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Alcoholism and depressionA significant number of those who experience alcoholism will also suffer from depression.

We feel it fair to say that there is a strong causal link between alcoholism and depression.

However, it may be difficult to determine which condition arose first.

In some cases, you may drink alcohol to self-medicate the symptoms of depression, whilst in others, it’s possible that your depression might have arisen due to your drinking. Alcohol is a depressant after all.

No matter which condition arose first, it’s important to correctly diagnose these co-occurring conditions before alcoholism treatment is embarked upon. This ensures you are treated for both conditions simultaneously for maximum effectiveness.

The link between depression & alcoholism

The causal link between alcohol and depression is well established. It’s possible that you drink alcohol merely to stop feeling depressed, whilst others may develop depression as a direct result of their drinking.

Studies indicate that those who suffer from depression are twice more likely to also experience alcoholism.

Before your alcoholism treatment begins, the assessing doctor will help to determine which condition arose first. A robust treatment plan will then be designed to ensure both conditions are treated at the same time.

How Alcohol Changes Your Brain Chemistry

Any drug or substance that changes your brain chemistry can almost always fit into one of two main categories: depressants or stimulants. Depressants are substances that slow down or reduce the functioning of the nervous system.

These substances are known to relax you, but they can also worsen systems of depression. On the other hand, stimulants are substances that excite the nervous system. Stimulants make you feel more energetic, alert, and can improve your mood.

Today, it is common knowledge that alcohol has many qualities of a depressant, but it does not fit solely into that category. When alcohol first enters the system, it acts more as a stimulant.

Alcohol triggers an increase in neurotransmitters associated with positive emotions such as dopamine as it enters the bloodstream.

Due to this increase, people have a greater sense of pleasure and feel freer to “let go” and have fun. This is why so many people believe self-medicating with alcohol works.

Unfortunately, the positive effects stop before long, and as soon as someone stops drinking and their blood alcohol content begins to decrease, the depressive qualities start to kick in.

Alcohol lowers the functionality of neurotransmitters that regulate energy, causing your overall energy level to drop, but this alone does not necessarily make depression worse. Alcohol also has the ability to mimic GABA, an inhibitory neurotransmitter.

This means that it can bind to GABA receptors and stop (or inhibit) signalling between neurons. These two things combined results in an increase of depression symptoms and an overall worse mood. People will then want to feel good again, so they end up drinking again.

Alcoholism Rooted in Self Medicating

Whether someone is just grabbing a drink at the end of a particularly bad day or suffers from a mental disorder, the most common reason given for drinking is ‘to take the edge off.’ In other words, they are trying to feel better. And the truth is, at least at first, it does.

While this may be an okay choice for some people, for others, it is a slippery slope that can lead to drinking copious amounts of alcohol regularly. The later is considerably more likely to happen to those who suffer from MD (major depression), which makes every day feel like a bad one.

The more people suffering from AUD (alcohol use disorder) drink, the more they feel they have to drink. Eventually, they start to build up a tolerance and have to drink larger amounts to successfully ‘take the edge off’ and achieve the pleasure they are seeking.

At this point, most alcoholics feel as if they cannot stop because it is the only thing in their lives that gives them relief from the symptoms of their depression or other mental disorder.

This can be true even if they do not realise they are suffering from depression, which they often do not.

It is usually not until the fear of drinking outweighs or at least equates to the fear of not drinking that someone will stop self-medicating. When an alcoholic wants to get sober and seeks treatment themselves, they are more likely to be successful.

When they get sober, no matter what treatment method they use, they can work to recognise if they were self-medicating and start to treat the underlying mental disorders healthily.

Understanding Alcohol Dependency

It is easy to become dependent on alcohol and not even realise it. The more people turn to alcohol, the more their body develops a tolerance to it, and the more of it they have to drink to get the effect they are seeking.

As tolerance develops, usually, so does the dependency, and the challenge of getting sober becomes increasingly more difficult.

So what exactly is a dependency? Dependency is when a person shifts from wanting a drink or choosing to have a drink every once in a while to feeling an intense urge or need to have one.

If anyone feels they need any substance, that is not required for survival, to feel good or function, they are dependent on that substance. Furthermore, when that need or desire for alcohol take precedence over relationships and work, the person is dependent on it.

At the point of dependency, recovery becomes so much more difficult because the person is less likely to want to give it up, will often feel like they cannot give it up, and will most likely experience withdrawal if they try to stop.

Often the physical and emotional turmoil of withdrawal stops someone from getting sober.

Understanding depression

Depression is described as ‘a low mood that lasts for a long time, affecting your everyday activities’. This definition of depression was offered by the mental health charity MIND.

Whilst it is perfectly normal to experience bouts of unhappiness, it’s not normal to feel like this for more than a few days. If you feel immensely unhappy for more than a few days, you could be suffering from clinical depression.

Depression has the potential to have a significantly detrimental impact on your everyday life.

It’s thus not difficult to understand why so many people who suffer from depression ultimately begin to self-medicate with alcohol or other substances.

