the context of alcohol withdrawal.

Forty percent of ninth-grade students reported having consumed alcohol before they were age 13. In contrast, only 26.2 percent of ninth graders reported having smoked cigarettes, and 11.6 percent reported having used marijuana before they were age 13.

Depression and the Elderly

image: businessman upset over alcoholism-related depression Some people have the mistaken idea that it is normal for the elderly to feel depressed. Research, however, indicates that people who experience alcohol problems both before and after age 60 have the highest rates of depression. In fact, seniors who suffer from alcoholism and depression are at increased risk of suicide.

Due to the fact that depression and alcohol abuse are related to suicide, and given the high rate of suicide in older individuals, health care professionals as well as substance abuse treatment providers need to be sensitive to the presence of suicidal ideation in older clients. In short, clinicians must raise their awareness about depression and alcoholism as "problem areas" for older adults and they should not confuse these disorders with “normal aging.”

In the United States, roughly 50,000 cases of alcohol poisoning are reported each year, and approximately once every week, someone dies from this preventable condition.

Depression and Alcoholism: Suicide

Alcohol impairs judgment, which to a great extent explains its association with suicide. Moreover, due to the fact that alcohol abuse can exaggerate depression and increase impulsiveness, an individual 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 alcoholism or alcohol abuse receive prompt medical attention.

“Eye-openers” are common during the third stage of alcoholism. That is, drinks that are taken whenever the person awakens. Eye-openers are normally taken to lessen a hangover, calm the nerves, or to quiet their feelings of remorse the drinker experiences after a period of time without a drink.

Depression and Alcoholism: Treatment

Regrettably, many people, including health practitioners, tend to view depression and alcoholism as separate problems when in image: young lady depressed over husband's alcoholism fact, they are associated with one another. As a consequence, the positive relationship between depression and alcoholism or alcohol abuse definitely calls for a comprehensive approach to treatment. This means not only taking into consideration the treatment of depression - which can require anti-depressant medications and/or psychotherapy but also paying attention to the problem of alcohol. It is claimed that this type of wide-ranging treatment approach will help to 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 depression and bipolar illness and depressed individuals are at increased risk for alcoholism and alcohol abuse. According to some clinicians and researchers, therefore, the clinical assessment of current and past alcohol use and alcohol-related disorders should be considered a routine part of all psychiatric or medical evaluations.

Studies have shown that inpatient detoxification programs are more effective and longer lasting than outpatient detox programs. The important issue here, however, is the following: the more severe the alcohol-related withdrawal symptoms, the more likely that inpatient detox programs should be used.

image: nurse checking pulse of elderly alcoholic man In addition, all depressed patients should be frequently asked about their alcohol and drug use and abuse throughout the course of their treatment and advised to refrain from alcohol and drug abuse. Since relapse prevention is one of the most critical tasks in the management of depressed patients with a past history of alcoholism, it is important to maximize the chance of long-term sobriety in patients with depression.

In short, when alcohol abuse or alcoholism occurs with depression, both the substance abuse and the mood disorder demand professional treatment.

Lost productivity from alcohol-related absenteeism, illness and premature exiting of the workplace, due to death and forced retirement, amounts to more than $70 billion each year.

Famous People Who Had Depression

Abraham Lincoln is perhaps the most famous individual to successfully manage his depression. Another noteworthy person, Winston Churchill, the British Prime Minister, successfully coped with depression he referred to as his "black dog." Leaders in other fields like film (Woody Allen and Jim Carrey), television (Mike Wallace and Dick Cavett), sports (Terry Bradshaw) and any number of doctors, nurses, lawyers, scientists, and educators have coped with depression and moved forward to live highly successful and productive lives.

These "success stories" should offer hope to individuals who suffer from depression that this illness need not be a crippling blow to the ways in which they live their lives.

According to one study, alcohol use is a factor in 40% to 60% of auto accidents resulting in personal injury or death among American college students.

Depression and Alcoholism: Conclusion

Depression and alcoholism have a high comorbidity. Stated differently, depression and alcoholism occur in the same people at a image: young woman depressed over alcoholism of boyfriend rate higher than they would occur if both disorders were not linked. The "link" can be social, genetic, psychological, biological, or most likely a combination of these and other factors. If people can be made aware of the link between alcoholism and depression AND made aware of some great people in history who battled through depression and became very successful, some will be more able to deal with depression without resorting to alcohol abuse.

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

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The following represents mild to moderate physical withdrawal symptoms that typically occur within 6 to 48 hours after the last alcoholic drink: enlarged or dilated pupils, pulsating headaches, tremor of the hands, loss of appetite, vomiting, clammy skin, abnormal movements, sweating (especially on the palms of the hands or on the face), rapid heart rate, looking pale, involuntary movements of the eyelids, sleeping difficulties, and nausea.

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