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Marjorie Bekaert Thomas
Advances in health and medicine.
Nutrition & Wellness Channel
Reported February 14, 2013

Depression & Alcoholism: What Comes First?


(Ivanhoe Newswire) -- The famous question, what came first, the chicken or the egg, can now be applied to alcoholism.  Problem drinkers can have depressive symptoms, but do they drink because they are depressed or does the alcohol cause the depression?
New research suggests that depressive symptoms are often a direct result of their heavy alcohol intake.  
Experts have known that heavy drinking can spur episodes of depression, called “substance-induced depression.”  However, this information is not always apparent to busy health-care professionals.
"I don't know that the average person realizes that heavy drinking can induce mood problems," lead researcher Marc A. Schuckit, MD, of the University of California, San Diego School of Medicine, was quoted as saying.  
Dr. Schuckit emphasizes that because depression caused by heavy drinking has a different prognosis and is treated differently than major depression that are not seen in context of heavy drinking, it is important that every doctor pay close attention to this problem.  Independent and substance-induced depressions’ symptoms can be identical, but if the sadness develops in the context of drinking heavily, then the symptoms are likely to disappear within several weeks of abstinence. 
The findings came from a 30 year study of close to 400 men who started drinking at 18.  Half of them had an increased risk for developing a drinking problem due to their fathers being alcoholics.  Over the course of 30 years, 41% of the men with alcoholic fathers developed alcohol abuse or dependence and 20% suffered at least one major depressive episode.  However, almost 1/3 of those major depressive episodes were seen only while they were drinking heavily.
Dr. Schuckit suggests that doctors should consider alcohol use disorders as a possible cause of the patients’ depression symptoms, instead of automatically recommending an antidepressant.  
"If you're an alcoholic, you're going to have a lot of mood problems and you may be tempted to say, 'Well, I drink a lot because I'm depressed.' You may be right, but it's even more likely that you're depressed because you drink heavily,” Dr. Schuckit said.
SOURCE:  Journal of Studies on Alcohol and Drugs, February 2013
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