Doing so often provides these people with a means of escaping their current reality that’s tearing them apart from the inside.

The signs and symptoms of depression

Depression may bring a combination of both mental and physical symptoms. The severity of these symptoms is influenced by the type of depression you are experiencing. We shall discuss types of depression below.

Psychological symptoms caused by depression include:

  • Low self-esteem
  • An inability to experience joy and happiness
  • Feel hopeless
  • Loss of interest in hobbies or activities
  • Feeling guilty
  • Feeling worried or anxiety
  • Suicidal ideation

Physical symptoms caused by depression include:

  • Constipation
  • Low energy
  • Loss of appetite
  • Aches and pains
  • Menstrual problems
  • Sleeping problems

The main types of depression

There are many forms of depression and we shall outline the most common forms of depression below:

  • Chronic depression: this is when you feel depressed for two or more years. Chronic depression is typically mild in nature. However, because of the long-term nature of chronic depression, it typically has a negative impact on your life. Another name for chronic depression is persistent depression disorder
  • Major depression disorder (MDD): this is the most common form of depression. MDD is characterised by feelings of unhappiness and sadness. For MDD to be diagnosed, you must continue to feel unhappy for more than two weeks. Your GP may recommend you take a short-term prescription of anti-depressants
  • Bipolar disorder: this disorder is characterised by severe mood swings
  • Post-natal depression: this occurs following the birth of a child. Giving birth is overwhelming and this overwhelm may cause some women to feel depressed. It’s believed that around 20% of all women will experience some form of mental health issue following childbirth

The AUD/MD Cycle

There are two ways that the cycle between alcohol abuse disorder and major depressive disorder can happen. It is a debate amongst researchers which one is more likely, but no matter which one someone experiences, it can be tough to get out of it.

The first possibility is that the cycle starts with MD. A person will develop major depression first and then discover that in the short run, drinking alcohol takes the edge off of their disorder/what they are feeling.

Unfortunately, when they turn to alcohol because it seems to make them feel better, their depressive symptoms will end up worsening because of how alcohol affects the inhibitory neurotransmitters like GABA.

When their depression symptoms worsen, they will turn back to drinking to seek the pleasurable/happy feelings they felt at first.

Eventually, they will start to depend on the alcohol to make them feel better (even just for a little while), and thus, they will develop AUD.

The MD results in the AUD, which makes the MD worse, which in turn makes the person turn more towards alcohol, develop more severe AUD, and the cycle continues like that—usually, until they hit rock bottom and want help.

The other possibility is that the cycle starts with AUD. According to certain researchers, people are more likely to develop an alcohol use disorder first.

They try alcohol, and their bodies and minds become addicted to the substance and its effects.

Unfortunately, along with the positive effects they feel, they are more likely to go through a depressive episode and develop MD.

When the person develops MD, they turn more and more to alcohol to avoid the negative feelings, and their AUD worsens. Of course, the vicious cycle continues back and forth, one disorder worsening, and then the next, until they seek help for themselves.

Common myths about depression

Unfortunately, depression is still largely stigmatised and much misinformation surrounds this often-serious mental health condition.

Below, we list some of the misguided beliefs that empower the stigma surrounding depression:

  • You must be weak if you suffer from depression: in reality, depression is an illness that has the potential to affect anyone no matter how tough or weak they perceive themselves to be. The occurrence of depression does not correlate with character
  • You must have reasons to be depressed: if you have ever experience from depression, close friends or family members may say ‘you have absolutely no reason to be depressed.’ They may even cite examples of people who are worse off than you. This line of reasoning is misguided because you do not need any reason for feeling depressed. Listening to this poor advice will only serve to make you feel even more depressed and perhaps guilty too. Whilst it’s true that you could have an obvious reason for feeling depressed, such as the loss of a loved one, it’s equally true that you may feel depressed without being able to pin down a specific reason for being so
  • You must have suffered a traumatic experience to be depressed: people often equate depression with those who have experienced a traumatic event such as a vehicle collision, child abuse or the loss of a loved one. Whilst these traumatic events are known to cause depression, it’s equally true that you could experience depression without experiencing any sort of traumatic event

The role of antidepressants

Antidepressants definitely play a major role in treating depression, but you must not use medications as a crutch. If you suffer from alcoholism, it’s important to understand that alcoholism is itself a depressant.

It, therefore, does not make logical sense for you to consume an antidepressant if you also consume a depressant simultaneously. A much better idea is to treat the alcoholism before you look to tackle the underlying depression.

Whilst antidepressants may be effective for treating depression for many, not everybody will benefit from their use. If your antidepressants are not working, your GP may be able to increase your dose.

It may take up to two months before the symptoms of depression begin to improve whilst taking antidepressants.

Further, it’s always a good idea to analyse your life and look at ways of promoting your happiness in natural ways such as taking up a hobby or some form of physical activity.

Can alcohol aggravate the symptoms of depression?

