ADHD And Alcohol: How Alcohol Use Affects ADHD
Attention-deficit/hyperactivity disorder (ADHD) and substance abuse—in this case, alcohol and ADHD—are associated with one another. However, some people with ADHD who use alcohol excessively may not realize that this increased risk of alcohol misuse exists, or just how excessive their use has become.
One way to avoid developing an unhealthy relationship with substances like alcohol is to understand what your risks are. It can be helpful to gather information on the links between ADHD and alcohol, including details about treatment, the detrimental effects of alcohol on ADHD symptoms, and why the two often overlap.
What is attention-deficit/hyperactivity disorder?
According to the National Institute of Health, attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder and form of neurodivergence that affects an estimated 5% of the adult population.
Here are some other statistics that may be relevant to you:
- About one-third of children diagnosed with ADHD find that their symptoms persist into adulthood.
- Only around 20% of (one in five) adults with ADHD seek treatment.
- About 40% (two in five) cases of ADHD in adults are considered severe.
- Men are more likely to be diagnosed with ADHD than women, particularly in early adulthood. However, this may not be representative of actual differences (or similarities) in rates of ADHD between men and women, and could be related to factors such as potential underdiagnosis in women.
ADHD causes symptoms related to inattention, hyperactivity, impulsivity, or a combination of these. People with this condition may avoid activities that require sustained mental effort, and often struggle to feel motivated to start or stick to a task because their brain is not as responsive to rewarding stimuli.
Additionally, people with ADHD tend to struggle with impulsivity and hyperactivity that interferes with their daily lives. Impulsivity in particular may be a substantial contributor to substance misuse in those with ADHD. For reference, teens and adults who are not diagnosed or treated for ADHD but have the condition may be up to ten times more likely to misuse substances like alcohol than those without the disorder.
What is excessive alcohol use?
Misuse of alcohol is about more than total consumption. It’s also about one’s ability or inability to moderate their consumption, and the behaviors they engage in related to their alcohol use. One night of binge drinking, for example, does not necessarily mean one is misusing alcohol in the long term. But several nights of binge drinking each week, regularly drinking so much that you black out, or needing to consume alcohol in order to function can all point to likely misuse or dependence.
Those with ADHD may find it more difficult to moderate pleasurable or rewarding activities like drinking, and so may be more likely to engage in frequent, heavy, or otherwise problematic drinking behaviors than those without the disorder.
How common is it for ADHD and alcohol use disorder to occur together?
Overlap between ADHD and alcohol use disorder is fairly common: one study estimates that up to 43% of adults with ADHD experience alcohol use disorder, and that around one in five adults with alcohol use disorder may have ADHD.
Children with more severe symptoms of ADHD may be more likely to engage in alcohol or other substance misuse more frequently and increase use more quickly than peers with less severe symptoms or no ADHD at all.
Why can ADHD and alcohol use be linked?
According to Dr. Carl Sherman from the ADHD publication, ADDitude, alcohol and drug misuse may be more common in those with ADHD because individuals may use these substances to self-medicate. The driving force behind substance use for many with ADHD is to find relief from racing thoughts, challenging emotions, and other symptoms.
ADDitude reports that 30% of young adults with ADHD and alcohol use disorder said they drank or used drugs primarily to get high, while 70% said that they use alcohol and drugs, including tobacco smoking, primarily to counteract symptoms such as insomnia, hyperactivity, and social awkwardness.
There may also be a biological link between ADHD and alcohol use. The same genes that are associated with increased risk-taking and impulsive behavior—and which are associated with substance misuse— are also the same genes associated with ADHD. People with parents or close relatives with alcohol use disorders, ADHD, or both are likelier to have both disorders.
How alcohol use and ADHD symptoms are related
Alcohol is a depressant which, though it initially stimulates the dopamine system within the brain, ultimately slows down the nervous system. By extension, people with ADHD may find that it slows down their racing thoughts or other hyperactive symptoms. Plus, alcohol may have a more profound effect on those with the diagnosis than those without.
Some adults with the hyperactivity and impulsivity subtype ADHD (ADHD-HI) or combined ADHD subtype find that their hyperactivity transitions from physical outlets like jumping and climbing to mental outlets like racing thought patterns as they age, which can silently interfere with their occupation, education, and other activities. Alcohol, in this case, might be used to slow thoughts down and boost feelings of calmness and comfort.
Though it may seem to help, alcohol use causes more harm than good to the brain. Both ADHD and alcohol overuse can affect the frontal lobe of the brain, which dampens a person's ability to think clearly. When combined, alcohol may ultimately serve to worsen ADHD symptoms by compounding these effects on the brain. One’s thoughts may stop racing, but they’ll struggle to focus more than they would have without alcohol.
Another difficulty related to self-medicating is the tendency to binge drink—to consume more than four to five drinks in a single sitting. Some people who use alcohol regularly to manage symptoms may feel trapped in a cycle of drinking to feel better, feeling worse because of hangovers or alcohol withdrawal, and repeating the first step to cope with both the ADHD- and alcohol-related symptoms. The cycle can be challenging to break.
