Drowning Your Sorrows: the link between alcohol and depression

Medical Reviewer

The history of depression and alcohol is both long and well documented. Reasons for hitting the bottle range from a simple desire to lift mood to that of reaching a state of oblivion. Many people assume that alcohol follows depression in the way that taking aspirin follows a headache. Unfortunately the self-medication notion of alcohol is only part of the story. What we are increasingly waking up to is the knowledge that alcohol actually causes depression in its own right.

Despite the current economic downturn we, as individuals, are richer than ever before. Comparatively high levels of disposable income and a wide range of cheap booze have resulted in a situation where approximately 1 in 15 men and 1 in 50 women are physically dependent on alcohol. But why do men appear more vulnerable to alcohol dependence? Long working hours, stressful lives and accessibility of alcohol provide a potent mix but another part of the answer seems to lie in the way men respond to stress.

In May 2008, the ScienceDaily website reported Tara Chaplin's findings on how men and women respond to stress. Chaplin, a research associate at Yale University School of Medicine, stated:

"Women are more likely than men to focus on negative emotional aspects of stressful circumstances, for example they tend to 'ruminate' or think over and over again about their negative state." Chaplin went on to say that men, "are more likely to distract themselves . . .from their physiological arousal, possibly through the use of alcohol."

This provides a partial understanding of why men may turn to alcohol following a change in mood, but it does not explain how alcohol can cause depression in its own right. A recent report in the March issue of Archives of General Psychiatry suggests the link may arise from alcohol triggering genetic markers that increase the risk of major depression. David M. Ferguson, Ph.D., and colleagues write, "further research suggests that alcohol's depressant characteristics may lead to periods of depressed affect [mood] among those with alcohol abuse or dependence."

Towards half of all people who drink heavily have depressive symptoms, yet if they stop drinking only five per cent of them will show the diagnostic criteria for depression just a few weeks later.

Whether alcohol follows a change in mood or precedes it the effects are similar. Alcohol interferes with brain chemistry and leaves the individual feeling anxious, ill and solemn. Tetchy moods, arguments and poor performance at work start to become more common. Sexual and emotional difficulties begin or increase and friction between couples and families is more common and may lead to break ups. This serves only to add to a cycle of stress and depression and may result in even more alcohol being consumed.

How do you know when you're drinking too much? A simple internet search will provide you with a variety of tables and charts pointing out the acceptable limits of alcohol intake. From a lifestyle perspective there are a number of warning signs. The most obvious involve the effects that alcohol, or the lack of it, is having on you. For example, if you use alcohol as a way to deal with a stressful day, and these days occur frequently, you may well have a dependency issue. Similarly, if you find you need to drink more and more to feel the effect. Regular hangovers, jitters, the frequent sense that you need a drink, and drinking earlier in the day are more signs of an alcohol problem.

Depression and alcohol may feel like a chicken and egg situation in that you aren't certain which is the cause and which the effect. There's a very good chance that the two are interlinked but what seems absolutely clear is that depression is never helped by alcohol, which may lead to suicidal thoughts and actions. To get help for your depression you may first need to tackle alcohol. Alcohol and antidepressants are a poor mix, so your doctor may first want assurances that any medication for depression isn't going to have the opposite effect to what is intended.