According to the American Association of Family Physicians (AAFP), 7.4 percent of the United States population met the criteria for alcoholism in 1992. Alcoholism is a chronic disease in which the body becomes dependent on alcohol, and long-term alcohol use causes many changes in the brain which can create a susceptibility to depression.
Background
As discussed by the MayoClinic, depression is a medical illness that affects the way a patient thinks, behaves and feels. While there are many causes of depression, alcohol abuse is one of the risk factors for this illness. Alcohol inhibits receptors in the brain and has a depressive effect on the central nervous system, which is thought to contribute to alcohol-induced depression. It is also possible that patients with depression are more susceptible to alcoholism.
Symptoms
Symptoms of sadness, irritability, sleeping disturbances and weight changes are common in alcohol-induced depression. A depressed patient may have difficulty getting out of bed or have feelings of pervasive guilt and anxiety. Excess fatigue, difficulty making decisions and even thoughts of self-harm or suicide are other potential symptoms. These symptoms need to be present on most days to be categorized as depression. Additionally, major depression is not formally diagnosed in the context of alcohol abuse because alcohol is thought to play an integral role in depressive symptoms.
Diagnosis
Depression is diagnosed on the basis of a patient's history, or the details surrounding the symptoms and current life events. In some cases, the history is consistent with depression but the circumstances surrounding the symptoms suggest a different diagnosis. For example, if the symptoms of depression occur in the context of a major life crisis, the condition is termed adjustment disorder rather than depression. While depression is not formally diagnosed in the context of alcohol abuse, it is often treated concomitantly with the alcoholism.
Treatment
The first step in treating alcohol-induced depression is treatment of alcoholism. If the alcohol abuse is longstanding or the symptoms of depression are severe, this treatment may need to take place in a hospital or other inpatient setting. Counselling for both the depression and alcohol abuse is often helpful. Medications to help prevent future alcohol abuse, such as a medication that causes nausea and vomiting if alcohol is consumed, can be utilized as well. Once alcohol use has stopped, medications to treat depression can be used. Selective serotonin reuptake inhibitors (SSRIs) are often used and may help to restore the chemical balance in the brain that has been affected by alcohol abuse.
Considerations
The mainstay of treatment and prevention of relapse in alcohol-induced depression is community and psychological support. Attending meetings and psychiatric appointments is critical even when the symptoms of depression seem to improve. It is also important to remember that even though alcohol may temporarily relieve the symptoms of depression, it worsens symptoms overall.
