Alcohol-Use Disorder and Depression: Understanding the Facts
Alcohol misuse is a continuing problem in the USA. According to the National Institute of Alcohol Abuse and Alcoholism (NIAAA), there are 88,000 alcohol-related deaths per year, and alcohol abuse ranks as the fourth leading cause of preventable death. However, when someone needs help with an alcohol-related issue, there is usually only one solution: a 12-step recovery program. While these are accepted solutions, do they really work? With mental illnesses on the rise, it could be questioned whether the “one size fits all” approach of 12-step programs does anything to address the underlying mental health problems that can drive problem drinking.
When it comes to alcohol abuse, the common orthodoxy of 12-step therapy states that a person struggling with a drinking problem has no control over the issue. These individuals are alcoholics, not merely people with temporary problems. They are alcoholics; they have always been alcoholics, and they will always be alcoholics. The only solution is admitting they are alcoholics, total abstinence, and adherence to the 12-step program.
The difficulty here lies in proving whether the program is really effective. There has never been an independent study that proves the effectiveness of 12-step programs. AA themselves claim a 75 percent success rate — 50 percent become sober immediately, while a further 25 percent struggle initially and then become sober. However, the retention rates of AA participants are difficult to gauge due to client confidentiality, so studying 12-step programs to produce accurate statistics results in incomplete data.
It has been pointed out that most of the statistics for continued abstinence are based on patients actively enrolled in the program. However, those who leave the program often relapse, and this is seldom taken into account. Many 12-step programs have no medical professionals involved in their day-to-day running, and this means that those with mental health issues such as depression do not have their condition considered as a possible cause of alcohol misuse.
Depression is a condition where low levels of the feel-good chemical serotonin can lead to feelings of anxiety and hopelessness. While there are many manifestations of this condition, it is often a contributory factor in over-drinking. Alcohol gives a short-term mood boost to sufferers however, escalating alcohol consumption actually exacerbates the condition.
Those suffering from depression are unlikely to recover by abstinence alone, so the condition is seldom addressed by 12-step programs which focus on this as the sole solution. The 12-step industry started with Alcoholics Anonymous in 1935 when psychiatry was in its infancy, and it has remained the same. AA groups are usually run by unqualified volunteers and those who have followed the program in the past, so there is very little specialist help for those with both depression and alcohol issues.
New schools of thought are beginning to redefine alcoholism as Alcohol-Use Disorder (AUD). This approach views it as a temporal condition that should be treated using scientifically proven treatments that take underlying conditions such as depression into consideration. However, those with alcohol issues often find 12-step programs are the only available option for treatment.
The stigma of being labeled as an alcoholic often prevents those needing help from reaching out, further risking their health. It is time for a new approach to the treatment of problem drinking. Unless the US ends its love affair with unscientific methods for dealing with alcohol misuse, it will continue to proliferate.
Alcohol tends to pose difficulties and consequences in people’s lives. If you have recently run into an alcohol-related consequence, such as a DWI, please consult our DWI attorney in Houston.