Alcoholism and Mental Health Problems

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  1. Effects of Alcohol Addiction on The Brain
  2. Alcohol Addiction and Post-Traumatic Stress Disorder
  3. Does Alcohol Abuse Cause Stress?
  4. Alcohol Abuse and Depression
  5. Alcoholism and Suicide
  6. Does Alcohol Abuse Cause Memory Problems?
  7. Alcoholism and Anxiety Disorders
  8. Sources

Effects of Alcohol Abuse

Alcohol abuse and mental illness constitute a major public health problem.

  • 0.7% of all years of life lost to poor health, disability or early death can be attributed to alcohol--the most for any psychoactive substance. 5.76% can be attributed to mental disorders.
  • Additionally, mental disorders are responsible for around 19% of the Years Lived with Disability (YLD) world over.
Effects of Alcohol Abuse

More importantly, alcohol addiction and mental disorders tend to co-occur at a frequency greater than what would be expected by chance.

  • General population based surveys have documented that the odds of developing a mood disorder and an anxiety disorder are 3.6 and 2.6 times higher, respectively, if someone is dependent on alcohol as compared to one who is not dependent on alcohol.

The co-occurrence of alcoholism and mental disorders has important implications as it is associated with:

  • Greater risk of various psychological, interpersonal and social problems.
  • Impaired decision making.
  • Poor therapeutic adherence.
  • Increased risk of relapse.
  • Increased risk of self-harm (including the risk of suicide).


If you or someone you love is struggling with alcohol abuse or addiction, chances are that they might have an underlying mental health condition, like depression. Dual diagnosis treatment can help with both. Please call 1-888-993-3112Who Answers? to find a treatment program now.

Effects of Alcohol Addiction on The Brain


Psychological Impact Icon

Prolonged alcohol abuse has been associated with structural and functional changes in the brain.

  • Alcohol dependence can lead to generalized atrophic changes in the brain.
  • Also, certain regions of the brain, such as frontal lobe systems, are more vulnerable to the adverse effects of alcohol as compared to other regions.


Behavioral Sign Icon

All these changes in the brain can contribute to the emergence of a comorbid psychiatric condition.

  • It has been proposed that common neurobiological pathways may be involved in alcohol dependence and various psychiatric disorders.
  • Moreover, the psychosocial stresses that go hand in hand with a life-impacting alcohol dependence can exacerbate a susceptibility to mental illness.


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Alcohol IconThe presence of a psychiatric disorder can also increase one's propensity to abuse substances.

It has been proposed that patients with psychiatric disorders may try to self-medicate with substances (including alcohol) to achieve:

  • Relief from the psychiatric symptoms of the illness.
  • Reduction in the adverse effects associated with medicines used to treat these disorders.


Alcohol Addiction and Post-Traumatic Stress Disorder

Alcoholism and Post-Traumatic Stress Disorder (PTSD) frequently occur together:
  • In 2014, a systematic review reported that the prevalence of alcohol misuse among those with PTSD ranged from 9.8 to 61.3%.
  • Similarly, the prevalence of PTSD among those with alcohol misuse has ranged from 2.0 to 63.0% across studies.

Can exposure therapy for PTSD exacerbate alcohol abuse?
  • However, recent studies have demonstrated no reinforcement or increased risk of drinking behavior in a group of dually diagnosed (co-occurring alcohol use disorder and PTSD) individuals being treated for their PTSD.

Research has suggested that:

  • PTSD and alcoholism may share a common genetic vulnerability that partially accounts for their co-occurrence.
  • Additionally, the environmental factors associated with the emergence of PTSD can also explain the presence of comorbid alcohol abuse in these individuals.

There is limited research on the relative effectiveness of treatment interventions for co-occurring PTSD and alcohol dependence. The following interventions have demonstrated some success:

1. Sequential Treatment

  • This program offers six weeks of skills development followed by six weeks of trauma processing.
  • The participants have to complete a rehabilitation program with six months.
  • It has been found significantly reduce symptoms, along with a reduction in alcohol use and drinking to extreme intoxication.

Get Help Now Combined treatment can help you overcome both addiction and mental illness, paving the way for a new life.

2. Concurrent treatment

Utilizing Cognitive Behavior Therapy (CBT) for PTSD in the addiction treatment setting has been associated with a reduction in PTSD symptoms and lower composite scores on the Addiction Severity Index (ASI).

3. Integrated treatment

Approaches based on group CBT have been found to be effective in reducing substance use and trauma-related symptoms in some studies but not in others.

  • Recently, a randomized controlled trial of combined naltrexone and exposure therapy was shown to be a feasible intervention with potential benefits.

Does Alcohol Abuse Cause Stress?

