Research tends to show that problems with alcohol and mental health go hand-in-hand. The relationship between the two appears to be bi-directional, as alcohol use disorders tend to co-occur with mental health disorders and vice versa [1].

How does alcohol affect mental health?
People with an alcohol use disorder, which is the clinical term for an alcohol addiction, have a high rate of mental health disorders. Similarly, there is a high rate of alcohol use disorder among those with mental health conditions. Given these facts, it seems that the relationship between alcohol and mental health is bi-directional, meaning alcohol can worsen mental health, and mental health disorders can worsen alcohol misuse [1].
There are several explanations for the mental effects of alcohol. First, people with mental health disorders may use alcohol to cope, which can make mental health symptoms worse. At the same time, people who drink alcohol over the long term may develop psychiatric problems as a result of disordered alcohol use. Finally, it’s also likely that risk factors (like traumatic experiences) can lead to both alcohol misuse and mental health problems [1].
When a person has both an alcohol addiction and a mental health problem, they are said to have co-occurring disorders. Researchers have analyzed the timing of co-occurring disorders, and they recently found that many people with co-occurring disorders develop a psychiatric condition before a substance addiction. This is especially true for men [2]. Findings like this support the hypothesis that people with psychiatric problems may use alcohol to cope, thus developing alcohol addiction.
Other researchers have commented that studies related to the temporal sequence of alcohol use disorder and psychiatric disorders have produced inconclusive results. These researchers have noted that most studies show anxiety disorders precede alcohol addiction. However, they also noted that it can be difficult to determine whether alcohol misuse or mental health problems came first. They concluded that some evidence supports that people with mental health disorders may self-medicate with alcohol, but that doesn’t necessarily mean that mental illness causes alcohol addiction [3].
The relationship between alcohol abuse and mental health may be complex. However, there is plenty of evidence that the two conditions are related. For some people, alcohol problems may develop when alcohol is used to cope with symptoms of disorders like anxiety or depression. In other cases, it’s possible for alcohol to cause changes that worsen mental health. For example, alcohol can cause damage to the brain, changing both its structure and function. It can also interfere with memory and problem-solving abilities, which can worsen mental health functioning [4].
Common Mental Health Disorders Linked to Alcoholism
The psychological effects of alcohol can lead to mental health disorders, or, in some cases, a person with a mental health condition may use alcohol to cope. Regardless of which comes first, the reality is that several mental health disorders tend to co-occur with alcohol problems [1]. Some of the mental health disorders that frequently occur with an alcohol use disorder (the formal term for alcoholism) are discussed below.
Anxiety Disorders
Research shows that anxiety disorders and alcohol addiction commonly occur together. Up to 40% of people with anxiety disorders also have an alcohol use disorder. Alcohol abuse and mental health problems (like anxiety) may occur together because the same genetic and environmental risk factors that contribute to alcohol misuse also contribute to anxiety. On the other hand, people may use alcohol to cope with anxiety because it is temporarily relaxing. Unfortunately, long-term heavy drinking and withdrawal symptoms are likely to make anxiety worse [1].
Depression
Alcohol addiction also occurs alongside depression. As is the case with anxiety disorders, up to 40% of people with major depressive disorder will have an alcohol use disorder at some point during their lifetimes. Genetics play some role in the high overlap between alcohol addiction and depression. Depression can make alcohol misuse worse, while the converse is also true [1].
Bipolar Disorder
As is the case with depression, alcohol use disorders are common in people with bipolar disorder. Around 42% of people with bipolar disorder have an alcohol use disorder, making bipolar disorder the most common co-occurring mental health disorder with alcohol addiction. Long-term alcohol misuse can worsen manic and depressive symptoms, harm cognitive functioning, and increase suicide risk [1].
