ALCOHOL AND MENTAL DISEASE

Mental health problems not only result from drinking too much alcohol. They can also cause people to drink too much. There is much more evidence showing that drinking too much alcohol leads to serious physical and mental illnesses. Put very simply, a major reason for drinking alcohol is to change our mood - or change our mental state. Alcohol can temporarily alleviate feelings of anxiety and depression; it can also help to temporarily relieve the symptoms of more serious mental health problems.

Alcohol problems are more common among people with more severe mental health problems. This does not necessarily mean that alcohol causes severe mental illness. Drinking to deal with difficult feelings or symptoms of mental illness is sometimes called self-medication by people in the mental health field. This is often why people with mental health problems drink. But it can make existing mental health problems worse.

When we have alcohol in our blood, our mood changes, and our behavior then also changes. How these change depends on how much we drink and how quickly we drink it. Alcohol depresses the central nervous system, and this can make us less inhibited in our behavior. It can also help numb our emotions, so we can avoid difficult issues in our lives.

Alcohol can also reveal or magnify our underlying feelings. This is one of the reasons that many people become angry or aggressive when drinking. If our underlying feelings are of anxiety, anger or unhappiness, then alcohol can magnify them.

One of the main problems associated with using alcohol to deal with anxiety and depression is that people may feel much worse when the effects have worn off. Alcohol is thought to use up and reduce the amount of neurotransmitters in the brain, but the brain needs a certain level of neurotransmitters needs to ward off anxiety and depression. This can lead some people to drink more, to ward off these difficult feelings, and a dangerous cycle of dependence can develop.

Alcohol-related psychosis is a secondary psychosis that manifests as prominent hallucinations and delusions occurring in a variety of alcohol-related conditions. For patients with alcohol use disorder, previously known as alcohol abuse and alcohol dependence, psychosis can occur during phases of acute intoxication or withdrawal, with or without delirium tremens.

In addition, alcohol hallucinosis and alcoholic paranoia are 2 uncommon alcohol-induced psychotic disorders, which are seen only in chronic alcoholics who have years of severe and heavy drinking. Lastly, psychosis can also occur during alcohol intoxication, also known as pathologic intoxication, an uncommon condition the diagnosis of which is considered controversial.

In chronic alcoholic patients, lack of thiamine is a common condition. Thiamine deficiency is known to lead to Wernicke-Korsakoff syndrome, which is characterized by neurological findings on examination and a confusional-apathetic state. Korsakoff psychosis (or Korsakoff amnesic- or amnesic-confabulatory state) refers to a state that memory and learning are affected out of proportion to other cognitive functions in an otherwise alert and responsive patient.

Alcohol is a neurotoxin that damages the brain in a complex manner through prolonged exposure and repeated withdrawal, resulting in significant morbidity and mortality. Alcohol-related psychosis is often an indication of chronic alcoholism; thus, it is associated with medical, neurological, and psychosocial complications.

Alcohol-related psychosis spontaneously clears with discontinuation of alcohol use and may resume during repeated alcohol exposure. Distinguishing alcohol-related psychosis from schizophrenia or other primary psychotic disorders through clinical presentation often is difficult. It is generally accepted that alcohol-related psychosis remits with abstinence, unlike schizophrenia. If persistent psychosis develops, diagnostic confusion can result. Comorbid psychotic disorders (eg, schizophrenia spectrum and other psychotic disorders) and severe mood disorder with psychosis may exist, resulting in the psychosis being attributed to the wrong etiology.

Some characteristics that may help differentiate alcohol-induced psychosis from schizophrenia are that alcohol-induced psychosis shows later onset of psychosis, higher levels of depressive and anxiety symptoms, fewer negative and disorganized symptoms, better insight and judgment, and less functional impairment.

