Exploring Women’s Alcohol Use as Self-Medication for Depression
Significant findings on depression and the use of alcohol have recently emerged in
a Nova Scotia study which explored the relationship between binge eating and binge
drinking among women in treatment for alcohol problems (Stewart, Brown et al., 2003).
In this community based sample, it was found that 18 out of 18 women participating in
qualitative interviews had histories of depression and 14 of the 18 women (78%) were
using anti-depressant medication. While extant literature reports a co-existnece between
alcohol use and depression (McGrath et al., 1990; Najavits 2002; Plant 1997), the
considerable prevalence of the co-existence in this study has led us to believe this
relationship deserves more substantial investigation. Additionally, although
epidemiological literature reports a significant overlap between depression and
alcoholism among women, the dynamics of this relationship require further investigation
(Abraham & Flava 1999; Conrad et al. 2000a; Conrad & Stewart et al. 2000b; Hartka et
al. 1991; Helzer & Pryzbeck 1988; Hesselbrock et al. 1985; Gilman & Abraham 2001;
Grant & Hartford 1995; Kessler et al. 1997; Regier et al. 1990). Some researchers have
claimed that depression is the result of chronic alcohol abuse rather than the cause.
However, important often unacknowledged gender differences have emerged (see review
in Conrad et al. 2000a; Schuckit 1994). In particular, depression appears to most often
follow alcohol abuse in men, but most often precede it for women (Gilman & Abraham,
2001; Hartka et al., 1991; Helzer & Pryzbeck, 1988; Kessler et al., 1997). This suggests
women may use alcohol to self-medicate for depression. The proposed study is unique in
its exploration of the meanings that women attach to their experiences of the relationship
between depression and alcohol use.
The objectives of the proposed research are: 1) to gain an understanding of
women’s experiences of the relationship between depression and alcohol use problems,
2) to investigate the extent to which women use alcohol as a form of self-medicating for
depression including potential stimulant, and sedating effects, 3) to examine the gendered
context of the stories women tell about their depression and alcohol use, and 4) to
investigate women’s treatment experiences to determine whether the co-existence of
depression and alcohol have been adequately addressed.
Methods: We will employ a multi-method research design using standardized
questionnaires (including the Beck-II Depression Inventory, Hamilton Depression
Inventory, Beck Anxiety Inventory, Beck Hopelessness Inventory, Short Form Inventory
of Drinking Situations, Revised Drinking Motivations Questionnaire), interviews with
service providers, and a thematic analysis of both semi-structured qualitative interviews
and a focus group among depressed women in treatment for alcohol use problems.