No two dual diagnoses are identical. Each one has its own nuances, symptoms, and difficulties that must be addressed and overcome. However, alcohol addiction is a common factor in a majority of dual diagnosis cases, and the role it plays is similar in each. Those with a history of alcoholism were up to four times more likely to have a severe depressive episode than others, and were three times as likely to develop anxiety. To understand exactly why this is, we first need to understand how alcohol works in general.
Alcohol operates by being absorbed into the bloodstream from the stomach. Once it’s in the bloodstream, it goes everywhere, but most importantly it heads to your brain. Once there, it begins to manipulate your reward center. From here it releases excess amounts of dopamine, causing the euphoric effect common to alcohol. It also affects the rest of the brain while there, increasing confidence, lowering inhibitions, and affecting coordination. However, alcohol is still technically a depressant. What it’s doing to the brain is depressing its function, which can easily result in depression. When alcohol begins to affect things like coordination, what it’s actually doing is shutting down areas of the brain. This is why alcohol can kill in higher doses, as it shuts down the parts of the brain responsible for breathing. However, at lighter doses, it shuts down non-essential areas like coordination. It can also shut down areas that control and regulate emotion, which explains why sometimes when you drink, you are overcome with emotion. This is important when considering how alcohol works as part of a dual diagnosis.
Depression is caused by an imbalance in neurotransmitters in the brain like dopamine and serotonin. When alcohol hits the brain, it floods the brain with these neurotransmitters. When alcohol wears off, the user is likely left in an even deeper hole than the one they had hoped to pull themselves out of with alcohol. In the short term, alcohol can effectively cancel out the feelings of depression, but when it leaves the body, so too does the excess serotonin and dopamine. The body became used to that amount, and now demands more, despite the fact it already had far less than what is considered normal. This is why alcohol as part of a dual diagnosis is so dangerous. It takes the part of the brain that made the mind so susceptible depression and worsens it, leaving in its wake a bigger issue than what was there to start.
Alcohol addiction is already dangerous. It can consume lives with deceptive quickness and uncaring devastation. When coupled with a mental illness, alcoholism is only more dangerous, deceptive, and deadly.