Is Alcoholism a Mental Illness?

Edited by Beth Durling

Last updated August 4, 2020

Alcoholism (also known as alcohol use disorder or AUD) is a disease that doesn’t discriminate on age, gender, ethnicity, geographic location, or income. Virtually anyone can suffer from the condition, but alcoholics aren’t the only ones who suffer. Alcohol use disorder can impact an individual’s family, friends, job, and community. On top of that, alcohol misuse is a contributing factor in around 88,000 deaths in the U.S. every year1

AUD is a progressive, chronic, and sometimes fatal disease — and it often coincides with mental health conditions, such as anxiety, depression, borderline personality disorder, or bipolar disorder. But is alcoholism a mental illness in and of itself? The answer to this complex question depends on who you talk to. However, AUD affects a person’s physical, mental, and behavioral state, and to ignore the non-physical aspects would be a failure in fully understanding the disease.

If you or a loved one are struggling with alcohol dependence, having a thorough comprehension of the condition can help you get the proper support to face the substance use disorder head on. At Northbound Treatment, we offer fully integrated alcohol and drug recovery programs at our treatment centers based in the Orange County region of California. Keep reading for more information on how alcohol addiction affects the brain, the stages of alcoholism, and the mental health conditions that often occur in conjunction with the disease.

Is Alcohol Abuse a Mental Illness?

Many people wonder, Is alcoholism a mental health issue? or Is alcohol abuse a mental illness? To answer these questions, it’s important to recognize that there are countless types of diseases and mental illnesses, all of which can manifest very differently in different people. So, while AUD doesn’t look like many other types of chronic disease, such as cancer or heart disease, it’s still considered a medical condition. Not only that, but treatment for alcoholism involves both physical and psychological components.

Based on updated criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders, an AUD diagnosis should qualify as a mental disorder2. Also, the National Council on Alcoholism and Drug Dependence describes alcoholism as “a mental obsession that causes a physical compulsion to drink.”3

Furthermore, under the Mental Health Parity and Addiction Equity Act of 2008, health insurance companies are legally required to cover treatment for substance abuse and mental health disorders, including alcoholism. In 2014, the Affordable Care Act (ACA) expanded on this law, requiring insurance carriers to cover mental health and substance abuse treatment at the same level as other essential medical services.

How Alcoholism Affects the Brain

According to a 2016 report by the U.S. Surgeon General, there is well-supported evidence to suggest that alcohol use disorder leads to dramatic changes in the way a person’s brain functions1.

Alcoholism typically follows a three-stage cycle:

  1. First, an alcoholic binge drinks to the point of intoxication — or with a notably high tolerance, the point of feeling “normal.” 
  2. When the effects of alcohol wear off, withdrawal symptoms kick in, including highly uncomfortable mental and physical sensations.
  3. Until more liquor is consumed or acquired, an alcoholic usually becomes obsessively preoccupied with the thought of drinking alcohol.

When AUD is severe, this cycle can lead to dramatic shifts in brain function. As a result, it becomes nearly impossible for an individual to control their drinking habits. That’s why it’s vital to seek alcoholism treatment as soon as possible. Call Northbound at (888) 978-8649 to learn about our rehab programs.

The Surgeon General’s report also outlines how alcohol addiction disrupts three areas of the brain: the basal ganglia, which is primarily responsible for motor control, the extended amygdala, which is involved in reward cognition, and the prefrontal cortex, which supports essential cognitive functions, such as decision making and moderating social behaviors1. These brain disruptions drastically increase the desire to drink alcohol, heighten feelings of stress, and reduce overall impulse control1.

Though many of the defining characteristics of alcoholism are mental and behavioral, the physical effects can be detrimental, especially in the final stages. This includes alcoholic hepatitis, cardiovascular problems, heart disease, liver damage, respiratory disease, malnutrition, debilitation, tremors, and complications due to infections.

Alcoholism is a Progressive Disease

The progression of alcoholism can be very subtle, often taking place over years or even decades. Once the condition becomes apparent, it can be hard to pinpoint exactly when an alcoholic lost control. And yet, understanding the stages of alcohol use disorder can help you determine whether you or a loved one has a problem and how to help an alcoholic on the journey to recovery. The stages include problematic drinking, severe alcohol abuse, and obsessive alcohol abuse.

Problematic Drinking

With problematic drinking, a person’s family members and close friends will usually start to take notice. As physical and psychological dependence (sometimes called chemical dependence) sets in, they’ll begin experiencing withdrawal symptoms when alcohol isn’t in their system.

