My mother has been drinking wine daily since my father died. Could she be an alcoholic, or does she need treatment for depression?
The possible risk of an untreated depression is the development of co-morbid substance abuse, including alcohol abuse. Alcohol and drugs make people feel better temporarily; unfortunately, however, this effect is only temporary. As the high wears off, despair can set in. After the death of a spouse or other close family member, if excessive drinking develops, depression may be present. Alcohol abuse can often be missed in older women, particularly if it involves only wine or beer consumption. Alcohol abuse can cause depression itself — in such circumstances, recovery from the substance abuse usually leads to resolution of the depression. Depression often precipitates the abuse of alcohol and/or drugs as an attempt to relieve the emotional pain and thus acts as a treatment for the depression; however, traditional medical treatment for depression will be necessary in order to promote the recovery from the substance abuse (see Question 68 for further discussion on mood disorders and alcoholism).
Alcoholism is an arguable risk factor associated with depression or other mood disorders because it remains scientifically unclear how the two are associated. Generally, in patients with true depression, the symptoms exist independently of the amount of alcohol consumed, and the symptoms will not improve simply by maintaining abstinence. Second, in individuals in whom alcohol is clearly playing havoc with their moods, generally a lot of environmental stressors exist as a consequence of the alcoholism that impacts on mood independently of alcohols direct biological effects. Losing a job, a broken marriage, poor financial supports, or a lack of housing as a result of the single- minded pursuit of alcohol all impact a person's mood. In this situation, merely taking an antidepressant medication with the thought that the problem is depression is akin to ignoring a broken leg by treating it with only pain medication. Generally, if in one's past a person has had significant periods of sobriety in which mood symptoms have abated, then the depression is more likely caused by the alcohol than an underlying mood disorder. This is not definitive, just more likely.
Alcohol abuse can cause depression itself- — in such circumstances, recovery from the substance abuse usually leads to resolution of the depression.
Regardless of whether alcoholism causes depression or depression causes alcoholism, alcohol to a depressed person is clearly like throwing an incendiary device on a dry, brittle forest.
Regardless of whether alcoholism causes depression or depression causes alcoholism, alcohol to a depressed person is clearly like throwing an incendiary device on a dry, brittle forest. The chances of a depressed person attempting suicide are doubled when that person drinks. Therefore, for any improvement in mood to occur, the person must stop drinking immediately; for many people with depression, however, this simple task seems not only absurd (it often becomes their only pleasure), but also close to impossible. As a result, the alcohol problem must be treated along with the depression. For most people, just telling them to stop drinking will not suffice. Support and persistence are required. Support may or may not come from programs such as AA, but it must come from family and friends. The more support systems that an alcoholic has, the better his or her chances are for a successful recovery.