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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Alcohol as the Cause of Depression?

Allan N. Schwartz, LCSW, Ph.D. Updated: Mar 5th 2009

 The March 2009 issue of the Archives of General Psychiatry discusses a piece of research done in New Zealand that points to the strong possibility that alcohol abuse causes depression rather than the other way around. The older view was that those who are depressed abuse alcohol in an attempt to self medicate depression.

In New Zealand a study was started 25 years ago with a sample of people born in 1977 and followed throughout. The sample size was 1055 people. The surprising results showed a correlation between alcohol abuse and major depression with the direction going from alcohol use leading to depression.

What the researches suggest is that there are additional factors that, added to alcohol use add weight to possibility of developing depression. These stressful factors include such stressful things as social pressures, employment problems and financial difficulties.

Discussion:

There are certain symptoms that should be taken as warning signs to an individual that they may be developing and alcohol problem:

1. Family history of alcohol abuse because that may suggest a genetic predisposition.

2. Looking forward to having a drink all day so that it becomes a major preoccupation.

3. Beginning the day with a drink.

4. Wanting to stop drinking but not being able to.

5. Having repeated episodes of drinking so much the night before that there is no memory of what you did or where you went the next day.

6. Experiencing cravings for alcohol and not being able to wait for the next drink.

7. Repeatedly missing work due to powerful "hangovers" the next day.

These are just a partial list and no one symptom indicates that there is a problem but rather a set of symptoms that form a pattern of behavior.

Many people stumble over the term "alcoholism" or "alcoholic." Without attempting to contradict Alcoholics Anonymous, I want to suggest that you not worry or think about that word if you are worried that you may have a problem but, rather, go and get some help. The first stop might be your medical doctor's office and then a psychotherapist.

Whether alcohol causes depression or vice versa the fact is that it can become a problem and should be addressed.

Your comments are welcome and encouraged.

Allan N. Schwartz, PhD

 

 

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

    Reader Comments
    Discuss this issue below or in our forums.

    Good Luck:) - Max - Sep 30th 2009

    I have been drinking about a case of beer during the week and a 2nd case of beer on the weekend for 4 years.  I remember having anxienty since middle, I am currently 25.  Over the past year my anxienty has worsened.  Somtimes I will tell somone I am '"shy", they always reply, no your not.  I am fully funtional and love life, I feel that somtimes my worring and nerviousness holds me back from living life, rather than just surviving it.  I like to drink in social to fight anxienty.  I have cut back to only drinking on the weekends.  I still drink way to much on the weekend and am going to attemp to take it down a notch.  I have been using alcohol as atool and maybe it has been making life worse for me all along.  In the last 2 months I saw a doctor, hungout with several new people, started working out, read alot about anxienty, and have been trying to go to more social evens that are alcohol free.  I generaly feel like the combination of everything I am doing its helping.  I am very nervious about having sex with a girl I just started dating.  Alot of girls like me, however I am very picky and also kinda scared of dating.  I told a buddy of mine the other day, it suck dating with anxiety, You feel excited and happy about the girl.  However I also feel sick, scared and unsure.  I am trying to look at everything with a positve point of view to prevent worrying.  Even when things dont go my way I try to think positve, it wont allow parasites of feer to cling to you mind.  I wish the best of luck to u me and anyone else with the same problems, and compassion to resolve it. 

    What have DNA Studies given knowledge of these dual diagnosed problems? - Just curious - Sep 13th 2009

    I heard that in some cases that depression, was found to be a part of the disease.  These patients need to be on some kind of medication for personality defects, depression or bi-polar for the rest of their life?  Is this true? AA seems as though it is not enough to help dual diagnosis? 

    Causality runs both ways; either way SMART Recovery can help - Dr. Henry Steinberger - Jun 7th 2009

    I’d caution anyone from drawing absolute conclusions from a correlational study, and further I’d note that there is clearly a two way street here. Many people who were not previously depressed do develop depression as a result of alcohol working its destruction on the body’s systems AND from the unsavory consequences that follow the problems that you listed. But many people start using alcohol to counter their depression (I’ve seen this especially with those having Bipolar Disorder) or to sleep, amongst other misguided but common attempts at self-medication.

