It is not unusual for people to use alcohol to alleviate anxiety. However, in this report by SADE OGUNTOLA, experts say that prolonged or excessive intake of alcohol actually increases anxiety and stress, and worsens depression.
Everyone experiences feelings of sadness occasionally, and it is not unusual for people to use alcohol to alleviate such poor mood, get a lift when fatigued or anxiety.
In fact, downing a glass or two of beer often make people more sociable, happier and less inhibited when it comes to sexual engagement.
Historically, the message about alcohol consumption has in the main, been positive — drinking red wine is good for you, a little alcohol a day will make you live longer, drink and be merry.
But over the past years, evidence indicates that over time or when taken in excess, alcohol can lead to increased levels of anxiety, stress sensitivity, depression, sleep problems and irritability. Alcohol only provides a temporary coping mechanism.
It temporarily reduces anxiety and tension, sometimes elevating mood, reducing pain and sometimes leading to brief respites from worries.
In fact, people who drink to cope with psychological distress may drink more over time, especially when they wake up feeling anxious or depressed. Also, turning to drink to cope with distress may even trigger or worsen depression.
“Alcohol on its own can make a person depressed; it can worsen symptoms of clinical depression, which is contrary to what people think,” said Dr Victor Makanjuola, a consultant psychiatrist at the University College Hospital (UCH), Ibadan, Oyo State.
According to him, drinking to feel better when feeling low is like self-medicating.
“The person may actually have clinical depression, because each time he uses alcohol, he feels much better. He continues to go back to drinking. This becomes a habit and ultimately, a major alcohol disorder in the individual,” he added.
For many people, feeling sad or unhappy is a prominent symptom of depression. Depression is more than just sadness, however. It can affect many aspects of a person’s life and can even be debilitating.
Dr Makanjuola stated that alcohol is a central nervous system(CSN) depressant and as such its use in excess can depress the mood, including other functions of the brain.
He added, “When alcohol use becomes habitual, it may lead to other social problems, including lack of money, loss of job and problem at the workplace, that can contribute to the individual slipping into a depressive mode.”
Dr Makanjuola, however, said the possibility of these happening is higher in those with a genetic vulnerability to alcohol-dependency and depression.
Signs that a person may have an alcohol use disorder include needing to drink to feel “normal”, being unable to stop drinking despite trying, being distracted by cravings for alcohol and needing to drink progressively more to get the same effects.
Moreover, he stated that the use and sale of alcohol, a psychoactive substance, is high in Nigeria, more in men than women and in certain professional groups.
According to him, about 56 .7 per cent of Nigerians had used alcohol in their lifetime and more in professional groups such as journalists, medical doctors and sailors.
Dr Champion T. Seun-Fadipe, a consultant psychiatrist, Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Osun State, corroborated that alcohol’s link with depression is a complex one.
He stated, “they work hand in hand. Alcohol can predispose to depression even as depression can also predispose to the use of alcohol.
“One of the earliest effects of alcohol is that it heightens the pleasure in an individual, but it gets to a stage that it depresses the central nervous system. In the end, the depressive disorder or symptoms reoccur more frequently with the use of alcohol.”
Several studies, including a 2013 study that used a nationally representative sample, have found that people who drink to manage a psychiatric condition are more likely to abuse alcohol.
Also another 2012 study found that 63.8 per cent of people who are dependent on alcohol are also depressed. The study did not test whether alcohol use causes depression, however.
Ironically, depression is very common and a major mental health challenge all over the world. It is a treatable mental health condition that can cause a range of symptoms.
Symptoms of depression include getting no joy from hobbies or activities previously enjoyed; feeling that there is nothing to look forward to or no hope for the future and unexplained health issues, such as headaches, muscle pain or stomach problems.
Others include changes in sleep habits, such as sleeping much more or less than usual, unintentionally losing or gaining weight, having feelings of worthlessness and experiencing thoughts of death.
Unfortunately, many people are not aware that they have this problem. Few that know something is wrong resort to prayer homes rather than the hospital for help.
Dr Seun-Fadipe declared that one out of every five individuals will experience depression at one point or the other in their lifetime and 90 per cent of suicide cases have their root in mental illness, with depression as the commonest.
“Generally, about one-third of those with depressive symptoms or that have depression use alcohol. Unfortunately, the incidence of suicide that is associated with depression also increases in the group of individuals that take alcohol. So, it is a complex relationship,” he noted.
Research from 2013 also supports the link between alcohol use and self-harm. The study found that teenagers with depression who drank alcohol were significantly more likely to act on suicidal feelings.
Dr Seun-Fadipe said life stressors such as unemployment, finances, marital problems, including childhood adversity, leave many people worrying and turning to the use of psychoactive substances such as alcohol and smoking.
He added, “It causes euphoria, it gives them the pleasure they want. Its effect lasts for a short time. In the longer term, it causes more problem than good. So, it is not the kind of coping mechanism that is healthy.”
Dr Seun-Fadipe declared that no level of alcohol is considered safe for use.
According to him, “Even if some people say it helps initially, there are so many complications that it causes which outweigh its benefits at the end of the day, which is where the problem is.”
Experts in 2017 who looked at 63 studies said reducing alcohol intake resulted in improvements in both depression and anxiety. They reported that reducing alcohol intake could improve people’s self-confidence, physical and mental quality of life, and social functioning.
Tobacco negatively impacted mental health. In a study that appeared in the journal PLOS ONE, the students who smoked were two to three times more likely to have clinical depression than those who had never smoked.
Those who smoked also consistently had more depressive symptoms and poorer mental health, as reflected in the “vitality” and “social functioning” parameters.
The new study included data from two cross-sectional studies that gathered information from two universities: the University of Belgrade and the University of Pristina.
At the University of Pristina, 14 per cent of those who smoked had depression, whereas only four per cent of their non-smoking peers had the condition. Among those who smoked at the University of Belgrade, 19 per cent had depression, compared with 11 per cent of those who did not smoke.
Here are some measures that some people with depression find helpful to manage their symptoms:
- Exercising can be as effective as medication in some cases
- Spending time with supportive friends or loved ones
- Abstaining from alcohol and illicit drugs
- Trying stress management techniques, such as yoga
- Breaking significant tasks down into smaller ones and only doing those that are a priority.
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