The Link Between Alcoholism and Depression
Do you have a friend or loved one who is suffering from depression and who you suspect is also misusing alcohol? If so, you are not alone. Alcohol use disorder often occurs in conjunction with depression. Additionally, the two issues can feed off each other, creating a cycle that can be increasingly problematic if it is not addressed and treated.
The good news, however, is that because this is a common problem, treatment options are well examined, and options are available that have been known to provide real help and improvement. The downside is that it may take a lifelong commitment. Both time and effort are required to overcome these issues.
However, for those who want to overcome the burdens of alcohol use disorder and depression, help is available that can help them go on to lead healthy, happy, and productive lives. At BlueCrest Recovery Centers, our mission is to help people with substance use disorders become and stay sober.
What Is the Impact of Alcohol on the Body?
Many people like an occasional drink. And even though any amount of alcohol impacts the body, in moderation, it is socially acceptable and not necessarily unhealthy. However, for those with alcohol use disorders, even one drink is too much. Since their bodies develop a craving for alcohol, they can easily drink enough to cause serious medical issues.
Here are some of the ramifications of overconsumption of alcohol on a regular basis:
• Brain: Alcohol can disrupt the pathways in the brain, which can affect mood, behavior, cognitive ability, balance, and coordination.
• Heart: Over time, drinking too much can cause cardiomyopathy, arrhythmias, stroke, and high blood pressure.
• Liver: Heavy drinking can cause liver inflammation and various conditions from hepatitis to cirrhosis.
• Pancreas: Alcohol induces the pancreas to produce toxic substances.
• Cancer: Alcohol can increase your risk for many types of cancer. The more a person drinks, particularly if he or she does so on a regular basis, the greater the risk of cancer death.
There are also effects on the immune system. Chronic drinkers are more likely to become sick with diseases like pneumonia.
What About Depression?
Most of us have felt sad. People might say they feel depressed, but that doesn’t mean they are clinically depressed.
What Is Clinical Depression?
Major depressive disorder, also classified as clinical depression, is a mood disorder that affects not only how a person feels but also how they think and behave. It can also have physical ramifications. The individual may not be able to function and may feel suicidal.
Depression is surprisingly common. Over 300 million people worldwide experience it every year.
Clients who are depressed should not blame themselves or feel there is no hope. Admonitions to “snap out of it” are not appropriate as depression has a clinical cause. It requires long-term treatment. Fortunately, most people respond well when provided with the appropriate treatment.
Risk factors that can play a role in clinical depression include:
• Genetics: A family history of depression can indicate a risk factor.
• Biological factors and illness: Those suffering from serious illnesses or chronic conditions such as diabetes, heart disease, or cancer can be at higher risk for depression. So can those who have a brain imbalance such that their levels of neurotransmitters are off.
• Stress and trauma: This is particularly true of childhood events that are traumatic.
• Certain medications: Some medications have side effects that can increase the likelihood of depression.
• Low socioeconomic status: This is a risk factor particularly early in life.
• Addiction issues: Alcohol and drugs can increase the possibility of depression.
Types of Depression
There are different forms that clinical depression can take. These include:
• Major depressive disorder: Must be present for a minimum of two weeks for a diagnosis.
• Persistent depressive disorder: While the symptoms are less severe, they last longer.
• Postpartum depression: This is a type of depression that occurs after giving birth.
• Seasonal affective disorder: This is depression caused by changing seasons. It usually occurs in winter when there is less sunlight.
• Psychotic depression: This includes hallucinations and delusions.
• Bipolar disorder: During one phase of this disorder, the person experiences irritability and low moods that would qualify as a major depressive disorder.
• Medication or substance-induced depression: Medications and other substances such as alcohol or drugs can cause depression.
Symptoms Indicating Depression
Typically, a diagnosis is not made unless a person shows symptoms for at least two weeks. Even though there are several types of depression, they tend to show the same types of symptoms:
• Constant low mood, feelings of sadness, or anxiety
• Feelings of hopelessness or pessimism
• Irritability, frustration, or restlessness
• Feeling guilty, worthless, or helpless
• Losing interest in activities that were once enjoyed
• Constant fatigue
• Moving or talking slower than usual
• Difficulty thinking, remembering, or making decisions
• Changes in sleep, such as trouble falling or staying asleep (insomnia) or sleeping more than usual (hypersomnia)
• Significant weight loss or weight gain
• Having thoughts of suicide
• Aches, pains, headaches, cramps, or digestive problems that aren’t easily explainable and do not improve with treatment
The Connection Between Alcohol and Depression
Research has shown that alcoholism and depression can coexist. In fact, alcohol use disorder, or AUD, can lead to depression, and depression can lead to an alcohol use disorder. These two disorders have the dubious honor of being two of the most common disorders and do, indeed, often coexist.
While each client’s situation is unique, there are common factors. Often when a person suffers from a depressive disorder, he or she self-medicates with alcohol. There are reasons why this provides short-term relief. Alcohol initially provides a burst of energy. It also may temporarily reduce anxiety, help someone feel more social, and lower inhibitions.
