Rural issues - alcohol and depression

People who live in rural and remote areas often face pressures that those in towns and cities do not. These can include extreme weather events (such as drought, fires, floods and storms), pest plagues, financial worries and isolation. Over time these stresses can contribute to psychological distress and mental health conditions such as depression and anxiety.

Some people who are feeling low turn to alcohol to feel better. This is known as ‘self-medication’. It is a common but unsafe and ineffective coping strategy for farmers and other people in rural and remote communities. Research suggests that people in farming and remote areas are more likely to drink at risky levels than the general population, and men in particular often drink more than is considered healthy.

Alcohol can mask stress in the short term, but it does not treat the underlying causes of distress, and over the long run it can make them worse. There is a strong link between heavy alcohol use, depression and suicide risk. Support is available to help people in rural communities find healthier ways to deal with psychological distress and mental health conditions.

Stress and depression are not the same#

Studies suggest that people who are depressed may not use the word ‘depression’ to describe how they feel, and may call it ‘stress’ instead. But stress and depression are different and need different approaches.

• Stress is a response to a challenging or dangerous situation. It happens when there is an imbalance between the demands placed on you and your resources to cope. Some stress can be positive and help you get things done, but if it causes ongoing discomfort and distress it can lead to other problems, such as anxiety and depression.
• Depression is more than feeling stressed or ‘down in the dumps’. A diagnosis of depression involves a number of symptoms present almost every day over at least a two-week period. One such symptom is feeling that life isn’t worth living. If you recognize this in yourself, seek help.

Why alcohol makes things worse#

Alcohol is a depressant. It causes changes in consciousness, mood and emotions, and its intoxicating effects can lead to accidents, injuries, illness and disruption to family life. Research shows a clear link between alcohol use, depression and suicide risk.

Some of the dangers of trying to treat depression with alcohol include:

• An increased risk of harm to yourself and others, including domestic and other violence, and harm to an unborn child during pregnancy
• An increased risk of suicide, especially among men
• Lost work time, as people who self-medicate may be unable to function at work, lose productivity through absenteeism, or face premature retirement or injury
• Social problems such as relationship breakdown, becoming withdrawn from friends, and difficulty parenting or supporting your family
• The financial burden of paying for alcohol

Alcohol use in rural communities#

Some patterns seen in rural and remote communities include:

• Higher rates of drink driving than in metropolitan areas
• Men in rural communities tend to drink more than men in metropolitan communities
• In one survey, about a third of rural men reported drinking up to four days a week, and a quarter reported more than four drinks per session
• Teenagers in rural areas are more likely to drink than teenagers in cities, partly because parents may drink in ways that encourage young people to do the same
• In one study of women in rural or remote communities, most of those who self-medicated with alcohol and other drugs also reported emotional or mental health problems

Possible reasons for these patterns include limited options for socializing, where the pub or local sports club may be one of the few places to meet others, along with boredom and a lack of employment or other entertainment.

Barriers to getting help#

Depression, anxiety and other mental health conditions can be serious and poorly managed in many rural communities. Barriers to getting help, and a lack of appropriate support, can lead people to self-medicate with alcohol and other drugs. Reasons people may not seek help include:

• Self-stigma, where people accept inaccurate negative views of themselves, leading to shame or embarrassment
• Social isolation
• Not having enough money to pay for travel or accommodation when treatment is only available in larger centres
• Not knowing what health services are available to people in rural and remote areas

Finding other ways to feel better#

Alcohol is not an effective treatment for poor mental wellbeing. To feel better you will need to find other ways to support yourself. Suggestions include:

• Talk with your doctor or a community health professional for information and referral. Your doctor may suggest a short-term trial of antidepressant medication.
• Listen to your friends and family. If they say you are drinking too much, then you probably are.
• Use counseling services. Counsellors are trained to help you find practical solutions, and many services are available online or over the phone.
• Make a deliberate effort to cut back. Simple strategies include not keeping alcohol in the house and having alcohol-free weeks.
• Take steps to address the real-life stressors getting you down. Focus on things you have some control over, and don’t try to go it alone.
• Don’t avoid making decisions. Use trusted and skilled people around you to help during tough times.

Make a start by reaching out to appropriate support services. Assistance is often free of charge, and in some cases support workers can come to you, or you can ask for help over the phone.

Key points#

• Self-medicating with alcohol is a common but unsafe and ineffective coping strategy for people in rural and remote areas
• There is a strong link between heavy alcohol use, depression and suicide risk
• Stress and depression are not the same and need different approaches
• Alcohol causes changes in consciousness, mood and emotions
• Research shows a clear link between alcohol use, depression and suicide risk

Where to get help#