Alcohol abuse has been reported to adversely impact stress. While alcohol in low doses may improve performance on complex mental tasks during stressful situations, its use has been shown to increase stress response mechanisms.

  • Alcohol use has been found to alter the release of 'stress hormones' from the hypothalamus, pituitary, and adrenal glands.
  • Experimental studies among humans have shown that while alcohol can lead to a reduction in the hormonal response to stress, it leads to an extended negative subjective experience of a stressful event and delays recovery.
  • Finally, alcohol use can worsen one's response to stress.

Alcohol Abuse and Depression

The rate of co-occurrence of mood disorders (including depression) and alcohol dependence is high.

  • General population based surveys have reported the one-year prevalence rate of 27.9% and 1.9% for depressive disorder and bipolar disorder, respectively.
  • Additionally, the risk of developing a depressive disorder and bipolar disorder is 3.9 and 6.3 times higher among those with alcohol dependence as compared to those without it.

What are the effects of having a mood disorder and also being addicted to alcohol?

Co-occurrence of alcohol dependence and mood disorders (including depressive disorders) is associated with adverse clinical outcomes like:

  • Mood destabilization and a greater likelihood of hospitalization.
  • Delayed recovery from alcohol dependence.
  • The sedative effect of certain antidepressant medications - such as mirtazapine and paroxetine - can be magnified by the concurrent use of alcohol and can adversely impact coordination, judgment and reaction time.

Is there treatment for alcohol addiction and mood disorders?

The limited evidence on treatment approaches to co-occurring alcohol dependence and mood disorders support the role of integrated treatment.

  • A systematic review of psychosocial treatment strategies for co-occurring alcohol addiction and depression reported integrated treatment to be better for alcohol and depression.
  • There is some evidence to support the use of combination CBT and Motivation Enhancement Therapy (MET) in this population.

Research on the effectiveness of pharmacotherapy is also limited and the findings are conflicting.

  • While some studies support the role of antidepressants, others have failed to demonstrate its effectiveness.
  • In a recent meta-analysis, nefazodone, desipramine, and imipramine were found to have the most robust effects.
  • Use of naltrexone in combination with Selective Serotonin Reuptake Inhibitors (SSRIs) has been associated with higher abstinence rates from alcohol.

Alcohol addiction and mood disorders can influence each other negatively; if you're having a tough time getting sober it may be because of an underlying problem. Integrated treatment can help.

Call 1-888-993-3112Who Answers? to learn about your options and get help today.

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Alcoholism and Suicide

The association between alcohol abuse and suicide has been established for a long time.

  • Close to 40% of treatment seekers with alcohol dependence report at least one suicide attempt in their lifetime.
  • Heavy alcohol drinkers are five times more likely to engage in suicidal behavior as compared to 'social drinkers'.

Woman depressed

What Affects the Risk of Suicide among those Struggling with Alcohol Dependence?

  • Unemployment.
  • Separation or divorce.
  • Poor social support.
  • Impulsivity.
  • Severity of the alcohol problem.
  • Co-morbid depression (especially with poor treatment adherence or treatment resistance).
  • Polysubstance abuse, or comorbid use of other substances.
  • Past incidence of suicidal behavior.

It is important for care providers to inquire about the presence of suicidal behavior among those with alcohol-related problems.

Interventions could be geared toward:

  • Strengthening coping skills.
  • Stress management.
  • Developing social relationships.

Does Alcohol Abuse Cause Memory Problems?

Individuals with alcohol use disorders are more likely to experience problems with memory. The studies have reported a prevalence rate ranging from 10-24% for dementia among alcohol abusers.

Alcoholism and Anxiety Disorders

The one-year prevalence rate of anxiety disorders among those with alcohol dependence in the general population has been reported to be 36.9%.

  • Individuals with an alcohol dependence have 2.6 times higher risk of developing an anxiety disorder as compared to those without alcohol dependence.

How Do Anxiety Disorders Affect Alcohol Dependence?

The co-occurrence of anxiety disorder and alcohol dependence adversely impacts the treatment outcome for both conditions. Therefore, both disorders need to be treated simultaneously.

  • Alcohol withdrawal involves anxiety symptoms that enhance the symptoms of the associated anxiety disorder.
  • High anxiety sensitivity is associated with an increased risk of alcohol use disorder.
  • Also, higher levels of anxiety can be a predictor of relapse to alcohol.

Can Alcohol Dependence and Anxiety be Treated?

A recent Cochrane review concluded that 'the evidence base for the effectiveness of medications in treating anxiety disorders and comorbid alcohol use disorders is inconclusive.

  • Similarly, the results of the studies exploring the role of psychosocial interventions in this population have been mixed.
  • An integrated treatment model including CBT for panic disorder along with the treatment for alcohol use disorder found better outcomes for both anxiety disorder and alcohol use disorder.


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