Interestingly, there are many types of depression, and some are typically diagnosed in individuals who are heavy abusers of alcohol.
The term “depression” is used commonly to refer to everything from a feeling of mild irritation to utter anguish ending in tragedy. Its real meaning is often misunderstood, as is the “cause.” The diagnosis of depression is the most common mental disorder suffered by Americans. Some estimates claim that roughly fifty to sixty million Americas will suffer from depression during their life. Young children, teenagers, and adults all experience depression in equal numbers. For many people with serious drinking problems, their fist misuse of alcohol came during a time of personal crisis and experiencing mild to moderate symptoms of depression. Treatments typically include counseling, behavior modification and medication.
By: Beverly Rayfield
Administrator, Sinclair Method
This information is a compilation of research materials reviewed by the author and is presented for educational purposes only. This information does not constitute medical advice, nor should it be relied upon as such. Please consult a professional health care physician before pursuing any course of treatment.
Depression, like alcoholism, is not a personal “weakness” – it is a disorder. And, just as with the use of alcohol, if the depression interferes with normal functioning, then immediate attention to the problem, and corrective treatment is required.
Actual depression is not a state of mind that you can “snap out of” – rather it has been described as a dark blue or black hole that is a vortex that sucks your energy and leaves you confused and feeling terribly alone. In one large study depression was shown to be more disabling than many other life threatening ailments that are often taken more seriously --including diabetes, high blood pressure (stroke), arthritis, and ulcers. Only advanced arthritis proves more painful, and only advanced heart disease caused more days in bed.
Depression is not the same thing as occasionally “having the blues” or “feeling down in the dumps” or “suffering from PMS or grieving the loss of a loved one of friend. Every one of us, on some occasion, feels “depressed” or has a bad day. These feelings are all-natural and don’t “push” someone into taking a drink or “make” them hang out in a bar in an effort to “cheer up.” These feelings pass with time, with an opportunity to talk to a close friend, most often without professional help or medicine therapy.
Generally, clinical depression is something else with very specific symptoms and have been present for two weeks or longer. For a diagnosis of depression, the symptoms must be troublesome enough to cause a person distress. It seems like it would be simple to diagnose. The problem in diagnosing depression, however, is that alcohol abuse mimics other psychiatric symptoms.
Depression is Often Misdiagnosed and Left Untreated
Alcoholism, as well as other addictions, can mimic or produce psychiatric symptoms – such as depression. Other illnesses that often appear with drinking include anxiety, panic attacks, hallucinations, mood swings, sleep problems, impulsive behavior, and low self esteem. These problems are usually difficult for the person, family or friends to deal with until treatment for the addiction is begun.
Severe emotional distress, which is often associated with suicide attempts, is frequently provoked with alcohol or other chemical substance abuse. Alarmingly, alcohol and substance abuse play a major part triggering 25% of completed suicides.
Untreated depression may last from months to years, and severely limit a person’s ability to enjoy a productive life. People suffering from untreated depression will say that “they haven’t been happy since they were children,” or “I feel intensely, acutely lonely and don’t want to be around anyone.” Many severely depressed people have extreme difficulty with relationships, have multiple marriages and partners and have a hard time keeping a job. Throw in alcohol abuse and the person’s problems are magnified tenfold times.
There are three typical depressive episodes: mild, moderate, and severe. In all of ranges, the individual usually shows symptoms of depressed mood (unusually quite, “sulking,” “moody”), loss of interest and enjoyment, and reduced energy. Marked tiredness after only slight effort is common. One typically hears the individual make statements complaining of increased fatigue, general malaise and decreased activity: “I don’t feel good; I’m tired; I just want to sleep; or I don’t feel like doing …”
Other common symptoms, ranging from mild to severe, include:
· increased consumption of alcohol
· reduced concentration and attention
· reduced self-confidence and self-esteem
· ideas of guilt and unworthiness
· bleak and pessimistic views of the future
· excessive purchases of alcohol and medications for somatic complaints
· ideas or acts of self harm
· radical change in appearance or dress
· diminished or increased appetite or bingeing/purging
· unusual concern for the future welfare of close family and children
· unusual purchases of potentially lethal poisons, handguns or rope
· writing diaries, updating wills, planning funerals, writing nasty letters
· stockpiling narcotics and controlled substances
· verbalizing that no one will miss them or care if they were dead
An individual experiencing a severe depressive episode will usually show considerable distress or agitation including hysteria and profound grief. There may be frequent periods of isolation both physically and emotionally. Major severe depression can include a stupor where the person refuses all food and liquids and must be immediately hospitalized. The severely depressed person can have delusions where they believe themselves to be sinful, extremely poor or have hallucinations where they hear accusatory voices or think they smell rotting odors.
