Alcoholism as a Mental Illness: The Science and Stigma

For some people, alcohol consumption can become problematic. In fact, ongoing alcohol misuse can lead to an alcohol addiction, and the need to seek treatment in order to stop drinking. Given the fact that some people develop problems with alcohol, it is not uncommon to ask, ‘Is alcoholism a mental illness?” Learn the answer, as well as information about treatment options, including medication assisted treatment for alcohol use, below.

Alcoholism Overview

When people refer to alcoholism, what they are usually referencing is an alcohol use disorder, which is the clinical term for an alcohol addiction. In today’s world, when addiction is being recognized as a legitimate medical condition, it is prefered to use the term “alcohol use disorder.”

When considering the answer to the question, “Is alcoholism a mental disorder?” it’s important to understand just what an alcohol use disorder is. Experts describe an alcohol use disorder as a medical condition that makes it difficult for a person to stop drinking, even when alcohol misuse causes serious problems, such as health consequences. Alcoholism falls under the umbrella of alcohol use disorder.

Alcohol Use Disorder (AUD)

An alcohol use disorder is a condition listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). As a condition in this manual, an alcohol use disorder is often considered to be a mental health condition. Beyond the fact that alcohol use disorder is included in this manual, it’s important to consider that chronic alcohol misuse causes lasting changes in the brain, which can make it difficult to reduce drinking. As such, it is reasonable to classify alcohol use disorder as a mental health condition. 

An alcohol use disorder can be either mild, moderate, or severe. A person with a mild alcohol use disorder will show 2-3 symptoms. A moderate alcohol use disorder is diagnosed when a person shows 4 or 5 symptoms, and a severe alcohol use disorder involves 6 or more symptoms. 

Signs 

When someone has an alcohol use disorder, they will show certain signs associated with alcohol misuse. 

Excessive Alcohol Consumption 

Expert guidelines recommend that men consume no more than 2 drinks per day and that women limit their alcohol consumption to 1 drink per day. Drinking more than this can place a person at risk of developing problems related to alcohol consumption.

For women, consuming 4 or more drinks in one sitting is defined as binge drinking. For men, binge drinking is defined as consuming 5 or more drinks in a sitting. Frequent binge drinking increases the risk of alcohol use disorder. 

Legal Problems

If someone has developed an alcohol use disorder, they may experience legal problems related to alcohol misuse. This could include arrests for drunk driving or public intoxication. 

Social Withdrawal 

A person with an alcohol use disorder may appear as if they are isolating themselves from friends, family, and their usual activities. This is because alcohol begins to take precedence over other areas of life. It may seem as if a person with an alcohol use disorder is no longer interacting socially, or they may only socialize when an activity involves alcohol consumption. 

Symptoms

Some warning signs may suggest that a person is struggling with or at risk of an alcohol use disorder. If a person does have an alcohol use disorder, there are specific symptoms that are used to determine whether a person meets diagnostic criteria for this condition. These symptoms or criteria are listed below.

Being Unable To Reduce Alcohol Use

Having an alcohol use disorder means that a person has a difficult time reducing their alcohol use. A person may strongly desire to stop drinking, but they are not successful with reducing or eliminating their alcohol use. They may have several failed attempts at quitting drinking. 

Spending a Significant Amount of Time Drinking

Brain changes from alcohol use disorder lead a person to compulsively consume alcohol. This means that they may spend most of their free time drinking, or recovering from the effects of alcohol use. For instance, entire weekends may revolve around alcohol. The person may drink heavily every evening, and then spend most of the morning and afternoon the next day recovering from the effects of being hungover. 

Giving Up Other Activities in Favor Of Alcohol Use

When drinking is compulsive, as it is with an alcohol use disorder, other areas of life fall by the wayside. This means that a person may no longer engage in hobbies or other enjoyable activities. 

Drinking, Even When It Causes Or Exacerbates A Health Problem

A person who lives with an alcohol use disorder may develop health problems related to alcohol misuse, such as high blood pressure. Once an alcohol use disorder takes hold, the person will continue to drink, even if they know that it is making their blood pressure problem worse.

