I had several bouts of depression during my drinking years, mainly reactive depressions caused by bereavements or being bullied. As I self-medicated with alcohol that was usually my first line treatment. I also referred myself to the GP practice for counselling to overcome it but on one occasion this was not enough to help me and I was prescribed anti-depressants. I took the course of anti-depressants and my low mood improved but in hindsight I realise that my drinking was probably not helping things at the time. I was prescribed a selective serotonin re-uptake inhibitor (SSRI) and it is recommended that you do not drink whilst taking this medication. I roundly ignored this advice washing down my tablet every day with a glass of wine. I mentioned in another post recently how much better my mood had been since I quit and this got me thinking and researching.
Last year a newspaper article reported the results of a survey of tens of thousands of GP’s sick notes and found that 35 per cent of illnesses were linked to stress, anxiety or depression. In the United Kingdom, the use of antidepressants increased by 234% in the 10 years up to 2002 and the number of antidepressants prescribed by the NHS in the UK almost doubled during one decade, authorities reported in 2010. Furthermore the number increased sharply in 2009 when 39.1 million prescriptions were issued, compared to 20.1 million issued in 1999. Also, physicians issued 3.18 million more prescriptions in 2009 than in 2008 (source). This is an alarming statistic in itself and I began to wonder how many other people were like me and had continued to drink whilst taking them?
A meta-analysis of depression and substance use among individuals with alcohol use disorder found that high rates of depression are common among individuals with alcohol use disorders (AUD), particularly alcohol dependence. Data from the National Comorbidity Survey estimated the lifetime prevalence of major depression to be nearly one quarter (24.3%) among alcohol-dependent men and nearly one half (48.5%) among alcohol-dependent women, exceeding the prevalence rates among individuals without AUD. In clinical samples, the lifetime rates of co-occurrence are greater still, ranging from 50% to 70%.
Research has shown that the pharmacological effects of alcohol may produce symptoms of depression more or less directly during periods of intoxication and/or withdrawal. Relatedly, laboratory studies have shown that depressive symptoms can spontaneously emerge in the context of heavy drinking and abate with abstinence.
So my thinking has become how much of my depressive symptomatology was caused by, or certainly exacerbated by, my drinking? And also how many other people may be being prescribed anti-depressants for depression that is caused or exacerbated by drinking and yet they do not know this link between drinking and depression and continue to drink?
Edited to add: 29th April 2016