Over the last 80 years, there have been thousands of studies and research focused on investigating the relationships between substance use and psychiatric disorders. Alcohol use and abuse have been the subject of many of these studies. Mental illnesses are regarded as both a contributing factor to and the result of alcoholism. These studies have helped design practical and potent treatment programs for individuals suffering from alcoholism and psychiatric disorders, providing various treatment options. In this article, Connecticut Addiction Medicine explores the link between psychiatric disorders and alcoholism as well as effective treatment strategies.
The Axis of Dual Diagnosis
According to the National Alliance on Mental Illness, nearly a fifth of people struggling with alcohol abuse also suffer some form, or forms, of mental illness.[i] Additionally, a study published in the Journal of the American Medical Association found that about 37 percent of people who abuse alcohol “have at least one serious mental illness.” The phrase “dual diagnosis” often comes up when discussing mental illnesses and substance abuse. The first question that comes to mind for many people is, what is dual diagnosis? In simple terms, this is when a person suffers from psychiatric disorder and substance abuse disorder simultaneously – in our case, alcohol abuse.
There is substantial research showing that excessive alcohol use can aggravate some signs and symptoms of various psychiatric disorders. These symptoms include: hallucinations, depression, anxiety, unreasonable fears, extreme mood swings, confusion, insomnia, and withdrawal from social settings, among many others. Likewise, a person suffering from a psychiatric disorder, such as bipolar disorder, is far more likely to self-medicate using alcohol.[ii]
So, does that mean that a person struggling with alcoholism will develop some form of psychiatric disorder? Absolutely not. However, it is advisable to address either one of these issues as soon as possible because they tend to feed off each other. It is devastating to have you or your loved one develop a detrimental alcohol dependency while battling a mental disorder at the same time.
Bipolar Disorder
Statistics show that more than six million people in the United States are diagnosed with bipolar disorder.[iii] It causes extreme mood swings, which can seriously catalyze substance abuse issues if not kept under control. On the other hand, alcohol may exacerbate the symptoms of bipolar disorder.
Depression
Many people suffering from depression use alcohol as a self-medicating approach to “escape” the dark pits of depression. Using alcohol in this way is ill-advised because it can cause the brain to associate a false sense of happiness with alcohol, thus creating an unhealthy over-dependency, and generally worsens depression.
Other psychiatric disorders aggravated by substance abuse include anxiety, Attention Deficit Hyperactivity Disorder (ADHD), and Obsessive-Compulsive Disorder (OCD). If you are interested in learning more about this, there are many peer-reviewed resources available. One great example is a 2002 study titled “Alcoholism and Psychiatric Disorders: Diagnostic Challenges” published by the National Institute on Alcohol Abuse and Alcoholism.[iv]
Treatment Options for Alcoholism and Alcoholism-Induced Mental Disorders
Illnesses and disorders are rarely just a problem for one person. It affects those around them almost as much as it affects the patient. With alcoholism and alcoholism-induced psychiatric disorders, both the person suffering from alcohol abuse and their loved ones must understand that many treatment options are available. However, there is no such thing as a one-size-fits-all solution. What works for one person will not necessarily work for another person. Nonetheless, to realize success, we must take the first step. In this case, the first step is to learn about available treatment options.
Psychological Counseling
Counseling is a behavioral treatment approach recognized as one of the most effective treatment strategies for alcoholism. It is bound to be a feature of the patient’s treatment plan at some point. Their healthcare and wellness team may recommend individual, couples, or family therapy sessions to help them build an effective support system.
Counseling is an essential part of the recovery process that encourages the patient to communicate and receive proper guidance. At this stage, the therapist will identify and address underlying issues deemed potential causes of the patient’s alcoholism and mental disorder(s). Counseling is a critical stage of treatment that must be carried out under the direct supervision of qualified and licensed healthcare practitioners such as the ones we have at Connecticut Addiction Medicine.
Oral Medications
In other cases, the healthcare staff may prescribe FDA-approved drugs designed to combat alcohol addiction and relapses.
- Antabuse: A drug known as disulfiram or Antabuse helps the patient refrain from drinking. It works by inducing reactions such as vomiting, flushing, and nausea whenever the person consumes alcohol.
- Naltrexone: Naltrexone works by impeding “highs” from alcohol, thus reducing the desire to drink. The drug also decreases cravings. It is available either in a pill form or a monthly injection (Vivitrol).
- Acamprosate: Acamprosate decreases alcohol cravings.
Alcohol Detox
At its most basic form, alcohol is a toxin that needs to be expunged from the body. This means that detoxification is one of the early processes for those dealing with severe alcoholism. When a person quits drinking, they will almost immediately begin to experience withdrawal symptoms. The symptoms can be uncomfortable and emotionally draining for the patient and their loved ones. Fortunately, with the right mindset and support system, coupled with counseling and medication management by the healthcare team, most patients successfully detox on an outpatient basis. Occasionally, inpatient detox is required for severe withdrawal.
There are numerous treatment avenues if you or a loved one struggles with a dual diagnosis of alcohol use disorder and one or more psychiatric disorders. Most importantly, establishing a stable, ever-present, and customized treatment plan is crucial to the patient’s recovery. This is something that only a professional and experienced provider can administer. At Connecticut Addiction Medicine, we adopt a patient-first treatment approach meant to help the patient get back to stable, normal, and fun life with their loved ones.
References
[i] National Alliance on Mental Illness (Updated 2020), “Mental Health by the Numbers” Retrieved from https://www.nami.org/mhstats
[ii] Susan C. Sonne, PharmD, and Kathleen T. Brady, M.D., Ph.D., (2002); National Institute on Alcohol Abuse and Alcoholism; “Bipolar Disorder and Alcoholism” Retrieved from https://pubs.niaaa.nih.gov/publications/arh26-2/103-108.htm
[iii] Editorial Staff Depression and Bipolar Support Alliance, (Updated 2021): “Bipolar Disorder Statistics” Retrieved from https://www.dbsalliance.org/education/bipolar-disorder/bipolar-disorder-statistics/
[iv] Ramesh Shivani, M.D., R. Jeffrey Goldsmith, M.D., and Robert M. Anthenelli, M.D. (2002): “Alcoholism and Psychiatric Disorders: Diagnostic Challenges” Retrieved from https://pubs.niaaa.nih.gov/publications/arh26-2/90-98.htm
