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Alcoholic depression in the presence of alcohol dependence is a mood disorder that occurs quite often in the structure of the course of alcohol dependence syndrome during the period of withdrawal syndrome and alcoholic psychoses. In addition, people with depression can use alcohol as a means of escaping their problems. In its symptoms, it is similar to the picture of manifestations of neurotic depression of a shallow degree, can occur with depression, components of anxiety and irritability, and have hypochondria symptoms. All these issues can be considered as potential causes of depression and its facilitation of alcoholism.
Potential Causes
It should be noted that in some cases, such as the background of severe withdrawal symptoms, more severe manifestations with deep depression can be observed, which corresponds to the picture of a major depressive episode. The presence of depressive symptoms in withdrawal symptoms should be regarded as an unfavorable prognostic sign. This may indicate the appearance of brain damage, toxic damage to the central nervous system, and the progression of alcohol dependence syndrome (Oo, Aung, Jenkins, & Win, 2016). It is depression with alcoholism that is one of the most common causes of suicidal attempts in alcohol abusers. In addition, maternal alcoholism can be one of the primary causes of depression and subsequent alcohol abuse (Herman-Stahl et al., 2017). Depression is often observed with meta-alcohol psychoses, most often in the first days after stopping alcohol, and it can be an initial cause for alcoholism. In the process and result of detoxification, as a rule, an affective disorder, which is characterized by a duration of several days to several weeks, has the opposite dynamics. Prolonged alcoholic depression manifests itself in fewer cases, and often, their presence requires differentiation with endogenous internal processes. Symptoms and signs of alcohol depression can be expressed by anxiety and tearfulness, and in more serious cases, have vital components such as atrial longing and signs of melancholic depersonalization, fluctuating intensity of the altered effect.
Substance abuse, such as alcohol, among people is often associated with emotional and behavioral disorders that are not directly related to the effects of the substance. Such concomitant disorders include depression, suicidal behavior, behavioral disorders, attention deficit hyperactivity disorder, eating disorders, and psychosis. Some reasons for causal relationships in specific subjects are possible, but so far, there is no general approach. Individuals with a high level of psychological distress tended to drink more often in a negative than in a positive affective state. In contrast, participants with low psychological distress had a tendency to drink more often in a positive than in a negative affective state. The propensity to drink alcohol in negative affective conditions predicts alcohol activation, and the propensity to drink alcohol in positive affective conditions determines inhibition. Low mood induces a desire to drink alcohol, even in the absence of exposure to the physical attributes of alcohol.
Alcohol consumers with high levels of neuroticism and introversion by results may show a more pronounced concern for the physical characteristics of alcohol than consumers with low similar personality characteristics. The degree of anxiety is caused by the characteristics of alcohol that determined the desire to drink alcohol. A neurotic and introverted profile indicates disturbing and depressive character traits. This indicates a common relationship between neurotic introversion and an anxious mood and suggests that the effect of psychological distress may mitigate the anxiogenic effects of alcohol (Oo et al., 2016). Negative emotional cues activate alcohol cognitive constructs to a greater extent in problem drinkers with high psychological distress than in problem drinkers with low psychological distress, and the same cues in relation to alcohol would likewise activate negative emotions more if high than low psychological distress in problem drinkers.
The complex relationship between alcohol and stress involves several different aspects. Still, it is most commonly assumed that people drink alcohol to reduce stress and that stress can affect increased alcohol consumption. This issue acquires particular importance in youth, that is, in the period between youth and adulthood, when involvement in alcohol consumption is much higher than in any other period of life (Herman-Stahl et al., 2017). Many theories on the etiology of alcoholism postulate the role of anxiety. However, contradictions remain about the nature of the relationship between anxiety and alcohol abuse. While anxiety symptoms can lead to alcohol abuse, withdrawal conditions, and other effects of chronic alcohol consumption can cause anxiety symptoms. Understanding the relationship between anxiety and alcohol dependence, especially in adolescents, is essential for health.