Alcohol idiosyncratic intoxication is an unusual condition that occurs when a small amount of alcohol produces intoxication that results in aggression, impaired consciousness, prolonged sleep, transient hallucinations, illusions, and delusions. These episodes occur rapidly, can last from only a few minutes to hours, and are followed by amnesia. Alcohol idiosyncratic intoxication often occurs in elderly persons and those with impaired impulse control.

Unlike alcoholism, alcohol-related psychosis lacks the in-depth research needed to understand its pathophysiology, demographics, characteristics, and treatment. This article attempts to provide as much possible information for adequate knowledge of alcohol-related psychosis and the most up-to-date treatment. Alcohol is addictive and can lead to dependency.

This is where the body requires more alcohol to achieve the desired effect (eg, altered mood), where use of alcohol interferes with a persons life (causing legal, work/study, relationship or social problems), where a person continues to use alcohol despite alcohol causing physical or mental problems and, if alcohol is not taken, withdrawal symptoms occur.

The severity of withdrawal symptoms depends on the quantity of alcohol consumed and the length of the drinking session. Symptoms including shaking of the hands, which commonly occurs the morning after the drinking session and may be relieved by more alcohol. If alcohol is not taken, symptoms can progress to insomnia, increased heart rate, temperature and blood pressure, sweating, agitation, nausea, flushing of the face, nightmares, hallucinations (seeing, hearing or feeling things that are not present) and fits.

The most serious withdrawal syndrome is delirium tremens, which develops in about 5% of people with alcohol withdrawal (more if fits are not treated) and by definition includes the symptom of delirium (an altered and confused state of mind). This syndrome has a death rate of around 5%.

In people who drink heavily, alcohol commonly causes mood disorders, including depression, anxiety and psychosis (a mental illness defined by changes in personality, a distorted sense of reality, and delusions). If these disorders only occur during drinking sessions or withdrawal, they will usually resolve once drinking is stopped. Alcohol abuse and dependency are also common in people with pre-existing mental health conditions.

Alcohol and Misconduct

Liquor is related in the brains of numerous individuals with wrongdoing, prostitution, rackets and different awful or unlawful exercises. There is justification for such conviction. Liquor is an impartial moral agent, neither great nor terrible, exceptionally subject to misuse. If critics of alcohol have exaggerated the abuses , wilfully or through unconscious bias , they have had shining mark for their propaganda .

Similarly few expert lawbreakers are absolute teetotallers; however liquor is presumably a minor calculate unlawful acts against property. Offense of an authoritative nature, for example, infringement of alcohol expense laws and regulative mandates, may be slighted in light of the fact that they are not typically dedicated affected by liquor. Smashed driving is genuinely unequivocal. There are numerous captures for tipsiness and sloppy behavior that can be charged specifically to liquor, yet the genuine crux of the arrangement is wrongdoings of viciousness, particularly those including sex and desire. Not all wrongdoings conferred affected by liquor, or in the wake of drinking, are created by inebriation. as a rule liquor just discharges forceful thought processes or persons with criminal goal use liquor to bloster their activities . Looters, Burglars and executioners don't dull their sharpness with liquor, however in no way, shape or form all criminal are so decently sorted out .The factual confirmation on wrongdoing and liquor addiction is neither late nor convincing, yet police, judges , probation or probation officers and jail chairmen are concurred that alcohol builds the greatness of issues occurrence to law authorization. Liquor is one component among numerous and quantitative assessment of its part is dangerous. Educated feeling doles out it a position of significance as a boost for fights, strike, sex offenses and homicide.

Certain aberrant or guarantee impacts of liquor on issues of behaviour are of sufficient significance to oblige notice. Changing has presented an influential defence for liquor addiction of folks as a reason for adolescent wrongdoing, and unlawful or corrupt behaviour. It is more likely than not a component in wrongness, yet one that is not promptly differentiated from others. The proclivity between alcohol Traffic and prostitution is very positive. The business estimation of liquor as a stimulant for venery has made taprooms focuses of advancement .Houses of prostitution with strict principles of forbearance would strike supporters as special. The peril of venereal malady is impressively expanded by liquor. It is not pass that liquor brings resistance down to diseases yet it makes supporters and whores less specific or segregating and less caution about prophylactic measures. In outline, the ill-use of liquor signifies a boundless element that forces substantial weights on the hierarchical structure for upholding ordinary benchmarks of behaviour.

