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What is a Mental Illness?

Mental illnesses are also known as mental health disorders. They refer to an extensive range of mental health conditions. These are disorders that affect your mood, thinking, and behavior.1

Some examples of mental health disorders include:

  • Depression
  • Anxiety disorders
  • Schizophrenia
  • Eating disorders
  • Addictive behaviors

Many people have mental health issues and concerns from time to time. But a mental health concern turns in to a mental illness when ongoing signs and symptoms lead to frequent stress and affect a person’s ability to function as usual.

Mental illnesses can make you feel miserable and lead to daily life problems, including at school/work and in relationships. In many cases, symptoms of mental health disorders can be treated and managed with a combination of medications and talk therapy, otherwise known as psychotherapy.

Is Alcoholism Considered a Mental Illness?

The physical effects of excessive drinking, like heart and liver damage, may suggest that the issue is more physical than anything else. However, the mental and psychological effects of alcohol dependence are significant enough to classify alcohol addiction as a substance use disorder or mental illness.

Alcoholism (or alcohol use disorder) is recognized as a substance use disorder that produces both physical and mental symptoms. Alcohol use disorder may also be referred to by doctors, addiction experts, and the general population as a mental health disorder or mental illness.

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Can Alcohol Addiction Lead to a Mental Health Disorder?

A mental illness that co-occurs with alcohol addiction may depend on the symptoms before the excessive drinking and/or may occur directly because of it. Knowing the patient’s family history, gender, and the timeframe of illness gives a better understanding of the diagnosis.

Alcohol-induced mental illness occurs due to neurotransmitters being affected and/or the hormonal imbalances linked to other mood disorders. Alcohol dependence and addiction can lead to permanent brain damage.

Learning to tell the difference between an alcohol-induced mental illness and a condition that existed before an alcohol use disorder can be challenging. Many clinicians have to determine whether patients are there because the condition existed before the substance use problem or if it was induced by alcohol.

What is a Dual-Diagnosis (Co-Occurring Disorders)? 

A co-occurring disorder (or dual-diagnosis) refers to when one person has two or more mental health disorders or medical illnesses.2 These co-occurring conditions may overlap and begin at the same time. Or, one may occur before or after the other.

There is a strong link between substance use disorders and other mental health disorders. Around half of people with one disorder will develop at least one more co-occurring mental health problem in their lifetime.

Co-occurring disorders can also worsen each other’s severity. 

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Common Mental Health Disorders Associated With Alcoholism

Here are some common mental health disorders associated with alcoholism:

Depression

Depression is a type of mental health disorder that affects an individual’s thoughts and actions. It is one of the most common mental health disorders in the United States, and people of all ages, genders, and backgrounds can experience it.

Alcohol is sometimes used as a quick fix to treat the symptoms of depression. However, self-medicating depression with alcohol is extremely dangerous and can lead to life-threatening withdrawal symptoms.

Alcohol consumption stimulates the brain’s reward system. This can lead someone to experience a ‘high.’ In time, the body begins to rely on drinking to reach feelings of happiness. This causes a cycle of alcohol dependence or addiction.

Quitting alcohol ‘cold turkey’ may be dangerous to a person’s health. The body may crash after the high and go into shock. This can heighten symptoms of depression, which significantly increases the risk of self-harm.

Anxiety Disorders

Around 18 percent of the general population have a co-occurring anxiety disorder of some form.4 Social anxiety disorders have a particularly strong link to marijuana use problems.

Generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder are all connected to an increased risk of co-occurring disorders. 

Bipolar Disorders

Bipolar disorder is described as a manic-depressive illness. The condition involves erratic mood swings that shift from extreme highs to severe lows.

Millions of people in the United States have bipolar disorder, ranging from adolescents to seniors. Mood swings resulting from bipolar disorder can lead to a wide range of mental and physical symptoms.

During the highs of bipolar disorder, a person is unusually upbeat. They may have a lot of energy and may feel overly confident. However, the lows come with feelings of tiredness, restlessness, and loss of interest.

The sudden mood changes caused by bipolar disorder are unpredictable. Symptoms differ from person to person. 

An individual with bipolar disorder has an increased risk of developing a substance use disorder, like alcoholism, compared to those who do not have the condition. These conditions can be very dangerous when they co-occur, as alcohol can worsen symptoms of bipolar disorder.

Obsessive Compulsive Disorder (OCD) 

Obsessive-compulsive disorder (OCD) is one of the most common types of anxiety disorders. It involves uncontrollable obsessions that lead to repeated compulsions. Many people with OCD also suffer from a co-occurring disorder like alcoholism.

Compulsions and obsessions linked to OCD come in many different forms. For example, someone may count items, wash their hands excessively, or constantly arrange furniture in a certain way.

Sometimes an individual may try to ignore or overcome OCD alone. However, this can increase their anxiety. Other times, they may give into compulsions to temporarily fulfill an urge.

To avoid intrusive thoughts or behaviors, some people with OCD turn to alcohol and drugs. However, instead of helping someone relax and escape their fears, substance misuse may make OCD worse.

Relying on alcohol or drugs to self-treat alcoholism and OCD can come with dangerous consequences. These include health complications and emotional problems.

Post Traumatic Stress Disorder (PTSD) 

Post traumatic stress disorder (PTSD) is a psychiatric disorder that affects many people who have experienced or witnessed traumatic events. These events include natural disasters, severe accidents, war/combat scenes, and rape, among others. 

Relative to those without PTSD, people with the condition are more likely to meet the criteria for a substance use disorder.

Personality Disorders

A personality disorder is a type of mental illness in which the patient has a rigid and unhealthy pattern of thinking, behaving, and functioning.

People treated with addiction are more likely to have a personality disorder than those who are not.

Treatment for Co-Occurring Disorders 

Integrated treatment for substance use disorders and mental illness is known to be consistently superior compared to separate treatments for each condition.5 

Treatment of substance use disorders and mental illnesses often involve using cognitive behavioral therapy strategies to enhance interpersonal and coping skills. It may also include using approaches that support motivation and functional recovery.

Patients with a co-occurring mental illness and substance use disorder show poorer treatment adherence and higher rates of treatment dropouts than those without a mental health condition. This negatively affects results.

However, steady progress is being made through new and existing treatments for co-occurring disorders.

How is Mental Health Treatment Different from Substance Use Treatment?

Someone with a mental health condition and a substance use disorder must have both problems treated.

Many treatment options for both conditions overlap and may include:

  • Rehabilitation
  • Medications
  • Support groups
  • Talk therapy

However, each condition may be addressed differently during treatment.

Resources

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 Mental illness, Mayo Clinic, June 2019

Comorbidity: Substance Use Disorders and Other Mental Illnesses, National Institute on Drug Abuse, August 2018

Common Comorbidities with Substance Use Disorders Research Report, National Institute on Drug Abuse, April 2020

Flynn, Patrick M, and Barry S Brown. “Co-occurring disorders in substance abuse treatment: issues and prospects.” Journal of substance abuse treatment vol. 34,1 (2008): 36-47

NIDA. "What are the treatments for comorbid substance use disorder and mental health conditions?." National Institute on Drug Abuse, 13 Apr. 2021

Drake, Robert E, and Kim T Mueser. “Alcohol-Use Disorder and Severe Mental Illness.” Alcohol health and research world vol. 20,2 (1996): 87-93.

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