Alcohol and Depression – Dual Diagnosis response still inadequate?

This comes courtesy of Alcohol Policy UK and Alcohol Concern regarding depression and dual diagnosis.

alcohol and depressionAlcohol Concern have released a new alcohol and depression factsheet [pdf], which highlights ‘a complex, powerful and mutually reinforcing relationship between alcohol and depression’.

The factsheet says depression is one of the most common mental health problems in the UK – experienced by as many as one in ten people in any year and costing around £11 billion in England. However treatment offered to those with alcohol problems and depression often falls short, a long running issue for the field.

Clinical research shows that regular drinking disrupts the brain’s chemistry, lowering the level of serotonin in the brain. Serotonin is responsible for regulating mood changes may lead to the development of depressive-like symptoms. Whilst for some alcohol may induce depression, others may turn to alcohol in an attempt to relieve it. However ‘self-medicating’ with alcohol has been shown to be one of the least effective methods of dealing with depression.

Dual Diagnosis – any further on?

Between a third and a half of people of who have a mental health problem also use drugs or drink to excess, and those experiencing depression while seeking alcohol treatment are both more likely to relapse and to relapse earlier, acccording to the factsheet.

However because of the complex nature of dual diagnosis, inadequate treatment has often resulted. As such the factsheet states it is important that the NHS and treatment services are equipped to deal with people who have a dual diagnosis, and ensure dual diagnosis patients receive comprehensive and coordinated care.

However a poor response to dual diagnosis has been a long running issue as identified in this Alcohol Policy UK post last year, following new research on the issue. Compared to other psychological therapies, cognitive based therapy (CBT) and/or motivational interviewing (MI) produced small but robust beneficial effects on both depression and alcohol consumption amongst the dually diagnosed.

Most promisingly, it suggested clinicians don’t need to identify a ‘primary’ diagnosis and treat that in the hope that the other will resolve; both can be treated at once.

More recently, further recent research has also demonstrated the positive impact of treatment approaches – as summarised in this Mental Elf blog: ‘combined treatment for co-morbid depression and alcohol use disorders is associated with a large early improvement in depression, irrespective of whether the depression is independent of alcohol misuse’.

Further reading :

I’ve also written a couple of blog posts about depression and dual diagnosis which you can revisit here and my good friend Libby Ranzetta writes extensively about depression over at her blog  Depression Lab.

2 thoughts on “Alcohol and Depression – Dual Diagnosis response still inadequate?

  1. You know, I just can’t imagine our paleolithic ancestors living with chronic depression. Can you picture someone going, “No, (heavy sigh) I’m gonna stay in my hut… mammoth hunting or berry-gathering is just too hard today.” Natural (and social) selection had no problem eliminating people who succumbed to that outlook.

    I’m not trying to be glib here, because I know I’m prone to those feelings myself. But there’s something in modern life – perhaps the fact that our activities of daily life are no longer imbued with the same sense of urgency, because they aren’t the only thing standing between us and a cold or violent death – that makes life seem boring and pointless to some people.

    That, plus the lack of community, including community accountability… I don’t know. I’m rambling and don’t want to hijack your blog. Maybe I’ll write my own post later.

    1. I’m sure you’re right SC – I think it’s a symptom of our comfortable times, although as you say we are more isolated than we used to be too. There is no easy answer ….

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