Unfortunately for the person who uses this strategy to feel better about themselves, alcohol is actually a psychotropic depressant that affects the central nervous system. It can have a strong neurological impact. Studies indicate that alcohol directly affects several neurotransmitters. One of those affected includes gamma-aminobutyric acid (GABA), which has a negative impact on the hippocampus. Alcohol also has an indirect effect on the limbic and opioid systems. Thanks to the multiple ways in which alcohol impacts the central nervous system, it can cause depression, memory problems, and other issues.
While some people are genetically susceptible to both AUD and depressive disorders, it is more likely that someone who is depressed turns to alcohol. At first, it relieves the symptoms the person is experiencing, but over time, they become dependent on alcohol.
Studies show that young military veterans, for example, are likely to use alcohol to treat PTSD symptoms and depression. Women with depression are more likely to turn to binge drinking, and individuals who were depressed as children are also at risk for AUD later in life.
AUD and depressive disorders, in particular major depressive disorder and persistent depressive disorder, when they occur in conjunction, generally express with greater severity and have a statistically worse prognosis than either disorder alone. This includes a heightened risk for suicidal behavior. Despite the severity of the issue, modern treatment modalities can be very effective.
Is There a Causal Link Between Alcohol and Depression?
Studies reveal that there is a causal relationship between AUD and depression; however, it is more common for AUD to lead to depression than vice versa. Alcohol is often the culprit when someone starts to show symptoms of depression. It may also make these symptoms worse. If the depressive symptoms are caused by alcohol, they may cease once the person is sober. However, sometimes substance-induced depression may become an independent problem, and the person will continue to be depressed even after he or she ceases to consume alcohol.
Even worse, alcohol can make depression worse and make it harder to recover from depression. While the worst outcomes occurred with those who were heavy drinkers, even those who only regularly consumed moderate or even mild quantities of alcohol had symptoms of worsening depression. There is some conjecture that AUDs are more prevalent in the population than we might be aware of simply due to the prevalence of depression.
How Long Does Depression Caused by Alcohol Last?
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The duration of depression caused by alcohol is not a set figure. When someone abstains from alcohol, then their depression symptoms will start to improve. For most individuals, a three-to-four-week timeframe is adequate to show improvement in symptoms. Unfortunately, in some cases, independent depression has occurred, and stopping the consumption of alcohol, while providing many other benefits, will not cure the depression.
Treatment Options
For those who are suffering from both AUD and depression, an integrated approach is called for. Fortunately, modern treatment methods focus on holistic modalities that can address both issues. Below we’ll discuss some of the components that make up a treatment plan for co-occurring AUD and depression.
Detox
As with any substance use disorder, effective treatment is not possible while someone is continuing to use that substance. Unfortunately, for most people dealing with AUD, the withdrawal will occur when they stop taking it. The reason clients experience withdrawal is that their central nervous system has adjusted to alcohol exposure. It takes time for the body and brain to adjust to the lack of alcohol.
This leads to withdrawal symptoms that may range from mild to serious. These may show up just six hours after the client took their last drink.
Symptoms can include anxiety, headaches, nausea, tremors, vomiting, insomnia, and sweating. Over time, other symptoms occur. After 12 to 48 hours, hallucinations and seizures may occur, and after 48 hours, there may be delirium tremens, as well as vivid hallucinations and delusions. These can last until about 72 hours after the person’s last drink. Fortunately, only a small percentage of people experience the worst symptoms. However, because of the risks involved, someone who is detoxing should only do so under medical supervision. At a treatment center, not only will clients have the medical care they need, but the center will also provide an atmosphere that will ease them through the detox by having soft lighting, healthy food and lots of fluids, and a supportive environment.
Medications
Clients suffering from both AUD and depression often require medication for the depression. They may be given antidepressants. They may also be given medications that help them to avoid drinking.
Behavioral Therapy
There are several different types of behavioral therapies that can work in conjunction or individually to help a client overcome both AUD and depression. These include the following.
Cognitive-Behavioral Therapy (CBT)
Often, those with AUD and depression have thoughts and behavioral patterns that direct them toward drinking and other behaviors that exacerbate their problems. This modality of therapy helps clients to learn positive coping mechanisms so they can replace their prior patterns of thought and behavior.
Dialectical Behavior Therapy (DBT)
DBT is a modification of CBT that focuses on developing healthy ways to cope with stress as well as regulating emotions and improving personal relationships. It uses techniques that help clients develop mindfulness skills. Mindfulness allows people to live more in the moment and pay attention to their senses to become more attuned to their environment. It is particularly helpful for those who have suicidal thoughts as it can help them cope with emotional pain.
Behavioral Activation
This type of therapy helps with both AUD and depression. The client develops a better understanding of how their negative past experiences and behaviors have influenced their emotions and moods. An active approach is encouraged so that the client can have more positive experiences.
Mutual Support Groups
Whether traditional 12-step groups or alternatives, groups are often an important part of recovery. They fill a void that may be left after a client is discharged from a treatment center.
As you can see, there is a long process that can take you from a place of dependence and sadness to a place of hope, healing, and happiness. For those who are committed to the process, no matter how bad your current situation, a full recovery is possible with help from a treatment facility like BlueCrest Recovery Center.