Depressed women were twice as likely as non-depressed women to become binge drinkers, according to a report published in the May issue of the American Journal of Psychiatry. These depressed women tended to be younger and more likely to be separated from their husbands than those not suffering from depression.
"Physicians should think about binge drinking as a possibility for depressed patients," says lead author Anita R. Dixit, MHS. "Since that’s a pretty serious health issue, physicians should look out for it." Dixit conducted the research along with Rosa M. Crum, MD, MHS, at the department of epidemiology and department of mental hygiene at the Johns Hopkins University School of Hygiene and Public Health in Baltimore.
"If you’re someone who is struggling with depression, you want to be cautious with using alcohol as a way of dealing with it. It can very well be the first step to developing an alcohol use disorder," says Darlene H. Moak, MD, of the Medical University of South Carolina in Charleston. Moak reviewed the study for WebMD.
"[The study] puts a finger on something that’s very important: trying to figure out the relationship between depression and alcohol use disorders," Moak tells WebMD. "Physicians certainly see clinically that some women tend to get depressed in their late teens and early 20s and then go on to develop alcohol use disorder. It’s not quite as common in men, although it can certainly happen to them."
The study’s data came from a large group of people thought to accurately represent the U.S. population. The group included women whose depression levels were assessed again one year after completing an initial survey. The study was funded by the National Institute of Mental Health.
Researchers asked the women how much they drank in the month before the first survey and at the one-year follow-up assessment. Any woman who reported during the first survey that she was a heavy drinker — defined as five drinks or more at a time — or who had a history of alcohol disorders, was excluded from the study.
Researchers also collected from the women demographic data and information about their history of other mental disorders, such as obsessive compulsive disorder, phobias, schizophrenia, and illicit drug use. Participants were also asked about depression and alcohol abuse in their parents.
Of the nearly 1,400 women in the study, 88 (6.4%) reported a history of major or mild forms of depression.
"Trying to figure out if depression leads to the development of alcohol use disorder is an important question," says Moak. "The authors go to great lengths in the discussion to say this study doesn’t say depression causes alcohol disorders. People may have a common factor that causes both the alcohol disorder and depression."
One of the strengths of the Dixit study, says Moak, is that it used a sample of people from the community at large, not psychiatric patients. However, she suggests that the authors could have used a lower threshold than five drinks at a time to define heavy drinking. For women, heavy drinking may be four drinks per time.
"Women probably get higher blood levels of alcohol from lower levels of drinking, compared to men," says Moak. "This is due to low levels of an enzyme that metabolizes alcohol and because women have less total body water."
She also says that the participants could have been questioned about drinking behavior over a three-month period, rather than only a one-month time frame. And yet, taking the authors’ "conservative thresholds into account, I find the results really believable and pretty suggestive," says Moak.
Beth S. Moscato, PhD, of the department of social and preventive medicine at the University at Buffalo School of Medicine and Biomedical Sciences in New York, advises doctors to treat depression early and to carefully follow-up with women who have a history of depression. "Be careful to assess your patients’ drinking patterns, including binge drinking. It’s the binge drinking that does a lot of damage to women because of their physiology," Moscato tells WebMD.
Moak agrees that physicians should question depressed patients about their drinking behavior, especially women in their late teens or early 20s. "From what we know about the effect of alcohol on the nervous system, alcohol is a particularly poor way of treating depression," Moak says. "Although it may give some very temporary relief, in the long run it often exacerbates depression."
Vital Information:
* New research shows that women who are depressed are twice as likely as non-depressed women to become binge drinkers.
* People who are struggling with depression should be cautious about drinking alcohol, as it may exacerbate the depression or lead to a drinking problem.
* The researchers who conducted the study say that depression does not necessarily cause alcohol disorders, but there may be a common factor in some people that causes both.
