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Mental Illness And Alcohol Use

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Alcohol use is a problem that can negatively affect physical, mental, and emotional health, resulting in many symptoms that overlap with other common psychiatric disorders. For some, these symptoms can be solely alcohol-induced and may go away once the person has become sober. However, for many others, mental illness can be an independent problem requiring alcohol recovery that goes beyond treating their alcohol use. When someone with a substance use problem, like alcohol use, also has a mental illness, this is referred to as dual diagnosis or a co-occurring disorder. Decades of research have consistently found higher rates of substance use in people with mental illness compared to the general population. The National Institute on Drug Abuse (NIDA) estimates that about half of people with a mental illness will develop a drug or alcohol problem at some point in their life. The reasons for this can be complex and can vary based on each person’s unique circumstances.

Why Do Mental Illness And Alcohol Use Occur Together?

There are several links between alcohol use and psychiatric disorders that experts believe can explain their common co-occurrence. Using alcohol to self-medicate: Alcohol and drugs can often be used as a form of self-medication for severe mental health symptoms. As a substance capable of slowing brain activity and relaxing the mind, alcohol can temporarily serve as a way to cope with symptoms of psychosis, depression, and anxiety. Shared risk factors: Risk factors such as genetics, environmental factors, stress, trauma, and other personal factors commonly underlie the development of both mental health and substance use disorders. Substance-induced symptoms: Some substances, including alcohol, are believed to be capable of contributing to the development of a mental disorder. This is referred to as a substance-induced disorder. Symptoms of mental illness that have been caused by substances like alcohol, however, may go away once a person has become sober. [middle-callout]

Common Mental Illnesses That Co-Occur With Alcohol Use

There are several mental health disorders known to commonly co-occur with alcohol and drug use, affecting millions of teens and adults in the United States. The most common co-occurring mental health conditions include:
  • depression
  • bipolar disorder
  • anxiety disorders
  • obsessive-compulsive disorder (OCD)
  • post-traumatic stress disorder (PTSD)
  • eating disorders
  • schizophrenia
If you or someone you know has a mental illness, understanding the risks of drinking can be important, especially if you are noticing other signs of alcohol use.


Major depression, also known as major depressive disorder (MDD), is a mood disorder that can affect behavior, mood, and impact one’s ability to regulate emotions. This is one of the most common mental illnesses experienced by people in the United States and affects people of all ages and backgrounds. Several symptoms of alcohol use— including low mood, irritability, and insomnia— commonly overlap with depression. Although someone may use alcohol to self-medicate these symptoms, abusing alcohol can also exacerbate these symptoms. Other forms of depression that can co-occur with alcohol use include:
  • postpartum depression
  • seasonal affective disorder (SAD)
  • dysthymia

Bipolar Disorder

Bipolar disorder is another type of mood disorder that involves dramatic mood swings between rapid highs (mania) and severe lows (depression). This affects an estimated 5.7 million people in the United States. Like depression, bipolar disorder is common in people who use alcohol, and vice-versa. People with bipolar disorder are often greater risk-takers and may be more likely to make impulsive decisions and be attracted to the effects of drugs and alcohol. Alcohol use in people with bipolar disorder can be very dangerous. This can increase a person’s risk of suicidal thoughts and behaviors and can risk dangerous behaviors such as driving drunk and having unsafe sex.

Anxiety Disorders

Alcohol use and alcoholism co-occur with several anxiety disorders, the most common of which include:
  • generalized anxiety disorder (GAD)
  • social anxiety disorder (social phobia)
  • panic disorder
Along with mood disorders, anxiety disorders are some of the most common mental illnesses to affect people with alcohol use disorder (AUD). Without an effective way to cope with anxiety disorder symptoms, drinking can become one way a person may try to relieve symptoms.

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a disorder in which the primary features are obsessive thought patterns and compulsions to do certain behaviors. This may include but is not limited to: obsessive counting, repeatedly checking whether appliances are turned on or off, and excessive hand-washing. Like those with anxiety disorders or depression, people with OCD may turn to alcohol to escape or calm their obsessions and compulsions. Compared to people with OCD who don’t use alcohol, people with these co-occurring problems may be more likely to have suicidal thoughts or attempt suicide.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a type of stress disorder that can affect anyone who has experienced significant trauma. This includes wartime veterans, as well as survivors of use, sexual violence, violent crimes, or other traumatic experiences. Experiencing and reliving the trauma through PTSD symptoms such as flashbacks can significantly impact a person’s wellbeing and their ability to function in everyday life. Substances like alcohol that can produce relaxing effects and distract a person from their trauma may often be welcomed. Recent research has estimated that up to 50 percent of people who misuse alcohol in the United States suffer from PTSD. Similarly, about 42 percent of those with PTSD reportedly meet the criteria for AUD.