Although there is no universally accepted agreement on these issues in order to draw any meaningful conclusions, certain difficulties may arise in assessing the state of anxiety since most diagnostic tools take into account the subjective assessment of the state by the client. The patient cannot always clearly differentiate the state of anxiety and stress. Sometimes it is important to try to conduct a qualitative and quantitative assessment of the state of anxiety by some autonomic parameters. Most often, heart rate is used as a non-specific characteristic, which manifests itself not only in anxiety states. Some of the known pharmacological effects of alcohol can have an effect on anxiety and related physiological reactions (Levinthal, 2014). The most significant results of alcohol on the peripheral and central nervous systems. The effects of alcohol on the adrenergic receptors of the heart and the sympathetic nervous system can determine the differences in cardiovascular reactions seen in anxiety reactions. However, the anxiolytic and anti-stress effects of alcohol cannot be fully explained by its peripheral effect.
The actual effects of alcohol on anxiety are somewhat different from the relationship between anxiety disorders and alcohol dependence. If a person believes that alcohol will reduce anxiety, this belief, combined with anxiety symptoms, can lead to alcohol abuse, regardless of its actual effects. Screening for alcohol abuse and dependence is critical in patients with anxiety symptoms. Anxiety disorders, especially social phobia, often precede alcohol abuse and dependence. The common features between the symptoms of alcohol withdrawal and generalized anxiety disorder, panic disorder cause difficulties in making accurate diagnoses before the period of remission.
Treatment
Treatment of alcoholic depression involves an integrated approach, as, however, the treatment of alcoholism in general. The severity of the diagnosis of this condition is often because the depressive state is not recognized as such and is attributed by the immediate environment to a completely insignificant one. Typical everyday situation and the patient simply does not receive help on time, which subsequently naturally leads to relapses in alcohol intake. The person tends to leave from unpleasant affective experiences in a manner well known to him. In the absence of therapeutic effect, this method is often the only one in the patient’s behavioral model. Thus, a vicious circle is formed, that is, excessive drinking, an attempt to get out of hard-drinking, alcohol depression that leads to hard drinking.
When social anxiety and alcohol addiction are combined, social anxiety precedes the alcohol problem in almost all cases and for about a decade. People with high social anxiety intentionally consume alcohol to cope with their social fears in social interaction situations rather than social production situations. Understanding the relationship between anxiety and alcohol dependence is important for planning treatment strategies (Hobden et al., 2018). The residual symptoms of anxiety can contribute to relapse in patients treated for chronic alcoholism because patients can return to drinking alcohol to stop the symptoms of anxiety. Treatment for anxiety disorders may increase periods of abstinence in some groups of patients. Further advances in understanding the relationship between anxiety and alcohol depend on considering anxiety, the effects of alcohol, and their interactions.
Conclusion
In conclusion, an integrated approach in the treatment of alcoholism and the effects of alcohol depression resulting from it is fundamental. The correct diagnosis and exclusion of endogenous causes are critically necessary. In addition, the provision of psychotherapeutic assistance and the formation of skills to control their own affective experiences are required. It is possible to include pharmacological therapy, that is, the appointment of a drug that suppresses the desire to drink alcohol. At the moment, new and safe means have been developed that allow achieving excellent results. No less important is working with the family as with a co-dependent environment because of the correct reaction of relatives to certain affective manifestations and competent help. The latter includes support that is really necessary and is an integral component of the treatment of alcoholism, as it is widely known that this disease is not only somatic but also social in nature. Thus, it is the right choice of a medical institution where specialists who have extensive experience and high qualifications can give the most long-term result and help in the complete cure of alcohol dependence.
References
Herman-Stahl, M., Saavedra, L. M., Morgan-Lopez, A. A., Novak, S. P., Warner, T. D., & Fishbein, D. H. (2017). Maternal depressive symptoms and adolescent alcohol use: The mediating role of youth depressive symptoms. The Journal of Early Adolescence, 37(4), 453-474.
Hobden, B., Bryant, J., Carey, M., Baker, A. L., Farrell, M., Oldmeadow, C., … Sanson-Fisher, R. (2018). Finding the optimal treatment model: A systematic review of treatment for co-occurring alcohol misuse and depression. Australian & New Zealand Journal of Psychiatry, 52(8), 737-750.
Levinthal, C F. (2014). Drugs, behavior, and modern society (8th ed.). London, England: Pearson.
Oo, K. Z., Aung, Y. K., Jenkins, M. A., & Win, A. K. (2016). Associations of 5HTTLPR polymorphism with major depressive disorder and alcohol dependence: A systematic review and meta-analysis. Australian & New Zealand Journal of Psychiatry, 50(9), 842-857.
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