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Alcohol Use Disorder and Mental Illness: What You Should Know

Cardinal Innovations Healthcare — April 3, 2020 — 4 min read
Heavy drinking is dangerous, especially for those who struggle with their mental health. In fact, one in three people diagnosed with a mental illness also face substance use challenges.

Alcohol, like other substances, changes a person’s mental state. Some people use it to cope with their negative emotions. But coping with alcohol can lead to alcohol misuse, like binge drinking. And in North Carolina alone, nearly 3,000 people die of binge drinking every year.

Many people don’t realize how mental illnesses and substance use disorders (SUDs) can impact each other. Diagnoses like bipolar disorderdepression, and obsessive-compulsive disorder (OCD) can complicate (and sometimes lead to) SUD. Likewise, SUDs can complicate (and sometimes lead to) mental illness.
mental health screening

Are you or a loved one struggling with alcohol? Try an online screening to learn more and find help.

If you or a loved one is experiencing a medical emergency, call 9-1-1 immediately.

What You Should Know about Mental Illness and Heavy Alcohol Use:

If you struggle with your mental health, it’s important to think twice before you drink. Here’s why:
  • Alcohol lowers one’s ability to concentrate and make good decisions.
  • Women with depression are twice as likely to drink heavily when compared to women without depression.
  • People with depression who drink heavily are more likely to experience suicidal thoughts.
  • Those diagnosed with both bipolar disorder and alcohol use disorder (AUD) have a higher risk of violence and suicide.

The Problem With Dual Diagnoses

Alcohol use doesn’t necessarily cause mental illness. However, it can worsen existing mental health symptoms. Things get even trickier if someone is diagnosed with both a mental illness and AUD.

In many cases, this is called a dual diagnosis. Dual diagnosis happens when:
  1. Someone is diagnosed with two or more behavioral health disorders, and
  2. Each disorder fuels the other’s symptoms
For example, let’s say “Ken” has depression and AUD. Ken was caught drinking and driving too many times, so he lost his license. Because he can’t drive anymore, he feels disconnected from his support system. He also lost his job because he can’t drive to it. This leads him to feel more depressed. To deal with these feelings, he drinks more alcohol.

This cycle will continue to worsen Ken’s symptoms until he gets help for both diagnoses.

How Alcohol Use Affects Common Mental Illnesses

Many people with mental illness take psychiatric medication. Alcohol can impact how that medication works. It makes some medicines less effective. And it can also cause unpredictable side effects.

But even if someone with a mental illness doesn’t take medicine, alcohol use can still cause harm.

Depression and Alcohol

Someone diagnosed with major depressive disorder (MDD) may use alcohol to cope. To them, the alcohol helps them manage their MDD symptoms like:
  • Loneliness
  • Insomnia
  • Physical pain
  • Anger
  • Loss of interest in hobbies
Someone with MDD might drink to help them fall asleep (alcohol actually hurts sleep quality). Or they may drink to ease their physical pain (which can increase the risk of pain medication overdose). They may also drink to numb their sadness. But this does little to solve the real problem.

Bipolar Disorder and Alcohol

Like someone with depression, a person diagnosed with bipolar disorder may use alcohol to cope with their symptoms. Someone with bipolar disorder often swings between high and low moods (aka manic and depressive episodes).
During their lows, they may misuse alcohol the same way someone with depression would. During their highs, they may behave in riskier ways. For example, they may drive under the influence of alcohol or illegal drugs.

Obsessive-Compulsive Disorder (OCD) and Alcohol

OCD is a type of anxiety disorder. Those with OCD have intrusive thoughts that cause them to do certain actions. For example, a person with a cleanliness obsession many constantly wash their hands, even if it starts to harm their skin.

(Note: There are many types of OCD. Not all are related to hygiene.)

Someone may use alcohol to relax the anxiety related to their OCD. However, as with bipolar disorder and MDD, alcohol only masks the real problems. The anxiety will return as soon as the alcohol wears off. This coping mechanism can lead to frequent heavy drinking and AUD.

Mental Illness and Alcohol Use Disorder Resources

You’re not in this alone. There are lots of options available to those struggling with mental illness or alcohol use. Check out these resources below:
  • Need mental health help fast? Call **ASK (star-star-2-7-5) from your cell phone or 1-800-939-5911 to get connected to a licensed clinician. They’ll get you connected to the service or support you need.
  • Use our quick Alcohol Use Disorder Screening to find out if you or a loved one might have alcohol use disorder.
  • Visit Alcoholics Anonymous’ website to find an AA meeting near you.
For immediate referrals and counseling related to alcohol misuse, call the Substance Abuse and Mental Health Administration (SAMHSA) National Hotline: 1-800-662-4357

Need Mental Health Help Fast?

Call **ASK (star-star-2-7-5) from your cell phone or 1-800-939-5911.


This blog was updated on October 4, 2021 to include updated information. 
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