Alcohol and Accidents

The way that such a large number of individuals accept liquor causes mischances, especially mechanical mishaps and auto collisions, does not demonstrate that its valid. Maybe it is genuine, yet how does a specialist exhibit the evidence? Affirmation of Earnest Public pioneers, including police authorities and protection administrators, does not demonstrate it, Newspaper articles and publications don't create the connections.

Most of the newspapers and television channels frequently report instances of road deaths due to drunken driving. The issue of drunken driving becomes headline news only when inebriated celebrities are involved in crashes. Such anecdotal evidence needs to be bolstered by more systematic studies examining the relationship between alcohol and road crashes. A survey in Delhi suggested that more than 45% of vehicles were being driven by drivers who had consumed alcohol. The pub capital of India, Bangalore city, reports the highest number of road accident deaths on weekends between 6.00 p.m. and 10.00 p.m. and the police attributed it mainly to drunken driving (Agarwal, 2003). In roadside surveys carried out in Bangalore, 89% of drivers stopped on suspicion of drunken driving by the police and 37% of drivers checked randomly were breathalyser positive for alcohol (Gururaj and Benegal, 2002). Previous studies from emergency rooms in New Delhi estimated that 729% of accident victims were under the influence of alcohol (Mishra et al, 1984, Adityanjee and Wig, 1989). But the problem of drunken driving is one of serious proportions as indicated by the study of Bathra and Bedi (2003) who found that 40% of truck and matador drivers, 60% of car drivers and 65% of two-wheeler drivers were under the influence of alcohol while driving at night. Mohan and Bawa (1985) in an analysis of police records noticed that 32% of pedestrian fatalities, 40% of motorized two-wheeler occupant deaths and 30% of bicyclist deaths occurred between 6 pm to 6 am and alcohol intoxication was a major factor in a majority of these crashes. Sahadev et al (1994) reported that one-third of the RTI deaths were linked to alcohol consumption, but are improperly documented in medical records. A cross-sectional study of 423 victims of road traffic accidents during 1999-2000 from Nagpur (Tiwari and Ganveer, 2008) reported that 64.5% of subjects consumed alcohol regularly. In Delhi, nearly 20% of the 550 students reported pillion-riding with a driver who had consumed alcohol, indicating the low-risk perception of consequences due to drunken driving among adolescents (Sharma et al, 2007). Patil from Maharastra reported that nearly 30% of accident victims were under the influence at the time of reaching hospital (Patil et al, 2008).

Alcohol and Dependency

Research suggests that there is a strong association between poverty, social exclusion and problematic drug use. Those who are unemployed, particularly long term unemployed, in poor or insecure housing and are early school leavers have a higher rate of substance abuse than those who do not fit into these categories. It should be noted, however, that these risk factors do not determine whether a person abuses drugs or alcohol.

There are many risk factors associated with drug and alcohol abuse. These include childhood experiences, genes, mental illness and psychological factors. In some cases, people who are poor also are in high risk factors. But people who are not suffering from poverty also may embody these risk factors. Unfortunately, many people who are poor become entrenched in the lifestyle that often includes incarceration, exposure to law enforcement, poor health outcomes and homelessness. Because of these issues, surveys and research often focuses on these communities and the result is an over-representation in public health reporting. The research that suggests that poor people abuse drugs and alcohol is potentially biased because of this reporting.

The monetary outcomes of consumptions on liquor are noteworthy particularly in high destitution regions. Other than cash spent on liquor, an overwhelming consumer additionally endures other unfriendly financial impacts. These incorporate brought down wages (as a result of missed work and diminished proficiency at work), lost vocation opportunities, expanded restorative costs for sickness and mishaps, lawful expense of beverage related offenses, and diminished qualification of advances. A late study led in 11 areas in Sri Lanka analyzing the connection in the middle of liquor and neediness found that 7% of men said that their liquor use was more noteworthy than their wage.

