Does Depression Form a Link Between Stress and Drinking Problems?
Alcohol and Depression
The term depression can refer to a temporary or short-lived “down” mood that, while unpleasant, does not particularly affect a person’s ability to function normally and take part in routine activities. However, the term can also refer to any one of several officially defined mental health conditions capable of seriously interfering with the ability to function normally and follow a productive daily routine. The most well-known of these conditions is major depression (major depressive disorder), which can easily produce recurring, debilitating changes in mood. Other recognized forms of depression include conditions called persistent depressive disorder (formerly known as dysthymia) and disruptive mood dysregulation disorder.
People who occasionally get drunk typically experience no alcohol-related changes in their risks for diagnosable depression symptoms, the federal Substance Abuse and Mental Health Services Administration reports. However, people who regularly consume heavy or excessive amounts of alcohol do have increased risks for developing depression. Significantly depressed states of mind also frequently occur in physically dependent alcohol users (i.e., alcoholics) who stop drinking and start going through alcohol withdrawal. In turn, an individual who relapses in alcohol recovery and starts drinking again can also develop a substantially depressed state of mind.
Alcohol and Stress
People who describe themselves as highly mentally stressed commonly consume more alcohol than people who don’t describe themselves in this way, according to findings compiled by the National Institute on Alcohol Abuse and Alcoholism. This tendency is typically stronger in men than in women. Men under serious stress participate in drunkenness-inducing binge drinking roughly 50 percent more often than women; men under such stress also have a roughly 150 percent higher chance of developing alcohol use disorder (alcohol abuse/alcoholism) than their female counterparts. Once a pattern of heavy drinking is established, the repeated impact of alcohol exposure can produce changes in brain chemistry that, among other things, lead to changes in the body’s stress response that can make alcohol withdrawal symptoms considerably more intense.
What’s the Connection?
In the study published in the Journal of Substance Use, the Washington State University researchers used a 14-year evaluation of 527 adults to explore the connection between depression, stress and alcohol problems. All of these individuals had at least reached middle age and were not receiving residential care for any health problems (including problems with depression or drinking). The researchers tested each study participant’s depression levels with a screening tool called the Center for Epidemiologic Studies Depression Scale (CES-D). They tested the participants’ self-reported stress levels with a screening tool called the Perceived Stress Scale. In addition, the researchers tested each participant’s level of risk for alcohol use disorder with a widely used screening tool called the Alcohol Use Disorders Identification Test (AUDIT). They also considered the potential influence of additional factors such as gender, age and place of residence relative to a city’s downtown district.
The researchers concluded that the presence of significant depression symptoms has a fairly clear influence on the relationship between mental stress and the chances of later having diagnosable alcohol problems. The specific nature of this influence apparently varies for specific groups of individuals. For example, among men in the study, depression was linked to greater risks for an alcohol use disorder diagnosis and lower levels of reported stress. Depression was also linked to heightened risks for alcohol use disorder in study participants who lived relatively close to their local downtown. Among younger people and people who lived relatively far from their local downtown, depression was linked to greater levels of long-term stress. Finally, among older study participants with a generally sound record of health, ongoing depression symptoms (as opposed to shorter-term symptoms) helped determine the connection between habitual levels of alcohol intake and the presence of mental stress.