The Dark Alliance: The Negative Influence of Alcohol Use on Mental Health in Patients with Major Depressive Episodes

Introduction

 

Alcohol consumption has long been a ubiquitous feature of British culture, with its use often serving as a social lubricant and a means to unwind after a long day. However, the relationship between alcohol and mental health is far more complex and sinister, particularly for individuals experiencing major depressive episodes. This article aims to shed light on the negative impact of alcohol use on mental health, specifically focusing on patients with major depressive episodes. We will explore how alcohol functions as a negative coping strategy, its effects on depression, increased suicide risk, alcohol use while on medication, and the role of mental health professionals in managing these patients. Throughout the article, we will draw upon relevant studies, statistics, and UK sources to emphasise the gravity of the issue.

 

Alcohol as a Negative Coping Strategy

 

For some individuals, alcohol serves as a maladaptive coping mechanism to deal with stress, anxiety, or other emotional challenges (Cranford et al., 2011). This form of negative coping can exacerbate mental health issues, as the temporary relief provided by alcohol can lead to an increased reliance on its consumption, fostering a dangerous cycle of dependency and worsening mental health.

 

Alcohol's Effects on Depression

 

Research has shown that alcohol use can have a detrimental impact on the mental health of individuals with depression. A study by Boden and Fergusson (2011) found that alcohol use may increase the risk of depressive symptoms by causing neurobiological changes that alter mood regulation. Additionally, alcohol can exacerbate existing depressive symptoms by impairing cognitive function, decreasing serotonin levels, and disrupting sleep patterns (NHS, 2021).

 

Increased Suicide Risk

 

Alcohol use is closely linked to an increased risk of suicide among patients with depression. According to the Office for National Statistics (ONS, 2019), alcohol is implicated in 25-30% of suicides in the UK. The disinhibiting effects of alcohol can lower an individual's inhibitions, making it more likely for them to act on suicidal impulses (Pompili et al., 2010).

 

Major Depressive Episodes Among Alcoholics

 

The prevalence of major depressive episodes amongst alcoholics is a significant public health concern. In a UK-based study, the Adult Psychiatric Morbidity Survey (APMS, 2014) found that 31.2% of individuals with alcohol dependence met the criteria for major depression. Furthermore, the Centre for Mental Health (2021) reports that individuals with alcohol use disorder are six times more likely to experience a major depressive episode than the general population.

 

Alcohol Intake While Using Antidepressants and Anxiolytics

 

The use of alcohol while taking antidepressant and anxiolytic medications can significantly undermine the efficacy of these treatments (NHS, 2021). Alcohol's depressant effects may counteract the therapeutic benefits of these medications, potentially worsening the symptoms of depression and anxiety. Additionally, alcohol can also interact with the medications, causing potentially dangerous side effects and increasing the risk of overdose.

 

The Counsellor/Therapist's Role in Working with Alcoholics with Depression

 

Mental health professionals play a critical role in supporting individuals with depression and alcohol use disorder. They must adopt a comprehensive, holistic approach to address the complex interaction between alcohol use and mental health. This can involve the use of evidence-based therapies, such as cognitive-behavioural therapy (CBT) and motivational interviewing (MI), to target both the depressive symptoms and the alcohol use disorder concurrently (NICE, 2018).

 

Working with Alcoholics with PTSD and Major Depressive Episodes

 

Trauma-focused therapies, such as Eye Movement Desensitisation and Reprocessing (EMDR) and Trauma-Focused Cognitive Behavioural Therapy (TF-CBT), have shown promising results in addressing the underlying trauma experienced by individuals with PTSD and major depressive episodes (NICE, 2018). When working with patients who also suffer from alcohol use disorder, it is vital for mental health professionals to integrate treatment for alcohol dependence alongside these trauma-focused therapies. This approach ensures that the complex interplay between trauma, depression, and alcohol use is thoroughly addressed.

 

Managing Suicide Risk Using the CAMS Approach

 

The Collaborative Assessment and Management of Suicidality (CAMS) approach, developed by David Jobes, is an evidence-based framework designed to assess and manage suicide risk in patients (Jobes, 2016). In the context of patients with depression and alcohol addiction, mental health professionals can utilise the CAMS approach to collaboratively engage with the patient, identify the drivers of their suicidality, and develop a tailored treatment plan targeting those specific factors. By incorporating the management of alcohol use disorder into the CAMS framework, professionals can effectively address the heightened suicide risk associated with the co-occurrence of depression and alcohol addiction.

 

Conclusion

 

In conclusion, the negative influence of alcohol use on mental health, particularly among patients with major depressive episodes, is a critical public health issue that requires the attention of healthcare professionals, policymakers, and society at large. Alcohol use not only serves as a harmful coping mechanism but also exacerbates depressive symptoms, increases suicide risk, and undermines the effectiveness of essential medications. Mental health professionals must adopt comprehensive, evidence-based approaches to address the complex relationship between alcohol use and mental health, while also managing suicide risk using frameworks like the CAMS approach. By raising awareness of the dark alliance between alcohol and mental health, we can support those who suffer and foster a healthier, more informed society.

