Alcohol plays a role in more than 200 diseases and injuries, contributing to more than 175,000 deaths in the United States each year and 3 million worldwide. Excessive alcohol consumption remains widespread, with 10.6% of Americans aged 12 and over – approximately 29.5 million people, which represents the criteria for alcohol consumption (AUD).
One of the most common co-occurrence conditions with the AUD is depression, affecting 33% to 50% of those with disorder. The relationship between the two is bidirectional, which means that having one increases the risk of developing the other. Researchers suggest that shared genetic predisposition and dysfunction in brain reward and stress systems as potential causes.
For decades, many believed that people with Aud and depression have mainly drank to relieve negative emotions – a concept known as self -medication theory.
This theory is aligned with the allostasis model of dependence, which describes how excessive alcohol consumption goes from a positive strengthening phase, where alcohol brings pleasure, to a phase of negative strengthening, where it is used to avoid withdrawal and emotional distress.
A new look at the effects of alcohol on the brain
A study of medicine at the University of Chicago questions the longtime belief that people with AUD and depression mainly drink self-medication. Research suggests that these individuals experience high levels of pleasure and stimulation when they are poisoned – similar to those who have no depression.
“We have this folklore that people drink excessively when they feel depressed and that it is really a question of self-mediatizing,” said Andrea King, PHD, professor of psychiatry and behavioral neuroscience in Uchicago and author main study. “In this study of the natural consumption of alcohol consumption and smartphones on the effects of alcohol in real time, participants with AUD and a depressive disorder declared to feel bitter, supported by positive alcohol effects And enriching – just like their unpublished counterparts. “
The study, published in the American Journal of Psychiatry, suggests that processing approaches may need to focus. Current treatments often focus on the fight against stress and depressive symptoms, but can ignore the role of the pleasant effects of alcohol in dependence.
“This is only addressed to one side of the medal if we do not also respond to increased stimulation, to love and want more alcohol that occurs in depressed and not depressed people with AUD,” said declared King.
Study the effects of alcohol in real time
The study involved 232 participants aged 21 to 35, the period when excessive alcohol consumption is the most common. Half of the participants met the AUD criteria, with a uniform split between those who had undergone a major depressive disorder in the past year and those who had not done so. People with severe alcohol withdrawal symptoms or suicidal ideas have been excluded for safety reasons.
Participants used smartphone surveys to record their alcohol experiences. During an episode of alcohol and an alcohol -free episode, they answered questions every 30 minutes over a three -hour period. The objective was to assess how alcohol influenced their emotions in real environment rather than in controlled laboratory environments.
The results have shown that alcohol slightly reduced negative emotions, but the effect was small and not specific to those with AUD or depression. However, the positive effects – stimulation and pleasure – were significantly higher in people with AUD. Surprisingly, these effects were just as strong in those with Aud and depression as in those without depression.
“For almost a decade, our group has improved methods to use mobile technologies to measure the results in real time and clinically significant in people with Aud and those at risk of alcohol -related problems,” said The co-author of the Daniel Fridberg study, PHD, associate professor of psychiatry and behavioral neuroscience in Uchicago. “These approaches allow us to fill the gap between the laboratory and real life and have led to new ideas that could one day lead to better treatments.”
Rethink dependence and treatment
The study raises questions on the theory of the “dark side of dependence” which prevails, which suggests that people with Aud end up drinking not for pleasure but to avoid withdrawal and emotional distress. If this was the case, people with depression would probably show positive responses reduced to alcohol, but this research revealed the opposite.
King compares the strong pleasant response to alcohol in these people to an “accelerator pedal” more food consumption. “As treatment providers, we were taught to people with drinking audience to self-mediatize and feel better,” she said. “But what exactly do they feel of our study, this seems to be high levels of stimulation and pleasant effects, with a modest decrease in negative states.”
This idea could reshape AUD treatment strategies. If the pleasant effects of alcohol play an important role in maintaining dependence, therapies may need to deal with these strengthening experiences rather than focusing solely on reducing stress.
King’s next study will examine if elderly people with long -term AUD also feel increased to drink. Conventional wisdom suggests that years of alcohol consume its pleasant effects, but if its previous results are true, these people can always feel a strong positive reinforcement of alcohol.
Understanding this could help refine dependence treatment strategies at different age groups.
