Alcoholism And Co-Occurring Disorders

Alcoholism and mental health disorders are a common co-occurrence. Researchers continue to debate whether there is a causal relationship. However, having one of these disorders puts you at a higher risk for having the other.

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Dr. Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS


Alcoholism is a substance use disorder linked to a wide range of co-occurring disorders.

Physical disorders, such as liver disease and myocarditis, often result from alcoholism.

The origin of co-occurring mental health disorders is far less clear. In a dual diagnosis, it can be difficult to fully understand the true order of events.

Regardless of which disorder comes first, comprehensive treatment is necessary to address and properly manage both an alcohol use disorder and mental health disorder.

What Causes Co-Occurring Disorders?

Researchers do not fully understand the relationship between alcoholism and mental health disorders.

Depending on the exact situation and co-occurring mental health disorder, the link may be genetic, environmental, or situational.

In cases where genetics are not involved, researchers often argue that alcohol consumption and drug use are forms of self-medication.

Overlap Of Risk Factors

Addiction and mental health issues both share risk factors, especially alcohol addiction risks. Genetic and epigenetic factors can make both more likely.

Environmental factors, including instability, trauma, and abuse can also increase the risk that you will develop a substance abuse disorder as well as a mental health disorder.


Mental health disorders are not always diagnosed and treated properly. Subclinical symptoms and lack of access can make it difficult to get the treatment you need.

In these situations, the prevalence of substance abuse is hard to ignore. Alcohol offers a temporary reprieve from unbearable symptoms, but it is not a solution.

In reality, alcohol and drug use is more likely to make your mental illness worse. Continued use may even result in self-harm. Self-medicating with alcohol offers too many risks and dangers for any alleged benefits.

Drug-Induced Brain Changes

Drugs and alcohol alter your brain chemistry. With repeated abuse, there can be permanent change.

It is common for people with addictions to develop anxiety disorders, depression, and other serious psychiatric disorders as a result of substance abuse.

Common Mental Health Disorders That Co-Occur With Alcoholism

Long-term alcohol abuse can permanently damage your brain and change the normal function of your brain chemistry.

Alcohol abuse also damages the parts of your brain that help with decision-making, memory, and self-regulation.

These changes may result in, increase the risk of, or exacerbate symptoms of these common co-occurring disorders.

Attention-Deficit/Hyperactivity Disorder (ADHD)

Research shows a positive correlation between adolescent ADHD and alcohol abuse.

In a study comparing young, college-aged people, those with ADHD had similar alcohol use patterns to those who didn’t.

By the age of 25, those with ADHD were almost twice as likely to have an alcohol abuse disorder.
Learn more about alcohol addiction and ADHD.

Major Depression

Depression is both a risk factor and a result of alcoholism. The release of dopamine you feel when you drink can provide some relief if you have untreated depression.

It’s a short-term solution that only makes the problem worse. Alcohol abuse can deepen depressive disorders and complicate treatment.

Anxiety Disorder

As with depression, anxiety disorders can be connected to alcohol use.

In most cases where the anxiety disorder clearly pre-exists alcoholism, self-medication is a common explanation.

Unfortunately, alcohol abuse is proven to worsen anxiety symptoms and can even cause new disorders as a result of changes to the brain.

Post-Traumatic Stress Disorder (PTSD)

Existing PTSD is a major risk factor for alcoholism. Researchers continue to debate what causes this correlation.

Some researchers argue that the correlation fits the self-medication theory. Others posit that certain environments increase the risk for both disorders.

Bipolar Disorder

Bipolar disorders are a set of mood disorders that result in extreme mood swings between mania and depression.

National surveys show that approximately 60% of people with bipolar I disorder also have a substance use disorder. Other bipolar disorders showed rates of 40 to 50%.

Researchers suggest that there may be a genetic explanation that increases the risk for bipolar and alcohol use disorders.

