People affected by depression can significantly misinterpret their level of exposure to alcoholism and diagnosable alcohol abuse, findings from a group of Swiss, Canadian and British researchers indicate.
There is a well-established interaction between any given person’s baseline level of alcohol consumption and the odds that he or she will have diagnosable symptoms of depression or some other form of depressive illness. In a study published in December 2014 in the journal Alcohol and Alcoholism, researchers from several Swiss institutions, one Canadian institution and one British institution assessed the ability of people with major depression to self-interpret their symptoms of alcoholism/alcohol abuse (i.e., alcohol use disorder). These researchers concluded that depression-affected individuals can easily misinterpret their alcohol use disorder exposure.
Depression and Alcohol Use
There is a reciprocal relationship between alcohol use and depression. Some people with clinically verified cases of alcohol use disorder subsequently develop symptoms of depression. Conversely, some people with clinically verified cases of major depression or some other depressive illness start consuming alcohol in risky ways and (in some cases) develop serious alcohol problems. When depression and alcohol use disorder appear in the same individual, the two disorders can produce much worse overall effects than they would on their own. (Doctors and researchers refer to such co-occurring and mutually reinforcing conditions as comorbid illnesses.) All combined cases of diagnosable substance problems and independently diagnosable, non-substance-based mental health problems are categorized by mental health professionals under an illness heading known as dual diagnosis.
Some depressed people use alcohol as a form of self-treatment for their unwanted/unpleasant mental states. Unfortunately, alcohol actually produces changes in brain function that increase the likelihood of feeling “down” or depressed. In addition, people who drink excessively may experience hangovers or other drinking aftereffects that increase their chances of experiencing some form of mood instability. People who drink excessively can also trigger damaging changes in their daily ability to function that ultimately contribute to a down or depressed mood.
Diagnosable Alcohol Use Disorder
The alcohol use disorder diagnosis applies to three groupings of alcohol-related symptoms: isolated indications of alcohol dependence (better known as alcoholism), isolated indications of non-dependent but damaging alcohol abuse and simultaneous indications of alcohol dependence and alcohol abuse that overlap. Under terms established in 2013 by the American Psychiatric Association, a person with the condition must have at least two symptoms that fall into one of these groupings. People with four or five isolated or overlapping alcohol-related symptoms have a moderate case of alcohol use disorder, while people with six or more isolated or overlapping symptoms have a severe case of alcohol use disorder. Doctors in the U.S. use a number of screening tools—including the Alcohol Use Disorders Identification Test (AUDIT or AUDIT-C)—to identify the most likely affected individuals.
Depression and Self-Estimates of Alcohol Problems
In the study published in Alcohol and Alcoholism, researchers from Switzerland’s University of Lausanne, University of Neuchatel, Lausanne University Hospital and Addiction Switzerland, Canada’s Centre for Addiction and Mental Health and the United Kingdom’s University of the West of England used data from 4,352 Swiss men between the ages of 20 and 25 to gauge the ability of people with major depression to self-report the presence of diagnosable alcohol use disorder. On two separate occasions, all of these men answered detailed questionnaires designed to identify their typical drinking patterns, uncover major depression alcohol use disorder.
The researchers concluded that the study participants affected by major depression were substantially more likely to diagnose themselves with alcohol use disorder than the participants unaffected by major depression. However, the participants with depression didn’t consistently use alcohol in heavy amounts, and there was little connection between alcohol intake and self-perceived exposure to alcohol use disorder in these individuals. The researchers confirmed the statistical connection between diagnosable major depression and diagnosable alcohol use disorder, but note the relatively weak strength of this connection.
The study’s authors do not intend to dispute the connection between depression and alcohol problems. However, they believe their findings indicate that people affected by depression might not have a reliable ability to gauge their level of alcohol use disorder exposure. The authors also believe their findings highlight the problems associated with relying on self-reports as screening tools for alcohol use disorder or other forms of substance use disorder.