Question:
My concern, is that I'm in one of my "bouts" right now...and I'm wondering about the usage causing chemical changes in my brain that may actually *enhance or promote* depression over the short or long term. By the same token, I've used it for over half my life, so I don't know how concerned I should actually be, but the question has been raised in my mind, so might as well seek out answers. Anyone know where studies in this regard have been done?
Answer:
Does anyone have any info on studies done that discuss the usage of alcohol by a person who has depression? I use alcohol in moderation, have and can quit when I desire to. The
alcohol is not a problem for me.
But I do use it as a form of medication as well. I have extreme ocd,
am mostly recovered from extreme anxiety, but still get mild to severe
bouts w/depression several times a year.
I won't use any form of med, ever, but will use alcohol, I suppose due
to familiarity.
My concern, is that I'm in one of my "bouts" right now...and I'm
wondering about the usage causing chemical changes in my brain that may
actually *enhance or promote* depression over the short or long term.
By the same token, I've used it for over half my life, so I don't know
how concerned I should actually be, but the question has been raised in
my mind, so might as well seek out answers. I am a recovering alcoholic who also has BP2Mixed. I had untreated BP
since my teens....over 30 years. I have been treated for BP nearly 3
years now (I am 53 years old). I used alcohol as a form of self
medication ....for a total of about 8 years. Alcohol in and of itself is
a depressive drug.
In my experience alcoholism and comorbid psychiatric conditions appear
to be common. Here is some info on alcoholism. I hope it is helpful to you. Also the
search engine www.google.com will give you many hits. Just type in
alcohol and mental iilnnes, or depression etc.
Diagnostic Criteria
A. Alcohol abuse: A destructive pattern of alcohol use, leading to
significant social, occupational, or medical impairment.
B. Must have three (or more) of the following, occurring when the
alcohol use was at its worst:
1. Alcohol tolerance: Either need for markedly increased amounts of
alcohol to achieve intoxication, or markedly diminished effect with
continued use of the same amount of alcohol.
2. Alcohol withdrawal symptoms: Either (a) or (b).
(a) Two (or more) of the following, developing within several hours to a
few days of reduction in heavy or prolonged alcohol use:
* sweating or rapid pulse
* increased hand tremor
* insomnia
* nausea or vomiting
* physical agitation
* anxiety
* transient visual, tactile, or auditory hallucinations or
illusions
* grand mal seizures
(b) Alcohol is taken to relieve or avoid withdrawal symptoms.
3. Alcohol was often taken in larger amounts or over a longer
period than was intended
4. Persistent desire or unsuccessful efforts to cut down or control
alcohol use
5. Great deal of time spent in using alcohol, or recovering from
hangovers
6. Important social, occupational, or recreational activities given
up or reduced because of alcohol use.
7. Continued alcohol use is continued despite knowledge of having a
persistent or recurrent physical or psychological problem that is likely
to have been worsened by alcohol (e.g., continued drinking despite
knowing that an ulcer was made worse by drinking alcohol)
------------------------------------------------------------------------
Associated Features
* Learning Problem
* Dysarthria/Involuntary Movement
* Depressed Mood
* Somatic/Sexual Dysfunction
* Addiction
* Sexually Deviant Behavior
* Dramatic/Erratic/Antisocial Personality
------------------------------------------------------------------------
Differential Diagnosis
Nonpathologic alcohol use for recreational or medical purposes; repeated
episodes of Alcohol Intoxication.
Part I
During the 1980s the average consumption of alcohol in the United States
declined, while more people than ever were making efforts to change
their drinking habits. The membership of Alcoholics Anonymous doubled to
nearly a million during that decade. In 1979 about 2% of Americans had
ever sought help for alcoholism, and by 1990 more than 5% had (about 8%
of men and 3% of women). These trends provide reasons for optimism about
the prevention, recognition, and treatment of alcohol problems.
One definition of those problems is given in DSM-IV, the American
Psychiatric Association's most recent diagnostic manual. There alcohol
abuse is defined as a drinking habit with consequences that include
marital conflict, legal problems, dangerous driving, violence,
accidents, job loss, and emotional or physical illness. Alcohol
dependence involves additional symptoms: tolerance, withdrawal
reactions, taking more than intended, unsuccessful efforts to stop or
cut down, continuing to drink despite serious health effects, and
allowing to occupy most of one's time and life.
But people with drinking problems are not easily classified as abusers
or dependent, healthy or diseased. Patterns of abusive drinking are
complicated and individually variable. Alcoholics are not always
drinking uncontrollably or even drinking at all. Partly because of this
complexity, diagnosis is difficult and the need for help is often
unrecognized or unacknowledged. Friends, family members, and others may
maintain silence for fear of being intrusive or having to assume
responsibility. Alcoholics themselves often deny, conceal, rationalize,
or blame others. Many accept treatment only reluctantly, under
compulsion by the law or pressure from family members and employers.