Drinking To The Extent That It Interferes With Functioning At Work Or School

When a person is compelled to drink, they may struggle to perform at work or school. They may start calling off from work in order to drink, or the mental effect of alcohol can make it difficult for them to perform work or school-related tasks. 

Continued Alcohol Consumption, Despite Relationship Problems Related To Alcohol 

In the case of an alcohol use disorder, alcohol will take precedence over other areas of life, including important relationships. A person may choose to drink, even if their spouse expressed concern over their alcohol consumption. 

Needing Larger Amounts Of Alcohol To Achieve The Same Desired Effects

Along with an alcohol use disorder comes the risk of tolerance, which means a person needs larger amounts of alcohol to achieve the effects they desire. Consuming 3 or more drinks may have caused intoxication previously, but once a person has an alcohol use disorder, they may not even feel impaired until consuming much more than this. 

Experiencing Withdrawal Symptoms When Not Drinking

Ongoing alcohol misuse can cause the body to become dependent on alcohol, meaning that it does not function the same without the presence of alcohol. When a person is dependent and stops drinking, they will experience uncomfortable symptoms, as the body is reacting to the absence of alcohol. 

Having Strong Alcohol Cravings 

Strong alcohol cravings are a symptom of an alcohol use disorder. These cravings can make it difficult to stop drinking, because a person may be unable to focus on anything else aside from the desire to drink. 

Drinking In Dangerous Situations, Such As Drinking Before Driving Or Operating Heavy Machinery 

When someone lives with an alcohol use disorder, they may not consider safety. They will consume alcohol, even if it places them at risk of harming themselves or others. This could involve drinking large amounts, even when a person knows that they are going to be driving soon after. 

Consuming Larger Amounts Of Alcohol Than Intended

A person who has an alcohol use disorder may intend to have just a drink or two, but because of losing control over alcohol consumption, they end up drinking large quantities, perhaps drinking to the point of intoxication.

3 Stages Of AUD

People sometimes divide an alcohol use disorder into three different stages, and the mental effects of alcohol are evident in each stage. Learn more below.

Problematic Drinking

In the initial stages of alcohol use disorder, a person may only show a few symptoms. At this point, the person may meet diagnostic criteria, but the condition is only mild or moderate. The person may drink in order to cope with stress or anxiety, but they find that mental health becomes worse, because they are beginning to experience problems from drinking.

A person in the problematic stage of AUD may begin to struggle at work because of their drinking, experience problems in their relationships, and spend most of their time drinking.

Severe Alcohol Misuse 

In the severe stage of alcohol misuse, drinking problems increase in intensity. A person may begin to have health issues related to alcohol misuse, and their life will begin to revolve around alcohol. Mental health deteriorates as alcohol causes changes to the brain that lead to compulsive drinking, even in the midst of serious consequences from alcohol misuse. 

Obsessive Alcohol Misuse

At the final stage of alcohol use disorder, a person has significant health problems related to alcohol. They spend their entire day drinking, and they are unable to function in important areas of life. They may lose their family, their job, and their home as alcohol takes center stage. A person who does not seek treatment for end stage alcohol use disorder may be at risk of death.

Mental Health Disorders Caused By Alcohol Misuse

Alcohol and mental health problems can go hand-in-hand. There is some disagreement regarding whether alcohol misuse itself causes mental health problems, or if people who have mental health problems are more likely to misuse alcohol to cope with symptoms of mental illness. 

Based upon what is known about the mental health effects of alcohol, both scenarios noted above are possible. Some people may have a co-occurring or pre-existing mental health disorder, whereas others may develop an alcohol-induced mental disorder. 

Some conditions that can result from ongoing alcohol misuse include:

• Psychosis/schizophrenia
• Depression
• Anxiety
• Antisocial personality disorder

While the conditions above are linked to alcohol misuse, it’s important to keep in mind that in some cases, they are not separate mental health conditions, but rather a byproduct of alcohol addiction. For instance, a person may seem depressed only when withdrawing from alcohol, or they may show symptoms of psychosis only when intoxicated.

