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  • Alcoholism and Depression: A Connection That Runs Deep

    Whether or not you are an alcoholic, you will agree on this one. Many of us, in some point of our lives, have downed a drink or two to “drown” the pain of a breakup, the disappointment of a job lost, or the grief of losing a loved one. Euphoria probably didn’t follow, but we did lighten up a bit.

    Alcoholism can cause depression or intensify existing symptoms.

    Alcoholism and Depression

    Now this seems ironic because we all know how a gin or a glass of wine lifts the mood and makes us forget our woes. But there is a wealth of research that suggests that alcoholism indeed increases the risk of a person developing depression. Alcohol also magnifies the symptoms of an existing depressive disorder.

    According to findings, about 30 to 50 percent of all people with alcohol use disorders also suffer from depression. The connection between depression and alcoholism runs both ways, and it runs deep.

    Does Depression Lead to Alcoholism?

    There is a reason why so many people reach out for an alcoholic drink when they are feeling the blues. That’s because, alcohol can truly lift the mood, at least for a while.

    According to research by a team of scientists at the Ernest Gallo Clinic and Research Center at the University of California, San Francisco, drinking alcohol triggers a rush of endorphins, the happy chemical, in the orbitofrontal cortex and nucleus accumbens, the areas of the brain responsible for producing feelings of pleasure and reward.

    A person feels happy when he drinks alcohol because of the endorphins released in the brain. The brain will recognize the alcohol as being pleasant thus urging the person to drink more whenever he feels depressed.

    So alcohol really causes you to feel a little less sad or depressed. And because it brings on feelings of pleasure, people tend to take refuge in it the next time they feel down in the dumps.

    Here’s how depression can lead to alcoholism:

    1. A person feels depressed and drinks alcohol.
    2. Alcohol releases endorphins in the brain that produce feelings of pleasure.
    3. As the person continues to drink, more endorphins are released and the more intense are these feelings of pleasure.
    4. The brain is “conditioned” to recognize alcohol as being pleasant.
    5. The person starts to drink more frequently to experience more pleasure.
    6. He or she begins to rely on alcohol to relax and feel happy.
    7. He or she eventually develops alcoholism.

    Can Alcoholism Trigger Depression?

    Yes, according to the American Psychological Association, alcoholism triggers depression or worsens existing symptoms of depression.

    Alcohol makes you feel depressed because it is a depressant. When consumed, it has a sedative effect on the brain and also triggers the release of endorphin and dopamine or the happy hormones. When the effect of alcohol fades, these hormones also drop down and make the user feel depressed.

    Alcohol is a depressant. Although the first few glasses of wine may seem to uplift your mood, the more you drink, the more depressed you become. Here’s why:

    • By intensifying the effects of GABA: Alcohol magnifies the effects of the “inhibitory” neurotransmitter GABA. Increased functioning of the GABA neurotransmitter brings about a sedative effect. Incidentally, this is the same neurotransmitter that drugs like Xanax and Valium affect and cause sleepiness.
    • By causing an imbalance in the action of neurotransmitters: Chronic alcohol consumption disrupts the fine balance between inhibitory and excitatory neurotransmitters. This results in depression and other mood disorders.
    • By causing a dopamine and endorphin crash: Alcohol triggers a release of “happy chemicals” dopamine and endorphin in the brain. This explains the “high” that people experience after drinking a few glasses of any alcoholic drink. But the effects taper off when the levels of these chemicals come down. This is when feelings of low and depression set in.
    • By impairing emotional processing: Alcohol damages the right hemisphere of the brain that is involved in processing non-verbal emotional stimuli. Alcoholics often have difficulty interpreting correctly facial expressions and as a result, feel hurt, persecuted, or threatened by others for no reason. This makes many alcoholics withdraw from society and live in isolation, a behavior that intensifies their depression.

    Alcohol can trigger depression in several indirect ways as well:

    • Chronic alcohol consumption blunts the effects of antidepressant medication.
    • Alcohol consumption clouds the senses and makes thinking fuzzy. Under the influence of alcohol, people have been known to be reckless and commit acts that they regret later—engage in violence or inappropriate sexual behavior or get involved in a DUI case.
    • Alcoholism takes a toll on personal relationships.
    • Alcoholics are often unable to perform the personal and professional duties expected of them. This causes stress, anxiety, and depression.
    • Alcoholism often leads to financial problems; addicts are known to go bankrupt as they try to fund their drinking habits with loans.
    • Alcoholism can cause a person to perform poorly in the workplace and as a result, lose his or her job.
    • Alcoholism may make a person neglect and/or abuse his or her children and as a result, have them taken away by Child Welfare Services.

