Most of my patients do not know that alcohol exacerbates their depression. Alcohol is a depressant and, as such, contributes to feelings of sadness, worthlessness and despair. Recently a woman spoke to me and said she had no confidence whatsoever in herself, she no longer found any enjoyment in what she did – cooking, her family, her garden, her career, and she could see no escape in sight from this living death that she called existence, except for the “few” drinks she looked forward to at the end of her day. She occasionally had thoughts of killing herself but was too afraid to do anything about it.  “I wake up two to three hours early every morning and cannot go back to sleep. I have been feeling like this for a few months and before that, on and off for weeks at a time for the last ten years, but this is the worst bout of depression I’ve ever had.” Do you think your depression has anything to do with your drinking?  I said.  “Of course not, I’ve been a social drinker all my life and can control my drinking.” “How many women tell the truth about the extent of their drinking?  Most women (and men) that come in to my office will reduce their intake of daily alcohol by a few glasses and tell me that they are only social drinkers.  I often take that statement with a grain of salt after I’ve asked a few other questions providing me with the ”tell-tale” signs of a problem drinker. Major depression affects millions of people and 1 in 5 people will suffer from it severely enough to warrant professional help – most will not get it, whilst the majority of those who do receive antidepressant medication and a few minutes chat from their GP, are lucky. By major depression, I mean something quite distinct from normal sadness and grieving which is also commonly called “depression” and something which we all experience as a result of the stresses of normal living amongst which are the death of a loved one, job loss, retirement, illness and loss of abilities with age. Clinical major depressions are profoundly disturbing, they interfere with people’s lives to such an extent that they cannot work properly, their relationships are seriously affected and they themselves feel terrible. Only people who have experienced this know how really bad it is.  People who use alcohol to self-medicate their depression are enticing death by insanity, heart disease, cancer and a myriad of other diseases. The first thing an alcohol dependent person needs to do is to stop drinking.  There is no such thing as controlled drinking for an alcoholic because their brain chemistry is wired differently to the social drinker.  The second important step is to get help and balance the brain chemistry before effective counseling, remedial dialectical behavior therapy and other modalities to help the alcoholic, can take place. If you are suffering from depression, a great benefit can come from the people around you. Confide your feelings in a supportive family member or friend. If you don’t have someone close to you, then attend group therapy sessions, like Alcoholics Anonymous, to start you off on the road to recovery. The only problem I have with Alcoholics Anonymous, is the majority of older sober members, do not believe in antidepressants or supplement intervention.  Every alcohol dependent person I’ve seen in my 30 years plus of counseling is suffering with depression or is in a major depression.  Some are suicidal and I know that initially sending them to AA is not going to heal their mind. AA is great for alcoholics to start learning The 12 Steps of Alcoholics Anonymous – a guide line for living, but impossible to implement these changes when the alcoholic is suicidal and/or hallucinating.  Medical intervention is the only way to get the practicing alcoholic back on his or her feet to deal with the underlying mental health issue that has been masked by alcohol for years. Get professional help through your local GP, Therapist or Psychologist but make sure they are all affiliated with an alcohol dependency program that provides options for the alcoholic. It could be live-in rehabilitation or a Counselor specially trained in alcohol dependency. There are many misguided individuals out there who will take your money and promise you long term sobriety.  Stick with people who know what they are doing and have your best interest at heart. Depressed alcohol dependent people need to be held accountable for their own actions. They are the hardest people to counsel because of the myriad of mental health issues underlying their alcoholism. Alcohol is only a symptom of an underlying problem. AA will tell people that all you need to do is stop drinking and your depression will lift.   My 32 years of experience with AA tells me a different story. I’ve known thousands of “dry drunks” during those years of dealing with people who stopped drinking to alleviate their depression, only to take on the persona of someone filled with anger, resentment and self-pity.  Why is this?   They have not addressed the underlying root cause of their alcoholism. Getting sober and staying sober is difficult.  After 6 weeks of sobriety, without medication, your depression may start to lift and after 3 months, it may enter a temporary remission but not for long. An alcoholic is often unaware of another mental health issue, which left unattended will lead them back to the bottle.  Pick up a drink after abstaining for 3 days, 3 weeks or 3 months and you are quickly back to where you started – at the bottom of the alcohol bottle. Older sober members of Alcohol Anonymous do not have the medical knowledge to detect the myriad of mental health issues associated with alcoholism. My recommendation is to get medical help for your depression then seek advice from an addiction counselor. After a period of stability, you can start attending group sessions of Alcoholic Anonymous to learn the 12 Steps for living a healthy, sober life. I know this advice is going to irritate many older sober members of AA but they need to look at the statistics of how many practicing alcoholics pass through the doors of Alcoholics Anonymous and how many alcoholics actually get sober and stay long term sober. This is empirical knowledge I’ve gained over 32 years of counseling alcoholics. I also recommend amino acids to help balance brain chemistry and a good liver tonic to help repair liver damage. Specific amino acids are essential for the liver to breakdown toxins and drugs and also for efficient metabolism in the liver. Glutamine – This amino acid is required for phase two detoxification in the liver and is required in increased amounts by those who consume excessive alcohol. It is able to reduce the craving for alcohol. Glutamine supplementation is helpful for intestinal disorders such as peptic ulcers and leaky gut syndrome. Leaky gut is the term used to describe an inflamed condition of the lining of the bowel, which makes the bowel too permeable, so that toxins and incompletely digested food particles can be absorbed from the bowels directly into the liver. This increases the workload of the liver and may cause many health problems. Glutamine is essential for the white cells to fight viruses such as hepatitis B and C. Glutamine is converted in the body into glutamic acid, which, along with the amino acids cysteine and glycine, is converted into the powerful liver protector glutathione. Glutathione is essential for liver phase two conjugation reactions used during detoxification of drugs and toxic chemicals. LivaTone Plus is a natural liver tonic containing the liver herbs St Mary’s Thistle with the benefits of Turmeric and Selenium.  It also contains all the B vitamins and the amino acid Taurine, as well as the antioxidants vitamin C and vitamin E. The LivaTone Plus formula contains the clinically proven dose of silymarin (a daily dose of 420 mg of silymarin). LivaTone Plus is designed to support step one and two detoxification  pathways in the liver, essential in helping the alcoholic’s liver to return to normal. The liver is the main fat burning organ in the body and regulates fat and carbohydrate metabolism. A healthy liver will take fat in the form of cholesterol and pump it via the bile into the intestines where it will be carried away in the bowel actions provided the diet is high in fiber. Tyrosine Mood Food – Tyrosine is a natural amino acid – one of the building blocks of protein.  It is required for the manufacture of the brain chemicals (neurotransmitters) dopamine and noradrenaline.  These neurotransmitters are required for concentration, alertness, memory and a happy, stable mood. Magnesium – the great relaxer. Magnesium plays an essential role in maintaining and promoting efficient muscle function and nerve transmission. Magnesium is a vital mineral for hundreds of cellular enzymes involved in the body’s energy production and metabolism. It is required by the nervous system to regulate the function of nerves and muscles. Magnesium may also assist in the reduction of stress, nervous tension, anxiety and sleeplessness.   The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.