Alcohol Abuse and Mental Health

Alcohol and Mental Health Effects

The co-occurrence of alcohol and mental health disorders is very prevalent in the U.S. One in four adults with a mental health disorder also suffer from alcohol use disorder (AUD). Both conditions share similar underlying causes such as genetic predisposition, exposure to stress or trauma, and changes in brain composition. 

Unfortunately, many people with underlying mental health conditions turn to substance use, such as drinking alcohol. They do so to self-medicate and avoid the negative feelings associated with their mental illnesses. 

Turning to alcohol rather than coping with these mental health problems can actually worsen your mental state and overall well-being. And, heavy drinking can result in serious consequences over time, such as suicidal thoughts, ideations, or attempts.  

Link Between Alcohol Abuse and Mental Health

Alcohol use disorder (AUD) and mental health disorders come together in two different ways. Those with existing mental health disorders turn to alcohol as a means of self-medicating. When symptoms escalate, alcohol provides a quick boost in mood and relieves symptoms temporarily. 

Unfortunately, in many cases, once the alcohol effects wear off, the symptoms may become worse. This creates a vicious cycle of drinking and mood changes.

On the other hand, those that have a substance abuse problem are predisposed to developing a mental health disorder. For example, alcohol is a brain depressant and, for individuals predisposed to depression, can trigger depressive episodes.

How Does Alcohol Affect Your Mood?

Drinking alcohol increases confidence and decreases inhibition. Alcohol also affects everyone differently. For example, some people notice an increase in mood, while others may feel depressed. 

Long-term and excessive alcohol consumption also disrupts your sleep cycle, which makes your body have to work harder to break down the alcohol in your system. If you do not get a proper amount of sleep every night, you will have less energy. Therefore, your mood will constantly fluctuate. This is because alcohol is a central nervous system (CNS) depressant. 

Those who drink alcohol often may also experience "numb" emotions, which means they feel apathetic and uninterested when not drinking. 

alcohol

What Is Alcohol Use Disorder (AUD)?

Alcohol use disorder (AUD), formerly known as alcoholism, is an unhealthy form of alcohol use that includes drinking excessively on a regular basis. This includes binge drinking. Symptoms of AUD include:

  • Being unable to limit your alcohol consumption
  • Having to drink more alcohol to achieve the same results
  • Spending a lot of time drinking or recovering from drinking
  • Continuing to drink even when it causes physical, emotional, or social problems
  • Giving up once-loved activities
  • Experiencing withdrawal symptoms when you do not drink
  • Mental Health Disorders Associated with Substance Abuse

In the U.S., there is a high co-occurrence of alcohol abuse and mental health disorders. For reference, a co-occurring disorder is when an individual receives a dual diagnosis for both a substance use disorder (SUD) and mental health disorder. Certain mental health disorders are highly prevalent in people who have alcohol dependence. These disorders included mood disorders, such as:

  • Depression, including major depressive disorder and bipolar depression 
  • Anxiety disorders, such as generalized anxiety disorder (GAD) and panic disorder
  • Bipolar disorder
  • Post-traumatic stress disorder (PTSD)
  • Schizophrenia
  • Mood Disorders

Mood disorders are the most common mental health disorders among people with alcohol use disorder (AUD). Alcohol consumption is often used as a way for people to self-medicate and temporarily reduce their symptoms. Unfortunately, this relief is short-lived, leaving many to suffer from increased symptoms after drinking. 

The main mood disorders associated with alcohol abuse include depression and bipolar disorder.

Depression

Depression is a condition that negatively affects how a person feels, thinks, and handles daily activities. While everyone experiences periods of ups and downs in life, people with depression experience these down periods for more than two weeks at a time. These periods of depression make a person highly susceptible to substance abuse to improve mood and self-medicate. 

Depression affects over 16 million adults in the U.S. and symptoms can include:

  • Continuous sad or empty mood
  • Feelings of hopelessness
  • Increased irritability
  • Feelings of guilt or worthlessness
  • Loss of interest in hobbies or social activities
  • Decreased energy
  • Problems with concentration and memory
  • Changes in sleep
  • Appetite and weight changes
  • Thoughts of death or suicide

Bipolar Disorder

Bipolar disorder is a condition that causes mood swings ranging from manic highs to depressive lows. These mood swings can affect everything from sleep and energy levels to one’s ability to think clearly. Bipolar disorder affects an estimated 4.4 percent of adults in the U.S. at some point in their lives.

