Author: Gary Jackson

Is Alcoholism a Mental Illness?

Taking an alcoholism screening quiz can help you determine whether you have the symptoms of an alcohol use disorder. If you feel that you sometimes drink too much alcohol, or your drinking is causing problems, or if your family is concerned about your drinking, talk with your health care provider. Other ways to get help include talking with a mental health professional or seeking help from a support group such as Alcoholics Anonymous or a similar type of self-help group. Many people with alcohol use disorder hesitate to get treatment because they don’t recognize that they have a problem.

Health care professionals use criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), to assess whether a person has AUD and to determine the severity, if the disorder is present. Severity is based on the number of criteria a person meets based on their symptoms—mild (2–3 criteria), moderate (4–5 criteria), or severe (6 or more criteria). Alcoholism is a treatable disease, with many treatment programs and approaches available to support alcoholics who have decided to get help.

If your loved one needs help

An overall emphasis on the AUD component may come first, or an emphasis on the co-occurring psychiatric disorder may take precedence, or both conditions can be treated simultaneously. The treatment priorities depend on factors such as each patient’s needs and the clinical resources available. During withdrawal from heavy drinking, people may develop delirium tremens, a complication of withdrawal marked by psychotic symptoms, such as hallucinations (see Core article on AUD). The mood disorders that most commonly co-occur with AUD are major depressive disorder and bipolar disorder.

Other pursuits in life that once brought pleasure and balanced out the lows no longer do so. When the drinking “song” starts playing in the mind of an alcoholic, they are powerless. The alcoholic didn’t put or want the thought there, the only way to get it to stop is to have another drink. Alcohol use disorder can include periods of being drunk (alcohol intoxication) and symptoms of withdrawal.

Renewal Center for Ongoing Recovery

You also can screen for depression, anxiety, PTSD, and other substance use disorders using a number of brief, psychometrically validated screening tools, which are described in a 2018 systematic review5 and which may be available in your electronic health record system. As needed, you can refer to a mental health specialist for a complete assessment. When a mental health problem is ignored, the drug or alcohol addiction can worsen. When alcohol or drug use increases, the symptoms of mental illness can intensify. Having a co-occurring disorder can make treatment more complicated, but recovery is possible—particularly when your mental health and behavioral health conditions are treated at the same time by professional, licensed providers.

They use 11 criteria established by the DSM-5 to assess alcohol use severity. When psychosis is suspected, a general physical and neurological exam should be performed to exclude medical causes such as subdural hematoma, seizures, or hepatic encephalopathy—any of which may be a consequence of AUD. Again, it’s important to create a timeline of mental health symptoms and alcohol use and to collaborate as needed with mental health specialists for selection of pharmacotherapies and psychosocial interventions. Some clinical features of AUD may also precipitate sleep disorders, such as a preoccupation with obtaining alcohol and AUD-related psychosocial stressors. Moreover, tolerance to alcohol can increase alcohol intake, which in turn may exacerbate sleep symptoms. PTSD may facilitate development of AUD, as alcohol is commonly used to numb memories of a traumatic event or to cope with symptoms of posttraumatic stress, and AUD may increase the likelihood of PTSD.29 The relationship between PTSD and AUD may have multiple causal pathways.

Steps to Treating Alcohol Use Disorder

For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH). ‌Drinking alcohol excessively can also get in the way of other activities, your relationships, and your self-esteem, which can further affect your mental health. Alcoholics build such a tolerance that they are no longer able to reach the high they once did, however, the lows they experience when not drinking become lower and lower.