Navigation: Understanding Alcoholism, Is Alcoholism Considered a Mental Illness?, What is the Relationship Between Alcohol Abuse and Mental Health?, What Mental Health Problems Typically Co-Occur with Alcohol Use Disorder?, How Are Co-Occurring Disorders Treated in Drug Rehab?
Substance use disorder (SUD) has a complex relationship with mental illness. While one condition does not necessarily cause the other, they have the tendency to co-occur and exacerbate one another. People with pre-existing mental health disorders may be more susceptible to substance abuse and vice-versa.
It’s worth noting that SUD itself is a treatable mental disorder. It affects a person’s brain and behavior, causing them to lose control over their intake of both legal and illegal drugs. Its symptoms can range from moderate to severe. Addiction is considered the most severe form of substance use disorder. [1]
There are shared risk factors that predispose certain individuals to both substance use disorder and mental illness. These factors include genetic predisposition, environmental influences, trauma, and stress.
Additionally, the stigma surrounding mental illness and substance abuse can further complicate matters, leading some people to feel ashamed or reluctant to seek help. This stigma can perpetuate a cycle of avoidance, making it challenging for those who have these conditions to access appropriate treatment and support services. Ultimately, it makes their problem a whole lot worse.
Since alcoholism is a form of substance use disorder, it is worth discussing the relationship between alcohol abuse and mental illnesses. Here we will discuss whether or not alcoholism can be considered a mental health disorder. We will also talk about how treatment works for these co-occurring conditions. Let’s have a closer look.
Understanding Alcoholism
Alcohol use disorder (AUD), more commonly known as alcoholism or alcohol addiction, is a chronic medical condition characterized by an inability to control or limit one’s consumption of alcohol. A person with AUD will keep drinking even when they are already suffering from its negative effects. [2]
Alcoholism tends to take control of a person’s life, affecting their physical health, mental well-being, and social relationships. It’s often considered a spectrum disorder, ranging from mild to severe. [2]
As a chronic condition, there is no specific cure for alcoholism. However, with proper treatment, a person can recover and keep their condition under control. It is entirely possible to get sober and maintain your sobriety.
The first step in the recovery journey is admitting that there is a problem and taking the steps to understand the effects of alcohol addiction.
Alcoholism can be very dangerous, posing a threat not only to the individual but also to the people around them.
On an individual level, the symptoms of alcohol use disorder may include a strong craving for alcohol, increased tolerance, and alcohol dependence which leads to withdrawal symptoms when not drinking. An addicted individual will spend a lot of their time thinking about alcohol, obtaining alcohol, drinking alcohol, and recovering from its effects. [2]
Chronic alcohol abuse can lead to severe health complications, including liver disease, cardiovascular issues, and neurological damage. Mental health suffers as well, with alcohol dependence often accompanying conditions like depression and anxiety, forming a destructive cycle of self-medication and worsening symptoms.
Socially, alcoholism strains relationships, jeopardizes employment, and increases the risk of accidents and violence. The societal costs of alcoholism are also substantial, including burdens on healthcare systems, law enforcement, and productivity.
Alcoholism is not just about excessive drinking; it encompasses a range of symptoms and behaviors that indicate an unhealthy relationship with alcohol. But can we consider it a mental illness?
Is Alcoholism Considered a Mental Illness?
The short answer is yes, alcohol use disorder is recognized as a mental illness.
It’s classified within the spectrum of substance use disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the standard classification of mental disorders used by mental health professionals. [3]
This is important to emphasize because many people still believe alcoholism to be a moral failing rather than a condition that needs to be treated. This only perpetuates the stigma and serves as an obstacle for those who need treatment.
AUD is characterized by a problematic pattern of alcohol consumption that leads to clinically significant impairment or distress. This can manifest in various ways, such as an inability to control drinking, continued use despite negative consequences, and withdrawal symptoms when alcohol use is stopped.
Like other mental illnesses, AUD involves complex interactions between genetic, environmental, and psychological factors. Biological components, such as genetic predispositions and neurotransmitter imbalances, contribute to a person’s vulnerability to developing alcohol addiction. [3]
Environmental factors, including stress, trauma, and exposure to alcohol at a young age, can also increase the risk.
Even psychological factors like coping mechanisms, personality traits, and co-occurring mental health disorders can play a significant role in the development and maintenance of alcoholism.
