Mental Health Disorders And Alcoholism: Dual Diagnosis

A dual diagnosis involves a mental health disorder and substance abuse problem that occurs simultaneously. For example, an individual with depression is more likely to drink alcohol to self-medicate symptoms of irritability, insomnia and feelings of helplessness. Research also shows that while excessive alcohol consumption does not produce behavioral conditions, drinking can exacerbate the symptoms of a mental illness.

Roughly one third of individuals struggling with alcohol abuse also suffer from a mental illness.

National Alliance on Mental Illness

Having a drinking problem or mental illness does not guarantee a person will develop a co-occurring disorder. However, it can significantly increase the likelihood of a dual diagnosis later down the road.

With dual diagnosis, the symptoms of alcoholism and a mental illness often feed off of each other. Because of this, any amount of alcohol will affect a person’s emotional well-being and vice versa. If left untreated, a co-occurring mental illness and alcohol dependency can spiral out of control, taking a toll on both the individual suffering and their loved ones.

A dual diagnosis is best treated under the care of medical professionals in a rehab setting. Programs that specialize in co-occurring disorders provide various types of therapy aimed at treating the whole person, rather than just addressing one disorder at a time.

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Common Mental Health Disorders That Occur With Alcohol Abuse

There are many mental health conditions that can co-occur with alcohol abuse. Some of the most common conditions include depression, bipolar disorder, and obsessive compulsive disorder (OCD). Each mental illness affects alcoholism in a different way, depending on the longevity and severity of the disorder.


Depression is a type of mood disorder that affects a person’s thoughts and actions. It is one of the most common mental health disorders in the U.S., and can occur in individuals of all ages, genders or backgrounds.

Symptoms of depression include:

  • Restlessness
  • Loss of interest in hobbies and activities
  • Difficulty concentrating
  • Decreased energy
  • Short-tempered
  • Insomnia

Alcohol is sometimes used as a quick fix to suppress the signs of depression. However, self-medicating depression is extremely dangerous and can lead to life-threatening consequences. After alcohol is consumed, it stimulates the brain’s reward system, which causes someone to experience a “high”. Over time, the body begins to rely on drinking to achieve feelings of happiness, leading to a cycle of alcohol dependence or addiction.

Quitting alcohol “cold turkey” can be detrimental to an individual’s health, as the body will crash after the high and go into shock. This can intensify symptoms of depression, which greatly increase the risk of self-harm.

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Bipolar Disorder

Described as a manic-depressive illness, bipolar disorder involves irregular mood swings that fluctuate from extreme highs to severe lows. Roughly six million people in the U.S., ranging from adolescents to seniors, are diagnosed with bipolar.

Mood swings caused by bipolar disorder can produce a wide range of mental and physical symptoms. During the highs, a person is abnormally upbeat, has an abundance of energy and feels overly confident. On the other hand, lows come with feelings of fatigue, restlessness and loss of interest. These sudden mood changes are unpredictable and symptoms vary from person to person.

A person with bipolar disorder has a higher risk of developing a substance abuse disorder, such as alcoholism, than those who do not have bipolar. Studies show that these conditions are incredibly dangerous when they co-occur, as alcohol can exacerbate symptoms of bipolar disorder.

Obsessive-Compulsive Disorder (OCD)

One of the most common types of anxiety disorders, OCD involves uncontrollable obsessions that trigger repeated compulsions. An estimated 24 percent of people with OCD also suffer from a substance use disorder, including alcohol abuse.

Obsessions and compulsions associated with this disorder come in many different forms, such as counting items, excessive hand washing and constantly arranging things in a specific way. Sometimes, a person may try to ignore or overcome OCD on their own, which can heighten their anxiety. Other times, they may perform a compulsive act to temporarily fulfill an urge.

As a way to distract from intrusive thoughts or behaviors, some individuals with OCD turn to alcohol. Instead of helping a person relax and escape their fears, drinking actually makes OCD symptoms worse. Relying on alcohol as a method to self-treat OCD can quickly turn into a dangerous addiction. Without proper treatment, co-occurring alcoholism and OCD can come with a lifetime of consequences, including health complications and emotional troubles.

Symptoms Of Dual Diagnosis

The symptoms of dual diagnosis vary greatly depending on the mental illness, as well as the frequency and longevity of alcohol consumption. However, knowing the warning signs to look for can help determine when there is a problem. This allows people to seek help sooner – rather than later.

The most common symptoms of dual diagnosis include:

  • Isolating themselves from family and friends
  • Changes in appetite, such as eating more or less than usual
  • Loss of energy and motivation
  • Trouble concentrating or completing tasks
  • Neglecting personal or professional responsibilities
  • Increased irritability, anger or anxiety
  • Rationalizing excessive alcohol consumption

The Stigma of Mental Health And Addiction

It is important to realize that while some individuals are open and honest about their well-being, others may deny having a problem at all. Denial is a common reaction for those who are not yet ready to get help. There are various explanations as to why someone may negate they have a problem.

For instance, individuals struggling with alcohol abuse or a mental illness are sometimes ashamed to admit there is something wrong. They might view their problem as a personal shortcoming or a failure that they are embarrassed to open up about. Alcoholism and mental health conditions can be a sensitive subject. In cases such as these, it may be beneficial to discuss the matter with an alcohol counselor or treatment provider.

The sooner that symptoms of a dual diagnosis are recognized and treated, the greater the chance for a life-long recovery. Sweeping the problem under the rug will only irritate the disorders further, allowing them to take complete control of a person’s life. Do not wait any longer to get help. Take the first step now by reaching out to a treatment provider.

How Is A Dual Diagnosis Treated?

There is no one-size-fits-all solution to treating a dual diagnosis. Typically, a comprehensive recovery plan is the safest and most effective way to overcome a co-occurring disorder. These plans incorporate various therapies and aftercare programs that address both alcohol abuse and a mental health condition.

Detoxification is usually the first phase of a comprehensive treatment plan. During this stage, alcohol is removed entirely from the body. Once detox is complete, a person will be able to enter an inpatient or outpatient treatment program to continue their recovery journey.

Inpatient rehab takes place in a residential facility where 24/7 care is provided. This type of treatment is well-suited for individuals who have battled co-occurring disorders, such as depression and alcoholism, over the course of many years. Inpatient facilities offer therapy sessions, support groups and medication-based therapy to treat alcoholism, as well as any underlying mental health conditions.

Outpatient rehab allows patients to recover from a co-occurring disorder while still attending to daily personal and professional responsibilities at home. This type of treatment requires individuals to visit a rehab facility several times each week to participate in various programs and support groups. With the help of treatment providers, an individual in outpatient rehab will learn how to cope with the mental health and apply various lessons to everyday situations.

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