A new study from the University of Chicago Medicine challenges the long-held belief that the pleasure derived from drinking alcohol diminishes with addiction. The study reveals that individuals with alcohol use disorder (AUD) and depression experience high levels of stimulation and pleasure when intoxicated, similar to those without depression.
Andrea King, PhD, Professor of Psychiatry and Behavioral Neuroscience, stated, “We have this folklore that people drink excessively when they’re feeling depressed and that it’s really about self-medicating.” However, this study of natural environment drinking and smartphone-based reports of alcohol effects in real-time shows that participants with AUD and depressive disorder report acute, sustained positive and rewarding alcohol effects, just like their non-depressed counterparts.
Published in the American Journal of Psychiatry, the study challenges conventional notions about alcohol’s effects on depressed individuals who drink excessively. It suggests that treatment approaches could improve by focusing more on alcohol’s pleasure reward pathways rather than stress-responsive systems.
The research followed 232 individuals across the U.S., aged 21 to 35, corresponding to the period when most heavy drinking occurs in a person’s lifetime. Half of the study group met criteria for AUD in the past year and were evenly divided between those who had or had not experienced a major depressive disorder in the past year. Individuals with suicidal ideation or severe alcohol withdrawal symptoms were excluded for safety reasons.
The researchers found that alcohol consumption reduced negative feelings, although the reduction was small and not specific to depression or AUD status. The positive effects of alcohol were significantly higher in individuals with AUD than those without and were similar in those with AUD and depression to those without depression.
These findings call into question the predominant theory that alcohol addiction arises from the brain’s attempt to maintain stability despite repeated heavy drinking. Instead, the study highlights the need for improved understanding of the factors that affect an individual’s vulnerability to AUD and depression to identify and initiate early, effective treatment.
