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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, masking anxiety, 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 have a mental illness.

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.

With a dual diagnosis, the symptoms of alcoholism and a mental illness often feed off each other. Because of this, 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 the individual suffering and their loved ones.

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

Common Mental Health Disorders That Occur With Alcohol Abuse

Many mental health conditions can co-occur with alcohol abuse. The most common conditions include depression, bipolar disorder, and obsessive-compulsive disorder (OCD). Each mental illness affects alcoholism differently, depending on the longevity and severity of the disorder.


Depression is a mood disorder affecting 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 significantly increase the risk of self-harm.

Bipolar Disorder

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

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 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 temporarily perform a compulsive act to fulfill an urge.

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

Symptoms Of Dual Diagnosis

The symptoms of dual diagnosis vary greatly depending on the mental illness and the frequency and longevity of alcohol consumption. However, knowing the warning signs to look for can help determine when there is a problem, allowing 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 essential to realize that while some individuals are open and honest about their well-being, others may deny having a problem. Denial is a common reaction for those who are not yet ready to get help. There are various explanations for why someone may negate their 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 they are embarrassed to open up about. Alcoholism and mental health conditions can be a sensitive subject. In such cases, discussing 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 life-long recovery. Sweeping the problem under the rug will only irritate the disorders further, allowing them to control a person’s life completely. 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 alcohol abuse and mental health conditions.

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 can 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 treatment is well-suited for individuals who have battled co-occurring disorders, such as depression and alcoholism, over many years. Inpatient facilities offer therapy sessions, support groups, and medication-based therapy to treat alcoholism and underlying mental health conditions.

Outpatient rehab allows patients to recover from a co-occurring disorder while attending to daily personal and professional responsibilities at home. This type of treatment requires individuals to visit a rehab facility several times weekly 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 mental health and apply different lessons to everyday situations.

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Last Edited: February 24, 2022

Clinical Reviewer — Last Reviewed: April 18, 2019

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