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Alcohol dependence and withdrawal can cause such severe anxiety that it’s often difficult for doctors and patients to distinguish between alcohol-induced anxiety and an organic anxiety disorder. Usually, the only way is to have the patient undergo medical detox and then monitor their symptoms as the alcohol leaves their system. Chronic alcohol use can cause the brain to release too much GABA, dopamine, and other neurotransmitters, causing these chemicals to become depleted over time. These neurotransmitters play a key role in helping to regulate stress and emotions, so depletion can make people feel anxious, depressed, and more easily stressed or upset. This can lead to a cycle of using alcohol to manage stress and difficult emotions, which heroin addiction makes people more vulnerable to developing alcohol addiction. A Hazelden Betty Ford Foundation publication discusses the prevalence of co-occurring alcohol or substance use disorders with other mental disorders, and which are most commonly comorbid.
The co-occurring mental health issues can lead to a cycle in which the user is drinking to alleviate symptoms of a disorder (for example, depression). At the same time, excessive alcohol use and abuse are likely making the symptoms of depression worse for the alcoholic. Many people with alcohol use disorder do recover with behavioral therapies, medications, or a combination of the two.
There is evidence to suggest the relationship between alcoholism and mental illness comes almost exclusively from the effects of alcohol on the brain. AUD, once known as alcoholism, is a medical diagnosis and mental health condition. The DSM-5-TR defines a mental health condition as a collection of cognitive, emotional, and behavioral symptoms caused by physical, mental, or developmental dysfunction. Long-term heavy drinking can also cause physical changes to the brain, leading to difficulties reasoning, remembering and understanding. These changes are sometimes referred to as alcohol-related brain damage (ARBD), alcohol-related brain injury (ARBI), or even ‘wet brain’. For that reason, managing your alcohol intake is one way of reducing your risk of developing depression.
Someone with a mental health condition and a substance use disorder must have both problems treated. Post-traumatic stress disorder (PTSD) is a psychiatric disorder that affects many people who have experienced or witnessed traumatic events. These events include natural disasters, severe accidents, war/combat scenes, and rape, among others. Alcohol is sometimes used as a quick fix to treat the symptoms of depression. However, self-medicating depression with alcohol is dangerous and can lead to life-threatening withdrawal symptoms.
For others, drinking can progress to mild, moderate, or severe alcohol use disorder, which doctors and clinicians now refer to as rather than alcoholism, alcoholics, or alcohol abuse. A person who is living with psychological effects of alcohol, including a mental health condition, should also receive treatment for this condition. If a mental health disorder like depression is left untreated, a person may relapse to drinking in order to cope with depression symptoms. While the conditions above are linked to alcohol misuse, it’s important to keep in mind that in some cases, they are not separate mental health conditions, but rather a byproduct of alcohol addiction. For instance, a person may seem depressed only when withdrawing from alcohol, or they may show symptoms of psychosis only when intoxicated. In the initial stages of alcohol use disorder, a person may only show a few symptoms.
One way to differentiate PTSD from autonomic hyperactivity caused by alcohol withdrawal is to ask whether the patient has distinct physiological reactions to things that resemble the traumatic event. Among those with AUD, about 15 to 30% overall have co-occurring PTSD, with increased rates of 50 to 60% among military personnel and veterans.33 The two conditions may worsen each other. Thus, here, too, it’s important to be cognizant of the signs of PTSD in patients with AUD, and vice versa.
Schematic representation of a diagnostic algorithm for evaluating psychiatric complaints in patients for whom alcoholism may be a contributing factor. The algorithm helps the clinician decide if the compliants represent alcohol-induced symptoms, or an alcohol-induced syndrome that will resolve with abstinence, or an independent psychiatric disorder that requires treatment. This means you experience withdrawal symptoms when you attempt to quit or reduce your alcohol consumption. Withdrawal symptoms can range from mild discomfort to severe and life-threatening complications. Getting help from a certified mental health and addiction rehab center like Footprints to Recovery is the best course of action if you need help with alcohol abuse and mental illness. Our team of clinicians are skilled and experienced in assisting clients on their journeys to a brighter future.
A moderate alcohol use disorder is diagnosed when a person shows 4 or 5 symptoms, and a severe alcohol use disorder involves 6 or more symptoms. If you keep drinking a lot of alcohol, it can cause more problems and make your depression and anxiety worse over time. While this can feel good for a short time, this effect doesn’t last for long. The feelings of bliss wear off, and they can worsen your depression symptoms. A major source of hope that comes with defining a condition as an “illness” is that illnesses have cures (or, at least, treatments).
Individuals in recovery need support and resources to rebuild mental well-being, fostering the development of healthy coping mechanisms alongside sobriety. Many individuals with anxiety may turn to alcohol as a way to cope with their symptoms. However, this can quickly develop into a cycle of dependence, as the person begins to rely on alcohol as a primary coping mechanism.
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