    Further, any of those symptoms you listed indicate some degree of an alcohol problem whether it be “risky drinking”, “heavy drinking”, alcohol abuse, or alcohol dependence (which many people under the influence of AA call alcoholism – but which I and many others prefer to call alcohol dependence as defined in the DSM and so avoid the stigma that comes with AA and its confrontational labeling). I usually suggest using the AUDIT, of which I’m sure you are aware, to decide whether there is enough problem to look further.

    Finally, I ask everyone to whom I write, if they are aware of SMART Recovery®? If not, the information about these FREE mutual self-help meetings around the country and now around the world which are, like all the rest of medicine and psychology, basically secular and science-based (leaving spirituality and religion up to the individual) can be found at: http://www.smartrecovery.org – I am on their board of directors and volunteer my expertise to them as we attempt to get volunteers to facilitate meetings and keep the science in our program current.

    chicken or the egg - Ray Smith - Jun 7th 2009

    I was diagnosed with depression in the early 70s, before I started drinking.

    I tried several different antidepressants, they either did nothing, caused side effects, or knocked me out. I was working two jobs and could barely muster the energy to crawl out of bed. A friend suggested I try her diet pills. (I had done some experimentation in high school, but had been drug free for years.) They not only gave me the energy to get work, they relieved the depression.

    After a short time of taking time, I started having trouble sleeping at night and started drinking to come down. I was quickly drinking about a half quart of scotch a day.

    Although I was only taking one or two pills a day, after a couple of years I started having side effects that bothered me, so I quit the pills, but was left with an alcohol habit. My depression and alcoholism had become hopelessly intertwined. When I attempted to quit on my own, I would go into major depressive episodes, a rebound effect.

    The common thinking in those days was that if a person quit drinking their depression would magically go away. Mine didn't. I became suicidal.

    Because I was now an alcoholic, not one psychiatrist, therapist, or counselor would take my depression seriously, and refused to treat the depression until I had been sober for several months. "Just quit drinking and it will go away." I was told repeated that drinking had caused my depression. When I attempted to explain that I had been diagnosed BEFORE I started, I was dismissed, what did I know, I was just another drunk.

    I would go back after the three or six months, they'd cluck and shake their heads and say, "Just give it a few more months." That is the wrong thing to tell someone who is suicidal. So I kept going back to drinking, a lousy solution, but it took enough of the edge off that I didn't end up dead.

    Now here you are trying to bring those days back for a new generation. We need more integrated services, not a return to the 12step treatment way of looking at mental illness.

    Dr. Kenneth Minkoff states: "Dual diagnosis is an expectation, not an exception" and "When both Mental Illness and Substance Disorder coexist, both diagnoses should be considered primary."

    Dual diagnosis clients are the highest utilizers of health care services, with the poorest outcome; they are routinely pushed into single diagnosis treatment that is the most expensive and least effective. In many instances, the best most dually diagnosed clients can hope for are separate, parallel treatments, often at odds with each other. Each system views it’s own slant on recovery to be the primary diagnosis.

    Kathleen Sciacca said, "Addiction professionals may believe that mental illness is a symptom or manifestation of substance abuse; mental health professionals may believe that substance abuse is a symptom of mental illness. Neither group is therefore likely to provide effective treatment for multiple diagnosed patients in their usual treatment setting."

    She began integrated programs in 1984 in a New York State outpatient psychiatric facility. In 1985, these programs using Motivational Interviewing Techniques were implemented in multiple sites. By 1986, they were being taught throughout New York state and the nation. They have been shown to have better results than traditonal treatment for everyone, but particularly with those with coexisting disorders.

    I don't find this surprising - - Mar 8th 2009

    In my late twenties,I slowly developed a regular drinking habit ranging from 2 to 6 beers a day.   It seemed harmless and didn't affect my life.  However, after about two years of this, I did notice a sustained, global change of my mood.  At the time, I didn't make the connection.  But after making several attempts at getting out of the funk--and failing--I started suspecting I was in fact depressed and that it had a connection to the steady drinking.

    I have now quit drinking all alcohol.  I'm hoping my mood improves over the longterm. 

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