Alcohol addiction is influenced by a combination of psychological, biological, and social factors. Like other chronic conditions, it often follows a pattern of relapse and remission. Some people can drink occasionally, even excessively at times, without developing a dependency. For others, alcohol use progresses into a more serious issue, ranging from mild to severe alcohol use disorder (AUD). Medical professionals now use this term instead of outdated labels like “alcoholism” or “alcohol abuse.”

Why Do Some People Develop Alcohol Addiction While Others Don’t?

Alcohol affects everyone differently. Some people can drink without it becoming a problem, while others develop a dependency. Several factors influence this, including genetics, mental health, environment, and when a person first starts drinking. One thing that remains consistent is how alcohol interacts with the brain.

Drinking triggers the release of dopamine, a chemical linked to pleasure and reward. For some, this effect is stronger due to differences in brain chemistry. When alcohol repeatedly provides an artificial sense of relief or enjoyment, the brain starts to prioritize drinking over healthier activities. Over time, this pattern makes it harder to stop, reinforcing the cycle of addiction.

How Alcohol Changes the Brain

Long-term alcohol use changes the way the brain functions, and some of these effects may be permanent. As a depressant, alcohol slows down the central nervous system, which affects movement, reaction time, coordination, and judgment. In large amounts, it can dangerously suppress critical functions like breathing and body temperature regulation, which can be fatal.

Alcohol’s impact goes beyond slowing down the body—it also rewires the brain’s reward system. Drinking triggers a surge of dopamine, a chemical linked to pleasure and reinforcement. Normally, dopamine is released in response to natural rewards like eating or social interaction. However, alcohol artificially floods the brain with high levels of dopamine, creating an exaggerated sense of pleasure and reinforcing the urge to drink.

With repeated use, the brain adapts by reducing its natural dopamine production and rewiring neural pathways to expect alcohol. This leads to tolerance, meaning a person must drink more to achieve the same effect. Over time, the brain prioritizes alcohol over other sources of pleasure, making everyday activities feel less enjoyable. This cycle not only strengthens dependence but also leads to withdrawal symptoms when alcohol use is reduced, as the body struggles to regain balance.

Is Alcoholism Considered a Disease?

Yes, alcoholism is a recognized medical condition. The American Medical Association (AMA) classified alcoholism as a disease in 1956, defining it as a chronic illness that does not resolve on its own, follows a progressive course, and affects both physical and mental health. Like other chronic diseases, alcohol addiction requires ongoing management and treatment.

In 1980, the American Psychiatric Association officially recognized substance use disorder as a primary mental health disorder in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). Before this, alcoholism was classified under personality disorders, reinforcing harmful misconceptions that framed addiction as a moral failing rather than a medical condition. This shift helped establish a more science-based understanding of alcohol addiction, paving the way for improved treatment approaches.

Beyond its classification as a disease, alcohol addiction often coexists with other mental health conditions. Many individuals with alcohol use disorder (AUD) also struggle with depression, anxiety, post-traumatic stress disorder (PTSD), or obsessive-compulsive disorder (OCD)—a combination known as a co-occurring disorder, dual diagnosis, or comorbidity. Studies show that untreated mental health conditions increase the risk of developing AUD, as individuals may turn to alcohol as a way to self-medicate distressing symptoms. At the same time, excessive alcohol use can contribute to or worsen mental illness, creating a cycle that reinforces both conditions.

Studies highlight the strong connection between alcoholism and other mental disorders:

• Depression: Up to 80% of people with alcohol addiction experience depressive symptoms, and 30% meet the criteria for major depression.

• Anxiety Disorders: Conditions such as panic disorder, social phobia, and generalized anxiety disorder affect between 10% and 60% of people in addiction treatment.

• PTSD: Roughly one-third of individuals entering treatment for substance use also have PTSD.

• Eating Disorders:  Between 15% and 32% of women with substance use disorders meet the criteria for an eating disorder at some point in their lives.

Genetics, environment, trauma, and social factors all play a role in the overlap between addiction and mental health conditions. When both are present, treating them together improves recovery outcomes, as addressing only one condition often leaves the other untreated, increasing the risk of relapse.

