Schizophrenia, or schizophrenia spectrum disorder, is a serious mental illness affecting
If you live with schizophrenia, your ability to relate to reality is significantly impaired. This can be highly distressing for you and your loved ones.
Data from 2013 revealed that schizophrenia was one of the
People with schizophrenia are significantly more likely to also have substance use disorder (SUD), which includes the more specific diagnosis of alcohol use disorder (AUD).
Schizophrenia in combination with alcohol use, and particularly AUD, can have serious health ramifications, both mental and physical.
Alcohol can intensify what doctors call the positive symptoms of schizophrenia — things that are added, like hallucinations and delusions. It can also strengthen negative symptoms — things that are absent, like the absence of joy (anhedonia) or motivation (avolition).
Read on to learn more about the risks associated with drinking alcohol for people with schizophrenia.
Alcohol negatively affects the way our brains work and process information. Therefore, in cases of mental health disorders like schizophrenia, it’s generally not a good idea to drink alcohol.
According to the
- Binge drinking. Consuming a high quantity of alcohol in a single 2- to 3-hour period. For women, this is four or more drinks, and for men it is five or more drinks.
- Heavy drinking. High alcohol consumption per week. For women, this is eight or more drinks, and for men it is 15 or more drinks.
- Underage drinking. Any alcohol consumption if you’re under 21 years of age.
- Pregnant drinking. Any alcohol consumption by a pregnant person.
Sometimes people assume that those with schizophrenia use alcohol to self-medicate their symptoms from either schizophrenia itself or from the antipsychotic medications used to treat schizophrenia. But research has
Some older, less commonly used antipsychotic medications might
There have been studies to examine the effects of antipsychotics on people with AUD, as well as the use of AUD medications for people with schizophrenia.
People with schizophrenia are
- increased severity of schizophrenia symptoms
- non-compliance with treatment
- increased rates of re-hospitalization
One review found that
For people who have schizophrenia, the additional diagnosis of AUD
- not taking medication
- higher rates of hospitalization
More broadly, studies show that alcohol use, when combined with mental illness, leads not only to an increase in physical aggression, but also an even
Alcohol, when misused, has the potential to cause psychosis.
Psychosis is a collection of symptoms that can make it difficult to relate to reality. It’s considered a hallmark of schizophrenia. Symptoms of psychosis include:
- disorganized thought
- disorganized behavior
- lack of expression or emotion
When psychosis is a result of alcohol, it’s known as alcohol-related psychosis or alcohol hallucinosis. There are several forms of alcohol misuse that
- alcohol poisoning
- alcohol withdrawal
- chronic alcohol use disorder
Although alcohol-related psychosis may appear similar to schizophrenia, it’s a distinct and separate condition. When compared to people with schizophrenia, people with alcohol-related psychosis are more likely to have:
- less formal education
- older age at first-episode psychosis
- more intense depression
- more intense anxiety
- fewer disorganized thoughts and behaviors
Researchers haven’t determined the exact cause of alcohol-related psychosis. But it’s believed to be related to neurotransmitters that are affected by alcohol, such as dopamine and serotonin. Symptoms usually occur shortly after heavy drinking or during withdrawal.
If you’ve had alcohol-related psychosis, you’re
Scientists haven’t proved that AUD causes schizophrenia, or that schizophrenia causes AUD. However, having one increases your likelihood of being diagnosed with the other.
People experiencing first-episode psychosis reported substance use between
This may point to schizophrenia and AUD sharing a common cause.
For example, researchers have
Another theory suggests that the reward and motivation circuits in the brains of people with schizophrenia may be physiologically impaired, and that AUD shares the same impairment.
It’s believed that the risk of schizophrenia is strongly connected to genetics.
Twin studies have found that when one identical twin is diagnosed with schizophrenia, the second has a
AUD may also have a genetic component, and studies have found a
Some signs that could
- being unable to control how much they drink
- frequent cravings for alcohol
- continuing to drink despite negative effects
- preferring to drink over other activites
- have tried to quit drinking in the past but were unable to
- spending a lot of time drinking or recovering from alcohol’s effects
- having troubles with home, social, or work life because of alcohol
- continuing to drink in risky situations
- continuing to drink despite alcohol worsening their mood or memory
- drinking more over time to feel the same effects
- symptoms of withdrawal when not drinking, including:
If you suspect someone with schizophrenia might be misusing alcohol, it’s important to remember that these signs are not definitive on their own, and if you’re going to approach them, to do so with empathy.
For people who have both AUD and a psychotic disorder such as schizophrenia,
You can expect treatment to include medication and possibly some form of psychotherapy along with social interventions. Consult with a doctor to determine the right therapies for your particular circumstances.
Managing substance misuse and behavioral health must both be considered when coming up with a treatment plan. Your healthcare team might include:
- social workers
- occupational therapists
There are also 12-step programs available for people with both SUD and mental illness.
If you have schizophrenia and believe you also have AUD, reach out to a mental health professional or primary care physician. They may have treatment available, and if they don’t, they’re likely to be able to help you find treatment. Including a loved one in your treatment search can help you feel supported and stay motivated.