Researchers from the Center for Studies Of Addiction in the Treatment Research Center at The University Of Pennsylvania School Of Medicine studied 170 alcohol-dependent patients with major depressive disorders for 14 weeks. Two different drugs were used: Naltrexone, a drug used to treat alcohol dependence, and an antidepressant medication called sertraline. Everyone in the study received weekly cognitive behavioral therapy, a form of individual counseling effective in substance abuse treatment. However, one group took only Naltrexone; another group took only sertraline; one group took a combination of the two drugs; and finally, one group took no drugs at all, just placebos. The group that took the combination had a higher rate of alcohol abstinence (54%) compared to 21% in the Naltrexone-only group, 23% in the sertraline-only group, and 23% in the placebo group.

The authors of the study said that doctors treating addictions are often reluctant to use drug therapies, because they "do not want to treat drugs with drugs."

"Fortunately, this attitude is fading as scientists impart knowledge to professionals and the public about the possibilities of correcting the neurobiology of addiction by treating the addicted brain with certain medications," author Helen Pettinati wrote in her report published in the journal Psychiatric Times. "While these findings require replication, they provide a practical recommendation to integrate or combine two medications — one for treating alcohol dependence and one for treating depression. The combined pharmacotherapy, with some platform counseling that integrates support and advice for both disorders, can provide an aggressive approach to treating co-occurring depression and alcohol dependence."

Statistics compiled on 43,093 adults in the National Epidemiologic Survey on Alcohol and Related Conditions found that 20% of those with major depressive disorders also had alcohol dependent disorders. Depression and alcohol dependence are risk factors for one another, and severity in one is associated with severity in the other. Alcohol dependence makes depression lasts longer. Patients who are depressed after they stop drinking are more likely to relapse into heavy drinking. Studies have also found that untreated depression predicts the worst outcome for alcoholic dependence.

The reason physicians usually do not treat the two disorders simultaneously is medications react with one another and with alcohol. Also, if the alcohol dependence is what causes the depression, then the depression will go away once the person stops drinking. In those cases, taking antidepressant drugs is not necessary.

Many physicians believe that genetic risk factors for mood disorders, including depression, may overlap for risk factors for alcohol dependence, which may be why the two disorders tend to "travel" together.

The findings referred to in Science Daily show how gender roles among heterosexual couples experience radical strains when the male partner experiences depression and the female tries to help. Depression is most often thought of as being a "woman’s" health issue and is often underreported among men. Therefore, little is known about how heterosexual couples handle it when the male is depressed.

The study underscores that women play an important role in helping their male partner manage depression. Since relationships are fundamental to how health decisions are made within the family dynamic, we need more research to better understand those dynamics.

The study found the "trading places" scenario to be most common pattern in heterosexual relationships. Partners typically took on atypical female and male roles in order to cope with the challenges created by the male’s depression. In these cases, men took on the homemaker role and the women went to work as the breadwinner.

In the "business as usual" scenario, the couples downplayed the problems caused by the male’s depression and held firm to gender roles despite the male’s struggle with depression as they maintained their careers.

In the "edgy tensions" pattern, the couples were caught in dysfunctional relationships. Each already held ideas of gender roles that differed from their partner’s view and they wrestled with resentment. Men often were involved with alcohol or illicit drugs to manage their depression.

The study was conducted on men from 20 to 53 years of age who had differing levels of education, from some high school to graduate level degrees.

“Anyone who has been touched by depression, obesity or alcoholism knows that these disorders on their own can be devastating. When they’re combined, these disorders become more costly, more difficult to treat and more impairing,” said Carolyn McCarty, Ph.D., in Psych Central News.

McCarty is the lead study author and a research associate professor at the University of Washington and Seattle Children’s Research Institute.

The study examined 393 men and 383 women at the ages of 24, 27 and 30, asking about their weight, alcohol use and depression symptoms within the past year. McCarty noted that when you look across time, alcohol use and obesity predict later depression. While the disorders are different, they appear to be related in some groups of women.

According to study findings, women who had alcohol use disorders at age 24 were more than three times as likely to be obese at age 27, compared with women who did not have these problems.

The study also indicated that women who were obese at 27 were more than twice as likely to be depressed at age 30. Women who were diagnosed as depressed at 27 had an increased risk of alcohol disorders at age 30. In men, these disorders did not appear to have similar connections over time.

“From a clinical or health care provider perspective, when you think about what to do about one of these problems, you have to think about what to do about the other,” said Gregory Simon, M.D., a psychiatrist and researcher at the Group Health Center for Health Studies in Seattle.

According to a piece in Science Daily, these decreased cravings could actually be at the root of a core symptom of major depressive disorder. This finding is in stark contrast to the long-held notion that those suffering from depression lacked the ability to enjoy rewards, rather than the ability to seek them.

The research was led by Vanderbilt psychologists Michael Treadway and David Zald. "This initial study shows that decreased reward processing, which is a core symptom of depression, is specifically related to a reduced willingness to work for a reward," Treadway, a graduate student in psychology, said in Science Daily.

A primary symptom of major depressive disorder is the decreased motivation to seek and experience pleasurable experiences. Also known as anhedonia, this condition is less responsive to many antidepressants and even persists after other symptoms of depression have subsided.

"In the last decade and a half, animal models have found that the neurotransmitter dopamine, long known to be involved in reward processing, is involved in craving or motivation, but not necessarily enjoyment," Treadway said. "To date, research into reward processing in individuals with anhedonia has focused on enjoyment of rewards, rather than assessing the drive to work for them. We think this task is one of the first to do that."

In this study, researchers found that subjects who had reported symptoms consistent with anhedonia were less willing to make choices requiring greater effort in exchange for greater reward. This was especially true when the rewards were uncertain.