Alcohol and stress

depression in alcoholism

Alcohol and stress can cause anxiety and depression. The frequency of depression in people suffering from alcohol dependence varies according to various sources from 26 to 60%. Psychiatrist-narcologist Vladislav Sipovich , Chief Physician of the multidisciplinary Medical Center “Health Harmony”, shares his knowledge on the development of a depressive symptomatic complex in patients with alcoholism at various stages of the disease and stages of its treatment.

What is primary in the occurrence of anxiety-depressive syndrome – depression or alcoholism?

In this pair of diseases it is difficult to determine what was the fundamental principle – depression or alcoholism. Their causal relationship is often implicit. Everything depends on the specific case. Quite often, a person in a stressful situation reaches for a glass of alcohol as a lifeline. Stress can be caused by various circumstances – conflicts at work and in the family, loss of income, death of loved ones, social problems, and even a simple quarrel in transport. The more unexpected the negative event, the stronger the stressful state caused by it.

On the other hand, it is known that chronic alcoholism causes a failure of the “stress” system, similar to depressive states with increased release of corticotropin and activation of the hypothalamic-pituitary system. It is corticotropin that is responsible for increasing the formation of cortisol in the adrenal glands, which is responsible for loss of appetite, the occurrence of subjective feelings of anxiety, immunosuppression and increased inflammatory reactions. These changes prolong depression after quitting alcohol for up to four weeks. With a combination of alcoholism and depression, the risk of their occurrence doubles, and long-term use of large doses of ethanol increases the risk of developing depression, suicide attempts and anxiety by 40%.

By the way, a huge role in the development of depressive states and alcohol dependence belongs to a common hereditary factor. It is responsible for 35-60% of these diseases.

Acupuncture treatment is an effective way to get rid of alcohol dependence in the early stages of the disease.

Can depression lead to a relapse of alcohol dependence in the process of remission of the disease?

Depressive conditions can occur at any stage of the treatment and rehabilitation of alcoholism, provoke a resumption of craving for alcohol and thus lead to a relapse of the disease. Therefore, it is important to diagnose and eliminate the cause of depression in a timely manner, otherwise the effectiveness of treatment and rehabilitation measures will be significantly reduced or practically reduced to zero.

What determines the duration of depression in alcoholism?

One of the most pressing questions – how long does depression last after drinking? First of all, it depends on the severity of depression with a hangover. In acute alcohol withdrawal syndrome, severe somatic, vegetative and neurological disorders are observed. In this state, depression is often combined with increased irritability, anxiety, and hysteria. Anxiety usually lasts 2-3 days, but depression after binge, accompanied by longing and self-blame, is more stable and lasts for 1-2 weeks.

How to treat depressive disorders in acute withdrawal syndrome?

In this case, it is impossible to do without specific therapy. The use of benzodiazepine tranquilizers , derivatives of GABA (gamma-aminobutyric acid) such as phenibut , antidepressants with sedative activity and lack of anticholinergic action, hepatoprotectors with antidepressant activity such as heptral , as well as drugs that stabilize the autonomic system are shown.

How to get rid of depression after drinking?

After leaving alcohol withdrawal, the main problem is the formation of a stable and prolonged remission. The difficulty of solving this problem lies in the fact that over the course of many years of alcohol abuse, the patient has developed an alcoholic lifestyle and a psychological attraction to alcohol, the so-called alcohol dominant. This can lead in the process of rehabilitation to affective disorders:

  • Hypochondria with numerous complaints of a headache of unclear localization, pressure surges, frequent colds, skin rashes. This is due to the fact that prolonged alcohol consumption blurred the clinical picture of vegetative-somatic disorders and the patient seemed to be healthy. Cessation of drinking brings out all these disorders to their full extent, which is often considered to be the sick result of improper treatment. He can say that while he was drinking, he was healthy, but stopped – he began to get sick. Such conclusions can serve as an impetus for the resumption of the alcoholic status of the body, when alcohol is taken as a cure for manifested diseases. For the treatment of such patients, a combination of psychotherapy and medication is most effective.
  • Apathy, which is often the result of the treatment of systematic household drinking without a significant decrease in social status, is also observed in patients with high tolerance to alcohol and its uniform daily distribution. After the start of treatment, especially by the method of encoding or torpedo, active patients become sad, lethargic, lack of initiative, indifferent, avoiding contact with relatives and friends. Treatment of depressive-apathetic disorders is carried out with the help of positive, activating psychotherapy and stimulant antidepressants. Without medical help, apathetic manifestations can last for years and eventually lead to a relapse of the disease.
  • Asthenizationcharacteristic of patients with an initially weak psyche with laziness, contemplation, lethargy, and escape from reality inherent in it. Alcohol literally transforms such patients, making them active, cheerful, with illusions of complete well-being and well-being. In this case, alcohol dependence is formed very quickly and then it is difficult to treat. Astheno- depressive disorders during remission are manifested in loss of interest in life, lethargy, weakness, unwillingness to take the initiative, to take any action. Long-term treatment with the connection of rational and family psychotherapy, biostimulants (ginseng, eleutherococcus, pantocrine, etc.), small doses of stimulating antidepressants.
  • Anxiety that occurs in suspicious, indecisive, shy and anxious patients. Often, if necessary, to perform embarrassing actions (new acquaintances, business meetings, interviews, etc.), such people fall into pessimism, their mood worsens. Alcohol becomes a means of adaptation to such conditions, the absence of which during the period of remission becomes a real stress for the psyche, accustomed to solving problems with the help of alcohol intoxication. Anxious and suspicious character traits become pronounced, the mood steadily decreases, patients become gloomy, grouchy and irritable. All arising problems are exaggerated and become unsolvable. Treatment includes positive psychotherapy, mild neuroleptics, tranquilizers, and antidepressants.
  • Dysphoria observed during the rehabilitation of patients with long-term alcoholism, binges with amnesia and aggression. For the first 3-6 months of rehabilitation, patients behave calmly, and then they become silent, gloomy, picky, tense, showing verbal aggression. Often there is a “dry hangover” in the morning with withdrawal symptoms. The appearance of such signs portends a relapse of the disease and requires the immediate connection of drug therapy.

Thus, in conclusion, I can say that the treatment of depression after hard drinking, acute abstinence and other conditions of alcoholic disease, regardless of the type of depressive conditions, the stage of the disease, the stages of treatment and rehabilitation, should be carried out only under the supervision of an experienced psychiatrist-narcologist. The specialists of the Health Harmony Medical Center will help you not only when the patient comes out of hard drinking, but also provide effective rehabilitation, stable remission and mild withdrawal of the patient from depression at adequate costs.

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