Eating Disorders

Eating disorders are mental disorders that involve disordered eating patterns and are often accompanied by distorted views of body image and weight. The causes of eating disorders are complex and can be linked to a variety of environmental, genetic, and personal factors. The most common eating disorders in the United States include:
  • anorexia nervosa
  • bulimia nervosa
  • binge eating disorder (BED)
  • otherwise specified feeding or eating disorder (OSFED)
The term “drunkorexia” is also used as an unofficial descriptor for people who exhibit disordered eating patterns and misuse alcohol. According to research on the link between eating disorders and alcohol misuse:
  • Nearly 50 percent of people with eating disorders use alcohol or drugs at some point in their lifetime.
  • Patients with a substance use disorder are more often diagnosed with OSFED (previously known as an eating disorder not otherwise specified) than anorexia or bulimia.
  • The rate at which people with eating disorders use drugs or alcohol is five times higher than that of the general population.


Schizophrenia is a severe and complex psychiatric disorder with symptoms that can cause people to lose touch with reality. People who have schizophrenia may experience recurring episodes involving hallucinations, delusions, and extreme paranoia, among other symptoms. Alcohol and drug use occur at high rates among people with schizophrenia. However, alcohol is typically the most common. Abusing alcohol or other addictive drugs can complicate a person’s symptoms profoundly and make treating their psychosis more difficult. Among people with schizophrenia, factors that can increase the risk for alcohol use include a family history of alcoholism, biological factors, poverty, and lack of access to effective treatments.

Can Alcohol Use Cause Mental Illness?

Alcohol can cause changes in the brain that can lead to a number of symptoms that overlap with those of other mental illnesses. For instance, chronic alcohol use and alcoholism may often increase depression, anxiety, and have negative effects on concentration and sleep. However, alcohol use does not necessarily cause mental illness. The overlap between symptoms, however, can sometimes present a challenge during treatment. To provide the most suitable treatment for people with alcohol use, it’s important to distinguish whether a person’s mental health symptoms were caused by alcohol use or are independent of it. For many people with co-occurring disorders, mental illness precedes— and might have influenced the development of— their alcohol use. That is, people sometimes turn to alcohol to cope with or avoid symptoms of their mental illness.

Symptoms Of Dual Diagnosis

While the symptoms a person experiences as a result of mental illness and alcohol use can vary, there are certain behavioral signs and symptoms that are often shared. Behaviors that can indicate co-occurring mental illness and alcohol use:
  • isolating from friends, family, or other loved ones
  • drinking more often or in greater amounts than normal
  • suffering more severe symptoms of mental illness (e.g. depression, paranoia, mood swings)
  • dramatic changes in appearance
  • acting more angry or hostile
  • experiencing problems at work or school as a result of alcohol use
  • denying or lying about how much they are drinking
Some people who have a mental health disorder may have previously sought treatment for their mental illness, but not their alcohol use. If someone is struggling with alcohol use, it is important to find treatment before symptoms become worse.

How To Treat Alcohol Use And Mental Illness

The most suitable treatment for someone who has a history of mental illness and alcohol use is co-occurring disorder rehab. This is an integrated treatment program that involves creating a personalized plan for each person based on their symptoms and any pre-existing mental health diagnosis. Dual-diagnosis treatment is commonly offered on an inpatient level within drug and alcohol rehab centers and by some outpatient providers. The first step to help a person who is abusing alcohol is to get them to stop drinking. The most effective way to do this is through medically supervised detox, which is offered in some hospitals and inpatient rehab centers. Following detox, dual-diagnosis treatment typically involves a structured schedule of individual counseling sessions and support groups. Medications may also be prescribed to reduce alcohol withdrawal symptoms and treat mental health symptoms. However, the type of treatment a person receives will largely depend on their psychiatric diagnosis and the severity of their alcohol use.

Find Treatment In Texas Today

Our drug and alcohol rehab in Texas offers a variety of specialized treatment programs, including dual-diagnosis, for people with one or more co-occurring disorders. Treating co-occurring disorders reduces the risk for relapse and can offer a more holistic healing process for people struggling with symptoms related to both their alcohol use and mental illness. To learn more about  Vertava Health Texas, contact one of our treatment specialists today.