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Is Alcoholism a Mental Illness?
Alcoholism & Mental Health
- Written By: Amanda Stevens, B.S.
- Reviewed By: Dr. Po-Chang Hsu, M.D., M.S.
- Updated:
- Published:
- Reading Time: 7 minutes
Find out more about the deep rooted connection between alcohol abuse & mental illness.
Alcoholism—which in modern times is called alcohol use disorder (AUD)—has long been a subject of societal concern and scientific study. According to the 2021 National Survey on Drug Use and Health, over 29 million people over the age of 12 had AUD that year, and 894,000 adolescents ages 12 to 17 had AUD in 2021 as well.[1]
Concurrently, 1 in 5 adults in the US experience a mental illness, with nearly 1 in 25 (or 10 million) adults living with a serious mental illness.[2] Mental illness encompasses a diverse range of conditions that affect mood, cognition, and behavior, and the question of whether alcohol use disorder (and substance use disorders in general) is a mental illness has been the subject of much debate over the past half-century. Currently, the Diagnostic and Statistical Manual of Mental Disorders (DSM) classifies alcohol use disorder as a mental disorder.[3]
Key Points
- Alcoholism—which is now referred to as alcohol use disorder—is a common condition, with over 29 million Americans estimated to meet diagnostic criteria for the disorder.
- The past few decades saw much debate as to whether or not alcohol use disorder is a mental illness, with most contemporary understanding in agreement that it is both a mental health condition and a chronic, relapsing health issue.
- Alcohol use disorder can also lead to the development of and worsening of co-occurring conditions or other physical and mental health ailments.
- Treatment is available for both alcohol use disorder and other co-occurring conditions.
Understanding Alcohol Use Disorder
AUD is a mental health condition which can come about as a result of several factors:
- Environmental factors: Your upbringing and social influences can contribute to the susceptibility and likelihood of developing an alcohol use disorder (or other substance use disorder).
- Genetic factors: Some people possess a genetic predisposition that may increase their potential for developing AUD.
- Psychological factors: Going through stress and having a co-occurring condition (such as depression) may increase someone’s potential for developing AUD.
In 1980, the third edition of the DSM classified alcoholism as a mental health disorder, which was further refined to the current diagnosis of AUD in the fifth version of the manual, the DSM-5.[4] DSM-5 provides the following criteria for alcohol use disorder, of which at least two criteria must be met in order to qualify:[5]
- Alcohol is often consumed in larger amounts or over a longer period than was intended
- There is a persistent desire or unsuccessful efforts to cease drinking or control your alcohol use
- A great deal of time is spent obtaining, using, or recovering from using alcohol
- Craving alcohol
- Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or at home
- Continued alcohol use despite having recurrent social or relational problems caused by alcohol
- Important recreational activities are given up or reduced because of alcohol use
- There is recurrent alcohol use in situations in which it is physically hazardous to do so
- Alcohol use is continued despite knowledge of having a persistent or recurrent physical/psychological problem that is caused or made worse by alcohol
- Tolerance, or needing increased amounts of alcohol to achieve intoxication
- Withdrawal symptoms when alcohol use is decreased or stopped
When viewed under this lens, it makes sense that AUD is classified as a mental illness. Mental health conditions can come in various forms, all typically displaying alterations in mood, thought patterns, and behavior. The symptoms of these conditions can be debilitating and have a significant impact on your quality of life. Furthermore, the underlying causes of these conditions can be varied, also involving complex interactions between genetics, brain chemistry, and environmental factors.[6]
Alcohol Use Disorder & Co-Occurring Disorders
People struggling with AUD sometimes face additional challenges when co-occurring conditions, also known as dual diagnosis or comorbid disorders, are present. These conditions can range from mental health issues to physical ailments, further complicating the journey toward recovery. Co-occurring conditions and alcohol use disorder frequently go hand-in-hand, creating a complex and intricate relationship.[7]
Some common co-occurring conditions seen in individuals with AUD include:
Depression and Anxiety
Many individuals turn to alcohol as a way to cope with feelings of depression and anxiety. However, alcohol’s depressive effects can worsen these conditions over time, creating a harmful cycle.
Post-Traumatic Stress Disorder (PTSD)
Those who have experienced trauma may attempt to self-medicate their distress with alcohol. Unfortunately, this often leads to intensified symptoms of PTSD and a heightened risk of AUD as well.
Bipolar Disorder
The mood swings that often characterize bipolar disorder can be exacerbated by alcohol consumption. Conversely, alcohol can also trigger episodes of mania or depression.
Schizophrenia
Alcohol use can interfere with medications used to manage schizophrenia, potentially making symptoms more severe and treatment less effective.
Chronic Physical Conditions
Individuals with chronic physical illnesses, such as liver disease or diabetes, may find their conditions worsened by alcohol consumption. This can complicate treatment plans and contribute to a poorer overall prognosis.
The Need for Comprehensive Treatment
Addressing alcohol use disorder (and any co-occurring conditions) often requires a holistic and integrated approach to treatment, and recovery from AUD is possible with the right support. Comprehensive treatment acknowledges that individuals struggling with alcohol are multifaceted and complex beings, and providing integrated care that’s tailored to the individual can lead to a more effective recovery journey.[8]
If you or someone you know faces alcoholism and co-occurring mental health concerns, reaching out for professional help is a courageous step to take toward a brighter, healthier future.
Frequently Asked Questions About Alcoholism & Mental Illness
Absolutely. Co-occurring conditions of alcohol use disorder and other mental health conditions are common. People with mental health disorders might be at a higher risk of developing alcohol-related issues due to self-medication, while excessive alcohol consumption can contribute to the onset or exacerbation of mental health symptoms. Treating both conditions simultaneously is essential for effective recovery.
Treating alcohol use disorder often requires a specialized approach due to its unique physiological aspects. Detoxification, medical management of withdrawal symptoms, and addressing physical health complications are important steps in the treatment process.[8]
Yes, alcoholism can exacerbate existing mental health conditions. For individuals who are already dealing with conditions like depression, anxiety, bipolar disorder, or PTSD, alcohol can act as a depressant and intensify symptoms. This can create a cycle where alcohol is used to alleviate distress temporarily but ultimately worsens the mental health condition over time. Seeking treatment that addresses both the substance use and the underlying mental health issue is crucial for breaking this cycle.
Genetics can play a significant role in both alcohol use disorder and other mental health conditions, and certain genetic factors may make individuals more susceptible to both conditions. For example, someone with a family history of alcohol addiction might also have a genetic predisposition to anxiety or depression. Additionally, shared neural pathways and neurotransmitters that influence mood and reward are impacted by both alcohol use and mental health. These biological connections contribute to the complex relationship between AUD and mental illness.
While treatment for alcohol issues primarily focuses on the substance use itself, quality providers will also be able to address the mental health aspect as well. Many treatment centers offer integrated offerings that target both conditions simultaneously. By addressing both aspects of the individual’s well-being, such treatment can lead to a more comprehensive and lasting recovery.
Mental Health Resources
- Mental Health Facilities in New Jersey
- Best Psychiatric Hospitals in New Jersey
- New Jersey Mental Health Hotlines
- Mental Illness vs Mental Disorder: What Is The Difference?
- What To Do If You’re Struggling with Mental Health Concerns
- Is Alcoholism a Mental Illness?
- How to Treat Mental Illness Without Medication
About Treatment
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