New York: People with alcohol use disorder (AUD) and depression experience high levels of stimulation and pleasure when intoxicated, similar to drinkers who do not have depression, according to a new study.

The study by the University of Chicago Medicine in the US reveals that counter the long-held belief that the pleasure people experience when drinking alcohol decreases with addiction and that drinking to intoxication is mainly to reduce negative feelings as a form of self-medication.

"We have this folklore that people drink excessively when they're feeling depressed and that it's really about self-medicating," said Andrea King, PhD, Professor of Psychiatry and Behavioral Neuroscience.

In this study of natural environment drinking and smart phone-based reports of the effects of alcohol in real-time, participants with AUD and a depressive disorder reported feeling acute, sustained positive and rewarding alcohol effects — just like their non-depressed counterparts.

The study, published in the American Journal of Psychiatry, challenged conventional notions about alcohol’s effects in depressed people who drink excessively and could improve treatment approaches by focusing medication and behavioural approaches more on alcohol's pleasure reward pathways and less on stress-responsive systems.

The effects of alcohol on the brain are complex, and improved understanding of the factors that affect an individual's vulnerability to AUD and depression is critical to identify and initiate early, effective treatment.

The research followed 232 individuals across the U.S. between the ages of 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 in terms of those who had or had not experienced a major depressive disorder in the past year. Individuals who had suicidal ideation were excluded for safety reasons, as were people who had severe alcohol withdrawal symptoms.

The researchers found that alcohol consumption reduced negative feelings, although the reduction was small and nonspecific to their depression or AUD status.

The positive effects of alcohol were much higher in individuals with AUD than those without AUD and contrary to lore, similar in those with AUD and depression and those without depression.

The findings call into question the predominant theory that alcohol addiction arises from the brain's attempt to maintain stability despite repeated heavy drinking.

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