 

The importance of understanding and addressing the negative impact of alcohol use on mental health, particularly in patients with major depressive episodes, cannot be overstated. As a society, we must engage in ongoing conversations and educational efforts to raise awareness about the risks associated with alcohol use and its effects on mental health. By providing appropriate support and resources to those who are struggling, we can hope to reduce the prevalence of alcohol-related mental health issues and create a more informed, compassionate society.

 

In addition to mental health professionals, policymakers must also take steps to address the issue at a systemic level. This may include investing in mental health and addiction services, as well as implementing targeted prevention and early intervention programmes. The collaboration between mental health professionals, addiction specialists, and policymakers is crucial in order to effectively address the complex interplay between alcohol use and mental health.

 

Moreover, it is essential to foster a culture of understanding and empathy towards those who are suffering from the effects of alcohol use and mental health issues. By breaking down the stigma associated with mental health and addiction, we can create a supportive environment that encourages individuals to seek help and facilitates their recovery process.

 

Together, we can work towards a future where the dark alliance between alcohol and mental health is acknowledged and addressed, ultimately leading to a healthier, more resilient society.

 

There are numerous helpful resources available for therapists working with individuals struggling with mental health issues and alcohol use. Here are some key resources that can enhance a therapist's knowledge and skills in addressing these complex issues:

 

The National Institute for Health and Care Excellence (NICE) Guidelines:

 

Alcohol-use disorders: diagnosis, assessment and management (CG115): https://www.nice.org.uk/guidance/cg115

 

Depression in adults: recognition and management (CG90): https://www.nice.org.uk/guidance/cg90

 

Post-traumatic stress disorder (NG116): https://www.nice.org.uk/guidance/ng116

 

Substance Abuse and Mental Health Services Administration (SAMHSA):

 

SAMHSA's website offers a wealth of resources on substance use and mental health, including treatment approaches, evidence-based practices, and training materials: https://www.samhsa.gov/

 

The British Association for Behavioural and Cognitive Psychotherapies (BABCP):

 

BABCP offers resources, training, and accreditation for cognitive behavioural therapy (CBT), which can be an effective treatment for individuals with depression and alcohol use disorders: http://www.babcp.com/

 

Motivational Interviewing Network of Trainers (MINT):

 

MINT provides resources, training, and support for mental health professionals interested in learning and implementing motivational interviewing (MI) techniques: https://motivationalinterviewing.org/

 

The Collaborative Assessment and Management of Suicidality (CAMS):

 

The official website for the CAMS approach, offering training materials, research, and resources for mental health professionals: https://cams-care.com/

 

EMDR Institute, Inc.:

 

The EMDR Institute offers resources, training, and certification for therapists interested in using Eye Movement Desensitisation and Reprocessing (EMDR) therapy: https://www.emdr.com/

 

Beck Institute for Cognitive Behaviour Therapy:

 

The Beck Institute offers training, certification, and resources for cognitive behaviour therapy, which can be beneficial for addressing both depression and alcohol use disorders: https://beckinstitute.org/

 

These resources can help therapists enhance their knowledge, skills, and competence in addressing the interrelated issues of mental health and alcohol use, ultimately providing better support and care for their clients.

 

Dr Robert Becker, MCMA, Mental Health Specialist, Neuropsychologist, Psychotherapist, Substance Misuse Therapist, Psychiatric Assessor

 

References:

 

Boden, J. M., & Fergusson, D. M. (2011). Alcohol and depression. Addiction, 106(5), 906-914.

 

Centre for Mental Health. (2021). The link between alcohol and mental health problems. Retrieved from https://www.centreformentalhealth.org.uk/alcohol-and-mental-health

 

Cranford, J. A., Eisenberg, D., & Serras, A. M. (2011). Substance use behaviours, mental health problems, and use of mental health services in a probability sample of college students. Addictive Behaviours, 35(2), 134-145.

 

Jobes, D. A. (2016). Managing suicidal risk: A collaborative approach. New York, NY: Guilford Press.

 

NHS. (2021). Alcohol and mental health. Retrieved from https://www.nhs.uk/live-well/alcohol-support/alcohol-and-mental-health/

 

NICE. (2018). Alcohol-use disorders: Diagnosis, assessment and management of harmful drinking and alcohol dependence. Retrieved from https://www.nice.org.uk/guidance/cg115

 

Office for National Statistics. (2019). Suicides in the UK: 2018 registrations. Retrieved from https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2018registrations

 

Pompili, M., Serafini, G., Innamorati, M., Dominici, G., Ferracuti, S., Kotzalidis, G. D., ... & Lester, D. (2010). Suicidal behaviour and alcohol abuse. International Journal of Environmental Research and Public Health, 7(4), 1392-1431.

 

Adult Psychiatric Morbidity Survey. (2014). The Adult Psychiatric Morbidity Survey 2014. Retrieved from https://digital.nhs.uk/data-and-information/publications/statistical/adult-psychiatric-morbidity-survey/adult-psychiatric-morbidity-survey-survey-of-mental-health-and-wellbeing-england-2014