Alcoholism is something that affects millions of people on a daily basis. While, unfortunately, there are many misconceptions out there as it relates to alcoholism, namely that it is a choice or a sign of weakness, the fact of the matter is that, just like other substance use disorders, alcoholism is a disease.
Understanding alcoholism through this lens is essential for reducing stigma, increasing access to treatment, and fostering empathy for those struggling with alcohol use disorder (AUD). In this blog, we will explore how alcoholism is defined, how it fits into our broader understanding of mental illness, why recognizing it as a mental health condition is crucial to offering effective treatment and support, and answer the question, “Is alcoholism a mental illness?”
Defining Alcoholism: What Is It?
Formally known as Alcohol Use Disorder (AUD), alcoholism is a chronic disease characterized by a person’s inability to stop or control alcohol use despite the negative consequences associated with its use. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), AUD is a medical condition that ranges from mild to severe and is diagnosed based on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Common symptoms of AUD include:
- Drinking more or longer than intended
- Unsuccessful attempts to cut down or stop drinking
- Spending significant time obtaining, using, or recovering from alcohol
- Cravings or strong urges to drink
- Neglecting responsibilities at work, school, or home
- Continuing to drink despite the problems it causes
These behaviors are more than just bad choices, they reflect a deeper, often uncontrollable struggle that affects brain function and decision-making ability.
Understanding Mental Illness: Key Characteristics
In order to properly answer the question of whether or not alcoholism is a mental illness, we must first look at what exactly constitutes a mental illness. According to the American Psychiatric Association, a mental illness is defined as “a health condition involving changes in emotion, thinking, or behavior (or a combination of these) and is associated with distress and/or problems functioning in social, work, or family activities.”
Key features of mental illnesses include:
- A disruption in cognitive, emotional, or behavioral functioning
- A significant impact on daily life and responsibilities
- A basis in biological, psychological, and environmental factors
As we briefly mentioned in the intro, just like with alcoholism, mental illnesses are diagnosable medical conditions and not a character flaw or a sign of weakness. They range in severity and can be temporary or chronic, mild or severe. Most importantly, just like other medical conditions, they can be treated and managed with the right support.
Is Alcoholism a Mental Illness?
So, to answer the question we have been teasing, yes, alcoholism is classified as a mental illness. More specifically, it’s a mental illness that falls under the category of substance-related and addictive disorders in the DSM-5 because of the traits associated with the condition, such as the way in which it affects brain chemistry, alters behavior, and significantly impairs functioning in everyday life.
As for the type of mental illness alcoholism is?
Well, AUD is considered a chronic brain disease because it affects the way the brain functions, particularly in areas related to reward, motivation, memory, and decision-making. Much in the same way that depression alters mood regulation or schizophrenia affects perception, alcoholism hijacks the brain’s natural systems, creating compulsive behavior that is extremely difficult to control without help.
Alcoholism and the Diagnostic and Statistical Manual (DSM-5)
You may have noticed we have mentioned the DSM-5 and may be wondering what it is. Well, the Diagnostic and Statistical Manual, also known as the DSM-5, is the standard classification system for mental disorders used by clinicians and researchers in the United States.
In the DSM-5, alcoholism, or alcohol addiction, is listed formally as Alcohol Use Disorder and is classified under the broader category of Substance-Related and Addictive Disorders.
The DSM-5 outlines 11 criteria for diagnosing AUD, including:
- Inability to cut down despite the desire to do so
- Failure to fulfill major obligations due to alcohol use
- Continued use despite social or interpersonal problems
- Tolerance and withdrawal symptoms
A diagnosis is typically made based on how many of the criteria are met within a 12-month window. Meeting two or three suggests a mild disorder, four to five indicates a moderate disorder, and six or more points to a severe case.
How Alcoholism Affects the Brain and Behavior?
Alcohol affects the brain in a number of different ways. Primarily, it affects the central nervous system and interferes with the brain’s communication pathways, which, over time, can alter mood, behavior, and cognitive function.
Some of the key areas of the brain that are the most impacted by alcoholism include:
- The Prefrontal Cortex – Responsible for decision-making, impulse control, and reasoning. Chronic alcohol use can impair judgment and increase risky behaviors.
- The Limbic System – Involved in emotion and memory. Alcohol stimulates dopamine production in this area, reinforcing pleasurable sensations and encouraging repeated use.
- The Cerebellum and Brain Stem – These control motor skills and vital life functions. Prolonged alcohol abuse can result in motor coordination issues and life-threatening complications.
