Written by Becky Banham
Becky Banham
Counselling Directory Content Team

Reviewed by Sean Tierney
Last updated 11th July 2023 | Next update due 10th July 2026

Alcoholism, also known as alcohol addiction or alcohol dependence, describes the repeated misuse of and dependence on alcoholic substances. On this page, we'll explore alcoholism, including the signs and how it develops. We'll also discuss how counselling can help to break destructive drinking habits.

We recognise that the language of addiction can be considered controversial, as well as being highly personal. The terms used on Counselling Directory are those generally used by trusted sources in the UK. We use these with the hope of reaching and supporting as many people as possible.

Generally, it is advised to use person-first language such as 'person with alcohol dependence' or 'person in recovery', and to avoid terms such as 'alcohol abuse' to help reduce stigma.

Some people who are in recovery use the term 'alcoholic' to describe themselves. If this is the case for you, that is completely your choice. Just know that other people (including those in the medical profession) may use other terminology.

Alcohol misuse

Alcoholism is a form of alcohol use disorder. This refers to a pattern of drinking that is considered to have an increased or high risk - meaning it is very likely to cause harm to your health. It is a progressive illness, where sufferers are unable to control their compulsion to drink in excess. They will be preoccupied with alcohol and will continue drinking even when it starts to cause problems.

No form of alcohol misuse is completely risk-free, but alcohol addiction is harmful enough to affect the quality of life - for both the sufferer and their friends and family. It is thought to be caused by cognitive and physiological dependence and can lead to extensive tissue damage and disease across the body.

There are several types of alcohol misuse (including binge drinking), but alcohol dependence is considered to be the most severe and problematic. When dependence sets in, alcohol takes over. It becomes the central importance of a person's life.

In this video, psychotherapeutic counsellor Andrew Harvey MBACP (Accred) explores some signs that could indicate you have a drinking problem, and how therapy can support your recovery.

What effect does alcohol have on our mental health?

The link between alcohol and our mental health is twofold. Mental health problems can not only result from drinking too much alcohol but, often, mental ill-health can be the cause of drinking too much. This is often referred to as self-medicating; using alcohol to change our mood, to help us sleep, to help us forget about our problems, or to temporarily alleviate feelings of anxiety and depression.

However, in reality, alcohol can make existing mental health problems worse.

Research suggests that alcohol problems are more common among people with more severe mental health problems. Also, people who consume high amounts of alcohol are vulnerable to an increased risk of developing mental health problems.

Alcohol addiction is thought to increase the risk of:

  • depression
  • dementia
  • hallucinations
  • memory loss
  • blackouts
  • mood swings
  • decreased sex drive
  • suicidal thoughts
Find a therapist dealing with alcoholism

Recognising you have a drinking problem 

What kind of drinker are you? Do you enjoy a drink once in a while with family and friends? Do you drink for the sake of getting drunk? Do you drink because it makes everything feel better? Understanding your own drinking habits will help you recognise where you might need to make changes.

A person can have a negative relationship with alcohol without having an addiction, and you can want to work on your relationship with alcohol before it turns into dependency.

Consider the following questions to identify if you might have a drinking problem:

  • How much do you spend on alcohol every week? Do you track how much you spend on it? Are you ever shocked by how much you spend on alcohol?
  • Why do you drink alcohol? For escapism? For fun? Because your friends do? Because there's nothing else to do? Because you crave it?
  • Does your drinking ever affect your personal relationships? Does it cause arguments? Do you ever say things you wish you'd never said?
  • How do you feel when you don't drink alcohol? Do you feel empty, agitated, or anxious? Or do you not even think about it?

If you identify with having a problematic relationship with alcohol, the sooner you can address it, the better. Often, problems with alcohol tend to get worse over time.

Each time I got drunk, I would justify the reason or blame external events and people for influencing me. I was in denial. When a persistent loved one constantly challenged my excuses, it eventually led me to question my truth and going through the slow realisation and acceptance that my drinking was dysfunctional.

- Counsellor Gina Easom describes her own issues with alcohol.

Signs of alcohol misuse

Alcohol addiction can show itself in a variety of ways. Below are some common symptoms which may indicate that you are experiencing alcohol dependence:

  • Drinking alone/in secret or being dishonest about your alcohol consumption. Feeling a strong desire for alcohol that distracts from everyday activities.
  • Being unable to control your drinking - you crave a drink every day and when you start you find it difficult to stop.
  • Your body builds up a tolerance to alcohol so you require more and more of it to feel the same effects.
  • You drink first thing in the morning or during the night.
  • You spend a lot of time in places that sell alcohol.
  • You neglect other areas of your life, such as hobbies, work or family.
  • Worrying about when you're next going to be able to drink and planning social events around alcohol.
  • You are in denial about your drinking - downplaying the negative consequences or complaining that friends and family are exaggerating your problem.
  • You reach for alcohol to help you cope with difficult feelings or experiences.
  • You have tried to cut down your alcohol consumption in the past but were unable to do so.
  • If you try to stop drinking, you experience withdrawal symptoms such as irritability, shakiness, trembling, nausea, anxiety, fatigue and insomnia.

