Why are alcohol and depression so commonly linked?

By: Tom Scheve

If you're diagnosed with either alcohol abuse or depression, you have a higher chance of being diagnosed with the other.
©iStockphoto.com/CaroleGomez

Alcohol abuse or dependence, a physical addiction, often acts as co-pilot with at least one mental health disorder, so it's little surprise that people experiencing problems with alcohol are more likely to also experience depression [source: Nurnberger]. Studies have found that if you're diagnosed with either alcohol abuse or depression, you have a higher chance of being diagnosed with the other [source: Harvard Health Publications].

When the two coexist, it presents a "chicken or the egg" scenario: Which came first? And if there's not a causal effect, are the two genetically linked? These are questions researchers, substance-abuse specialists and mental-health professionals are getting closer to answering.

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Depression and alcohol abuse are similar in that each is more likely to occur in people who have a family history of the condition. When an individual has both conditions, it's also likely there's a genetic history of the combination [source: Nurnberger].

Depression -- or, more formally, "major depression" -- is an extended period during which a person feels overwhelmed by sadness, despair, hopelessness or anger in such a way that it interrupts the normal functioning of life [source: U.S. National Library of Medicine]. A common theory has been that people dealing with depression may self-medicate by abusing alcohol. In fact, a study conducted by the Harvard School of Public Health has shown that symptoms of depression were a precursor to alcohol dependence [US No Drugs].

If you're dealing with the loss of a family member, for instance, the immediate escape offered by alcohol would seem appealing. However, there's a price to pay for the alcohol-induced feelings of euphoria: dysphoria, the sense of anxiety, malaise and restlessness that so often occur the following day. If you again seek out the solace offered by intoxication, it creates a repeating cycle of self-induced highs and lows.

In some cases, increased alcohol use may be an attempt to secure a night's sleep, since insomnia is a symptom of depression. However, sleeping while intoxicated actually disturbs the normal sleep cycle, resulting in less effective and fulfilling sleep [Doghramji].

Depression and alcohol abuse are a dangerous combination. When a person feels life is not worth living, and then consumes a depressant that hinders good decision-making, it can lead to risky behaviors and even suicide.

But what if it's the other way around? What if alcohol abuse is the cause of depression, and not the effect? We'll consider that in the next section.

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Does Alcohol Cause Depression?

Recent studies suggest that while depression may lead to increased alcohol abuse, the reverse is actually more common [source: Anderson]. The 1996 U.S. National Comorbidity Survey found that nearly one in three respondents who had alcohol dependence also had a mood disorder such as major depression, and those with alcohol dependence were almost four times more likely to have had a major depressive disorder in the year prior to the survey [source: Petrakis].

This may occur because alcohol alters the way certain neurotransmitters work in the brain [source: Anderson]. But researchers say it's more likely that alcohol abuse simply wreaks havoc in one's life, and the fallout -- losing one's job, relationship troubles, legal problems -- prompts depressive episodes.

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Let's say, without previous symptoms of depression, you began drinking to excess twice every week. That would mean two nights of poor sleep, and two days of feeling physically ill due to a hangover, as well as anxious or guilty feelings resulting from alcohol-related dysphoria. Perhaps your alcohol abuse creates financial insecurity, as a result of poor decisions you've made while under the influence, along with legal troubles, such as a D.W.I. offense. When abusing alcohol, you're more likely to hurt yourself, and you might also experience diminished cardiovascular health, poor diet and low energy. Friendships and relationships may be damaged, your reputation harmed. After a year of this, the results of those twice-weekly bouts of heavy drinking would practically double as the symptoms of depression.

In these cases, treating alcohol abuse or dependence might also effectively treat depression -- or, rather, it would eliminate the need to treat depression because the underlying cause -- alcohol abuse -- would no longer exist [source: Anderson].

However, the reverse isn't necessarily true. In other words, treating major depression may not affect problems with alcohol abuse.

Some patients might try taking a selective serotonin reuptake inhibitor (SSRI), such as sertraline, which in some cases serves as an effective pharmaceutical treatment for both depression and alcohol abuse [source: Misra]. For others, counseling alone -- or participation in a 12-step program like Alcoholics Anonymous (AA) -- may be the best option. For many, some mix of ongoing counseling and medication is most effective.

To learn more about the effects of alcohol abuse and depression, read on to the next page.

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Lots More Information

Related Articles

  • Anderson, Pauline. "Causal Relationship Between Alcohol and Depression May Start with Alcohol Abuse." Medscape Medical News. Mar. 10, 2009. (Jan. 20, 2012) http://www.medscape.com/viewarticle/589338
  • Chang, Louise. "Alcohol and Depression." May 18, 2009. (Jan. 20, 2012) http://www.webmd.com/depression/alcohol-and-depresssion
  • Doghramji, Karl, M.D. "The Effects of Alcohol on Sleep." (Jan. 25, 2012) http://www.medscape.org/viewarticle/497982
  • Gilman, S.E. "A longitudinal study of the order of onset of alcohol dependence and major depression." Aug. 1, 2001. (Jan. 20, 2012) http://www.ncbi.nlm.nih.gov/pubmed/11418232
  • Halverson, Jerry L., M.D. "Depression." Dec. 29, 2011. (Jan. 20, 2012) http://emedicine.medscape.com/article/286759-overview
  • Harvard Health Publications. "Treating depression along with alcohol dependence." July 1, 2010. (Jan. 20, 2012) http://harvardpartnersinternational.staywellsolutionsonline.com/HealthNewsLetters/69,M0710d
  • Massachusetts General Hospital. "Attendance at Alcoholics Anonymous meetings may reduce depression symptoms." Jan. 28, 2010. (Jan. 20, 2012) http://www.massgeneral.org/about/pressrelease.aspx?id=1200
  • Merikangas, K.R. "Comorbidity for alcoholism and depression." The Psychiatric Clinics of North America. Dec., 1990. (Jan. 20, 2012) http://www.ncbi.nlm.nih.gov/pubmed/2281009
  • Misra, Achal, M.D. "How common is depression in people with alcohol problems?" Sept. 22, 2010. (Jan. 20, 2012) http://www.netdoctor.co.uk/diseases/depression/alcoholanddepression_000486.htm
  • Nauert, Rick, Ph.D. "Treat Alcoholism and Depression Together." Mar. 18, 2010. (Jan. 20, 2012) http://psychcentral.com/news/2010/03/18/treat-alcoholism-and-depression-together/12231.html
  • Nurnberger, John L. Jr., M.D., Ph.D. "Is There a Genetic Relationship Between Alcoholism and Depression?" National Institute on Alcohol Abuse and Alcoholism. June 2003. (Jan. 20, 2012) http://pubs.niaaa.nih.gov/publications/arh26-3/233-240.htm
  • Petrakis, Ismene L., M.D. "Comorbidity of Alcoholism and Psychiatric Disorders." Alcohol Research & Health. 2002. (Jan. 20, 2012) http://pubs.niaaa.nih.gov/publications/arh26-2/81-89.pdf
  • U.S. National Library of Medicine. "Major depression." Mar. 15, 2011. (Jan. 20, 2012) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001941/
  • US No Drugs. "Alcoholism and depression." (Jan. 20, 2012) http://www.usnodrugs.com/alcoholism-and-depression.htm

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