    Alcoholism and depression is a vicious cycle. The depression brought about by alcoholism makes a person drink more that worsens his or her depressive mood. On the other hand, depression can lead to alcoholism that, in turn, aggravates the symptoms of the depressive disorder.

    Substance Abuse and Depression

    According to several research studies, binge drinking is one of the most common causes of alcohol-induced depression. Here’s why:

    • The more a person drinks in a single sitting, the more intense is the “high” he or she experiences. As a result, the crash that comes afterwards—the feelings of low—is also more intense.
    • Binge drinking is a form of problem drinking behavior that can develop into full-blown addiction in no time at all. Alcoholism then increases the risk of the person developing depression.

    Alcoholism and Depression: The Genetic Link

    People whose families have a history of alcoholism tend to have lower endorphin levels. This means that they are more prone to depression and also have a higher chance of becoming alcohol dependent.

    It is futile to ponder over what develops first: alcoholism or depression. There are as many neurological and environmental factors that trigger alcoholism in people with depressive disorders as there are factors that contribute to depression in alcoholics. But what is interesting is that scientists have also uncovered genetic links between alcoholism and depression.

    Given below are the findings from some studies:

    • People from families with a history of alcoholism tend to have lower levels of endorphin than those who do not have close relatives with alcohol use disorders. Endorphin is involved in the identification of rewards and pleasure responses. Low levels indicate that the person has reduced pleasure arousal and is prone to depression.
    • The incidence of alcohol dependence and depression occurring together tend to run in families. The more the number of first-degree relatives who have co-occurring alcoholism and depression, the greater is the incidence of an individual developing this co-morbid condition.
    • According to the findings of a study on twins, a history of major depression in a twin greatly increases the risk of alcohol dependence and/or abuse in the other identical twin.
    • Women are more prone than men to suffer from co-occurring alcoholism and depression. According to research, there are both genetic and environmental factors at work here.

    Alcohol, Depression…Suicide

    Alcoholism and depression are common co-morbid disorders, according to the findings of the Epidemiologic Catchment Area study carried out by the National Institutes of Health. The consequences of this co-morbidity are frightening:

    • Inability to form, sustain, and find pleasure in personal relationships
    • Inability to derive fun from the activities the person once enjoyed
    • Inability to focus on work or find meaning in it
    • Inability to envision and look forward to happier times

    However, the most severe consequence is the high rates of suicide amongst people who suffer from alcoholism and depression, according to research conducted at the Western Psychiatric Institute and Clinic of the University of Pittsburgh Medical Center.

    The feelings of listlessness, despair, and hopelessness brought on by depression are potent enough to trigger suicidal thoughts in individuals or actually drive them to take their own lives. Alcoholism compounds matters. Here’s how alcohol tweaks and twists the brain and makes a person engage in self-destructive behavior:

    • By depressing inhibitions: Chronic alcohol consumption damages the prefrontal cortex, a region of the brain involved in executive functioning that helps one plan and regulate behavior. Alcohol consumption depresses inhibitions and makes one behave impulsively.
    • By clouding judgment: Alcohol impairs rational thinking by depressing activity in the cerebral cortex, the region of the brain involved in processing thoughts and developing consciousness. A person under the influence of alcohol is unable to think straight, connect the dots, and arrive at rational conclusions. He or she cannot gauge the consequences of self-destructive actions and make the right decision.
    • By triggering binge drinking behavior: Those who suffer from both alcoholism and depression tend to binge drink more than people who have one disorder or none at all. Binge drinking raises the risk of alcohol poisoning, a situation where the person loses all control over his or her mental faculties and is at a greater risk of harming himself or herself.
    The connection between alcoholism and depression is evident.
    So what does this mean for you?
    • If you have been diagnosed with depression or feel that you are often depressed, seek psychiatric help instead of self-medicating with alcohol.
    • If you are a chronic user of alcohol or abuse it, go to an addiction counselor who can help you modify your drinking habits.
    • If you are a medical professional who works with people with depressive and/or alcohol use disorders, ensure that you educate your patients on the connection between the two disorders and how one can trigger another.
    • As a medical professional, you should also yourself screen a patient suffering from depression for alcohol abuse symptoms and vice versa, to rule out co-morbidity.

    Alcoholism and depression alone throttle life and waste potential. Knowing about the connection between alcoholism and depression will help you break a vicious cycle that can otherwise lead to catastrophic consequences. The key is always to seek medical help to manage the condition(s).