A framework for relating alcoholism and depression

A diagnosis of primary, as opposed to secondary, depression in alcoholics is not easy to make and not always a helpful clinical guide when it is made. A useful framework for understanding alcoholism and depression clinically is to distinguish between alcoholics who are actively drinking, newly sober, or in recovery. Medication for depression should never be given to an actively drinking alcoholic. Newly sober alcoholics and those in various stages of recovery are expected to be depressed. Medication is generally not needed to deal with depression due either to withdrawal or to life problems associated with recovery from alcoholism. The use of antidepressant medication may be appropriate only when depression continues after all other avenues of therapy have been exhausted.