Untreated Alcoholism Symptoms

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What Are The Symptoms Of Untreated Alcoholism?

The big book of Alcoholics Anonymous describes untreated alcoholism as feeling restless, irritable and discontented [2].

Alcohol addiction continues for long periods when underlying emotional issues go unaddressed, e.g.

  • Not taking part in any recovery processes such as a 12 step programme
  • Not having a relationship with a sponsor
  • Isolating from others [3]

The untreated alcoholic exhibits long term denial and specific dysfunctional beliefs:

  • Unwavering denial of their addictive behaviours, even when challenged
  • Consistent refusal of help, even when offered
  • A belief that their problems are too complex, or too extreme to be resolved
  • A belief that they do not deserve help


Pompilli et al have linked impulsive behaviour seen in untreated alcohol dependence to a 40% increase in suicide attempts, due to social isolation and a loss of personal support [4].

Alcoholics become used to instant dopamine reward of alcohol. 

In order to replace that feeling after stopping drinking, untreated alcoholics rely on other forms of instant gratification such as impulsive spending or unsafe sexual practises [5].

Disproportionate Reactions To Small Stressors

Alcohol impairs cognitive function, making it difficult to control anger. Users are more likely to misread a situation and overreact [6].

The Hypothalamic–Pituitary–Adrenocortical (HPA) axis, is responsible for how the brain reacts to stress, and is activated by increased levels of Corticotrophin Releasing Factor (CRF) occurring during withdrawal from chronic alcohol dependence.

This dysregulation of CRF results in increased reactions to small forms of stress [7].

untreatedalcoholismsymptoms2 infographic abbeycare lg

Overtly Risky Behaviour

Untreated alcoholism sufferers engage in risky behaviours such as:

  • Drink driving
  • Smoking
  • Causing or being the victim of violence
  • Attempting suicide
  • Misusing substances [8]

A study by Korlakunta found that high risk behaviour was higher amongst alcohol dependents, with 35% of participants taking part in crime and violence and 21% taking part in high risk sexual behaviour [9].

Loss Of Interest/Enthusiasm/Passion

Untreated alcoholics either experience positive life changes after immediately stopping drinking that later slow down, or do not experience the type of changes that they expected, such as thinking all problems will be fixed by recovery or that relationships with friends and family will be repaired [10].

Untreated alcoholics have a self-centred attitude, which causes a lack of awareness towards the needs of other members of the family, as well as neglecting roles and responsibilities such as work or household responsibilities [11].

Early Stage Alcoholism vs Long Term Untreated Alcoholism

Those in early stage alcoholism use alcohol as a coping mechanism to relax, feel more comfortable in social situations and fall asleep, but are not necessarily drinking more than those around them [12].

Whereas, long term untreated alcoholism causes severe physical, psychological and social deficits that continue to affect the alcoholics' life, long after drinking.

Physical Symptoms Of Untreated Alcoholism


Psychological Symptoms Of Untreated Alcoholism

  • Cravings for alcohol - long term untreated alcoholics associate alcohol with past positive memories and begin to crave those as well as alcohol [16]
  • Irritability - Godlaski et al found that social drinkers experience an average of 53.76 on the caprara irritability scale after consuming alcohol, whereas untreated alcoholics irritability comes from the effects of withdrawal and isolation from support [17]
  • Depression - 1 in 3 alcoholics have experienced episodes of depression during addiction, with untreated alcoholics also suffering from depressive and suicidal episodes [18]
  • Anxiety - 40% of alcoholics have reported having one or more panic attacks, untreated alcoholics experience anxiety about the future and life away from alcoholism [19]
  • Hallucinations - Early stage alcoholics may experience hallucinations, of which Perme et al found 13.5% of those studied, were still experiencing after 3 years of abstinence [20]
  • Sleep disorders - Insomnia affects 18% of alcoholics but only 10% of non- alcoholics, there is also a link between untreated alcoholics suffering from sleep disorders and the possibility of relapse [21]