What is the Relationship Between Alcohol Abuse and Mental Health?
AUD is a mental health condition because the DSM-5 defines a mental health condition as a “collection of cognitive, emotional, and behavioral symptoms caused by physical, mental, or developmental dysfunction”. [3]
This mental condition makes it more difficult to regulate your emotions and behaviors, causing physical, mental, and emotional symptoms. This is how AUD creates obstacles in a person’s day-to-day life. [3]
It’s worth noting that the relationship between alcohol abuse and mental health is bidirectional. This means people with pre-existing mental health conditions like depression, anxiety, or post-traumatic stress disorder (PTSD) may turn to alcohol as a means of self-medication to alleviate their symptoms temporarily. But on the other hand, those who have been drinking for a long time may develop mental health disorders as a result of their substance abuse.
This often leads to a vicious cycle where alcohol abuse exacerbates their mental health issues over time, creating a loop of dependence and worsening psychological distress.
On the flip side, prolonged alcohol abuse can also directly contribute to the development of mental health disorders. Chronic alcohol consumption can disrupt the balance of neurotransmitters in the brain, leading to mood swings, cognitive impairment, and even psychosis in severe cases.
There are also social and interpersonal consequences that come into play. Strained relationships, financial difficulties, and legal problems caused by alcohol abuse can contribute to the onset of mental health issues. [3]
What Mental Health Problems Typically Co-Occur with Alcohol Use Disorder?
Alcohol use disorder often co-occurs with various mental health problems. This creates a complex scenario for those affected.
One of the most common comorbidities is depression. Many people with AUD struggle with persistent feelings of sadness, hopelessness, and worthlessness, which can exacerbate their reliance on alcohol as a coping mechanism. [3]
Ironically, excessive alcohol consumption can disrupt neurotransmitter balance in the brain, leading to or worsening depressive symptoms. This often leads to a downward spiral that can be challenging for a person to overcome.
Addiction is a condition wherein you lose motivation to change your addictive habits because it is easier to keep taking the substance.
Another common co-occurring mental health issue with AUD is anxiety disorders. Those with alcohol addiction frequently experience overwhelming feelings of anxiety, including panic attacks, generalized anxiety disorder, or social anxiety disorder. [3]
Alcohol may initially provide temporary relief from these symptoms, leading some individuals to self-medicate with alcohol to manage their anxiety. However, long-term alcohol use can actually intensify these symptoms and trigger panic attacks.
Chronic alcohol misuse can even impair cognitive function, exacerbating irrational fears and further complicating the management of anxiety disorders.
Other mental health conditions that are likely to co-occur with alcohol use disorder include bipolar disorder, schizophrenia, antisocial personality disorder, and PTSD. [3]
How Are Co-Occurring Disorders Treated in Drug Rehab?
Treating co-occurring disorders requires a comprehensive approach that addresses both conditions simultaneously. Here’s how it’s typically approached in drug rehab:
Integrated Treatment
Rather than treating substance abuse and mental health disorders separately, integrated treatment addresses both conditions concurrently. Otherwise, it may be more difficult for the person to achieve long-term recovery. [4]
Both problems need to be addressed at the same time, given the complex interplay between addiction and mental health. Dual diagnosis treatment acknowledges this complicated relationship and recognizes that treating one while ignoring the other may only lead to relapse.
Integrated treatment typically involves a team of professionals, including therapists, psychiatrists, and medical doctors, who work collaboratively to develop personalized treatment plans tailored to each patient’s needs. [4]
These plans may include a combination of medication management, behavioral therapies, support groups, and holistic interventions aimed at promoting long-term recovery.
Dual Diagnosis Assessment
Before you can receive personalized treatment, you need to undergo an assessment process so that healthcare providers understand your condition.
A thorough dual diagnosis assessment is conducted to identify both the substance use disorder and any accompanying mental health conditions. Once the conditions are properly diagnosed, the rehab center can come up with an appropriate plan of action.
Medication Management
Medication management involves prescribing medications to alleviate symptoms associated with mental health conditions. Medications can also help keep cravings and withdrawal symptoms under control. [5]
This process is typically overseen by healthcare professionals like psychiatrists or addiction medicine specialists, who carefully administer these medications based on the patient’s medical history, current symptoms, and substance use patterns. [5]
The goal is to stabilize the person’s condition so that they can focus on their recovery journey.
