Alcohol symptoms | signs of dependence

Some alcohol symptoms point to a harmful drinking pattern, such as regularly drinking far more than you planned. Others are physical and point to dependence: your body has adapted to alcohol and reacts when you stop drinking. A third group shows up in your behaviour and mood and points to addiction. Drinking starts to take priority over things that once mattered more.

Alcohol abuse symptoms

Alcohol abuse symptoms describe a pattern of drinking that causes harm, even without physical dependence or a persistent loss of control. Doctors no longer recognise alcohol abuse as a separate diagnosis, but the term is still widely used. Signs of this pattern include:

• regularly drinking far more than you planned on a night out
• drinking before driving or in other risky situations
• anxiety the morning after, also known as hangxiety
• missing work or other commitments because of drinking or a hangover
• arguments or tension with others about alcohol
• injuries, accidents or behaviour you later regret

Left unchecked, a pattern of alcohol abuse can develop into dependence or addiction. It often starts with occasional heavy nights that turn into regular binge drinking. At this stage your body is not yet used to large amounts, so the risk of alcohol poisoning is higher. Over time you find you can handle more and more drink. This is tolerance – your body adapting to alcohol – and it is one of the first signs of dependence.

Alcohol dependence symptoms appear when your body has adapted to a regular supply of alcohol. Your brain adjusts its own chemistry to make up for the alcohol, so over time you need a drink just to feel normal.

Physical signs of dependence

Typical physical signs of alcohol dependence include:

• needing more alcohol to get the same effect
• shaking, sweating, nausea or restlessness as the alcohol wears off
• drinking in the morning to steady your nerves or stop the shakes
• drinking at set times to avoid feeling unwell
• sleeping badly without a drink in the evening

The reactions that set in as alcohol wears off are known as alcohol withdrawal symptoms. They range from unpleasant to dangerous, depending on how much you have been drinking and for how long.

Dependence and addiction are not the same

Dependence describes what alcohol does to your body, while addiction describes what it does to your behaviour and priorities. You can be physically dependent and still hold down a job and run a household. You can also lose control of your drinking without obvious physical dependence. In practice the two usually overlap, which is why doctors group them under one diagnosis: alcohol use disorder, ranging from mild to severe.

Alcohol addiction symptoms are mainly about control. Drinking stops being a choice and becomes something you need in order to function.

Signs in behaviour

Behavioural signs of alcohol addiction include:

• drinking more or for longer than intended
• repeated attempts to cut down that do not last
• hiding bottles, drinking alone or lying about how much you drink
• spending a lot of time drinking or recovering from it
• giving up hobbies, work or time with other people in favour of drinking
• carrying on drinking despite problems with health, relationships or work

Mental and emotional signs

Alcohol addiction also affects how you think and feel:

• a constant pull towards the next drink
• irritability or low mood when unable to drink
• drinking to cope with stress, anxiety or difficult feelings
• feeling ashamed or guilty about drinking, then drinking again anyway

Physical signs of long-term drinking

Years of heavy drinking leave their mark on your body as well. On their own, these signs are not proof of addiction, but they often appear alongside it:

• a persistently red face from alcohol, often with broken veins on your cheeks
• disturbed sleep and constant tiredness
• memory gaps or blackouts
• stomach problems, poor appetite and changes in weight
• yellowing of the skin or eyes, a late sign of alcoholic liver disease

A red, swollen nose is often linked to drinking. The so-called alcoholic nose, however, is usually a form of rosacea and says little about how much you drink.

If you recognise several of these alcohol symptoms in yourself or someone close to you, the drinking may be worth a closer look. If you would like to talk about your drinking, we are here to answer your questions and help you work out your next step. That step may be an addiction assessment at Connection Mental Healthcare. The assessment looks at your drinking, your physical and mental health and what keeps the pattern going.

Stopping safely

If your body has become dependent on alcohol, stopping suddenly on your own carries real risks. During a detox, your body has time to adjust to being without alcohol, with round-the-clock care from a team that includes addiction doctors. At your initial assessment, we will work out whether you need a detox. Whether quitting alcohol on your own is safe depends partly on how much you have been drinking and for how long.

Treatment at our rehabilitation centre

Treatment at our clinic looks at your drinking itself and at any problems that may lie behind it. At our alcohol rehabilitation centre, you work on triggers, patterns and new ways of coping through individual and group therapy. Alcohol may have become a way for you to deal with anxiety, depression or trauma. If so, we treat these alongside the addiction – an approach known as dual diagnosis treatment.

If you recognise these alcohol symptoms, call Connection Mental Healthcare in confidence on +27 21 541 0643.