Definition

Alcohol affects the brain, causing immediate calmness and relaxation. However, as you consume more, intoxication can lead to inappropriate and dangerous behavior.

People with stress, depression or anxiety disorders usually use alcohol to help relieve their complaints. However, excessive use of alcohol will harm behavior and mental health.

It is not uncommon for someone to be diagnosed with a mental health disorder and alcohol abuse simultaneously. Symptoms of alcoholism and mental illness often influence each other. If left untreated, mental illnesses that occur alongside alcohol dependence can worsen and impact the lives of patients and their families. This dual diagnosis needs to be treated by mental health specialists and other mental health professionals through rehabilitation programs.

Causes

The brain relies on a delicate balance of neurotransmitters, which are chemicals that send signals from one nerve to another. If there is an imbalance in these brain chemicals, it can lead to mental health problems or behavioral disorders. Alcohol, on the other hand, is a depressant that can disrupt the balance of neurotransmitters. Therefore, consuming alcohol can affect a person's thoughts, feelings, behavior, and even long-term mental health.

After consuming alcohol, the body undergoes chemical changes that can induce a feeling of calm. However, consuming excessive alcohol can increase the intensity of these chemical changes, leading to the opposite effect, which in turn can cause negative emotions. Such negative emotions can adversely impact mental health and behavior. 

Risk factor

People who are at risk of developing alcohol abuse problems and have a dual diagnosis include:

• Family history of alcohol abuse
• Drinking alcohol becomes a tradition and is taught in the family or environment
• Living in an environment where it is easy to get alcohol
• Unhealthy alcohol drinking patterns, namely more than 12-15 glasses per week
• Drink excessive alcohol regularly, namely 5 glasses or more at one time
• History of mental health disorders, such as anxiety or depression
• Having a high-stress or stressful job
• Teenagers and young adults who lack self-confidence and peer pressure
• Experiencing a traumatic event, such as losing a loved one

Symptoms

Some mental and behavioral disorders that can arise due to alcohol abuse are

Anxiety disorders

For people who suffer from anxiety disorders, drinking alcohol may help them feel more comfortable. However, this feeling did not last long. Feelings of comfort occur due to chemical changes in the brain, whose effects quickly disappear.

Relying on alcohol to mask anxiety can also lead to greater dependence and create a tolerance for alcohol. So, you need to drink more alcohol to get the same feeling. In the long term, this pattern will lead to alcohol dependence.

Feelings of anxiety can also occur when drunk. For some people, this feeling is almost unconscious. However, if you already have an anxiety disorder before, the effects of drinking can worsen anxiety symptoms. Drinking alcohol can also make a person feel more anxious in certain situations.

Depressive disorders

Depressive disorders and alcohol consumption are like a vicious cycle. People drink alcohol to overcome their depression. On the contrary, excessive alcohol consumption actually makes depressive disorders worse. Alcohol affects the neurochemical system, which is important in regulating mood. Excessive alcohol consumption or stopping drinking suddenly can disrupt your mood.

Bipolar disorder

Bipolar disorder is a disorder of mood swings or moods that are irregular and fluctuate from the highest or very happy mood to the lowest or very sad mood. These drastic mood changes can cause various mental and physical symptoms. A person with bipolar disorder has a higher risk of developing substance abuse disorders, including alcoholism. This condition is hazardous because, on the contrary, alcohol can worsen bipolar disorder.

Obsessive-compulsive disorder (OCD)

OCD is a type of anxiety disorder in the form of uncontrolled obsessions that trigger compulsive behavior. Compulsive behavior is behavior that is done repeatedly to relieve anxiety. Compulsive behavior will continue even though it has a negative impact on the health or life of the sufferer.

As a way to distract from disturbing thoughts or behaviors, some people with OCD turn to alcohol use. An estimated 24% of people with OCD also suffer from a substance use disorder, including alcohol abuse. Instead of helping to calm and relieve fear, alcohol consumption will worsen OCD symptoms.

Relying on alcohol as a method of OCD treatment can quickly turn into a dangerous addiction. Without proper treatment, alcoholism and OCD disorders can last a lifetime, including the health complications and emotional disturbances they cause.

Promiscuity (Sexual relations)

While some drinkers get into fights, other drinkers seek to satisfy their sexual desires. Our culture seems to depict that alcohol and sex go together, and alcohol is used as an excuse to behave as we please. Indecent behavior associated with alcohol consumption varies from mildly disturbing to dangerously violent. Experts call alcohol the number one rape drug.

