An "acute blackness" that comes over perhaps thousands of young people in the middle of the night, "almost certainly" when combined with alcohol, contributes to numerous suicides and attempted suicides, a conference in Dublin was told yesterday.
Mr Rolande Anderson, project director of the Helping Patients With Alcohol Problems programme at the Irish College of General Practitioners, said it was impossible to say with certainty how prevalent this suicidal depression in the middle of the night was.
"But it's definitely something that an awful lot of GPs speak about and it's a matter of real and great concern, particularly among young men," he said.
"When it comes with excessive alcohol consumption, it's then that someone might reach for pills or some other means of taking their own lives or of attempting to.
"The thing is then that when they wake up in the morning there may be no memory or trace of the suicidal thoughts."
Mr Anderson, was speaking at a conference called "Reaching Out To Young People With Mental Health Problems" organised by the UCD Department of Psychiatry and the Mater Hospital.
He said it was extremely important that the link between alcohol and depression was better established.
Heavy drinkers were five to 10 times more likely to be at risk of committing suicide as non-problem drinkers and 20 times as likely to attempt suicide as non-problem drinkers, he said.
There was a culture of denial about alcohol and particularly about its depressive impact, and this was true within the medical culture, too.
GPs could play a greater role in identifying problem drinking, he said, but young people were largely absent from their surgeries as they tended to be healthy, in a physical sense.
"This makes it all the more important that GPs use the small window of opportunity they may have when young people come to see them," Mr Anderson said.
While the majority of young people were responsible drinkers, a significant number were not, he said.
By simply asking about alcohol consumption the GP might effect a reduction.
He also highlighted the impact of parental alcoholism, which could lead to depression and/or alcohol abuse in the young person.
Mr Andrew Collcott, a lead practitioner in Gateshead, England, spoke on the issue of deliberate self-harm by young people.
It was important that doctors embarked on a collaborative approach when dealing with young people who may be cutting themselves or taking overdoses, he said.
"It's important not to wag the finger, but to recognise that in some way the self-harm is a 'help' to them, whether as a form or self-punishment or as a release or distraction from emotional pain.
"Find out about the event [of self harm\] and take the opportunity to engage with them about it. Tell them, 'You must have had a good reason for doing that,' " he said, rather than just asking why they did it.