How Is Alcohol Addiction Different from Other Mental Health Disorders?

Alcohol addiction shares many characteristics with other mental health conditions, but treatment for substance use disorders differs in key ways. While therapy is a core component of both, addiction treatment often includes detox and medical stabilization to address the physical effects of alcohol dependence. Since withdrawal can be severe—or even life-threatening—medical supervision is often necessary to ensure safety.

At the same time, many of the therapeutic approaches used in mental health treatment also apply to addiction recovery. Cognitive-behavioral therapy (CBT), group therapy, and psychiatric care play important roles in both. Many treatment professionals are trained in both mental health and addiction, allowing for integrated treatment when conditions like depression, anxiety, or PTSD occur alongside alcohol use disorder (AUD).

While mental health treatment focuses on managing symptoms and improving emotional well-being, addiction treatment also includes relapse prevention strategies and long-term recovery support. Twelve Step programs, peer-support groups, and continuing care help individuals maintain sobriety after formal treatment ends. Because addiction and mental health disorders often influence each other, treating both at the same time provides the best chance for lasting recovery.

The Link Between Alcohol Addiction and Mental Health Disorders

Alcohol addiction and mental health conditions are often connected, with each condition making the other worse. Some people turn to alcohol as a way to cope with depression, anxiety, or trauma, using it to temporarily numb emotional distress. Others may develop mental health symptoms as a result of heavy drinking, as alcohol disrupts brain chemistry and can increase feelings of sadness, anxiety, and hopelessness.

According to the National Institute on Drug Abuse, about half of all people with a substance use disorder also have a co-occurring mental health condition. This overlap, known as a co-occurring disorder or dual diagnosis, makes treatment more complex because both conditions feed into each other.

The National Alliance on Mental Illness (NAMI) reports that among the 20.2 million U.S. adults with a substance use disorder, 50.5%—or 10.2 million people—also have a mental health disorder. When these conditions are untreated, they tend to worsen over time. Ignoring mental health issues can increase alcohol use, while excessive drinking can intensify symptoms of depression and anxiety.

Because these conditions are so closely linked, effective treatment must address both simultaneously. Integrated care that combines addiction treatment with mental health support gives individuals the best chance at long-term recovery.

Treatment for Alcoholism vs Mental Health Treatment

While substance use and mental health disorders share many similarities, treatment for each has distinct elements. Many professionals are trained to treat both, allowing for an integrated approach that addresses addiction and underlying mental health conditions at the same time. This method is particularly important for individuals with co-occurring disorders, as treating one condition without addressing the other can lead to relapse or worsening symptoms.

Mental health treatment typically focuses on understanding thoughts, emotions, and behaviors through individual or group therapy. Medication may also be prescribed to help manage symptoms of depression, anxiety, or other mental health conditions.

In contrast, addiction treatment often includes medical care to address physical dependence, especially for those experiencing withdrawal symptoms. Detox is usually the first step, with medical supervision ensuring safety and comfort. Once stabilized, individuals move into therapy and recovery-focused interventions.

Despite these differences, both types of treatment share key components:

• Assessment: A thorough evaluation of medical history, substance use patterns, and mental health helps shape a personalized treatment plan.

• Stabilization: Detox and medical supervision may be needed to safely manage withdrawal symptoms and cravings. For mental health conditions, stabilization may involve medication adjustments or hospitalization in severe cases.

• Education: Learning about addiction and mental health helps individuals understand their conditions, reduce guilt and shame, and develop strategies for managing symptoms.

• Behavioral Therapy: Individual and group therapy help people develop healthier coping skills, challenge negative thought patterns, and improve emotional well-being.

• Peer Support: Programs like Twelve Step groups and mutual support meetings provide community and accountability, benefiting both addiction and mental health recovery.

• Continuing Care: Ongoing therapy, medication management, and support groups help maintain long-term recovery, as both addiction and mental health conditions require lifelong management.

Integrated treatment is the most effective approach for individuals facing both addiction and mental health challenges. A well-rounded recovery plan that addresses both the mind and body increases the chances of long-term success.