As the brain adapts to the addition of alcohol to the system, it begins to become dependent on the substance, even going so far as to think that it requires alcohol in order to function “normally”, thus starting the vicious cycle of addiction.
The Link Between Alcohol Use Disorder and Other Mental Health Conditions
Often, the development of alcoholism is the result of other undiagnosed or untreated mental health conditions such as depression, anxiety, bipolar disorder, or post-traumatic stress disorder (PTSD).
For one reason or another, whether it be shame, embarrassment, lack of access to proper care, or all of the above, a person may turn to alcohol as a way to self-medicate their other mental health condition or conditions. While initially drinking may seem to be effective in numbing the proverbial or even literal pain, long term not only does it leads to the development of an AUD but it also often worsens the mental health condition that they were trying to self-medicate in the first place.
When an AUD forms in addition to another mental health condition, this is known as co-occurring disorders. Co-occurring disorders require special dual diagnosis treatment in order to address both conditions simultaneously. That’s because, without treating the underlying mental illness, alcohol use may persist as a coping mechanism. At the same time, chronic alcohol use can interfere with the effectiveness of psychiatric medications and therapies.
Why Alcoholism Is More Than Just a “Lack of Willpower”?
We mentioned earlier how, unfortunately, far too many people associate mental illnesses, such as alcoholism, with a lack of willpower or even see it as a choice. Common misconceptions like these often discourage people who do suffer from seeking proper help.
Not only are these misconceptions outdated, they are also just flatly wrong. These assumptions or misconceptions completely ignore the extensive research that has been done over decades in order to show the neurobiological, psychological, and environmental factors involved in the development of AUD.
Addiction rewires the brain in ways that diminish a person’s ability to make rational decisions. Willpower alone is often not enough to overcome the physical cravings, withdrawal symptoms, and psychological dependency that characterize alcoholism.
This is a key reason why, in many cases, the person suffering from an AUD knows and understands the negative impact drinking has on them, yet, even when they try and stop drinking, they often can’t.
The Importance of Treating Alcoholism as a Mental Health Issue
Recognizing alcoholism as a mental illness is more than just removing a misconception or “setting the record straight”. It’s also a critical step toward effective treatment and long-term recovery. Being better informed about mental health as a whole can help address the root causes of addiction, such as trauma, stress, and co-occurring disorders.
When alcoholism is treated as a disease rather than a behavioral problem, individuals are more likely to:
- Seek help without fear of judgment
- Access holistic and evidence-based treatments
- Receive integrated care for co-occurring conditions
- Build the coping skills needed to manage cravings and avoid relapse
This, in turn, leads to better outcomes, reduced relapse rates, and an overall improvement in quality of life for those in recovery.
Treatment Options for Alcohol Use Disorder
While there is no “one-size-fits-all” approach to treating AUD, there are a number of different treatment options available, all designed to help each person and their unique needs.
These treatment options include:
- Detox – The crucial first step in treatment, detoxing removes all the harmful toxins in the body in a safe environment surrounded by trained medical professionals.
- Inpatient Rehab – A residential treatment program that provides a structured environment where individuals receive therapy, education, and support 24/7.
- Outpatient Rehab – Provides access to treatment while allowing the person to still maintain a somewhat regular schedule.
- Behavioral Therapies – Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), and Dialectical Behavior Therapy (DBT) help individuals change thought patterns and develop coping strategies.
- Support Groups – Programs like Alcoholics Anonymous (AA) and SMART Recovery provide community support and accountability.
Final Thoughts: Understanding and Compassion in the Face of Alcoholism
Alcoholism is a complex, multifaceted disorder that affects the mind, body, and spirit. By recognizing it as a mental illness, we move away from harmful stereotypes and toward a more compassionate, scientifically grounded understanding.
Whether you or a loved one is struggling with alcoholism, know that help is available and that recovery is possible. At Agape Detox Center, we offer personalized, comprehensive treatment rooted in empathy, respect, and proven clinical practices. Contact us today to learn more about our programs and how we can get you started on the road to recovery.
Stephanie Robilio is an accomplished Clinical Director at Agape Behavioral Healthcare. With a Master of Social Work degree, LCSW license, and extensive training in Rapid Resolution Therapy under her belt, she brings a wealth of expertise to her role. Her unique combination of education and experience allows her to provide exceptional care to clients and lead her team with confidence. Stephanie’s joy comes from witnessing the moments when her patients creatively connect the dots and bravely move toward reclaiming their power. Her purpose is to help individuals understand their past so they can create a future full of hope, growth, and success. Stephanie attributes a large portion of her success to the supportive culture and strong sense of community fostered by the Agape team.