On the other hand, a person who shows symptoms of a mental health disorder even when they are not withdrawing or under the influence may have a separate condition not directly associated with alcohol misuse. 

How To Treat AUD

Alcohol use disorder treatment can vary from person to person. There is no single approach that works for everyone, but there are multiple options that are known to be effective. Medications are commonly used in the treatment of alcohol use disorder. Prescription drugs like naltrexone, acamprosate, and disulfiram can help people to reduce their drinking. 

People who participate in medication-assisted treatment for alcohol misuse typically also receive behavioral services, such as individual and group counseling. They may participate in mutual support groups like AA to help them stay committed to recovery. 

A person who is living with psychological effects of alcohol, including a mental health condition, should also receive treatment for this condition. If a mental health disorder like depression is left untreated, a person may relapse to drinking in order to cope with depression symptoms. 

Alcoholism And Mental Illness FAQs

If you’re asking about the effects of alcohol on mental health, the answers to the following questions provide additional information. 

Which Mental Disorder Is Most Commonly Comorbid With Alcohol Use Disorder?

Numerous mental health diagnoses tend to overlap with alcohol use disorder. According to a review of multiple studies concerning the relationship between mental illness and alcohol, anxiety and depression are both common among people with alcohol use disorder. In fact, around 37% of people who have an alcohol use disorder at some point during their lives will also be diagnosed with major depression. Around 19% of people with an alcohol use disorder also experience an anxiety disorder.

How Do Psychiatrists Treat Alcohol Use Disorder?

A psychiatrist working with a patient with an alcohol use disorder may prescribe medications to help the person control cravings for alcohol. Medication-assisted treatment is a common modality for treating alcohol use disorder, and since a psychiatrist can prescribe medications, they may offer this form of treatment. A psychiatrist treating alcohol use disorder will likely refer patients for other services, such as counseling with a social worker or mental health therapist. 

Which Personality Disorder Is Associated With Alcohol Use Disorder?

Antisocial personality disorder (ASPD) is commonly linked to alcohol use disorder. A review of the research found that 18% of people with an alcohol use disorder also meet criteria for antisocial personality disorder. 

While ASPD is commonly associated with alcohol use disorder, it is not the only personality disorder that occurs frequently in people who misuse alcohol. Research also shows that 21% of people with alcohol use disorder have a borderline personality disorder diagnosis. 

How Can I Help Someone With Mental Illness And Alcohol Use Disorder?

If a friend or family member seems to struggle with alcohol use and a mental health condition, it’s important to be available as a source of support. Be willing to listen to their concerns, without passing judgment or criticizing them. Encourage them to seek treatment and stay connected to the recovery community. You can also support them by learning more about mental illness and alcohol misuse, so you have a better understanding of what they are experiencing.

Can Alcohol Make You Depressed?

Depression is common among people who have an alcohol use disorder. In some cases, depression may be a risk factor for later developing an alcohol use disorder. In other cases, a person may develop depression as a result of the physical and social consequences linked to alcohol misuse. 

Is Alcohol Use Disorder Defined As A Mental Illness?

An alcohol use disorder is listed as a condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM). As such, it is commonly regarded as a mental health condition. An alcohol use disorder causes changes in the brain and leads to changes in behavior, both of which make it reasonable to classify alcohol use disorder as a mental illness. 

How Does Alcohol Use Affect Mental Health?

There is a high degree of overlap between alcohol use disorder and mental health conditions, such as depression and anxiety. In some cases, these conditions can develop as a result of the consequences of alcohol misuse. Alcohol also causes lasting changes in the brain and can negatively affect mental health by leading to compulsive drinking, social withdrawal, and exacerbation of psychological problems. 

Consult With Confidant’s Doctors for Alcohol Use Disorder Treatment

If you’re experiencing physical and mental impairment resulting from the use of alcohol, Confidant Health is here to help. We offer online medication assisted treatment for alcohol use, so you can receive the services you need to stop drinking and reduce negative consequences, such as the mental effect of alcohol. Download our app today to begin medication assisted treatment. We are available on both the App Store and the Google Play Store.