Suicidal ideation, Hurt, and Psychosis

Alcohol is also linked to suicidal ideation, self-harm and psychosis. Psychosis is when someone experiences a disturbed relationship with reality so that they cannot differentiate between what is real and what is not real. Extreme alcohol consumption or alcohol poisoning can cause psychosis. Psychosis can also be caused by suddenly stopping drinking.

Alcohol can cause people to lose control and behave impulsively, giving rise to dangerous ideas, including self-harm and even suicide. There is a strong association between excessive alcohol consumption and suicidal thoughts, suicide attempts, and death by suicide.

Diagnosis

The doctor will conduct a medical history interview with you and your family and a physical and psychological examination to determine your risk factors for these two disorders. This examination also helps rule out other conditions that may cause complaints.

If you are diagnosed with one of these conditions, your doctor will also ask about other symptoms. This is normal in making a diagnosis because the two often occur together.

Management

Treating one of the mental and behavioral disorders as well as alcohol abuse can improve the symptoms of both. However, for best results, the doctor will treat them simultaneously. Treatment for alcohol abuse and mental/behavioral disorders is generally almost the same. The following treatments can be done for alcohol abuse and depression:

Drugs

Alcohol can affect chemical compounds in the brain, making depression worse. Antidepressant drugs can help normalize brain chemicals and relieve symptoms of depression. Apart from that, doctors can also prescribe medications to reduce alcohol addiction.

Rehabilitation

People with alcohol use disorder often experience physical dependence. Stopping suddenly can cause withdrawal symptoms. These symptoms can be severe and even life-threatening.

By carrying out rehabilitation, patients will be assisted medically when experiencing withdrawal symptoms. Patients can also undergo therapy at the same time to overcome their mental disorders. During treatment, patients will learn coping or self-defense mechanisms so they can live everyday life again without alcohol.

Therapy

Cognitive behavioral therapy (CBT) is a type of psychotherapy. This therapy helps people understand the events and thought processes that lead to depression and substance abuse. CBT will also teach you how to change your thoughts and behavior for the better and help avoid alcohol abuse.

If you use alcohol to treat a mental disorder, you may feel successful. However, this step will cause problems for you in the long run. If you have an anxiety disorder, abusing and suddenly stopping alcohol will worsen symptoms.

To reduce stress or anxiety without alcohol, try exercise or relaxation methods, such as meditation or yoga. You can also try breathing techniques when you feel worried or anxious. Telling stories to people you trust can also help reduce anxiety.

If the complaint does not improve, you need to seek help from a doctor or mental health professional. There are many effective treatments for anxiety and alcohol abuse, including individual therapy, group therapy, medication, or a combination of these methods.

Complications

These two dual disorders can damage your health, relationships, work, and quality of life if left untreated. Alcohol abuse itself can cause accidents, injuries, sexual violence, overdose, or sudden death. The worst complication of this mental and behavioral disorder is hurting or taking the life of yourself or someone else.

Prevention

Preventing mental and behavioral disorders due to alcohol is by preventing the consumption and abuse of alcohol itself. Here are some tips to prevent alcohol abuse & addiction:

• Drink in small amounts or in moderation
• Divert the desire to drink alcohol with other activities such as eating, chatting with other people, or drinking non-alcoholic drinks
• Avoid triggers that make you consume alcohol
• Do not attend gatherings or celebrations where alcohol is served
• Avoid people who drink a lot of alcohol or encourage you to drink
• Don't store alcohol at home
• Avoid people and situations that remind you of past trauma
• Don't live in a place that has easy access to alcohol
• Learn healthy coping mechanisms to prevent emotional drinking
• Enlist the support of friends and family to help regulate drinking habits, avoid triggers, and teach healthy coping mechanisms

When to see a doctor? 

If you or someone you know has symptoms of the disorders mentioned above, immediately consult a doctor or psychiatrist. Quick and appropriate treatment can prevent worsening of symptoms and complications.

If an emergency occurs, such as violence, suicidal ideation or murder, immediately contact the relevant officials, such as the police or the local emergency telephone number. Once the emergency condition has been stabilized, the patient should be immediately taken to the hospital emergency unit for medical assistance.