At this stage of AUD, many individuals attempt to conceal their drinking habits from others. Other problems might occur as well, such as declining physical health, poor performance at school or work, and financial struggles. Since alcoholism is a progressive disease, it can be challenging to identify in the earliest stages.

Severe Alcohol Abuse

During the severe alcohol abuse stage, alcoholics become even more physically and psychologically dependent on liquor. At this point, many have seemingly out-of-control cravings that can lead to anxiety, irritability, depression, and aggression toward others.

This is when many individuals suffering from alcoholism start to experience relationship issues, avoid their responsibilities, withdraw from friends and family, and become secretive. You can also expect to see worsened health problems.

Obsessive Alcohol Abuse

Obsessive alcohol abuse is considered the final stage of alcoholism, though it can occur over the course of years. During this period, those with AUD will be under the influence of alcohol more often than not. The psychological preoccupation with liquor becomes compulsive and all-consuming with a heightened physical dependence.

End-stage alcoholism is characterized by serious distress to a person’s physical and mental state4. Due to liver damage and neglect for proper nutrition and personal hygiene, alcoholics often experience a range of medical issues, including some severe and fatal diseases, like cirrhosis.

Alcohol Rehab in Orange County 

Northbound Treatment has been successfully helping alcoholics and addicts overcome their substance abuse issues for over 30 years. Our fully integrated treatment programs for AUD involve a full continuum of care. Recovery plans typically begin with medically supervised alcohol detox, followed by residential rehab, then outpatient treatment, and finally, aftercare addiction treatment and support that incorporates the Al Anon 12 Steps.

Alcohol withdrawal can be extremely uncomfortable and sometimes unsafe to go through at home. At Northbound’s accredited detox and alcohol treatment facilities in Orange County, patients can safely detoxify in a comfortable, secure environment with around-the-clock access to clinical staff and psychiatric care.

Residential (inpatient) rehab is often a pivotal stage of recovery. This is when many clients discover the root causes of their alcohol abuse disorder, identify their triggers, develop coping strategies, and work on their physical, emotional, spiritual, and mental health.

Dual Diagnosis Treatment

At Northbound Treatment, many clients receive dual diagnosis treatment throughout their recovery journeys. This means that any co-occurring psychological conditions are addressed in conjunction with alcoholism. Some of the mental health conditions we treat include anxiety disorders, depression, OCD (obsessive-compulsive disorder), eating disorders, codependency, bipolar disorder, borderline personality disorder, PTSD (post-traumatic stress disorder), and other trauma disorders.

It’s not always clear whether an individual’s alcoholism or mental health disorder occurred first. Sometimes, mental illness can develop as a result of severe AUD, but many people turn to alcohol to cope with trauma or an underlying mental health condition. In any case, Northbound has found that treating substance abuse and mental health simultaneously is more effective than addressing them separately. 

Start Alcohol Treatment Today

As we mentioned, health insurance plans are legally required to cover substance abuse and mental health disorders, so there’s a good chance your policy includes alcohol rehab. Northbound Treatment is in-network for most major insurance carriers, and we can help you determine the types of care covered under your plan. As for any remaining out-of-pocket costs for treatment, we offer flexible payment options.

If you or someone close to you is suffering from alcoholism, don’t delay getting treatment. Northbound welcomes new clients every day, and we’d love to hear from you. Fill out our admissions form or call us at (888) 978-8649.

External sources:

1. https://store.samhsa.gov/sites/default/files/d7/priv/surgeon-generals-report.pdf

2. https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-017-0082-0

3. http://ncaddms.org/?page_id=2388

4. https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243

Article Reviewed by Beth Durling

Beth DurlingBeth Durling BA, CADCII, ICADC is the Clinical Director of Northbound Treatment Services. She is also the proud owner of The Durling Group, Inc., a national consulting firm, where she worked closely with large scale corporations, healthcare companies, and universities, helping to enhance outcomes.

Beth founded and resided as CEO for The Center for Life Change, a non-profit drug and alcohol treatment center in Riverside County where she gained national recognition for her outcomes as a leader in the field of addiction surrounding patient care, specializing in retention strategies for both staff and patients.

She also founded The Heart Culture Academy, creating a collaborative national community of trained influencers, helping people change their relationships, their work environments and personal lives through her published Model, Heart Culture.

Beth believes individual lives can be enhanced through learned consciousness, utilizing her specialized techniques that offer long-lasting, connection-based relationships. She has toured the country speaking and distributing this message.

Beth has been writing and speaking to assist individuals and organizations through transformative processes for the last 25 years. She is the mother to two adult children, Ridge and Rachel and resides in San Clemente, California.

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