Comorbid Depression and Alcohol Abuse

Depression and comorbid alcoholism is extremely common; in the National Epidemiologic Survey on Alcohol and Related Conditions (2001-2002) it was found that of the 43,093 adults surveyed, 20.5% of the participants suffering from alcoholism also had a concurrent depressive disorder. Those participants with alcohol-dependency were also 3.7 times more likely to develop major depression compared to those without alcohol dependency. Sher (2005) has gone so far as to suggest that all patients diagnosed with alcoholism should also complete a suicide risk assessment when admitted to any drug and alcohol treatment center. Comorbid disorders, also known as dual diagnosis disorders,  are not only devastating because the patient has to deal with two mental health issues rather than just one, but each disorder can also exacerbate the effects of one another. A study by Cornelius et al., (1995) found that where alcoholism and depression were comorbid, low self-esteem was 22% higher, and suicidality was 59% higher than when depression was present alone. This indicates that having comorbid depression and alcoholism can make each condition difficult to treat, because low self-esteem can lead to a higher consumption of alcohol (e.g. Glindermann, Geller and Fortney, 1999) which will make both conditions more severe. Low self esteem has also been shown to be a risk-factor for suicidality (Emler, 2001) and so having comorbid alcoholism and depression may make suicide a more likely reality. The risk of suicide is also higher in those suffering from alcoholism which is comorbid with bipolar disorder (Oquendo et al., 2010).

Due to the highly interwoven nature of the dual diagnosis disorders, drug and alcohol treatment centers need to target both disorders, and also show awareness for the higher risk for thinking of suicide. Oquendo et al. (1999) assessed how effectively major depression was treated when thoughts of suicide was extremely high, and found that regardless of any suicidal history, antidepressant medication was under-administered. The authors claim that many suicide attempts may be preventable if antidepressant medication is provided to the extent it is required. When alcoholism is a factor, however, antidepressant medication is not enough to treat both disorders effectively (Nunes and Levin, 2004). Although a modest beneficial effect was found when treating patients with antidepressant medication, the addiction is not targeted and so is not treated.

Despite the fact that antidepressant medication may not be administered effectively in all cases, when it is, and when the correct drug is used, even severe suicidal ideation and suicide attempts can be addressed in alcohol and drug treatment centers by using the best treatment available for substance abuse.

Because our treatment center relies on evidence based practices, our Substance Abuse Intensive Outpatient Program shares many common methods with other successful rehab programs.  The foundations of our treatment program for substance abuse also rely on the principles of harm reduction, motivational interviewing, stages of change and cognitive behavioral therapy to promote recovery from alcohol abuse and drug treatment.  In fact, our Intensive Outpatient Program in Memphis, TN that has been proven to be effective in the treatment of alcohol abuse and drug treatment in peer reviewed treatment outcome studies.   Our treatment center  provides services to those who need more treatment than one hour a week, but less than 24 hour care, by providing three hours of treatment per day, three to five days per week, in an intensive outpatient setting.  If you or a loved one is showing signs of alcohol abuse or needs drug treatment rehab, they should be assessed by a trained mental health professional who can help design a treatment plan that can result in recovery.