Physicians and mental health professionals are sometimes reluctant to
treat people they may see as both demanding and ungrateful. Only 20% of
doctors routinely talk about alcohol with their patients.
Changing the emphasis
Merely asking how much a person drinks is usually unhelpful, because
alcoholics may not keep track or tell the truth. Better questions are:
"Do you sometimes feel uncomfortable when alcohol is not available? Do
you drink more heavily than usual when you are under pressure? Are you
in more of a hurry to get to the first drink than you used to be? Do you
try to avoid certain people while drinking? Do you sometimes feel guilty
about your drinking? Are you annoyed when people talk about your
drinking? When drinking socially, do you try to sneak in some extra
drinks? Have you ever woken up in the morning and not remembered parts
of the evening before? Do you often regret things you did or said while
drinking? Are you constantly making rules for yourself about what and
when to drink?"
Some questions for friends and relatives: "Are you ever worried or
embarrassed by this person's drinking? Does he or she often promise to
quit? Do you lie to conceal the drinking? Do you try to justify it? Has
he or she ever driven drunk? Do others talk about the drinking? Does he
or she sometimes apologize after a drunken episode?"
Some alcoholics need help only in acknowledging the problem and can do
the rest themselves. A further brief intervention immediately following
recognition or diagnosis may also be useful in persuading incipient
problem drinkers to enter treatment.
A doctor or other professional offers advice and information, provides
referrals to self-help groups, and suggests therapeutic alternatives. In
one type of brief intervention, family members and friends are asked to
make a list of frightening or embarrassing events associated with the
drinking and invited to attend a meeting with the problem drinker for a
dramatic confrontation.
Beyond recognition and brief intervention, the variety of alcohol
problems is matched by the variety of proposed treatments, which range
from the biochemical (use of agents that block the effects of alcohol)
to the religious (encouraging repentance and spiritual renewal).
Some alcoholics are so severely dependent that they must be detoxified,
or treated for acute withdrawal symptoms (mainly anxiety, racing heart,
tremors, nausea, dry mouth, sweating, and weakness). Although these
symptoms will usually subside in a week or two, they are extremely
uncomfortable and provoke an urge to resume drinking. One way to ease
withdrawal is to substitute another sedative drug, usually a
benzodiazepine such as diazepam (Valium) or chlordiazepoxide (Librium),
and gradually reduce the dose to zero. Atenolol and other
beta-adrenergic blockers may speed up the process and reduce the need
for benzodiazepines by eliminating tremors and lowering heart rate,
blood pressure, and body temperature.
A few withdrawing alcoholics have to be hospitalized. Some have failed
in outpatient detoxification and will not stop drinking as long as they
have access to alcohol. Others have serious psychiatric disorders or
medical problems such as high blood pressure or diabetes. In about 5% of
cases hospitalization and use of antipsychotic or anticonvulsant drugs
is necessary because of withdrawal delirium (delirium tremens), which
has symptoms that include agitation, disorientation, hallucinations, and
occasionally seizures.
Available medications
Two drugs have been used to prevent relapse in alcoholics. Disulfiram
(Antabuse) blocks the normal metabolism of alcohol; the toxic breakdown
product acetaldehyde accumulates, and the resulting nausea makes the
patient avoid alcohol. Because the body eliminates disulfiram slowly,
its effects may persist a week or more after the patient stops using it.
Side effects are usually mild, although numbness and pain from
inflammation of nerve tissue (neuritis) may develop. Unfortunately, the
dropout rate is high. Disulfiram is effective mainly when the patient is
committed to long-term change and needs protection against momentary
lapses while undertaking other forms of therapy.
In 1995 the FDA approved another drug for the prevention of relapse:
naltrexone, an opioid antagonist that has been used for years in the
treatment of heroin addiction. It blocks the activity of natural opioids
(endorphins) that are apparently stimulated by alcohol as well as
narcotics. Alcoholics who take naltrexone feel less craving, drink less,
and are less likely to lose control if they do take a drink. Typically
about 50% of patients taking a placebo but only 25% of those given
naltrexone relapse in the first three ...I don't, but I'm sure a quick search with a search engine would
give you some very good information. A good medical site is Medscape. That's too bad. Alcohol is not a good med. If you have extreme
ocd and anxiety, and obviously bad bouts of depression, I would
think you might want to try something that would help rather than
using something that will exacerbate these conditions. Or at the
very most just temporarily mask a couple of them. I'm assuming you are talking about alcohol here? Alcohol *is* a
depressant. Alcohol will not help depression. Like I stated above, I'm sure there is a ton of info out there
is you do searches, I'd recommend do searching in medical site
though. *My opinion* is that your behavior is self-destructive. Alcohol
is not a medication. And as far as *I* know, the only theraputic
use of alcohol is *small doses* of red whine.
