Sober living

Treatment of Depression With Alcohol and Substance Dependence: A Systematic Review PMC

alcohol and depression

Here are a few strategies to help you lift your spirits in the moment. Increased anger might lead you to pick a fight with a loved one, for example, while extreme sadness or self-loathing could lead to intense depression symptoms. When you regularly turn to alcohol to manage challenges and negative feelings, you may not take other actions that could help you address those problems effectively. You might begin drinking more regularly in order to feel better or forget about those unwanted emotions and memories. Maybe you tossed and turned, had bizarre dreams, or woke up with your heart racing.

We’re transforming healthcare

Alcoholics anonymous (AA) and alcohol treatment centers offer classes and support group meetings. In these, you can also find support from others in the same situation. Naltrexone, Acamprosate, and disulfiram are also FDA-approved medications that can help curb alcohol cravings.

Starting With a Primary Care Doctor

Drinking alcohol can become a coping mechanism to deal with feelings of hopelessness, numbness, guilt, and worthlessness. During therapy, you can learn coping mechanisms that can help you return to life without drinking. Alcohol can significantly impact the levels of neurotransmitters in your brain, making depression worse. Antidepressants can help even levels of these chemicals and can help relieve symptoms of depression. Cognitive behavioral therapy can also be used to treat co-occurring AUD and MDD, by improving your emotional regulation, changing your cognitive behaviors, and helping you develop personal coping strategies.

Treatment of the Depressed Alcoholic Patient

Having one clinician or treatment team under one roof work with a patient simultaneously on the depressive disorder and AUD can improve communication with more consistent articulation of diagnostic impressions and treatment recommendations. Moreover, this approach could provide greater convenience for the patient (thereby improving the selling prescription drugs illegally chances of retention in treatment), and more treatment flexibility in the face of evolving clinical impressions and management recommendations. One challenge to this model is having the resources to provide expert simultaneous AUD and depressive disorder evaluation and treatment in the form of a single clinician or treatment team.

What are the immediate clinical implications of coexisting depressive and anxiety states among alcoholics?

alcohol and depression

Two recent reviews, however, indicate that research does not unanimously support the prior existence of severe depressive or anxiety disorders as a usual cause of alcoholism (Allan 1995; Schuckit and Hesselbrock 1994). Of course, when an alcohol-dependent person complains of severe depressive or anxiety symptoms (which might or might not indicate a long-term disorder), those conditions must be acknowledged and steps must be taken alcoholism wikipedia to help decrease them. If the psychiatric symptoms occur, however, as a consequence of the person’s consumption of high doses of alcohol (i.e., the complaints are alcohol induced), then the symptoms are likely to improve fairly quickly with abstinence. In this case, it is uncertain whether the longer term treatment of alcoholism requires additional aggressive therapies aimed at treating underlying depressive or anxiety disorders.

alcohol and depression

alcohol and depression

Also, an 18-year followup of 80 children who had experienced severe depressive episodes earlier in life revealed no evidence of an increased risk for alcoholism during the followup period (Harrington et al. 1990). Finally, Schuckit’s research group followed 239 alcoholic men 1 year after they received alcoholism treatment, and the data revealed no significantly increased rates of major depressive or anxiety disorders (Schuckit and Hesselbrock 1994). It is possible, however, that some of these studies might have excluded subjects with more severe anxiety or depressive disorders from the original samples, and consequently more work in this area is required (Kushner 1996).

However, as pointed out by Kushner (1996), larger studies of COA’s who have passed the age of risk for most disorders will need to be conducted before final conclusions can be drawn. As for depression co-existing with alcohol dependence, Jordans et al. [17] evaluated the use of psychotherapy combined with anti-depressants for patients with depression and alcohol dependence. They showed that psychotherapy addition would improve treatment success rates, especially when delivered by community-based counselors, after one year of follow-up.

Out of the eight included studies [15-22], only one study had a retrospective design [16], whereas the remaining seven studies were prospective, where one study was a case-control study [15], five studies were randomized controlled studies [17,19-22], and one study was a prospective cohort study [18]. Contributors to this article for the NIAAA Core Resource on Alcohol include the writers for the full article, reviewers, and editorial staff. In some people, the initial reaction may feel like an increase in energy. But as you continue to drink, you become drowsy and have less control over your actions.

The co-occurrence of AUD and another mental health disorder can complicate the diagnoses and negatively impact the clinical course of both conditions. Many clinical features of AUD have significant overlap with other psychiatric disorders, including sleep disturbances and negative emotional states such as worry, dysphoria, sadness, or irritability that often occur during cycles of alcohol intoxication, withdrawal, and craving. (See Core article on neuroscience.) As described in the sections to follow, a timeline of your patient’s symptoms is a key tool for a differential diagnosis. Clinically, the data may be viewed as providing some reassurance that low-level, below-guideline drinking is safe for most individuals, at least regarding risk of depression, as long as it stays low. For clinicians, the priority remains to screen patients for escalation from low-level to problem-level drinking.

But for some people, these feelings don’t go away – they get worse and their feelings of depression can start to interfere with everyday life. These findings were also confirmed by Anand et al., who also examined cocaine, cannabis, substance use amphetamines alcohol, and hallucinogenic agents. Additionally, their study demonstrated a significant correlation between the severity of depression symptoms and the frequency of administration of the abused substance and its type [18].

Do not disregard or avoid professional medical advice due to content published within Cureus. PTSD is characterized primarily by alterations in arousal and recurrent intrusive thoughts that follow a traumatic event. Among those with AUD, about 15-30% overall have co-occurring post-traumatic stress disorder, with increased rates of 50-60% among military personnel and veterans.28 The two conditions may worsen each other. Thus, here, too, it’s important to be cognizant of the signs of PTSD in patients with AUD, and vice versa.

  1. This, combined with heightened mood states, can have some unpleasant effects.
  2. In this case, it is uncertain whether the longer term treatment of alcoholism requires additional aggressive therapies aimed at treating underlying depressive or anxiety disorders.
  3. Several separate lines of evidence cast doubt on the possibility that high proportions of alcoholics have severe, long-term depressive or anxiety disorders.
  4. If they report daytime sleepiness, one possible cause is alcohol-induced changes in sleep physiology.
  5. It showed that CBT-D had shown significant improvement in depressive symptoms at the beginning of treatment; however, the improvement was non-significantly different after following up [21].

When treating depression and substance abuse, consult with a mental health professional and/or an addiction specialist who can provide resources and recommendations for possible treatment options. In the spirit of integrated treatment, recent studies have sought to investigate the efficacy of co-administration of an established pharmacologic treatment for AUD with an antidepressant medication. Interestingly, emerging data also support the use of the anticonvulsant topiramate in the treatment of AUDs,39,40 although, topiramate is not currently FDA-approved for this purpose.

We included the results of only original research articles investigating depression treatment outcomes in patients with alcohol use disorder or SUD or both. Selected trials mentioned the condition under investigation, whether it is depression with abused substance or alcohol dependence. Only studies published in English were classified as related articles, which can be further evaluated in the second step.

On the other hand, both conditions also share certain risk factors, such as genetics and social isolation. Having either depression or alcohol use disorder increases your risk of developing the other condition. Major depressive disorder involves persistent and prolonged symptoms, but depression, in general, takes on many different forms. Depressive symptoms can result from life stressors, mental health conditions, medical conditions, and other factors. Many studies have found that alcohol dependence is closely linked to depression. When it comes to diagnosing an alcohol use disorder and a major depressive disorder, it’s important to address them simultaneously, as they can significantly impact your recovery.

Leave a Reply

Your email address will not be published. Required fields are marked *