The connection between bipolar disorder and alcohol is very common. In fact, studies estimate that 43 percent of people with bipolar disorder will develop an alcohol use disorder. Symptoms of bipolar disorder depend on whether it is manic or depressive.

Mania or Hypomania:

  • Abnormally upbeat and jumpy
  • A major increase in activity levels
  • Agitation
  • High level of self-confidence
  • Very talkative
  • Easily distracted
  • Poor decision making

Depressive Symptoms:

  • Feelings of sadness and hopelessness
  • Feelings of guilt or worthlessness
  • Loss of interest
  • Sleep changes, insomnia, or continual sleeping
  • Loss of energy and fatigue
  • Thoughts of suicide or death

Anxiety Disorders

Anxiety is a normal part of life. However, those with anxiety disorders experience frequent, intense episodes of fear about everyday situations. These fears can affect everyday activities and make life difficult for some. There are many different anxiety disorders. This includes generalized anxiety, social anxiety, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), and panic disorder. Symptoms of anxiety disorders include:

  • Regular feelings of nervousness and restlessness
  • A sense of impending danger
  • Increased heart rate
  • Hyperventilation
  • Sweating
  • Trouble concentrating
  • Trouble sleeping
  • Stomach problems

Schizophrenia

Schizophrenia is a serious mental health disorder that affects how a person interprets reality. It combines hallucinations, delusions, and impaired thinking that can be disabling. It is one of the top 15 causes of disability worldwide.

 While substance abuse is common in people with schizophrenia, alcohol abuse greatly increases the risk of schizophrenia in those predisposed to the condition. Symptoms of schizophrenia include:

  • Delusions
  • Hallucinations
  • Disorganized thinking
  • Abnormal motor behavior
  • Loss of interest in everyday activities
  • Lack of emotion
  • Neglecting personal hygiene
  • Unpredictable agitation
treatment

How is Treatment for Mental Health Disorders and Substance Abuse Different?

Treatment for co-occurring conditions, like mental health disorders and alcohol abuse, presents unique challenges. Treating only one condition may worsen the other and can increase the occurrence of relapse. Those that suffer from both mental health disorders and substance abuse require specialized treatment. Additionally, treatment should occur in a facility experienced in treating co-occurring conditions.

A treatment program typically begins with detox. Unfortunately, detox often causes mental health symptoms to be exacerbated. Symptoms of substance abuse often mimic symptoms of mental health conditions. By detoxing first, medical providers can evaluate what symptoms were alcohol-related and what are the symptoms of a mental health condition. 

So, having a professional medical provider available to deal with these symptoms is crucial. Once detox is complete, treatment focuses on your mental health condition. This may include medications, counseling, support groups, and other therapy options.

Resources

“Alcohol Use Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 July 2018, https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243.

“Anxiety Disorders.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 4 May 2018, https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961.

“Bipolar Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 31 Jan. 2018, https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955.

“Bipolar Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml.

“Comorbidity of Alcoholism and Psychiatric Disorders.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, https://pubs.niaaa.nih.gov/publications/arh26-2/81-89.htm.

“Depression.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/topics/depression/index.shtml.

“Major Depression.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/statistics/major-depression.shtml.

“Mental Health and Substance Use Disorders.” Mental Health and Substance Use Disorders | MentalHealth.gov, https://www.mentalhealth.gov/what-to-look-for/mental-health-substance-use-disorders.

Newman, Tim. “Schizophrenia Risk Increased with Alcohol, Drug Abuse.” Medical News Today, MediLexicon International, 21 Oct. 2016, https://www.medicalnewstoday.com/articles/313602.php#4.

Quello, Susan B, et al. “Mood Disorders and Substance Use Disorder: a Complex Comorbidity.” Science & Practice Perspectives, National Institute on Drug Abuse, Dec. 2005, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851027/.

“Schizophrenia.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 10 Apr. 2018, https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443.

“Schizophrenia.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/statistics/schizophrenia.shtml.

Smith, Joshua P, and Carrie L Randall. “Anxiety and Alcohol Use Disorders: Comorbidity and Treatment Considerations.” Alcohol Research: Current Reviews, National Institute on Alcohol Abuse and Alcoholism, 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860396/.

Updated on: August 6, 2020
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Alcohol Rehab Help Writing Staff
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Medically Reviewed
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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