Alcohol and Drugs
People who are depressed, by definition, do not feel good. They experience low energy, sleep poorly, and feel helpless, hopeless and often unwilling to interact with others. As a first line of self-medication, many people turn to drinking alcohol or taking either legal or illegal stimulant drugs. This is actually the worst possible strategy for dealing with depression. Alcohol and some drugs are depressants. Depressed mood can be a direct outcome of substance abuse. Conversely, use of alcohol or of some drugs by people with a depressive disorder may increase the severity of their depressive symptoms.
Alcohol
In low doses, alcohol produces a feeling of relaxation and well-being, makes people more interactive and talkative, and has beneficial effects on the cardiovascular system. However, in even moderate doses, alcohol begins to have its real effect--as a depressant.
At relatively low doses, the effects of alcohol include:
- Loss of good judgment. Impaired judgment often causes an individual to drive faster than normally, thereby increasing the risk of automobile and other accidents.
- Reduced peripheral vision. This also results in increased risk of accidents, particularly automobile accidents.
At moderate-to-high doses, alcohol also causes:
- Feelings of sadness. If alcohol consumption continues, the depressed person eventually feels even worse, instead of better. "He was crying in his beer!"
- Impaired coordination.
- Impaired perception.
- Impaired reaction time.
- Sleepiness. Feeling tired is a result of general depression of brain function due to alcohol itself or its metabolite acetaldehyde. However, chronic use of alcohol tends to reduce dream sleep, resulting in reduced quality of sleep, increased irritability, and decreased feelings of well-being.
Alcohol abuse has deleterious consequences on the user's health and on society. To mention a few:
- Alcohol abuse can lead to obesity and heart, liver, kidney, and gastric disease.
- In at least one-half of suicides and severe accidents, alcohol (or other drug) consumption is a contributing factor. The combination of loss of judgment, impaired vision, impaired coordination, and sadness can be immediately deadly due to accidents or accidents that are in fact attempted suicides.
- At least one-half of domestic violence episodes, assaults, and homicides are associated with consuming alcohol (and other drugs). Impaired judgment may lead to loss of inhibition, which in turn may, in some people, result in increased violent behaviors.
- It is estimated that at least 10% of the population has a dangerous or addictive pattern of alcohol use, and alcohol misuse is estimated to be one of the top five precipitating causes of death in the U.S. One of the most devastating consequences of chronic alcohol abuse is that alcohol can become an addiction. Alcohol addicts cannot control consumption and must have the drug to feel normal. For these people, seeking alcohol becomes an essential and central theme and purpose of their lives, and alcohol becomes more important than home, job, friends, or even family. As in a vicious circle, all relationships and activities suffer dramatically, eventually making all aspects of the addicted person's life worse.
Stimulant Drugs
Two stimulant drugs are in common use:
Caffeine is found in coffee, tea, chocolate, many carbonated beverages, and some medications. It is a mild stimulant and has low toxicity, though addiction and side effects, such as changes in heart rhythm, can occur at high doses.
Nicotine is found in cigarettes and chewing tobacco. It also has a mild stimulant effect but is rapidly addicting. Nicotine itself causes few physiologic problems, but the method of its delivery leads to cancers and chronic heart and lung disease, in addition to an increased risk of cancer and lung disease for others in the user's immediate environment (effects of secondhand smoking or side-stream smoking).
Illegal stimulants include various forms of amphetamine and cocaine. These substances temporarily make users feel good (high) by increasing the release of up, or excitatory, neurotransmitters in the brain. However, the supply of these up neurotransmitters is eventually depleted. This suddenly results in a relative overabundance of the down neurotransmitter, which cannot be counteracted. The drug user crashes and feels suddenly more depressed than ever! The depressive feelings are so severe that cocaine and amphetamine users often seek to reduce their drug-induced lows by taking other drugs such as marijuana and alcohol. The resulting polypharmacy makes for increased potential health risks, side effects, and negative consequences on the user's life and on society:
- Use of stimulant substances increases the risk of heart attacks and irregular heartbeat, strokes, asthma attacks, and seizures, depending on dose and method of administration.
- All of these substances, such as nicotine, are rapidly addicting. As in the case of alcohol, the primary focus of the addict's life becomes the seeking of the drug and, as a consequence, all relationships and activities suffer dramatically, eventually worsening all aspects of the addicted person's life.
- All of these substances also reduce judgment and inhibitions, as in the case of alcohol, leading to a potential risk of accidents and to violent or other socially dysfunctional behavior.
