Schizophrenia and Alcohol Use Disorder

schizophrenia and alcohol

About 17.5 million people in the U.S. over the age of 18 have lived with some kind of mental health disorder in the last year. To top that off, 4 million of these people also suffered from addiction to alcohol or drugs. The sad part is, more than half of people living with a dual diagnosis (having both a mental health disorder and a drug/alcohol dependency) did not receive a psychiatric intervention or medical treatment of any kind. 

People with co-occurring disorders must understand how each of their conditions combined can greatly harm them in the long run. Two of these conditions, schizophrenia and alcohol use disorder, can make a deadly pair when they interact with each other.

Defining Schizophrenia: What is It and How Does it Affect People?

Schizophrenia is a serious, chronic mental disorder in which people misinterpret reality. This can affect how a person behaves, thinks and feels. Unfortunately, the symptoms of schizophrenia can be crippling to the person suffering from them, and treatment usually lasts a lifetime.

Schizophrenia is most commonly detected between ages 16 and 30, and some children may also be diagnosed with it. Symptoms of schizophrenia commonly involve hallucinations, delusions, and disorganized speech, and they can be divided into three categories: cognitive, positive and negative.

  • Cognitive: Cognitive symptoms of schizophrenia involve changes in memory or other areas of thinking.
    • Trouble concentrating or paying attention
    • Decreased ability to make decisions and understand information
    • Poor working memory
  • Positive: In this sense, “positive” symptoms of schizophrenia are psychotic behaviors that cause people to lose touch with reality.
    • Delusions
    • Hallucinations
    • Abnormal motor function
    • Disorganized thinking and speech
  • Negative: Negative symptoms are related to disruptions in normal functioning.
    • Loss of interest in everyday activities
    • Reduced speaking
    • Trouble beginning and sustaining activities
    • Lack of emotional expression (also known as “flat affect”)

Other symptoms of schizophrenia, like lack of motivation and withdrawal from family and friends, might be more difficult to recognize in teens than in adults. This is because many of them could be mistaken as common characteristics of teen development. 

Types of Schizophrenia

In the past, doctors would divide schizophrenia into four different “subtypes.” Below are four main types of this disorder in which doctors tend to place people.

  • Paranoid schizophrenia: People suffering from this type of schizophrenia may have extreme paranoia and act on it. 
  • Schizoaffective disorder: Depression and mania are common symptoms of people with schizoaffective disorder. They will also show signs of delusional thinking.
  • Undifferentiated schizophrenia: Various vague symptoms are present here, like poor hygiene and little to no expression.
  • Catatonic schizophrenia: People who have catatonic schizophrenia look paralyzed since they shut down mentally, physically and emotionally. They also lack the urge to drink, eat or urinate. If someone appears catatonic for several hours, call 911. 

In recent years, doctors have strayed from using these subtypes of schizophrenia to diagnose patients. In 2013, the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-V) changed protocol so that each of these types falls under the general schizophrenia umbrella. Now, to be diagnosed as schizophrenic, a person must have one of the following symptoms:

  • Disorganized speech
  • Hallucinations
  • Delusions

Another major change made in the same year was that a person was no longer required to hear two or more voices talking during an auditory hallucination to receive a schizophrenia diagnosis.

The original four subtypes of schizophrenia are now largely considered to be “specifiers” for the disorder as a whole.

What is Alcohol Use Disorder?

Alcohol use disorder refers to the inability to control drinking that has become severe. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), about 15 million people ages 12 and older in the U.S. suffer from alcohol use disorder. 

NIAAA defines a drink as 12 ounces of beer, 8 to 9 ounces of malt liquor, 5 ounces of wine, or 1.5 ounces of 80-proof hard liquor. Binge drinking is considered to be five or more drinks for men and four or more drinks for women in about two hours.

Alcohol use disorder can stem from several factors, including:

  • Family history
  • Binge drinking
  • Starting to drink from an early age
  • History of trauma
  • Mental health disorders

Frequent and uncontrolled drinking can affect how your brain functions in areas of judgment, self-control, and pleasure. It can also result in numerous health problems like liver disease, diabetes complications, a weakened immune system, and a higher risk of cancer.

A good way to assess whether you or a loved one has alcohol use disorder is to ask the following questions about your/their drinking in the last year:

  • Has your drinking interfered with responsibilities at work and home?
  • Have you experienced a strong craving to drink?
  • Have you wanted to stop or cut down on drinking more than once, but couldn’t?
  • Have you continued drinking even when it has disrupted relationships with friends and family?
  • Have you had times when you ended up drinking longer or more than you intended?

If you answer “yes” to any of these questions, you may have alcohol use disorder.