Many people suffering from alcoholism began to drink as a means of self-medicating the symptoms of depression.

Whilst alcohol may temporarily relieve the symptoms of depression, these symptoms will rebound as the effects of alcohol wear off. Thus, you must continuously drink alcohol in order to alter your reality in this way.

This psychological addiction to alcohol will eventually develop into a physical dependency. This is because alcohol is itself a physically addictive substance if abused on a daily basis. In the end, the pain caused by alcohol will certainly outstrip any benefits you could possibly derive from its consumption.

The Physical Dangers of Excessive Drinking

The dangers of drinking can be divided up into several categories. The first of which is the physical dangers while the alcohol is actually in the person’s system.

During this time, someone may have vision and hearing problems along with memory issues as their brain is not functioning and processing as well as it does when sober.

They also may have a delayed reaction time and poor decision-making skills. While these symptoms may not be dangerous alone, they can be very dangerous depending on what decisions the person makes (such as getting behind the wheel.)

Next is the dangers, or discomforts, that someone can experience after the alcohol leaves their system (usually the next morning.) These symptoms are known as a hangover.

A hangover can include nausea, headaches, dizziness, fatigue, extreme thirst, sensitivity to light, and many other unpleasant symptoms. A hangover is not usually dangerous in the long-term.

The final category is the long term effects that come with excessive drinking. First, drinking too much can lead to nerve damage that results in a loss of balance, inability to walk well, failure to sense things, and even dementia.

Next, one of the more commonly known dangers is liver damage. Because the liver is where most of the alcohol gets processed, breaking down all the toxins can cause severe damage.

If liver disease is not stopped or fixed (it can be hard to get a transplant as an alcoholic,) it can lead to death.

Furthermore, alcohol can raise blood pressure and cause someone’s heart to beat faster, which increases the likelihood that they will have a heart attack or stroke.

Additionally, excessive alcohol can increase the chances someone will get cancer, cause severe damage to the digestive system, and even result in infertility.

How to Avoid Self Medicating With Alcohol

First of all, before you start to drink, be honest with yourself why you are drinking.

If your answer is to ‘take the edge off’ or make yourself feel better, you should reconsider and find something else to do as drinking will make you feel worse in the long run.

Of course, there are other activities you can try to help cope with a bad day or bad feelings (and they do not worsen your feelings in the long term.)

There are techniques such as exercise, yoga, meditative breathing, and meditation that can refocus you and improve your mood.

It is understandable if there are times when techniques and coping mechanisms are not enough.

At that point, the best course of action is to talk it out with someone. You can talk to a friend, mentor, or go see a therapist.

Sometimes, getting the feelings and thoughts out is enough to improve your mood enough to make alcohol feel less like a necessity.

The best way to avoid self-medicating with alcohol is to limit yourself (even when you are in a good mood) or avoid it altogether (a good option if you are in a bad mood or struggle with mental illness.)

Of course, you can use the above methods to turn away from alcohol even if you have started self-medicating. It will be easiest if you turn back before you develop a dependency.

Treatment Options for Alcoholism & Depression

Below, we briefly outline some effective treatment options that assist in helping you overcome alcoholism and depression:

  • Medication: This has to be discussed between someone and a doctor, whether that be a primary care physician or a psychiatrist. You can use medication to help with recovery from AUD and MD, but it must be done in a safe, controlled manner and alongside a medical professional
  • Rehabilitation: Going into rehab has a lot of different stereotypes surrounding it, but it can be an excellent way for someone to remove themselves from temptation and kick-start their recovery. Before choosing to check into rehab, it can be smart to research different facilities if you have the frame of mind to do so
  • Therapy: There are a lot of kinds of therapy that can be helpful to someone recovering from AUD and MD. Some options are group therapy, DBT (Dialectical Behavioural Therapy), one-on-one talk therapy, coaching, etc. The goal of all kinds of therapy is to give a person the chance to talk out what they are going through, receive the skills they need to overcome their disorders, and support them through challenges. Often therapy will be used in conjunction with one or more other treatment options
  • Support Groups: This is the best way to build up a support system if someone does not have one. It allows them to meet other people that are going through similar things, who will not judge, and are from all different places in their journeys. For many people, support groups are the best way to find recovery

Getting Professional help

When depression and alcoholism arise together, you are said to suffer from a dual diagnosis disorder.

To overcome a dual diagnosis disorder, it is vitally important for you to undergo specialist treatment.

When you contact Rehab 4 Addiction on 0800 140 4690, we are able to advise on rehab clinics in your area that is able to help you overcome both depression and alcoholism simultaneously.

We endeavour to refer you to an alcohol rehab clinic that offers a bespoke treatment plan for dual diagnosis disorders.

This plan will be tailored to your needs. You will begin your treatment by undergoing a medically assisted detox. You will then benefit from psycho-therapeutic therapies, meditation and complementary therapies.

References

[1] https://pubs.niaaa.nih.gov/publications/arh26-2/90-98.htm

[2] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/483005

[3] https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5995-3