Alcoholism and Depression

Alcoholism and depression often go together. Now a study finds that alcohol problems tend to come first.

The study from New Zealand enrolled 1,055 teenagers. Researchers kept track of them for the next 25 years. People in the study who abused alcohol were twice as likely as average to become depressed. Researchers said the abuse appeared to come first, then the depression. They were not sure why this occurred. The study appeared in the journal Archives of General Psychiatry on March 2

What Is the Doctor's Reaction?

The link between depression and alcohol abuse is well-established. Research studies have found that people who are depressed are more likely to have problems with alcohol. But the reverse is also true: People who abuse alcohol are more likely to have depression. While they often occur together, it's uncertain why.

The connection could be explained in at least three ways:

1. Depressed people "self-medicate" with alcohol. This leads to alcohol dependence.
2. Alcohol abuse damages health and relationships. This leads to depression.
3. A single factor (perhaps a person’s genes) makes certain people prone to both alcohol abuse and depression. This could explain why both conditions tend to run in families.

To sort this out, you'd need a large study. It would have to keep track of people for many years to find out whether one condition led to the other.

That's just what researchers in New Zealand did. The new study is published in the journal Archives of General Psychiatry. Researchers kept track of 1,055 young adults over time. They found that alcohol abuse appeared to lead to depression, not the other way around. In fact, major problems with alcohol nearly doubled the risk of major depression.

As interesting as these findings are, they raise new questions. It's not clear how alcohol abuse increases the risk of depression:

Does alcohol unmask genes involved in the development of depression?

Does alcohol exert a direct effect on the brain that leads to depression?

Does alcohol increase the risk of depression because it can damage health or disrupts relationships?

More than one of these mechanisms could be involved. Many questions are unanswered. But this study clearly provides one more reason to avoid excess drinking.

What Changes Can I Make Now?

Think about how much you drink. Know the risks of too much alcohol. In general, more than one drink per day for women and more than two for men may be enough to cause problems.

It's clear that too much drinking can put your health at risk. Liver disease, injuries and depression are just a few of the ways high alcohol intake can affect you. And a recent study suggested that even moderate drinking may increase the risk of cancer.

But there is also evidence that people who drink small amounts may have a lower risk of heart and artery disease than those who don't drink at all.

Think about the social, cultural and religious connections that are tied to your drinking. It's important to have a sense of the benefits as well as the risks of drinking. Then you can make a reasonable decision about whether to drink less.

If you think you may have a problem with alcohol now, talk to your doctor about it. Together, you will review the effects of alcohol on your life and health. This will include the impact on your family, social and work relationships. Your doctor can determine whether there is a problem. And he or she can help you deal with it.

Your doctor also can get help for you if you think you may be depressed. Symptoms of depression include: