Author: Alex Thompson

Alcoholism: Definition, Symptoms, Traits, Causes, Treatment

Quitting drinking on its own often leads to clinical improvement of co-occurring mental health disorders, but treatment for psychiatric symptoms alone generally is not enough to reduce alcohol consumption or AUD symptoms. Among people with co-occurring AUD and psychiatric disorders, AUD remains undertreated, leading to poorer control of psychiatric symptoms and worse outcomes. The co-occurrence of AUD and another mental health disorder can complicate the diagnoses and negatively impact the clinical course of both conditions. (See Core article on neuroscience.) As described in the sections to follow, a timeline of your patient’s symptoms is a key tool for a differential diagnosis. AUD is a brain disorder and disease that occurs when people cannot stop or control their drinking despite adverse effects on relationships, work or school, finances, and overall health. Healthcare providers use the umbrella term “alcohol use disorder” to classify a wide range of problematic alcohol use, such as alcohol abuse, dependence, addiction, and severe alcohol use disorder (alcoholism).

1. Like depression and other mental illnesses, addiction is a very real medical disorder that is rooted in brain changes—but the condition is so much more complex than that.
2. Read on to learn why AUD is considered a mental health condition, which mental health conditions commonly occur alongside it, and treatment options.
3. AUD, once known as alcoholism, is a medical diagnosis and mental health condition.
4. Mindfulness may also help address depression and trauma conditions that co-occur with AUD.
5. Your treatment setting will depend on your stage of recovery and the severity of your illness.
6. 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).

Research from 2019 found ACT may help people who haven’t benefited from existing AUD treatments, but larger studies are needed to support its effectiveness. CBT works by helping you explore how your thought patterns affect your reactions and behaviors so you can learn new ways of responding to emotions. As far back as 1933, the Standard Classified Nomenclature of Diseases listed alcoholism as a disease. Both the American Medical Association (AMA) and APA approved this classification. Drinking while pregnant can seriously harm the developing fetus, raising the risk of fetal alcohol syndrome, premature birth, and miscarriage. Hosted by Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares strategies for coping with alcohol cravings and other addictions, featuring addiction specialist John Umhau, MD.

What are the stages of alcohol use disorder?

The same dopamine neurotransmitters affected by alcohol and other substances are also involved in the ability to feel pleasure from ordinary pursuits such as eating food, having sex, and engaging in social interaction. ‌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 Anonymous is available almost everywhere and provides a place to openly and non-judgmentally discuss alcohol problems with others who have alcohol use disorder. The sooner you recognize there may be a problem and talk to your healthcare provider, the better your recovery chances. Your treatment setting will depend on your stage of recovery and the severity of your illness. You may need inpatient medical (hospital), residential rehabilitation (rehab), outpatient intensive therapy or outpatient maintenance.

At this point, their reward system has become pathological, or, in other words, diseased. When the drinkers were still relatively healthy, they could control their impulse to drink because the judgment and decision-making circuits of their prefrontal cortex would balance out those impulses. Alcohol use can progress to a point where the only thing that can relieve the withdrawal symptoms is more alcohol. While the brain’s dopamine transmitters drive us to seek pleasure, the stress neurotransmitters found in the extended amygdala region of the brain drive us to avoid pain and unpleasant experiences. When so many things in life become reminders of drinking, it becomes more and more difficult for people to not think about drinking.

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. Brief tools are available to help non-specialists assess for AUD and screen for common co-occurring mental health conditions. You can determine whether your patient has AUD and its level of severity using a quick alcohol symptom checklist as described in the Core article on screening and assessment. 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.

Understanding Alcoholism and the Signs of Severe Drinking Problems

People with depression and anxiety might use alcohol to help ease symptoms, but excessive alcohol use can also worsen your mental health. Too much alcohol affects your speech, muscle coordination and vital centers of your brain. This is of particular concern when you’re taking certain medications that also depress the brain’s function.

If you still have depression after 4 weeks of not drinking, talk to your doctor. If you binge drink alcohol, your depression and anxiety may also worsen. Binge drinking is when you drink a lot of alcohol in one day — more than 8 units of alcohol per day for men and more than 6 units of alcohol per day for women, with 1 unit of alcohol being equal to half a pint.

Does the medical community recognize alcoholism as a disease?

You may not realize how much alcohol you’re actually drinking in a week. A good first step is to keep a record of how much alcohol you drink and of when you don’t drink throughout the week. Alcohol affects your brain, making you feel relaxed in a small amount of time.

The therapy goals are to develop the skills needed to manage your habits, build social support, set and work toward realistic goals, and deal with or avoid things that trigger drinking. However, alcoholism has been recognized for many years by professional medical organizations as a primary, chronic, progressive, and sometimes fatal disease. The National Council on Alcoholism and Drug Dependence offers a detailed and complete definition of alcoholism, but the most simple way to describe it is a mental obsession causing a physical compulsion to drink. For some people, alcohol dependence can also cause social problems such as homelessness, joblessness, divorce, and domestic abuse.

Core Resource on Alcohol

Many of the same treatment approaches and therapies are used to address substance use and mental health disorders. In fact, many treatment professionals are integrated providers, trained in both addiction and mental health treatment. A comprehensive approach to integrated treatment can also be delivered by a multidisciplinary team of clinicians and professionals working together on an individual’s treatment plan. For healthcare professionals who are not mental health or addiction specialists, the following descriptions aim to increase awareness of signs of co-occurring psychiatric disorders that may require attention and, often, referral to a specialist. Alcohol addiction is a complex disease with psychological, biological and social components, and like other chronic illnesses, addiction often involves cycles of relapse and remission. Some people can drink alcohol—and even over-indulge on occasion—without it becoming an issue.

‌Some medications shouldn’t be mixed with alcohol as this might make you sick. Contributors to this article for the NIAAA Core Resource on Alcohol include the writers for the full article, reviewers, and editorial staff. These contributors included both experts external to NIAAA as well as NIAAA staff. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. ACT could help people with AUD acknowledge and work through challenging emotions instead of blocking them out.

What’s Technically Considered Alcoholism?

When someone drinks alcohol—or takes drugs like opioids or cocaine—it produces a pleasurable surge of dopamine in the brain’s basal ganglia, an area of the brain responsible for controlling reward systems and the ability to learn based on rewards. If you have depression and anxiety and want to drink alcohol, there are some considerations. Generally, you should limit your intake to 14 units of alcohol in a week — this is equal to six standard glasses of wine or six pints of lager. Be sure to spread those drinks out evenly over the week and have drink-free days in between. Long-term heavy drinking can also cause permanent changes to the brain, such as problems with understanding, remembering, and thinking logically.

Unhealthy alcohol use includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems. It also includes binge drinking — a pattern of drinking where a male has five or more drinks within two hours or a female has at least four drinks within two hours. For people who also experience alcohol dependence, the first step in AUD treatment may involve medical support. Still, only a small number of people with AUD need medical care during this process. Research from 2019 suggests social support as well as building self-efficacy and a sense of meaning can help reduce rates of AUD recurrence, and mental health care often fills this role.