Is Alcoholism A Mental Illness? (Yes, But Why?)

Alcoholism is a vastly complicated disease that has a number of social, psychological, and biological components. Addiction usually involves multiple periods of remission, or relapse.

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Whilst some people may indulge in alcohol without it becoming a problem in their lives. Others will develop alcoholism or ‘alcohol use disorder’ with their addiction causing havoc for themselves and their loved ones. 

Why Do Some People Become Addicted Whilst Others Do Not?

There are numerous risk factors that play a part in the development of alcoholism. The include family history, biology, societal influences, trauma, age, and your environment.

One key factor that applies throughout is the impact that alcohol has on the brain’s reward center. 

Whenever we consume our favorite foods, or listen to music that we love, our brains release hits of dopamine. Dopamine is a chemical that makes us feel good and this results in us wanting to repeat the activity.

According to research conducted by psychologists, those who are prone to addiction tend to have a significant dopamine deficiency in their brains. These defects arrive as a result of a person’s brain chemistry as opposed to their life choices. 

Research has also proven that the brain reward centers for these people become flooded with alcohol-induced levels of dopamine, which results in the brain being conditioned to associate pleasure with these dopamine hits that derive from alcohol.

This leads the afflicted individual to seek out alcohol at the expense of far healthier dopamine inducing activities.  

In essence, the desire for these addictive substances becomes programmed into the brain, leading to difficulties in distinguishing between alcohol-rewards and healthier rewards.

The National Institute on Drug Abuse states that this is the reason why afflicted persons who misuse alcohol will eventually become depressed, and unable to enjoy activities that they used to seek great pleasure in.

The person then becomes dependent on consuming alcohol in order to experience normal levels of reward in the brain’s reward center, which further promotes the vicious cycle of addiction. 

Does The Medical Community Acknowledge Alcoholism As A Disease?

Yes, the American Medical Association has recognized alcoholism as a disease since 1956. This disease is characterized by impulsive behavior, compulsive decisions, and relapse. They have also based their diagnosis of this disease on the following criteria;

  • The disease doesn’t go away on its own.
  • It exhibits observable symptoms.
  • It is biological in nature.
  • It is fatal if left untreated. 
  • It has a predictable timeline of progression and recovery (see also ‘Top 10 Coping Methods For Addiction Recovery‘). 

At What Stage Was Alcoholism Recognized As A Mental Illness?

Alcoholism and substance use disorder was recognized by the American Psychiatric Association in 1980, and listed as a primary mental health disorder within the Diagnostic and Statistical Manual of Mental Disorders.

In previous versions of the DSM, alcoholism had been recognized as a form of personality disorder, a subset of pre-existing disorders as opposed to its own entity. 

How Is Alcoholism A Mental Health Disorder?

Similarly to depression and other forms of mental illness. Addiction has serious medical implications that are rooted in various brain changes.

Addiction of any form has been characterized as a chronic brain disease that impacts brain reward, memory, related circuitry, and motivation. 

In this sense, the dysfunction that alcohol abuse leads to within the brain’s chemistry and overall functionality leads to serious disturbances in psychological, social, spiritual, and biological manifestations.

By its very essence, alcoholism and addiction of any form should not be treated as a moral problem, or a criminal issue. It is a mental illness that leads to the exhibition of chaotic behavior within these key areas. 

Although many behaviors that are driven by alcoholism become criminal acts, the disease itself is about brain chemistry.

Thus, alcoholism is about the underlying neurology of the brain, as opposed to the outward actions that occur as a result of these malfunctions.

The emotional and mental symptoms of alcoholism will manifest long before any physical symptoms begin to appear.

Thus, if mental symptoms are not treated with rehabilitation, alcoholism can lead to cirrhosis of the liver and brain deterioration that eventually leads to death. 

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How Is Depression And Alcoholism Linked?

As opposed to considering cause-and-effect. It is useful to assess the co-morbidity of these mental health conditions.

Mental illnesses will play a large part in most substance use disorders, and substance misuse also leads to the development of specific mental illnesses like depression.

An individual may start to drink because they are depressed, or their drinking could be used as a means to alleviate pre-existing symptoms of anxiety and depression.

Ultimately, alcohol is a depressant, and alcoholism only leads to the exacerbation of these other mental illnesses in the end. 

The National Institute on Drug Abuse has stated that nearly half of those who suffer with addiction will also have depression. Thus, most people receive a dual diagnosis of depression and alcoholism.

The National Alliance on Mental Illness has also reported that 10.2 million adults who have experienced substance use disorder, also have a co-occurring mental disorder.

Whenever a preexisting mental health condition is ignored or untreated, substance misuse disorders like alcoholism will exacerbate. \

This is because symptoms of mental illnesses like depression will intensify whenever a person increases their intake of alcohol.

The treatment for alcoholism can be more complex as a result of these other conditions, However, recovery is always possible, especially when the individual is engaging in therapy and//or attending a twelve-step program of rehabilitation. 

Does Treatment For Alcoholism Differ From Other Forms of Mental Health Treatment?

Many of the same approaches are applied to address substance use disorders and other mental health disorders.

This is why many therapists are considered to be integrated providers, who will be trained in mental health treatment and addiction treatment (see also ‘Best Drug Addiction Treatment Centers America‘). Implementing a comprehensive approach to treatment is the best way to address substance use disorders.

However, there are some key differences between the two kinds of treatment. Mental health treatment may often place focus on the exploration of an individual’s feelings, behaviors, and thoughts via a process of one-on-one therapy.

Whereas, some people may choose to treat their alcoholism by attending group therapy sessions.


To conclude, alcoholism is a mental illness that is recognized in the DSM. It is a disease that affects the brain’s reward center, causing biological, psychological, and spiritual repercussions for the person who is suffering from the disease. 

Joshua Damie
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