Question: Is alcoholism a form of depression or does it cause depression in those genetically susceptible? Also, can you be an alcoholic and not suffer from depression??
Answer: Alcoholism is not a form of depression, but both are quite common, and there is plenty of overlap between the two.
Depression makes people more vulnerable to alcoholism and vice versa, said Dr. Shelly Greenfield, a professor of psychiatry at Harvard Medical School and director of McLean Hospital’s Alcohol and Drug Abuse Clinical and Health Services Research Program.
About a third of depressed people also have a problem with alcohol, she said, adding that the depression usually comes first. Genetics makes some people more vulnerable to each — and perhaps the combination, Dr. Greenfield said, “but it’s not the whole story.”
Social environment, particularly in childhood, also plays a key role. People who are the victims of physical or sexual abuse, for example, are at higher risk for both alcoholism and depression later in life, she said.
Depressed people who drink will most likely see their depression worsen, because alcohol is a depressant, tamping down the nervous system, said Dr. Kathleen Brady, a distinguished university professor at the Medical University of South Carolina. Abstinence will be harder for alcoholics who are depressed, because of the hopelessness that comes with depression.
Getting help promptly may make recovery from alcoholism easier, Dr. Greenfield said. Needing help to quit drinking or to resolve depression is not a sign of weakness or personal failure, she noted. In families with a history of either depression or alcoholism, it is important to be vigilant about drinking, particularly in adolescence.
Treatment may involve a combination of medications, talk therapy and social support, said Dr. Larissa Mooney, an associate clinical professor of psychiatry at the University of California, Los Angeles, and director of the U.C.L.A. Addiction Medicine Clinic. In the past, alcoholism might have been treated before addressing depression, but now, she said, the thinking is that both should be treated at the same time.
But people with both depression and alcoholism should know that they definitely can get better, Dr. Mooney said.