New research has found that a major factor predicting how much an alcoholic will drink is immediate mood.
The new study also found that suffering from long-term mental health problems did not affect alcohol consumption, with one important exception: Men with a history of depression had a different drinking pattern than men without a history of depression. Surprisingly, the researchers found that those men were drinking less often than men who were not depressed.
“This work once again shows that alcoholism is not a one-size-fits-all condition,” said lead researcher Victor Karpyak of the Mayo Clinic. “So the answer to the question of why alcoholics drink is probably that there is no single answer. This will probably have implications for how we diagnose and treat alcoholism.”
The study, presented at the 2017 European College of Neuropsychopharmacology (ECNP) Congress, determined the alcohol consumption of 287 males and 156 females with alcohol dependence over the previous 90 days, using the accepted Time Line Follow Back method and standardized diagnostic assessment for life time presence of psychiatric disorders (PRISM).
The researchers were then able to associate this with whether the drinking coincided with a positive or negative emotional state (feeling “up” or “down”), and whether the individual had a history of anxiety, depression, or substance abuse.
The results showed that alcohol dependent men tended to drink more alcohol per day than alcohol dependent women.
As expected, alcohol consumption in both men and women was associated with feeling either up or down on a particular day, with no significant association with anxiety or substance use disorders.
However, men with a history of major depressive disorder had fewer drinking days and fewer heavy drinking days than men who never a major depressive disorder, according to the study’s findings.
“Research indicates that many people drink to enhance pleasant feelings, while other people drink to suppress negative moods, such as depression or anxiety,” Karpyak said.
“However, previous studies did not differentiate between state-dependent mood changes and the presence of clinically diagnosed anxiety or depressive disorders. The lack of such differentiation was likely among the reasons for controversial findings about the usefulness of antidepressants in treatment of alcoholics with comorbid depression.”
While the study will need to be replicated and confirmed, Karpyak said the reasons alcoholics drink depend on their background, as well as the immediate circumstances.
“There is no single reason,” he said. “And this means that there is probably no single treatment, so we will have to refine our diagnostic methods and tailor treatment to the individual.”
It also means that treatment approaches may differ depending on targeting different aspects of alcoholism, such as craving or consumption. Treatment also needs to take into account whether the alcoholic patient is a man or a woman and whether the patient has a history of depression or anxiety, he noted.