Medication management is typically done during medical detox, which is the process of gradually lowering the patient’s alcohol intake while keeping their withdrawal under control. Withdrawal is a normal part of recovery and is usually a painful or uncomfortable process. But with the help of medical experts and addiction treatment professionals, the patient can go through it safely.
Medication management is integrated into a broader treatment plan that includes therapy, support groups, lifestyle changes, and ongoing monitoring to ensure optimal outcomes. [5]
Therapy
In drug rehab programs, treating co-occurring disorders is not just about addressing the physical effects of addiction, but also the root causes of addictive behaviors.
Dual diagnosis treatment typically involves a comprehensive approach that integrates various therapies. Cognitive-behavioral therapy (CBT) is commonly used to address both substance abuse and mental health issues by identifying and modifying dysfunctional thought patterns and behaviors. [5]
Additionally, dialectical behavior therapy (DBT) may be employed to enhance emotional regulation and interpersonal skills, particularly beneficial for people with complex conditions like borderline personality disorder. [5]
This is where most rehab centers vary in their approach. Different rehab centers may offer different types of behavioral therapies. By combining these therapeutic modalities, drug rehab facilities aim to provide patients with the necessary tools and support to address co-occurring disorders effectively.
Support Groups
Participating in support groups such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or groups specifically for individuals with co-occurring disorders can provide valuable peer support and encouragement during recovery. [4]
These groups offer a platform for patients to share their experiences, provide mutual understanding, and receive encouragement from peers who know exactly what they are going through.
Support groups can provide participants with a sense of community and validation, fostering a supportive environment conducive to recovery.
Education and Skill-Building
Since addiction tends to affect every aspect of a person’s life, it is important to offer both practical and emotional support. Co-occurring disorders can overwhelm an individual and erode their self-worth. But through education and skill-building, they can learn to rebuild their confidence.
Education and skill-building also allows people to take back control of their lives, making informed decisions that will benefit them in the long run. They can even use their newfound skills to channel their energy into something productive and meaningful. They will be able to cope with their cravings even if they leave rehab.
Skill-building activities encompass a range of therapeutic techniques aimed at enhancing emotional regulation, problem-solving abilities, and interpersonal skills. By equipping individuals with knowledge and practical tools to manage both their substance use and mental health challenges, rehab programs facilitate long-term recovery.
Lifestyle Changes
Education and skill-building can pave the way towards healthy lifestyle changes, which are important for those who want to maintain their sobriety in the long term.
These changes often encompass various aspects such as adopting healthier dietary habits, engaging in regular exercise routines, and establishing consistent sleep patterns. [4]
Patients are also encouraged to cultivate positive coping mechanisms, including stress management techniques and mindfulness practices, to effectively navigate triggers and cravings. [4]
Rehab facilities integrate structured daily routines to help bring order back to their patients’ lives. When it comes to maintaining sobriety and managing co-existing mental health conditions, promoting a balanced lifestyle is essential.
Aftercare Planning
Because rehab is only the beginning of a lifelong journey to long-term sobriety, aftercare planning is a necessary step.
Treating co-occurring disorders involves comprehensive aftercare planning to ensure continued support and recovery. It typically begins during the rehab program, where clinicians work with individuals to identify their specific needs and develop a personalized plan.
This plan may include ongoing therapy, medication management, support group participation, and lifestyle adjustments to address both substance abuse and mental health issues.
Additionally, connecting patients with community resources and establishing a strong support network of family and friends can be crucial for long-term success, especially when it comes to dual diagnosis. Through tailored aftercare planning, they can receive the ongoing support necessary to maintain sobriety and manage their mental health effectively.
Treating co-occurring disorders in drug rehab requires a holistic approach that addresses the complex interplay between substance abuse and mental health issues. By providing comprehensive treatment that addresses both conditions simultaneously, rehabs can improve their patients’ chances of achieving and maintaining long-term recovery.
If you or someone you love is struggling with alcohol use disorder or any other type of addiction, look for a rehab near you today and learn more about the available treatment programs. The journey to recovery begins today.
Sources:
[1]: https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health
[2]: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder
[3]: https://healthline.com/health/mental-health/is-alcoholism-a-mental-illness
[4]: https://www.helpguide.org/articles/addictions/substance-abuse-and-mental-health.htm
[5]: https://my.clevelandclinic.org/health/diseases/24426-dual-diagnosis
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