Is Alcoholism a Mental Illness?
So, you’ve been wondering if alcoholism is a mental illness or not. It’s a complex topic, but here are the basics. Some people are just more prone to addiction and alcoholism due to genetics, environment, mental issues, or a combination of factors. The medical community officially recognizes alcoholism as a disease, and it is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Alcoholism can interact with conditions like depression or anxiety and make symptoms worse. Treatment may involve therapy, medication, support groups, or a combination. Treating co-occurring alcoholism and mental illness can be particularly challenging. The bottom line is that alcoholism is a medical issue, though not always a simple one.
In this article, we will delve into the topic of alcoholism and its relationship with mental illness. We will explore the factors that elevate the risk of alcoholism and addiction, examine how it affects the brain, and discuss the most effective treatments for co-occurring disorders, such as alcoholism and mental illness.
If you are interested in learning more about our alcohol rehab program in Kokomo, IN, please reach out to us today.
What is Alcoholism?
Alcoholism, also known as alcohol use disorder (AUD), is a widespread problem that affects people of all ages, genders, and socioeconomic statuses. It is officially recognized as a chronic relapsing brain disorder characterized by an impaired ability to cease or regulate alcohol consumption despite experiencing adverse social, occupational, or health-related consequences.
Some people may be more prone to addiction and alcoholism due to genetics, mental health issues, trauma, or environment. The risk increases significantly if you start drinking at a young age or have a family history of addiction.
Furthermore, alcoholism can exacerbate the symptoms of a variety of mental health conditions, such as anxiety, depression, bipolar disorder, obsessive-compulsive disorder, and others, creating a difficult cycle of co-occurring disorders. Conversely, mental illnesses can increase the risk of alcohol abuse and complicate the journey to recovery.
A medical doctor utilizes the criteria set forth in the DSM-5 to diagnose alcoholism or AUD. They do this by inquiring about patients’ behaviors over the past year, posing a series of questions such as:
- Consuming more alcohol than intended
- Struggling to cease alcohol consumption despite efforts
- Devoting more time to drinking than desired
- disregarding familial, social, or work commitments due to drinking.
- Engaging in risky behaviors while under the influence, like drinking and unsafe sex, may be indicative of having an AUD.
Patients who answer affirmatively to at least two of these questions may be indicative of having an AUD. Specifically, those responding positively to 2-3 questions may exhibit a mild AUD, while 4-5 positive responses may suggest a moderate AUD. If a patient answers “yes” to six or more questions not listed here, it may indicate a severe AUD.
Is Alcoholism Acknowledged as a Disease by the Medical Community?
Since 1956, the American Medical Association (AMA) has adopted a firm position, formally designating alcoholism as a disease. This classification is based on specific criteria that highlight the biological, progressive, and observable characteristics of alcoholism.
- Biological Nature: The AMA’s recognition acknowledges that alcoholism is a condition that exists independently of external factors. It’s not simply a result of poor choices or moral shortcomings. Instead, it is rooted in the biological and neurological changes that occur with chronic alcohol abuse.
- Chronic and Progressive: Alcoholism, according to the AMA, is not a transient issue that will naturally resolve or heal on its own. It is chronic in nature, meaning it persists over time. Furthermore, it is progressive, meaning it can become increasingly severe and even life-threatening if left untreated.
- Observable Signs and Symptoms: The disease model of alcoholism emphasizes that the condition exhibits observable signs and symptoms. These may include physical health problems, behavioral changes, and psychological distress. This acknowledgment underscores the need for a medical and clinical approach to diagnosis and treatment.
- Predictable Timeline: The AMA’s recognition suggests that alcoholism follows a predictable timeline of development and recovery. Understanding this timeline is vital for healthcare professionals to provide effective treatment and support to individuals battling alcoholism.
How Alcoholism Affects the Brain and Mental Health
Alcoholism takes a major toll on both physical and mental health. When you drink heavily and frequently over a long period of time, it causes changes in your brain that can lead to or worsen mental health issues.
Repeated alcohol use alters the levels of neurotransmitters in your brain that regulate mood and stress, like gamma-aminobutyric acid (GABA), dopamine, and serotonin. This can make you more prone to anxiety, depression, and other issues. The changes also make your brain reliant on alcohol to function normally and lead to cravings and addiction.
- GABA, an inhibitory neurotransmitter, calms and slows brain activity. Chronic alcohol use amplifies GABA’s effects, creating a sedative sensation. While this relaxation is initially sought, excessive GABA activity due to alcohol can heighten anxiety and depression risks. This paradoxical effect results from the brain’s attempt to counteract alcohol’s depressive impact, leading to a rebound effect upon alcohol cessation.
- Dopamine, the brain’s “feel-good” neurotransmitter, is stimulated by alcohol, initially causing euphoria and reinforcing alcohol consumption. However, in the course of alcoholism, reduced responsiveness to dopamine diminishes the ability to derive pleasure from everyday activities, fostering anhedonia and raising the risk of depression.
- Serotonin regulates mood and emotions. Chronic alcohol use can disrupt serotonin pathways, potentially leading to mood disorders, including depression. Low serotonin levels are linked to feelings of sadness, irritability, and anxiety, which may be worsened by alcohol abuse.
