The interrelationship between alcoholism, depression, and anxiety

Depression and anxiety are the most common psychological disorders to have a comorbid diagnosis with alcohol use disorders (AUDs). There have been inconsistent findings regarding the direction of these relationships, and few studies have attempted to determine the causal direction of the relationship between AUDs and the development of depression and anxiety. To provide some clarity on this debate, we provide an overview of the different factors that are contributing to this common comorbid diagnosis. We explain the complex relationship between these disorders by discussing the association between alcohol dependence and depressive symptoms; and the association between alcohol dependence and anxiety symptoms-with some discussion of the causal role of genetic predisposition to developing a comorbid diagnosis. The role of anxiety sensitivity, the mediating role of rumination, and experiential avoidance are discussed; with a focus on how self-medication contributes to individuals utilizing alcohol to cope with the negative affect associated with depression and anxiety. We also show how specific psychosocial risk factors are contributing to comorbidity. Based on our review, we suggest that our understanding of the comorbidity between AUDs, anxiety, and depression can be enhanced by identifying multiple risk factors that might be predictive of a comorbid diagnosis.