Alcohol and depression: new study disproves 'self-medication' myth

According to a recent study by scientists at the University of Chicago Medical Centre, people with alcohol dependence (AUD) and depression experience similarly high levels of stimulation and pleasure from intoxication as those without co-occurring mental disorders. This finding challenges the widespread belief that the 'positive' effects of alcohol diminish over time, with drinkers turning to drinking solely to alleviate negative emotions.

Study leader Andrea King, Professor of Psychiatry and Behavioural Neuroscience, emphatically states: "There is a folklore notion that people with depression drink to relieve sadness and anxiety. However, our data, collected in real time via smartphones, demonstrates that such people experience vivid, lasting positive feelings just as much as other participants with AUD but without depression."

The findings, published in the American Journal of Psychiatry, point to the importance of rethinking treatment approaches. Traditionally, experts have emphasised reducing stress and symptoms of depression, but the reward and pleasure system associated with alcohol use is proving to be just as significant. According to King, unless the high degree of "rewarding" effects, which persist even with chronic use, are taken into account, the therapy may be incomplete.

The study involved 232 volunteers 21-35 years old from across the United States, half of whom had been diagnosed with AUD and some of whom had concurrent episodes of major depression. During one typical drinking episode and on a control day when participants did not drink, they reported their well-being every half hour via smartphone. The analysis showed that alcohol did slightly reduce negative emotions in everyone, but the key finding was a similarity in the high levels of pleasure and stimulation in subjects with AUD and depression compared to the rest.

The study's lead co-author Daniel Friedberg notes the importance of mobile technology in collecting data right in the real-world environment. This reduces the risk of bias typical of laboratory experiments and allows for a more accurate understanding of what factors influence the development of alcohol dependence and depression.

According to the authors, the results contradict the "dark side theory of addiction," according to which people drink more for stress relief than for pleasure. The new findings show that even with long-term abuse, alcohol continues to produce a marked sense of euphoria and can remain a serious craving factor.

King says the next step is to study similar processes in an older group (40-65 year olds) with a long history of AUD. It's thought that the rewarding effect should diminish over time, but if the new study's hypothesis holds true, it could refocus addiction treatment and prevention in general.

Link to original study: American Journal of Psychiatry (2025), DOI: 10.1176/appi.ajp.20240069