This post was originally published on October 16, 2014.
As anyone who regularly attends AA meetings or some other form of alcohol recovery program can tell you, drinking and depression go together like peanut butter and jelly (or in my case schnapps and cocaine). So it really shouldn’t come as a surprise that there are a slew of scholarly articles to back up this point. HuffPost writer (and happiness advocate) Hannah Sentenac’s recent post makes a number of great points on this topic, and she includes the (sometimes dense) academic and clinical research to back it up. Which is really helpful, given the quality of unsolicited medical and psychiatric advice you’re likely to get in a room full of drunks, whether it’s in a barroom or an AA meeting. Here are a couple drinking/depression studies from the article and elsewhere that I found helpful:
A little while after I put down the booze and pills (and after the withdrawal anxiety had subsided), I started to feel the effects of depression. When I mentioned this to an old timer, he said to me with a straight face, “Of course you’re depressed—you can’t fucking drink anymore!” While this was darkly funny to both of us, it was also lacking the clinical assurance I was looking for. Luckily, other folks explained to me that what I was feeling was in fact quite normal, and that unless I was feeling suicidal, it would probably pass with time (and it did). But in hindsight, it is comforting to find out that what I was feeling could be easily be backed up clinically, as Post Acute Withdrawal Symptoms (PAWS)—is something which is pretty well accepted by the scientific community. A 2010 report by The Substance Abuse and Mental Health Services Administration (SAMHSA) does a good job explaining this in non-clinical terms, including this litany of symptoms most drunks have experienced after putting down the drink: anxiety, hostility, irritability, depression, mood instability, fatigue, insomnia, difficulties concentrating and thinking, reduced interest in sex and unexplained physical complaints.
Sounds like depression to me. The good news is that although pretty much all recovering alcoholics and addicts go through it for a period, it almost always passes unless they suffer from clinical depression. The bad news (also revealed in the report): It can take a couple of years.
There is certainly no more profound symptom of depression than suicide, and alcoholics not only attempt it way more than the general populace but also spend an awful lot more time contemplating it. The number of sober AA’s that I have heard tell stories of attempting to hang themselves, putting guns in their mouths, or hoping to just slip quietly into a nap after downing a couple bottles of pills is staggering, and these are just the ones that lived to tell about it. Sure, it’s a lot easier to discuss such things at AA meetings rather than say, cocktail parties, but the clinical evidence backs this up, too. A report by the National Institute of Health (NIH) reveals that heavy alcohol consumers had a five-fold higher risk of suicide than social drinkers and that approximately 40% of all patients seeking treatment for alcohol dependence report at least one suicide attempt at some point in their lives. Among alcoholics, the lifetime risk of suicide is about 10-15 percent, according to the research. So those are some pretty intriguing numbers to ponder if you’re on the fence about giving up the booze but can’t imagine life without it.
Does alcoholism cause depression or does depression create alcoholism? At the end of my drinking, I was convinced that I was suffering from depression on top of my alcoholism, but my depression lifted about a year after I put down the booze and pills. I also know that’s clearly not the case for a lot of my sober friends who treat their depression with therapy and meds (as they should). And anyone who tells you that meetings and the 12 steps are a cure-all is a nitwit. Still, pretty much any study you read will tell you that people who are depressed shouldn’t drink to excess. Alcoholics trying to treat their depression are of course going to have an impossible time doing that if they’re still drinking, since therapy isn’t very effective for active drunks and the meds don’t work if you’re washing them down with a depressant like alcohol.
The National Institute of Health’s conclusion in a different report is this: Alcohol abuse can cause signs and symptoms of depression and a myriad of psychological disorders, both during intoxication and during withdrawal. These symptoms can last weeks or months, and often mimic frank psychiatric disorders, but usually disappear after a period of abstinence. So prematurely labeling these conditions as major depression or panic disorder or whatever, can lead to misdiagnosis and inattention to a patient’s principal problem—the alcoholism (which they classify into categories of abuse or dependence). For instance, when I was first getting sober, a fellow drunk with bipolar disorder diagnosed me with bipolar, based on my manic way of speaking, which faded over time.
So what does all this research mean? Well for one, like many studies prove, we often do research to prove things we already strongly suspect (there was a Canadian study in 2010 that revealed that unsafe sex is more likely after drinking). Still, it’s nice to have the guys in the lab coats remove any doubt.
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