Post-Traumatic Stress Disorder (PTSD)
There is a strong link between alcohol misuse and PTSD. Up to 30% of people with an alcohol use disorder also have PTSD. There is a complex relationship between PTSD and alcohol use disorder, with several underlying factors that explain the link. First, individuals with PTSD may self-medicate with alcohol to block out memories of traumatic experiences. Second, misusing alcohol may increase a person’s risk of being a victim of violence, which in turn can lead to PTSD symptoms. Finally, alcohol misuse can lead to problems with thinking and sleep, making it difficult to cope with trauma [1].
Schizophrenia
Finally, psychotic disorders (like schizophrenia) can co-occur with alcohol use disorder. Just over one-fifth of people with schizophrenia will have an alcohol use disorder during their lifetimes. A family history of alcohol addiction increases the risk of addiction in those with psychotic disorders, such as schizophrenia. Alcohol misuse can worsen schizophrenia symptoms, and in some cases, alcohol withdrawal can cause symptoms that mimic those seen with schizophrenia [1].
The Cycle of Alcohol Abuse and Mental Health Issues
There is clear evidence that alcohol misuse and mental health issues are strongly connected. In some cases, people with psychiatric disorders may use alcohol to cope with their symptoms. Typically, this leads to a vicious cycle of addiction and poor mental health.
A large U.S. study found that when people used alcohol to self-medicate mood-related symptoms, they had three times the risk of becoming dependent on alcohol. Furthermore, alcohol dependence was likely to be persistent and long-lasting when alcohol was used as a form of self-medication [5].
Not only does self-medicating with alcohol lead to addiction but it’s also linked to worsened mental health. Research has shown that individuals who self-medicate psychiatric symptoms with substances tend to experience worsened mental health after substance misuse. Symptoms of depression are especially likely to worsen after self-medicating with substances [6].
So, when a person with a mental health disorder uses alcohol to cope, they are likely to show a deterioration of mental health functioning. Furthermore, repeated use of the substance is linked to dependence [5][6]. Over time, this can create a cycle that’s hard to escape. As mental health worsens, a person is likely to use more and more alcohol to cope, thus falling further into addiction.
Treatment Options for Alcoholism and Co-occurring Disorders
Recovering from the effects of alcohol abuse and mental health problems often requires treatment. Professional treatment can help people to learn healthy coping strategies and overcome the effects of addiction. Treatment can also provide tools for managing mental health symptoms so that a person does not turn to self-medication.
Some of the recommended treatments are as follows:
- Integrated Care: Because alcohol misuse and psychiatric problems are deeply intertwined and often in a complex fashion, effective treatment programs provide integrated care. This means that both the alcohol addiction and the mental health disorder are treated simultaneously [7]. If addiction is treated without addressing mental health symptoms, people are unlikely to find relief, as they may relapse to addiction to cope with poor mental health. Alternatively, if the addiction is not addressed, mental health may worsen.
- Psychosocial Treatments: Individuals with problems involving both alcohol and mental health benefit from psychosocial interventions, such as individual and group therapy. In therapy, people can learn healthy coping skills and develop strategies for managing stress and trauma [7].
- Pharmacological Treatments: People with co-occurring alcohol use disorders and mental health disorders may require medication to help with symptom management [7]. For example, there are various medications available that specifically treat alcohol use disorder. Medications like naltrexone can block the pleasant effects of drinking to deter alcohol consumption. Another medication, acamprosate, can also prevent drinking [8].
How to Help Someone Struggling with Alcoholism and Mental Health Issues
When a friend or family member struggles with addiction and mental illness, support from loved ones can play a critical role in recovery. The following strategies can be helpful for your loved one [9]:
- Offer a listening ear: Your loved one may want to talk with you about their struggles, and your support can make a world of difference. Be willing to talk with them about their concerns, and keep an open mind. Try to validate their experience without passing judgment. Tell your loved one that you’re there to help.
- Learn about local resources: Alcohol addiction and mental illness are treatable. It’s important to learn about local resources, including crisis services, so you know where to direct your loved one when they are seeking professional help.
