Separating depression from alcoholism
Not all depressed people are alcoholics, but are all alcoholics depressed?
Alcoholism is not a form of depression, but overlap is common. People who drink excessively are prone to depression. People with depression tend to self-medicate with alcohol. Roughly one-third of people with depression have a drinking problem. In the same vein, it is estimated 30 to 50 percent of people with an alcohol problem have a major depressive disorder. Does this mean, categorically, anyone who drinks alcoholically is clinically depressed?
Major depressive disorder versus alcoholism
In their paper, “Alcoholism and Psychiatric Disorders,” Dr. Ramesh Shivani, Dr. R. Jeffrey Goldsmith, and Dr. Robert M. Anthenelli make clear the distinction between alcohol-induced depression and major depressive disorder. The three authors – all with backgrounds in substance abuse – note mood disorders associated with alcoholism fall into three classifications/progressions:
- The normal outcome of a depressant’s (alcohol) effects on the brain
- Symptoms and signs indicative of an alcohol-induced mood disorder characterized by depressive features
- An existing depressive disorder (either comorbid with or predating alcoholism)
Their groupings are not without controversy. Some researchers question the causal relation between alcoholism and depression and whether there is, in fact, a clear distinction between alcoholism and major depressive disorder.
The authors refer to a study that shows 60 percent of alcoholics who were thought to have a major depressive episode did not actually have a major depressive disorder. Instead, they had an alcohol-induced mood disorder characterized by depression. The same study found the remaining 40 percent of alcoholics who experienced a depressive episode had a major depressive disorder and continued to display symptoms well into abstinence from alcohol.
It must be noted the study did find that individuals who are alcohol-dependent have a high risk for at least two major depressive episodes and for attempting suicide. The fact these individuals may or may not qualify as having a major depressive disorder in no way diminishes the need for treatment.
The importance of accurately diagnosing depression
An article appearing in the 2012 volume of International Scholarly Research Notes Psychiatry found depression among alcohol-dependent persons has more to do with the current binge or episode and less to do with a lifetime diagnosis of depression. The study notes depressive symptoms dissipate following periods of abstinence. It is important to differentiate between temporary alcohol-induced depression and clinical depression because the underlying causes of the latter need to be addressed during and after alcohol treatment. Any diagnosis based on a patient’s mood immediately following treatment is inaccurate if that individual is comorbid with alcoholism and a major depressive disorder.
Sovereign Health Group specializes in treating comorbid conditions. Our dual diagnosis treatment center focuses on the underlying causes fueling mental health problems and addiction. It is true substance abuse and mental health can form a vicious circle. Our clinicians are trained to recognize and treat both conditions. Contact our 24/7 helpline for more information.
About the author:
Darren Fraser is a content writer for Sovereign Health Group. He worked two and half years as reporter and researcher for The Yomiuri Shimbun until they realized he did not read, speak or write Japanese and fired him. Undeterred, he channels his love of research into unearthing stories that provide hope to those dealing with addiction and mental illness. Darren loves the Montreal Canadiens hockey club and horror films and would prefer to enjoy these from the comforts of his family’s farm in Quebec. For more information about this media, contact the author at firstname.lastname@example.org.