Eating Disorders

Alcohol abuse and eating disorders are commonly found together with people. It is especially prevalent among young women with bulimia nervosa.

Evidence shows that both tend to occur in families, making a genetic link possible.

Many theories exist, but many scientists believe that both conditions share an underlying cause.


Those with schizophrenia are three times more likely to abuse alcohol.

Schizophrenia is largely genetic, making researchers question whether the correlation is related to changes in the brain resulting in an increased risk for both conditions.

Currently, research does not support the self-medication theory for people with schizophrenia. To treat this condition, it is important to treat symptoms of both schizophrenia and alcohol abuse.

How Co-Occurring Mental Health And Alcohol Use Disorders Are Treated

Our current healthcare system is not well set up to deal with co-occurring mental health and alcohol use disorders.

The public health system tends to provide either addiction treatment or a psychiatry referral.

Fortunately, qualified treatment centers exist to help you receive integrated treatment for your addiction and your mental health disorder(s), known as dual diagnosis care programs.

There are several treatment options that have proven successful. The following may be included in a residential or inpatient program for dual diagnosis, or as part of targeted outpatient services.

Cognitive Behavioral Therapy

Cognitive behavioral therapy is a form of psychotherapy that uses a combination of two approaches.

Cognitive therapy is the first approach. It teaches you to recognize harmful thoughts so you can actively challenge them.

Behavioral therapy is the second approach. It helps you identify craving triggers and behaviors that reinforce your existing problems.

This is the first step to changing those patterns. Cognitive behavioral therapy is highly flexible.

Treatment plans that include cognitive behavioral therapy work well with:

  • antisocial personality disorders
  • eating disorders
  • generalized anxiety disorders
  • major depressive disorders
  • obsessive-compulsive disorders
  • panic disorders
  • post-traumatic stress disorders
  • social anxiety

Dialectical Behavior Therapy

Dialectical behavior therapy is designed to help with people who have a borderline personality disorder alongside substance abuse.

Dialectical behavior therapy includes personal weekly therapy sessions, weekly group skills sessions, and therapist consultation team meetings.

During these sessions, you will be encouraged to practice acceptance, regulation, and interpersonal skills.
As part of a larger treatment program, dialectical behavior therapy helps teach you the skills you need to make lasting change.

Contingency Management

Contingency management therapy is targeted directly at substance use disorders.

It is a type of behavioral therapy that encourages positive changes in behavior by offering a direct reward in exchange for negative urine tests.

By using positive reinforcement, contingency management does show consistent results with alcohol addiction.
This approach will require additional treatment if you have co-occurring mental health disorders.

Support Groups

There is limited data on the efficacy of traditional support groups. What scientists have collected shows promise.

Being part of a small community engaging in the same difficulties can be great if you thrive in a shared environment.

If you have co-occurring mental health disorders, you should attend support groups as well as another form of therapy.

Motivational Interviewing

Motivational interviewing is a client-centered therapy designed to help you find the motivation to make changes in your life.

Research shows that the approach does increase motivation as well as treatment adherence. It is largely a supplementary treatment that can bolster your efforts.

Find out more about dual diagnosis treatment.

Find Substance Use Disorder Treatment At Bedrock Recovery Center

At Bedrock Recovery Center we offer a wide range of inpatient and outpatient treatment options. Your dedicated team will help you to identify the strategies that are best suited to your specific needs.

Alcoholism can worsen your mental health. Call our treatment facility today and stop the cycle.

  1. National Center for Biotechnology Information
  2. National Institute on Alcohol Abuse and Alcoholism
  3. National Institute on Drug Abuse
  4. National Library of Medicine
  5. National Library of Medicine
  6. National Library of Medicine
  7. National Library of Medicine
  8. National Library of Medicine
  9. National Library of Medicine
  10. National Library of Medicine
  11. National Library of Medicine
  12. National Library of Medicine

Written by Bedrock Recovery Center Editorial Team

© 2024 Bedrock Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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