Treating ADHD and alcohol use disorder
If you experience co occurring ADHD and alcohol use disorder, it may be beneficial to treat both conditions individually. Adults who seek treatment for alcohol use disorder but have undiagnosed or untreated ADHD with impulse control problems may be more likely to experience relapse, and it can be challenging to create lasting change without addressing the root of the behavior problems.
Treatment for ADHD may involve behavioral therapy and, as necessary, prescription stimulant treatment. Options for alcohol use disorder can vary depending on the severity of the situation. Be candid with your doctor about your alcohol use, since alcohol can interfere with ADHD medications. If you've never received an official diagnosis and suspect you might be experiencing symptoms of either disorder, reach out to a healthcare professional for screening and further guidance.
How to support your mental health
There are several steps you can take in the present to manage the symptoms of ADHD and alcohol use disorder. First, if you misuse alcohol, consider limiting or halting alcohol intake if it is safe to do so. Some individuals who drink excessively for extended periods may require medical supervision when weaning off alcohol, so consult your doctor before changing your routine.
Second, reach out to your support system. Even if you struggle to stop using alcohol on your own, support resources like 12-step programs, group therapy, and individual therapy can be beneficial. Talking to friends and loved ones about what you're experiencing may also aid you as you recover, and their involvement may make it easier for you to address comorbid symptoms of ADHD.
As you navigate what treatment might look like for you, keep the benefits of working with a mental health professional in mind. Talking to a licensed therapist can assist you in seeing patterns in your behavior and identifying which solutions might most help you improve your habits.
Alternative support options
Some individuals with ADHD may struggle to connect with an in-person therapist due to barriers like commute times, inflexible work schedules, or financial insecurity. In these cases, online therapy platforms may be beneficial.
With online therapy, you can start therapy at your own pace and at the times and days that are convenient for you. In addition, you can reach out to your provider throughout the week outside of regular sessions and receive responses when they are available.
In addition to being convenient, online therapy may also be as or more effective for you. One study conducted in 2022 found that online behavioral intervention improved ADHD symptoms related to inattention and social functioning for adults and children, suggesting that treatments like these may produce real change in the lives of those who seek them.
Takeaway
Alcohol use disorder and ADHD are often linked. ADHD symptoms can lead an individual to take more risks, struggle to avoid pleasurable behaviors like drinking, and self-medicate by using alcohol despite its negative side effects. However, understanding how ADHD can overlap with alcohol use disorder—and the risk factors to look out for—may make finding treatment easier.
Contacting a therapist familiar with the clinical practice guidelines for treating ADHD is often the first step to finding resources and getting help. If in-person therapy isn’t a good fit for you, consider contacting an online provider to get started.According to Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), ADHD may be made worse as a result of a person’s “struggles with excessive anxiety, persistent depression, compulsive behaviors, difficulties with mood control, learning disorders, or other psychiatric disorders that may be transient, recurrent, or persistently disruptive of their ability to perform the tasks of daily life.”
Another factor that can make ADHD worse is alcohol consumption. Some people living with ADHD may use alcohol or other substances to self-medicate, but this can turn into chronic use. Substance use disorders may worsen ADHD symptoms, but there is help available for substance use and ADHD.
ADHD is a mental illness listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). If you aren’t sure if you have ADHD or are experiencing symptoms that may seem like coping mechanisms, it may help to speak with a mental health professional who knows how to diagnose and treat ADHD.
Some people with ADHD may have multiple drinks to relieve their symptoms. Binge drinking alcohol may seem to provide temporary relief from anxiety symptoms. Some people may begin with earlier alcohol use than their peers if alcohol provides relief from ADHD. Developing addictive behaviors can be a common phenomenon among those who experience this disorder.
Caffeine typically doesn’t help ADHD. Some amount may not be harmful, but it may be best to speak with a physician about caffeine and ADHD.
ADHD can often get better with age if a person receives treatment and practices evidence-based management techniques. Someone with severe childhood ADHD may see better outcomes if they receive treatment early on.
Some people with ADHD may qualify for disability benefits. This may depend on the severity of the symptoms as determined by a healthcare provider.
Some researchers believe that low levels of dopamine in the brain may contribute to ADHD. Taking ADHD medications, such as some stimulant medications, may inhibit the reuptake of dopamine from neurons in order to increase dopamine levels in the brain. It may also help to eat foods rich in folate, which can influence dopamine levels. These foods include avocado, black-eyed peas, spinach, and Brussel sprouts. Finally, research suggests there is a clinically meaningful link between exercise and dopamine levels in the brain.
A person living with ADHD may crave dopamine if they experience low levels of this neurotransmitter. It may help to speak with a healthcare provider if you think you may be craving dopamine.
A person living with ADHD may describe having a blackout, or a sense of lost time during tasks or conversations. It may be helpful to speak with others who live with ADHD about this sensation. Also, a mental health professional may be able to help you navigate blackouts.
An ADHD shutdown may lead a person to feel numb. They may experience a state of hypo-arousal after spending too much time in an anxious state with their fight-or-flight response activated.
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