Similar to the “chicken and the egg” question, medical researchers are asking which comes first–alcohol abuse, or depression? Are depressed individuals turning to the bottle for solace, or is depression a side-effect of alcohol abuse? Successful medical treatment strategies pivot on the answer to this question.
Co-occurring in statistically shocking frequency, depression and alcohol abuse represent two very common manifestations of dual diagnoses. According to 2014 data from Substance Abuse and Mental Health Services Administration (SAMHSA), nearly 8 million adults in the US have co-occurring psychological and substance abuse disorders.
Depression and Alcohol are Bad Neighbors
Depression and alcohol are terrible neighbors, sharing significantly terrifying reputations. Depression is the most serious mental disorder in the world, according to the World Health Organization (WHO). In 2004, depression was the third highest cause of disability, and WHO predicts it will rise to the leading cause of disability by 2030.
The statistics on alcohol run shockingly parallel with depression statistics. The National Council on Alcoholism and Drug Dependence (NCAAD) reports that alcohol is the third highest cause of death in America, killing around 88,000 people every year. One out of every 12 adults, or around 17.6 million people are suffering from alcohol abuse or dependence.
Decoupling the Dual Diagnosis
Many studies have been conducted to analyze the co-occurrence of alcohol abuse and depression. In 2009, the fascinating results were published of a study from New Zealand following 635 boys and 630 girls, all the same age, from birth to age 25. Researching the associations between alcohol abuse disorder (AAD) and major depression (MD), Doctors Fergusson, Boden, and Horwood examined medical measurements conducted on every child at ages 17-18, 20-21, and 24-25 years.
The findings concluded, according to the report authors, “that the associations between AAD and MD were best explained by a causal model in which problems with alcohol led to increased risk of MD as opposed to a self-medication model in which MD led to increased risk of AAD.”
How Alcohol Damages the Brain
As a potent central nervous system depressant, alcohol creates long-term damage to the drinker’s brain chemistry. Not only hijacking the dopamine-based reward system, inevitably leading to addiction, alcohol also hijacks the GABA and glutamate receptors responsible for inhibited (depressed) behaviors and excited (anxious) behaviors, respectively.
To counteract the numbing effect of high blood alcohol concentrations on these receptors, the body compensates by generating abnormally high levels of GABA and glutamate. Excessive GABA and glutamate are associated with the deadly epileptic seizures often accompanying alcohol withdrawal.
And, long after withdrawal and abstinence, damaging changes to the circuitry of a recovering alcoholic’s brain can take years to fully repair. The brain chemistry is very unstable in this time of healing, too. Depressive episodes are common occurrences, and they can trigger an alcohol relapse.
Alcohol Withdrawal is the Best Medicine for Depression
Understanding the relationship between alcohol and depression is critical for a recovering alcoholic. Medical studies confirm that depression can result from long-term alcohol abuse. Don’t let depression drag you back to the bottle, recognize it as a sign to seek help. Revisit your favorite sources of therapy and be patient. Brain circuitry sometimes takes a long time to heal.
If you or a loved one is dealing with the co-occurrence of depression and alcoholism, this information may help explain why depression keeps getting worse as more alcohol is consumed. Stop drinking depression, and seek medical care. With proper assistance and treatment, alcohol withdrawal is the best medicine for depression. Low-cost and even free alcohol and drug rehab is more available than ever before.
As Chief Editor for A leading addiction recovery blog, Palo Recovery, I aim to deliver value in the topics that I write about. My experience with addiction is similar to others and in going through it I realized how precious life really is. My aim is to help as many people as possible who are going through the same struggle. Staying true to A.A’s values about anonymity, the author uses the pseudonym Marco.