Start with a Physical
Your doctor knows your healthcare needs best – if you can be straightforward and honest about your life and what is triggering your drinking. You should contact your doctor (or other heath care provider) with any questions that you have about your depression and treatment.
Be aware that the people who love you are most likely to notice that you are experiencing emotional symptoms (such as sadness, or loss of interest in once-enjoyed activities) – tell the doctor what others have observed. It is important to understand that the symptoms of depression, as with other illness, may differ from person to person, and if you are also drinking, the physician may not immediately pick up the severity of your depression.
The exact cause of depression is not clear – no one is sure why some people get depressed and others do not. Sometimes depression seems to happen because of a stressful event. Many people relate depression to the seasons of the year (dark winters, for example), the absence of family members, or an anniversary. Sometimes it seems to happen for no reason at all.
Doctors also believe that chemicals in the brain may play a role in depression, just as it seems to do with alcoholism. Not having enough serotonin may contribute to causing depression. Alcohol is involved with endorphins in the brain.
Genes may play a role with depression and alcohol. People whose family members have had depression are more likely to have it too. Singer Hank Williams, Jr. wrote and sang a song about his alcoholism being a “Family Tradition.” In the case of Mr. Williams, both his mother and his father were substance abusers, and died at an early age from the effects of mixing alcohol and painkillers. Mrs. Williams, Hank’s mother, was a manic-depressive.
Change Your Behaviors, add Medication, Seek Counseling
Depression is no one’s “fault.” It’s not a sign of personal weakness or a character flaw. Depression is a real medical condition that can be managed by changing certain behaviors, and through the addition of medication therapy and counseling.
There are many medications available to treat depression. In all cases, it is recommended that you not drink while you are taking antidepressants, because the effect of alcohol is also a depressant on the nervous system. It is critically important to be honest with your physician. If you are going to drink tell your doctor so that the medications can be monitored closely. If your habit is to drink in the evening after work, your doctor may advise you to cut back significantly on the amount and type of alcohol you are consuming and take your medication midmorning to allow your body to remove as much alcohol as possible from your system before adding the medication.
Counseling can help with that change. All medicines for depression take time to work before you will start to experience relief from your depression. Drinking will only make you feel more depressed. During the time that you are waiting for the medication to start taking effect -- generally 2 to 4 weeks, sometimes 6 to 8 weeks -- it is important that you receive psychotherapy. Even in the absence of medication, psychotherapy is a critical component to getting well. Psychotherapy is nothing more than educating yourself to the mechanics of your body and mind. Your support team will help you get better.
Ten Ways to Dump Depression
Get your feelings out – Talk. Be specific, be honest, and be loving. Are you a mind reader? No? Well neither is your spouse, partner or best friend. Tell someone what is bothering you.
1. Learn from others – Read and Listen. There’s lots of good material out on the bookshelves and lecture circuit. You have to make a conscious effort to “get cured.”
2. Make a list – Write down what you are drinking; what you are eating; what dosage of medicine you are supposed to take are you taking everything correctly. 90% of overcoming depression is correctly following directions on the label and in life.
3. Be with others and be active – Find the happy people, the fun people who don’t drink, the people who enjoy walking the beach (without a beer), riding a bike (with a helmet); or volunteering at the humane shelter or senior center. Most of these people are in the age range of 6 to 12. Join them.
4. Try inspiration – Listen to soul music, doo-op, or the Boston Pops. Reconnect with soul-stirring music that makes you want to dance, get up and watch a run rise, visit an unfamiliar house of worship, sit quietly and meditate on all the good things that have come your way.
5. Try Exertion – Start with a walk, work up to a job, end with a short sprint or two, Build endurance. Shoot some baskets, learn to play tennis; take care of neglected chores (the garage, attic, junk room or closet). Wash the windows (hint: use Windex and newspapers – black ink only, no comics for a sparkling, “I’m proud of me” shine)
6. Fall in Love – Hopefully with your spouse or significant other; if not, a puppy or kitten will do. Give love and get love. Have something/someone to care about other than yourself.
7. Check your diet – Sugar is sometimes at the root of bouts of depression. Cutting it out of your diet may help considerably. If that works and you feel somewhat better, also try giving up wheat, anything with yeast in it, soy, fermented foods and sauces; give up all liquor: that is gin, whiskey, vodka, champagne, beer, wine, cooking sherry and cordials – everything that has sugar and yeast and is fermented. Give it up and see if your depression lifts.
8. Ask for help – Prayer can work wonders. Even little uncomplicated prayers like “God grant me peace.”
9. Call for help – If none of the above works or you are too depressed to even try, call your therapist as your first line of support. If your depression hangs on stubbornly, you need an immediate change. A change in medications, therapy and even location. You may need intensive outpatient treatment at a partial hospitalization program or inpatient treatment.
Depression, alcohol and recovery