[This is the third part in a series that examines alcohol use disorder as a brain disorder and how public perceptions prevent those with the disorder from seeking treatment.]

While science has established that AUD, or alcoholism, is a brain disorder and a medical issue, it has also been established that there is no single cause for its development.

A 2012 article by the American Psychological Association states that problem drinking has multiple causes, with genetic, physiological, psychological and social factors all playing a role.

Not every individual is equally affected by each cause, the article states. For some alcohol abusers, psychological traits such as impulsiveness, low self-esteem and a need for approval prompt inappropriate drinking.

Some individuals drink to cope with or “self-medicate” emotional problems. Social and environmental factors such as peer pressure and the easy availability of alcohol can play key roles. Poverty and physical or sexual abuse also increase the odds of developing alcohol dependence.

Drinking problems also have a very negative impact on mental health. Alcohol abuse and alcoholism can worsen existing conditions such as depression or induce new problems such as serious memory loss, depression or anxiety.

Pinelands Recovery Center of Medford, in New Jersey, states that there are many reasons why people turn to alcohol as a coping mechanism. These include drinking when young, having a family history of alcohol use, environmental factors and having experienced trauma.

People may turn to alcohol precisely for the effects it has on different parts of the brain that control thinking and emotions. As Pinelands points out, people may drink because alcohol helps them to avoid thinking about their life or problems. They are able to ignore the pain when they are under the influence of alcohol. If someone has a mental health disorder, they may use alcohol to cope with the symptoms.

Individuals may drink to cope with their problems, whether internal or external. However, most don’t realize that large consumption of alcohol creates problems and worsens existing issues.

Boca Recovery Center, with facilities in Florida, Indiana and New Jersey, echoes Pinelands in saying:

“One reason people drink alcohol is to self-medicate mood and anxiety disorders. There is a high connection between mood disorders and substance use disorders, such as alcoholism. Some people use substances like alcohol to treat distressing mental health problems, like symptoms of anxiety.”

A 2012 paper published by the National Library of Medicine reported that researchers found that nearly 25% of people with mood or anxiety disorders self-medicate with alcohol or drugs, adding that in many instances, the mood or anxiety disorder existed first, with substance use disorder developing later. Self-medicating is what a 2021 paper referred to as escapism.

The paper, titled To Get High or To Get Out? Examining the Link between Addictive Behaviors and Escapism, defines escapism as a tendency to seek escape and distraction from reality or real-life problems. Past research regards escapism as a negative inducement that leads to adverse consequences when combined with substance use and other addictive activities.

Boca summed it up: “People faced with daily challenges may drink alcohol to feel temporarily relieved of their struggles. People who drink alcohol in order to escape reality indicate a lower overall satisfaction with life.”

Pinelands concurs, stating that people who drink for the purpose of escapism are able to ignore the pain when they are under the influence of alcohol. If someone has a mental health disorder, they may use alcohol to cope with the symptoms.

The United Kingdom’s Mental Health Foundation article, Alcohol and Mental Health, states that alcohol and mental health are closely linked, saying that some people may try to relieve the symptoms of ill mental health.

“We may drink to try and change our mood: to feel more relaxed, courageous or confident,” the article states, going on to explain: “Alcohol affects the part of your brain that controls inhibition, so you may feel relaxed, less anxious, and more confident after a drink. But these effects quickly wear off. The chemical changes in your brain can soon lead to more negative feelings, such as anger, depression or anxiety, regardless of your mood.”

That leads to a common saying among those in AUD recovery: “The alcohol worked — until it didn’t.”