Schizophrenia and Alcohol: A Dangerous Combination

Schizophrenia and alcohol use disorder are both debilitating conditions on their own. Combine them, and you could harm your body and face serious health consequences. It is common for people with schizophrenia to dabble in drug and/or alcohol use.

Any time you combine a drug dependency with a mental illness, these are called co-occurring disorders, and they call for a dual diagnosis. Anywhere from 10 to 23 percent of people with schizophrenia will behave violently at some point in their lifetime, and when you bring alcohol into the mix, it can cause disastrous consequences.

Those suffering from schizophrenia may turn to extreme drinking for several reasons. Many times they do it to mask their symptoms and feel better about themselves. Since people who have schizophrenia tend not to get married or have children, they also may drink to alleviate feelings of hopelessness that can come with these conditions. 

Why is Alcohol Use Disorder Worse for Individuals Suffering from Schizophrenia?

Even though there isn’t concrete evidence that alcohol use disorder can cause schizophrenia, it does affect both the illness and its outcomes. Alcohol use disorder is already harmful to people without a mental illness, so when it is combined with other health problems, it can be deadly.

Alcohol may provide someone with schizophrenia with temporary relief and happiness, but this will wash away once its effects wear off. In these moments of bliss, the person may neglect what they actually need to feel better, like taking medication or going to a therapist. Alcohol use disorder can also complicate relationships with family and friends, and relations may already be strained by schizophrenia. Putting your treatment first is the only way that you will be able to manage schizophrenia symptoms and prevent them from getting worse. When you drink to excess, you’re also more likely to engage in risky and dangerous behavior that could endanger your well being.

Seeking Help For Co-Occurring Disorders

Treating both schizophrenia and alcohol use disorder simultaneously is crucial for a successful recovery. Much like the “chicken or the egg” scenario, it is not always known whether mental illness causes addiction or vice versa. People suffering from a mental illness like schizophrenia may turn to drugs or alcohol for comfort, and those with alcohol use disorder may end up exhibiting symptoms like lack of emotion and disorganized speech. For these reasons, both conditions must be understood and treated so that an effective solution may be found.

When schizophrenia and alcohol use disorder are cared for at the same time, there is a much lower risk of relapse among members. There is also a smaller number of suicide attempts among users. 

Once you realize and acknowledge that you have co-occurring disorders and that you need help, you are already taking the first step toward recovery. Dual diagnosis treatment at Sana Lake Recovery Center is administered by trained substance abuse disorder staff. Each member participating in dual diagnosis treatment at Sana Lake will be assigned to a therapist and substance use counselor. They will collaborate to evaluate your situation and determine the best course of treatment.

After you have completed your initial detox, which should last about 30 days, there are several aftercare options that you can choose from.

  • Medication therapy: People with co-occurring disorders will most likely need medication for their mental illness. Antipsychotics are common medications for schizophrenia that keep the disorder at bay by easing symptoms like hallucinations and delusions. A few newer antipsychotic medications are aripiprazole (Abilify) lurasidone (Latuda), and quetiapine (Seroquel).
  • Individual therapy: For people with alcohol use disorder and schizophrenia, one-on-one sessions with your therapist may consist of building new thought patterns and encouraging motivation. 
  • Group therapy/peer support groups: Group therapy offers a level of support that can be difficult to find normally. Surrounding yourself with others going through the same problems can put things into perspective and make a positive impact on your life. 

Receiving Dual Diagnosis Treatment at Sana Lake Recovery Center

Dual diagnosis treatment should be administered by experienced professionals who tailor programs to your individual needs. That’s why our licensed clinicians at Sana Lake Recovery Center can help. They understand that people with co-occurring disorders have particular challenges stemming from their mental illness. If you or a loved one is struggling with alcohol use disorder and schizophrenia, contact us today to learn more about how our treatment program can help.

References:

https://pubs.niaaa.nih.gov/publications/arh26-2/99-102.pdf

https://www.livingwithschizophreniauk.org/information-sheets/schizophrenia-and-alcohol/

https://www.medicalnewstoday.com/articles/313602.php#1

https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm

https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443

Article Reviewed by David Sherman, MD

David Sherman, MDDavid Sherman, MD is a Fellow of the American Society of Addiction Medicine (FASAM) and board certified in Addiction Medicine with the American Board of Preventive Medicine. He is a native Missourian and graduated medical school at the University of Missouri-Columbia School of Medicine. Dr. Sherman completed a two-year fellowship in Addiction Medicine at the University of Florida in Gainesville. He leads a highly trained staff of master level certified addiction professionals. Men and women from all over Missouri and the United States come to Sana Lake Recovery Center to get the care they need and deserve.