Drinking Your Blues Away

Drinking Your Blues Away

Rates of depression are higher among those who suffer from alcoholism. One article by Dr. L Sher from the Division of Neuroscience in the Department of Psychiatry at Columbia University cited in QJM: an International Magazine of Medicine stated of those suffering from major depressive disorder, “32.5% met the criteria for a lifetime diagnosis of alcohol dependence.”

Clinical implications for dual diagnosis are significant as the author also argues that history of alcohol abuse and dependence tends to be unseen by primary care physicians and psychiatric clinics. This is commonly an overlooked combination of mood disorders and addiction which requires specialized treatment at a dual diagnosis facility.

 (Source: http://qjmed.oxfordjournals.org/content/97/4/237.full)

Suicide, Alcoholism and Depression

The authors of another study in Advances in Psychiatric Treatment, had reviewed studies on the demographics of patients suffering from dual diagnosis. They found that:

“The most common mental disorders preceding suicide have consistently been found to be depressive illness and alcohol misuse. Comorbidity is more common in alcoholics who commit suicide than in alcoholics who do not commit suicide and has been found to predict suicide risk.” (http://apt.rcpsych.org/content/7/5/357.full)

A 2001 study published in the European Archives of Psychiatry and Clinical Neuroscience found that those alcoholics, who attempted suicide, also exhibited impulsive and aggressive traits. Suicide attempts were also higher among those alcoholics who suffered from depressive disorder. Sometimes, depression is attributed to alcohol dependence and instead of being seen as the underlying cause of the alcohol dependence, increasing the risk of suicide attempts. (http://www.springerlink.com/content/w4ff0c415fyuxat8/)

Alcohol Detox, Medication and Dual Diagnosis Treatment

There is a problem distinguishing whether a diagnosis is an underlying problem, such as a major depressive disorder, or substance-induced, such as a substance-induced mood disorder. If the disorder is substance-induced, antidepressants will not help it and if the underlying problem is a major depressive disorder, medications to address cravings alone will not relieve symptoms of depression.

Abstinence after alcohol detox and alcohol addiction treatment may provide help with a proper diagnosis. However, if depression is manifesting during early recovery, abstinence may be difficult or impossible for a patient to achieve. In a review of comorbidity of alcohol and depression, authors found that “untreated depression–whether primary or secondary – predicted worse drinking outcomes.”)

To prevent relapse, one must have an accurate diagnosis for both conditions. Alcohol and cravings need to be addressed as do symptoms of depression. Evidence, according to a new June 2011 review of research, illustrates that without proper treatment and the aid of medication for both depression and alcohol cravings, chances of relapse are greatly increased for the dual diagnosed patient in early recovery. All issues associated with multiple disorders must be identified and properly treated in addiction treatment.