Alcohol and depression: a clinical perspective

Sadness, even when intense enough to interfere with functioning, can be seen in a variety of conditions. Affective syndromes developing in the course of treatment with antihypertensive medications, sadness that accompanies various forms of cancer, and periods of sadness observed during the clinical course of schizophrenia might all have different contributory causes, prognoses, and optimal treatments. In that light, intoxication with brain depressants, especially alcohol, can cause clinically relevant changes in mood, with prolonged intoxication likely to induce depressive symptoms that resemble those seen in major depressive disorder. However, as is true of all complex clinical pictures developing in the course of a pre-existing physiological or psychiatric condition, the depressive symptomatology associated with heavy consumption of alcohol might not have the same causes as independent major depressive disorder, and the symptoms often disappear with abstinence. This paper reports studies documenting the phenomenon of depression in alcoholism, presents an approach for distinguishing between alcohol-related depressions and independent major depressive disorders, and explores the clinical and research implications of the relationship between alcohol and depression.