People with alcohol use disorder (AUD) have high rates of co-occurring mental health conditions. Symptoms of mental health conditions and excessive alcohol use may contribute to each other bidirectionally.

Mental health conditions associated with AUD include mood and anxiety disorders, post-traumatic stress disorder (PTSD), and schizophrenia.

However, people who experience AUD and mental health conditions can speak with a healthcare professional for support in treating and managing both.

This article lists some mental health disorders associated with AUD and explains when to seek help.

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According to a national survey, around 28.8 million adults in the United States had AUD in 2022.

A 2021 cross-sectional study suggests that people with mental health disorders are more likely to have AUD and that people with AUD have a higher risk of mental health disorders.

Some symptoms of mental health conditions, such as stress or negative emotions, may increase the risk of excessive alcohol use if a person uses alcohol to cope with their symptoms.

Other factors associated with this link may include environmental, social, and biological factors.

When people stop drinking alcohol, they may experience an improvement in co-occurring mental health conditions. However, treatment for psychiatric symptoms will typically not treat AUD.

Depression is a mood disorder that can cause chronic feelings of sadness, numbness, and loss of joy, regardless of changes in circumstances.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the lifetime prevalence of co-occurring depression and AUD is 27% to 40%, and the 12-month prevalence is up to 22%.

Researchers believe there may be genetic links between mood disorders, such as depression, and substance use disorders.

Other risk factors may include genetic or environmental trauma, such as childhood trauma, high levels of stress, and a lack of social support.

Learn more about depression and substance misuse.


Symptoms of depression can include:

People must have at least five of the above symptoms, including a persistent depressed mood, to have a depression diagnosis.


Treatment for depression typically involves a combination of the following:

The treatment for depression that co-occurs with AUD is typically the same and may also involve alcohol dependence medication, such as naltrexone.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Bipolar disorder is a mood disorder that causes changes in energy, mood, and activity levels. People with bipolar disorder may experience intense high moods, or episodes of mania, and periods of low, depressive moods.

Researchers have found strong associations between bipolar disorder and AUD. According to the NIAAA, the prevalence of co-occurrence may be as high as 42%.

AUD and bipolar disorder may exacerbate each other, and co-occurrence can lead to poorer outcomes. People with bipolar disorder and AUD may experience longer mood episodes and a higher risk of suicide.


The symptoms of bipolar disorder can vary between individuals. They may include symptoms of mania and depressive episodes:

ManiaDepressive episodes
an increase in energy levelslethargy and fatigue
feelings of euphoria or irritabilityfeelings of sadness
racing thoughts and speechslow movement and cognitive difficulties
needing less sleep than usualsleep disturbances or sleeping too much
delusions of grandeurfeelings of worthlessness
an excessive appetite for pleasurable activities, such as food or sexloss of interest in activities and interests a person previously enjoyed


Treatment of bipolar disorder typically involves:

Healthcare professionals may combine treatments for bipolar disorder and AUD. This may include adding AUD medication, psychotherapy aimed at AUD treatment, and a 12-step program to bipolar treatment.

Anxiety disorders cause feelings of fear and excessive nervousness. The feelings may be disproportionate to stressors or triggers in the environment.

The prevalence of AUD in people with anxiety disorders is 20% to 40%. Genetic and environmental factors both contribute to the co-occurrence of the disorders.

Anxiety disorders that most often occur with AUD are:


Symptoms of anxiety disorders include:

  • intense, uncontrollable feelings of worry
  • difficulty concentrating
  • feelings of restlessness
  • sleep difficulties
  • irritability
  • physical symptoms, such as nausea and sweating


AUD and anxiety disorders can mutually worsen each other. Healthcare professionals may treat the comorbid disorders in ways that target them together.

This may involve psychotherapy and medications, such as:

PTSD is a condition that involves long-term effects, such as anxiety, flashbacks, and trouble sleeping, following a traumatic event.

There is a prevalence of comorbid AUD and PTSD of 15% to 30% overall and a prevalence of 50% to 60% among veterans and military personnel.

A person with PTSD may develop AUD as a result of using alcohol to cope with or numb memories of the traumatic event.


Symptoms of PTSD can include:

  • flashbacks
  • nightmares
  • fearful thoughts
  • avoidance of situations related to the trauma
  • feelings of guilt
  • cognitive difficulties
  • symptoms of anxiety and depression
  • detachment
  • difficulty sleeping
  • hypersensitivity to potential danger
  • angry outbursts


Healthcare professionals may use treatments that target both PTSD and AUD. These include:

Schizophrenia is a chronic, severe condition that affects a person’s emotions, thinking, speech, and other abilities.

The prevalence of AUD in people with schizophrenia is around 11%, with a lifetime prevalence of 21%.

Researchers do not fully understand the links between AUD and psychotic disorders like schizophrenia but believe genetics may play a role.


Symptoms of schizophrenia include:


Treatments for co-occurring AUD and schizophrenia may involve:

  • antipsychotic medication
  • supervised alcohol withdrawal in a calm, supportive environment
  • individual and group psychotherapy
  • medication to treat AUD, such as naltrexone
  • 12-step program, such as Alcoholics Anonymous

People with AUD and co-occurring mental health conditions require treatment and support for both disorders.

Depending on a person’s circumstances, healthcare professionals may prioritize treatment for AUD or the mental health disorder or may opt for a treatment that addresses both simultaneously.

According to the NIAAA, alcohol cessation typically leads to improvement in the co-occurring mental health disorder. However, treating psychiatric symptoms alone does not typically help treat AUD.

Individuals could seek integrated treatment and support, which typically has better results than treatment for either a mental health disorder or AUD alone.

A person can speak with a healthcare professional for guidance and support, especially someone specializing in mental health.

People can also find resources and join support groups at the following:

How to help someone with mental illness and alcohol use disorder

The following tips may help a person support a friend or loved one with co-occurring AUD and mental health conditions:

  • educate themselves on AUD and mental health disorders
  • seek professional advice regarding treatments from sources such as the American Addiction Centre and SAMHSA
  • discuss treatment options with their loved one
  • avoid enabling alcohol use and placing blame on someone with AUD
  • offer to participate in treatment with them
  • call 911 or take them to an emergency room if there is a medical emergency

Mental health conditions commonly co-occur with AUD. This may be due to various factors, such as people attempting to self-medicate with alcohol. Genetic, biological, environmental, and social factors may also play a role.

Mental health conditions that commonly co-occur with AUD include depression, bipolar disorder, anxiety, PTSD, and schizophrenia.

A person can work with healthcare professionals to treat the disorders together. This often involves a combination of psychotherapy, medication, and AUD treatments and interventions, such as a 12-step program.