` Despite the fact that a generally little rate, this is still a stressing measurement for the families concerned and for those keen on helping the most noticeably bad off families (Baklien & Samarasinghe, 2001).

Alcohol and Family Discord

It is settled that drinking can seriously hinder the singular's working in different social parts. Liquor abuse is connected with numerous negative results both for the consumer's accomplice and in addition the youngsters. Maternal liquor utilization amid pregnancy can bring about fatal liquor disorder in youngsters, and parental drinking is connected with youngster ill-use and effects a kid's domain in numerous social, mental and monetary ways (Gmel & Rehm, 2003). Drinking can debilitate execution as a guardian, as a companion or accomplice, and as a patron to family working. There are additionally different parts of drinking which may hinder working as a relative. In numerous social orders, drinking may be done principally outside the family and the home. In this condition, time spent while drinking frequently rivals the time expected to bear on family life. Drinking additionally costs cash and can affect upon assets especially of a poor family, leaving other relatives penniless. Likewise, it is significant that particular inebriated occasions can likewise have enduring results, through home mischances and family viciousness (Room, 1998; Room et al., 2002). A late paper by Bonu et al. (2004) recommends that unfavorable youngster wellbeing impacts of liquor utilization are principally through two distal determinants (roundabout impacts) - renounced family unit extra cash and guardians' the ideal time for childcare. Redirection of inadequate monetary assets for liquor utilize that could have overall been utilized for looking for health awareness, may prompt selfcare or postpone in looking for human services. The other potential courses by which liquor utilization can lessen the family wage are through grimness connected with the drinking propensity among the expending people, bringing about increment in restorative consumptions and loss of salary because of lost wages, and, now and then, bringing about the unexpected passing of sole pay workers in a family (Bonu et al., 2004). Certain in the routine consumer's potential effect on family life is the way that the drinking and its outcomes can bring about generous emotional well-being issues of relatives. Such impacts, however possibly normal, are not frequently archived. Some knowledge into this issue can be picked up from meetings with individuals from Al-Anon, a sidekick association to Alcoholic Anonymous for life partners and relatives of individuals with liquor reliance.

In meetings with 45 Al-Anon individuals in Mexico (82% of them the wife of a spouse who was liquor subordinate), 73% reported emotions of tension, trepidation, and discouragement; 62% reported physical or verbal hostility by the life partner toward the family; and 31% reported family breaking down with significant issues including cash and the youngsters (Rosovsky et al., 1992, refered to in Room et al., 2002). The impacts of men's drinking on different individuals from the family is frequently especially on ladies in their parts as moms or wives of consumers. The dangers incorporate savagery, HIV disease, and an expanded weight in their part of monetary suppliers. In a paper that took a gander at liquor and liquor related issues confronting ladies in Lesotho, it was noticed that as in numerous other creating nations, the social position of ladies in Lesotho encourages an endless loop in which ladies are at one time brewers of liquor, then merchants, then get to be unreasonable customers because of the issues made by their drinking spouses (Mphi, 1994).

References:

ALCOHOL RELATED HARM ,Implications for Public Health and Policy in India Gururaj G Professor and Head Department of Epidemiology

Pratima Murthy Professor of Psychiatry Chief, Centre for Addiction Medicine

Girish N Rao Associate Professor Department of Epidemiology

Vivek Benegal Additional Professor of Psychiatry Centre for Addiction Medicine)

http://pubs.niaaa.nih.gov/publications/arh26-2/90-98.htm

https://www.drinkaware.co.uk/check-the-facts/health-effects-of-alcohol/mental-health/alcohol-and-mental-health

http://www.mentalhealth.org.uk/help-information/mental-health-a-z/A/alcohol/