- Encourage them to seek treatment: Ultimately, treatment is needed to recover from the effects of alcohol on mental health. When you talk with your loved one, remind them that treatment works. Be prepared to help them connect with resources, such as individual therapy services and support groups.
It can be challenging to cope with problems related to alcohol and mental health, but recovery is possible. With support and professional treatment, people can and do find relief.
- National Institute on Alcohol Abuse and Alcoholism. (2024). Mental health issues: Alcohol use disorder and common co-occurring conditions. Available at: https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/mental-health-issues-alcohol-use-disorder-and-common-co-occurring-conditions
- van Draanen, J., & Upchurch, D. (2023). Differences in co-occurring disorder timing, onset, and sequence by gender. International Journal of Mental Health and Addiction, 21, 3413-3429. Available at: https://link.springer.com/article/10.1007/s11469-022-00799-w
- Milani, R. M., & Perrino, L. (2021). Alcohol and mental health: Co-occurring alcohol use and mental health disorders. In D. Frings & I. P. Albery (Eds.), The Handbook of Alcohol Use (pp. 81–106). Academic Press. Available at: https://www.sciencedirect.com/science/article/pii/B9780128167205000232?via%3Dihub
- Hermens, D. F., Lagopoulos, J., Tobias-Webb, J., De Regt, T., Dore, G., Juckes, L., Latt, N., & Hickie, I. B. (2013). Pathways to alcohol-induced brain impairment in young people: A review. Cortex, 49(1), 3-17. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0010945212001839?via%3Dihub
- Crum, R. M., Mojtabai, R., Lazareck, S., et al. (2013). A prospective assessment of reports of drinking to self-medicate mood symptoms with the incidence and persistence of alcohol dependence. JAMA Psychiatry, 70(7), 718–726. Available at: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1684867
- Tomlinson, K. L., Tate, S. R., Anderson, K. G., McCarthy, D. M., & Brown, S. A. (2006). An examination of self-medication and rebound effects: Psychiatric symptomatology before and after alcohol or drug relapse. Addictive Behaviors, 31(3), 461-474. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0306460305001309?via%3Dihub
- Milani, R. M., & Perrino, L. (2021). Alcohol and mental health: Co-occurring alcohol use and mental health disorders. In D. Frings & I. P. Albery (Eds.), The Handbook of Alcohol Use (pp. 27-40). Academic Press.
- Substance Abuse and Mental Health Services Administration. (2024). Medications, counseling, and related conditions. Available at: https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions
- Substance Abuse and Mental Health Services Administration. (2024). Resources for families coping with mental and substance use disorders. Available at: https://www.samhsa.gov/families
Our Medical Affairs Team is a dedicated group of medical professionals with diverse and extensive clinical experience who actively contribute to the development of our content, products, and services. They meticulously evaluate and review all medical content before publication to ensure it is medically accurate and aligned with current discussions and research developments in mental health. For more information, visit our Editorial Policy.
MentalHealth.com is a health technology company guiding people towards self-understanding and connection. The platform provides reliable resources, accessible services, and nurturing communities. Its purpose is to educate, support, and empower people in their pursuit of well-being.
Dr. Jenni Jacobsen, PhD is a medical reviewer, licensed social worker, and behavioral health consultant, holding a PhD in clinical psychology.
Jennie Stanford is a dual-board certified physician in both family medicine and obesity medicine, holding an MD, FAAFP, and DipABOM. She has experience in both clinical practice and peer-quality reviews.
Our Medical Affairs Team is a dedicated group of medical professionals with diverse and extensive clinical experience who actively contribute to the development of our content, products, and services. They meticulously evaluate and review all medical content before publication to ensure it is medically accurate and aligned with current discussions and research developments in mental health. For more information, visit our Editorial Policy.
MentalHealth.com is a health technology company guiding people towards self-understanding and connection. The platform provides reliable resources, accessible services, and nurturing communities. Its purpose is to educate, support, and empower people in their pursuit of well-being.