WOMEN'S HEALTH
October 29, 2009

A Vicious Triangle

For women, alcohol, depression and obesity often go together and form a self−perpetuating cycle. Obsessively replaying negative events in one's mind seems to be what links these activities

For some women, alcohol use, depression, and over−eating are intimately connected, making it much more likely that a woman will suffer from at least one of these problems – and often all three – by the age of 30. The same connections were not seen in men, report the researchers, from the Seattle Children’s Research Institute say that in the journal General Hospital Psychiatry.

Carolyn A McCarty and her team followed male and female participants from 1985, when they were in the fifth grade, until they were about 30 years old, periodically asking them questions about alcohol use, depression, and their eating habits. When the participants were 21 years old, 8% of women and 12% of men suffered from at least two of the problems (alcoholism, depression, and obesity) – but after this age, women were far more likely to experience these issues in combination than were men.

McCarty says that in women, 'ruminative coping' may be at the heart of this vicious relationship.This term, she says, refers to the phenomenon in which people obsess and replay in their minds negative events of the past.

For example, women who were classified as alcoholics at age 24 had four times the risk for being obese at age 27. Those who overate and were obese at age 27 were twice as likely to be depressed at 30. And women who suffered from depression at 27 were over three times more likely to suffer from alcoholism at age 30. The same trends were not seen in men – those who were obese at 27 actually had less risk for depression at age 30.

McCarty says that in women, “ruminative coping” may be at the heart of this vicious relationship. This term, she says, refers to the phenomenon in which people obsess and replay in their minds negative events of the past. Earlier research has also shown that people who over−think or “ruminate” excessively are more likely than others to be depressed and overeat or overdrink as a coping mechanism.

McCarty stresses that problems with the brain’s reward system is typically what is responsible for this thorny triad. Effective treatments, she says, involve teaching the individual how to reward him− or herself differently, rather than turning to food or alcohol. The researcher points out that there are interventions that tackle all three problems at once, which include stress management, increasing physical activity levels, and mindfulness training. She says that “[w]e have to think about how people can start to build in naturally rewarding experiences in their lives.”

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