Alcoholism and Depression Go Hand in Hand
Alcoholics in recovery are often surprised to find that they have been using alcohol to treat a condition they may not have even known they had. The initial discovery that the condition exists and has a name—alcoholism—is reassuring, as the alcoholic may have repeatedly wondered, “What’s wrong with me?” Further reassuring is the notion that alcoholism has a solution.
However, there are problem-drinkers who also suffer from depression, and alcoholism and depression are often inextricably linked, though the dynamics may vary. Most alcoholics experience depression at some point after they stop drinking. For some, it’s simply a matter of having repressed emotions for so long—sweeping them under the rug with alcohol—that the sudden vulnerability to feelings is overwhelming. Additionally, by the time sobriety becomes recognized as a necessity, much harm has usually been done: relationships damaged, trust broken, professional lives disrupted, perhaps even legal problems and health issues. To suddenly have to face the reality of the accumulated harm can be a tremendous psychic burden. (A common joke in recovery circles is “You’d drink too if you had my problems.)
On the other hand, there are those for whom depression is a pre-existing—and co-existing—problem. Alcohol may have helped mask the depression but eventually became its own problem, leading to what is known as comorbidity: two or more disorders presenting concurrently. Each disorder separately carries a statistically significant risk for the development of the other, and the severity of one is usually an indicator of the severity of the other.
When this is the case, treatment for both alcoholism and depression is indicated. If only the alcoholism is addressed, the alcoholic faces an untenable situation: raw depression without (what’s left of) the self-medicating effect of alcohol. The probability of relapse is quite high. If, on the other hand, both alcoholism and depression are treated—using appropriate medication, counseling, and cognitive behavioral modification therapy, and introduction to a recovery community—then the patient has a realistic chance to regain a meaningful and functional life.