It’s a complex reality that nearly half of individuals with a lifetime history of alcohol use disorders also grapple with a co-occurring mental illness. These co-occurring disorders can significantly complicate the overall health and well-being of affected individuals. Some of the most prevalent co-occurring disorders that often accompany alcoholism include:
- Depression and addiction: Alcohol, a depressant, can worsen symptoms or trigger new episodes. While initially sought for emotional relief, alcohol’s depressive impact ultimately deepens the struggle.
- Anxiety and addiction: While alcohol may temporarily ease anxiety, chronic use can paradoxically raise anxiety levels over time due to brain chemistry changes from prolonged consumption.
- Bipolar Disorder and addiction: Alcohol can significantly affect those with bipolar disorder, potentially triggering more severe manic or depressive episodes and making mood swings harder to predict and manage.
- PTSD and addiction: Individuals suffering from PTSD may turn to alcohol as a form of self-medication, seeking relief from distressing memories and emotions. However, alcohol exacerbates PTSD symptoms, intensifying nightmares, flashbacks, and emotional distress.
The relationship between alcoholism and these co-occurring disorders is intricate and often bidirectional. Individuals may use alcohol to cope with the symptoms of their mental health condition, but in doing so, they inadvertently worsen both their mental health and alcohol dependence.
What are the Factors that Increase the Risk of Alcoholism?
Several factors can increase the risk of alcoholism and addiction. It’s important to recognize these risk factors, as they can help individuals, families, and healthcare professionals take preventive measures and provide appropriate support. Here are some key factors that contribute to the risk of alcoholism and addiction:
Some people are simply born with a higher risk of developing an addiction due to genetics. If you have close family members who struggle with addiction or alcoholism, you have a higher chance of developing those issues yourself. Addiction and alcoholism tend to run in families, so your DNA and genetics do play a role.
Those dealing with other mental health conditions like depression, anxiety, PTSD, or bipolar disorder also have a higher likelihood of developing an addiction. Many people turn to drugs or alcohol as a way to self-medicate and escape problems, only to find themselves struggling with addiction on top of their other issues. Dual-diagnosis treatment that addresses both the addiction and the underlying mental health condition is often the most effective approach.
Challenging life experiences such as trauma, abuse, the loss of a loved one, or extreme stress can heighten the likelihood of alcoholism or addiction. Many people turn to substances as a coping mechanism in times of distress, and that temporary relief can turn into a long-term habit that’s hard to break. Addressing the root causes of trauma or stress through counseling and learning healthier coping strategies is important for overcoming addiction.
The social circles you’re a part of can have a significant influence on your risk of developing an addiction. If heavy drinking or drug use is common and accepted in your social environment, the temptation and peer pressure will be much greater. Making a lifestyle change may involve finding new social circles that support your recovery and sobriety. Spending time with others in recovery can help strengthen your own resolve and motivation
While no one chooses to become an addict, some factors outside of our control do make certain individuals more prone to struggling with addiction. Understanding these risks can help in making a plan for prevention and getting the necessary treatment and support. The most important thing is not to blame yourself but rather to focus on the steps you can take now to overcome addiction and live a healthier, happier life.
Treating Co-Cccurring Alcoholism and Mental Illness
Dealing with both alcoholism and mental illness together can be challenging. The initial challenge lies in determining which issue should be addressed first: substance abuse or mental health conditions. Sometimes these disorders perpetuate each other in a cycle, making it essential to gain control over both for comprehensive recovery.
Assessing the Primary Issue
For some individuals, alcohol addiction may be the primary concern. In such cases, our alcohol detox program in Indiana, followed by our inpatient rehab program is typically recommended as the initial course of treatment. Detoxification allows for a safe withdrawal from alcohol, whereas rehabilitation provides counseling and support to help overcome addiction. Once alcohol use is under control, mental health treatments like therapy and medication can be introduced.
In other scenarios, an underlying mental health issue, such as depression or anxiety, may have contributed to alcohol abuse. In these situations, the focus should initially be on addressing the mental illness. A psychiatrist can determine an appropriate treatment plan, which may include medication, therapy, lifestyle changes, or other interventions. As the mental health condition stabilizes, the risk of relapse into alcoholism is reduced. Ongoing support may still be necessary to prevent a return to alcohol during challenging times.
Integrated treatment stands as the most efficient method for addressing co-occurring disorders. This means receiving care for both alcohol addiction and mental health issues simultaneously from professionals who are experienced with dual diagnosis. Treatments like counseling, group therapy, medication management, and family education are combined. The goal is to develop coping strategies for both staying sober and managing symptoms in a coordinated way.
There are many resources and support groups to help with recovery, including:
- Alcoholics Anonymous (AA) with its 12-step program and sponsor system.
- SMART Recovery, which uses cognitive-behavioral therapy
- Outpatient and inpatient rehabilitation programs.
Receive Comprehensive Care for Co-Occurring Disorders
Start your journey to recovery at First City Recovery Center. We offer integrated treatment for co-occurring disorders, addressing both alcohol addiction and mental health issues. Our experts are experienced in dual diagnosis, and we’re here to help you develop coping strategies, achieve sobriety, and manage your mental health effectively. Reach out to us today to initiate your journey toward a more promising tomorrow. Your well-being is our priority.
Dr. Vahid Osman, MD is a psychiatry specialist in Indianapolis, IN.
Dr. Osman completed a residency at Austin State Hospital. He has over 32 years of experience in Psychiatry & Behavioral Health. He is board certified by the American Board of Psychiatry and Neurology.