What's the difference between problem drinking and alcoholism?

It's important to remember that people who misuse alcohol - whether they drink too much or have a problematic relationship with alcohol - are not necessarily addicted to it. But, the terms 'alcoholic', 'binge drinker', 'problem drinker', 'social drinker', and 'high-functioning alcoholic' are sometimes used interchangeably, and the distinction between them isn’t always clear.

The important difference is that a person with an addiction has a physical and/or psychological dependency on alcohol. As a result, a problem drinker is less likely to experience physical withdrawal symptoms when they stop drinking.

When a person is physically dependent on alcohol, it's extremely important that medical assistance is sought before they change their drinking pattern. It can be dangerous to cut down or stop if there is a physical dependency.

How does alcohol addiction develop? 

There are two common variations of addiction - physical and psychological:

Physical addiction  

People who feel a need to drink for pleasure and an emotional high are considered to have a physical addiction. Just the sight, thought or smell of alcohol can evoke sensations of anticipatory pleasure. Due to chemical changes in the brain, heavy drinkers start to crave the emotional release and pleasure alcohol creates.

Giving in to the craving increases the need to drink again. The body eventually gets used to the presence of alcohol so that it no longer has the same effect. This 'tolerance' only enhances the desire to drink more, and if a person tries to stop they experience intense withdrawal symptoms. This traps them in a destructive cycle of alcohol dependence.

Psychological addiction 

In some cases, people develop alcohol dependence as a way of coping with a psychological issue. Drinking fills a void and helps to block out negative experiences and relieve associated stress. Psychological addictions are not the result of chemical changes in the brain. Individuals drink to excess on a regular basis to numb emotional strain.

This type of alcohol addiction can lead to further problems. Individuals may start to experience intense feelings of shame, despair and guilt. As a result, an increasingly destructive cycle of alcohol dependence develops.

Causes of alcoholism

There is no one cause of alcohol misuse. There are a number of reasons why someone may develop a drinking problem, and these will be personal to them.

Alcohol misuse is often imagined to predominantly affect working-class men. But, in reality, alcoholism can affect anyone. In fact, statistics have shown that, over recent years, women’s drinking has significantly increased, bringing their drinking habits to an equal level with men’s.

Factors that can increase a person's risk of addiction include:

  • Family history - Research suggests that alcoholism runs in families. In one study, over a third of people with an alcohol dependency had relatives who were also heavy drinkers. This suggests some people might be more at risk if they have a parent or close relatives with a drinking problem.

  • Personal experience - Certain experiences can make someone more likely to become dependent on alcohol. Alcohol misuse can be a side effect of a traumatic life event, as drinking is often used as a form of escapism.

How can counselling help with alcoholism?

People struggling with alcohol addiction can easily convince themselves they don't have a problem or that they're doing everything they possibly can to fight it. Therefore, the first step toward recovering from alcohol dependence is to admit to the problem. 

There are different treatments available for people diagnosed with alcohol-use disorders, including detoxification (abstinence), counselling (particularly CBT), mutual help groups (e.g. Alcoholics Anonymous), and medication.

Counselling can give you the space to honestly and openly (without judgement) explore your relationship with alcohol. A counsellor can help you decide if you need to make changes, and how you might make those changes and maintain them.

Cognitive behavioural therapy (CBT)

One of the most effective forms of alcoholism treatment is cognitive behavioural therapy (CBT). This form of counselling tackles patterns of thinking and behaviour in an attempt to break certain emotional or psychological ties to habits.

By understanding the underlying feelings and thought processes that cause their addiction, the client can gradually learn to control the impulse to drink. With the support and guidance of a counsellor, a person can not only come to terms with their drinking problem but understand what triggers the behaviour and learn the ways to cope in the long term.

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Supporting someone with alcohol dependence

Addiction is extremely powerful. It can dominate a person's thoughts and determine their actions. It can take over a personality and change the direction of a person's life. Understandably, this is incredibly difficult for spouses, children, colleagues, parents and friends to deal with.

It is hard to know how to help someone dependent on alcohol. If you're a carer for a problem drinker, accessing help can be a frustrating experience. Often they will deny their addiction, making it even harder to encourage them to seek professional support. But, alcohol - in excess - is really damaging to our mental and physical well-being and it can have irreversible and devastating effects.

When my dad and sister turned up out of the blue to see me, I immediately knew what was wrong. It was a deep internal pain I had never felt before. We were given the autopsy verdict. Mum had died of liver failure due to excessive alcohol consumption.

- James shares his story of losing his mum to alcohol.

There is often a lot of shame associated with addiction, which can itself be an obstacle to overcome in receiving help. A good first step is to encourage them to visit their GP. They'll be able to discuss the services and treatments available, such as counselling or hypnotherapy, to help them overcome the addiction.

If you are worried about a loved one, just let them know that you are there for them. Remember, addiction can take over a person’s life, and they may feel like they have no control, so try and support them as much as you can while they work things out.

Further help

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