The Association Between Major Depressive Disorder and Alcohol Use Disorder, a Clinical Case

Abstract

Introduction Major Depressive Disorder (MDD) is a severe condition marked by persistent low mood, anhedonia, cognitive impairment, and neurovegetative symptoms [1]. Alcohol Use Disorder (AUD) involves compulsive drinking, impaired control, and withdrawal [2]. These disorders often co-occur, with alcohol as a maladaptive coping mechanism that worsens mood instability and suicidality [3]. Case Presentation This case presents a 34-year-old man with MDD and AUD, highlighting the interplay of early-life trauma, affective instability, and substance dependence. Raised in a violent, alcohol-dependent household, he endured severe psychosocial adversity - parental neglect, domestic violence, and the loss of his parents and brother to substancerelated causes. These factors contributed to emotional dysregulation and early-onset depressive symptoms, leading to recurrent psychiatric hospitalizations from age 13. By adolescence, he exhibited moderate alcohol use, which escalated in his 20s as a maladaptive coping strategy for worsening depression, insomnia, and suicidality, resulting in secondary alcoholism. His suicidality fluctuated with alcohol consumption - intensifying during binges and manifesting as crises during withdrawal. Following a self-destructive week of alcohol abuse, his psychiatric state deteriorated, leading to a severe panic attack, violent ideation, and an emergency call expressing intent to harm himself and others. Due to the acute risk, he was admitted for inpatient psychiatric care where treatment was initiated. Discussion MDD and AUD frequently co-occur, with alcohol initially used to alleviate distress but ultimately worsening mood instability and suicidality [3]. Shared genetic vulnerabilities, early-life trauma, and dysregulated stress responses further increase this risk [4]. In this case, the patient’s childhood adversity and untreated depression fueled escalating alcohol use, reinforcing a cycle of dependence and psychiatric decline. Conclusions This case highlights the need for integrated treatment of mood disorders and substance use, emphasizing early intervention, trauma-informed care, and suicide prevention. It underscores the bidirectional link between alcohol and suicidality, stressing the importance of screening for substance-induced mood destabilization in high-risk individuals.