Social Symptoms Of Untreated Alcoholism

  • Job Loss - If an employer concludes that alcohol use is causing low productivity, frequent absences or poses a danger to other employees, dismissal may be considered, whereas untreated alcoholics still lack motivation and full brain function to achieve their full potential [22]
  • Loss Of Driving Licence - Loss of transportation leads untreated alcoholics to be further isolated [23]
  • Financial Difficulties - Early stage alcoholism leads to debt as sufferers spend excessively on alcohol. Debt patterns exacerbate as alcoholism escalates and remains untreated [24]
  • Relationship Problems - Research has found that 1 in 4 of all behaviour based divorces in the UK are caused by untreated alcoholism [25]

Symptoms Of Alcoholism Undergoing Treatment vs Symptoms Of Untreated Alcoholism

Symptoms Of Alcoholism Undergoing Treatment

Symptoms Of Untreated Alcoholism

Weight Gain - Alcohol is an appetite suppressant [26]

Weight Loss - Alcohol suppresses appetite and cirrhosis impairs liver's ability to metabolise nutrients.

Improved Sleep -  Ceasing alcohol intake restores REM sleep and regular breathing patterns [27]

Accountability - Alcoholics undergoing treatment accept problems in life, and understand how their behaviour affects others [28]

Blaming Others - Anger towards friends, destructive behaviours, romanticising drinking patterns, ignoring negative consequences [30]

Untreated Alcoholism Symptoms Over Time

Untreated alcohol addiction over time may develop into liver cirrhosis or alcohol related dementia [31].

As symptoms worsen, negative thoughts around recovery increase, and the risk of relapse increases [32].

Drinking alcohol permanently changes the way the brain functions, meaning those with untreated alcohol addiction still behave impulsively, and are more likely to take part in reckless behaviours [33].

Mental isolation worsens as sufferers will refuse to be involved in recovery programmes, and conclude that no one understands what they are going through [34].

Bio-Psycho-Social Factors In Untreated Alcoholism Symptoms

Factors that exacerbate untreated alcohol addiction symptoms:

  • Stress at work - Lack of job satisfaction, difficult relationships with colleagues or supervisors, heavy workloads, and job insecurity lead to untreated symptoms such as loss of interest in the workplace and disproportionate reactions to small stressors [35]
  • Unemployment - Excess free time and lack of structure may lead to more temptation to drink, as well as stress caused by financial difficulties [36]
  • Relationship Issues - Having a partner who uses alcohol, as well as difficulties in relationships exacerbate feelings of resentment that lead to untreated alcoholism [37]

Turning to alcohol to cope is not necessarily a symptom of untreated alcohol addiction, but becoming reliant on alcohol to relax, sleep and avoid confronting emotions demonstrates an unhealthy relationship with alcohol [38].

There is evidence of addiction transference where one compulsive behaviour, such as alcoholism, is exchanged for another form of addiction, such as drugs or gambling [39].

Those who have experienced long term addiction, even if they have recovered, are more likely to experience cross addiction, as another form of addiction will still trigger the brain's dopamine reward centres [40].


Symptoms Of Untreated Alcoholism And Co-Occurring Illness

Symptoms of fatigue and mood swings occurring in depression and anxiety, exacerbate untreated alcoholism and make it more difficult for the sufferer to get help for either illness [41].

According to a 2012 study by Kuria et al, untreated persistent depression may reduce alcohol abstinence rates, and lead to using alcohol to self-medicate [42].

How Do Alcoholism Symptoms Go Untreated?

Alcoholic symptoms may go untreated as a result of:

  • "Stinking thinking" - Reverting to old patterns of thinking such as self centeredness and blaming others, means that untreated alcoholics are looking for the source of their problems in the wrong area of their lives [44]
  • Lack of desire or belief in recovery - Due to either poor mental health, 55% of chronic alcoholics suffer from depression, or other addictions [45]
  • No support from friends and family - Psychosocial resources improve outcomes in both treated and untreated alcoholism, as friends and family members also provide motivation for a life in recovery [46]
  • Low self esteem - Self esteem issues are more prevalent during untreated alcoholism [47]
  • Misdiagnosis - Doctors diagnose fewer than one fifth of alcoholism cases accurately. Correct diagnosis is often a result of co-occurring liver disease [48]
  • Co-dependence - Family members, friends and others around the alcoholic either choose to ignore signs of untreated alcohol abuse, or develop co-dependent habits that prevent the alcoholic from pursuing treatment [43].
  • Family Members' Denial - From our own client experience at Abbeycare, some family members may unconsciously choose to live in denial as a means to avoid the stress or emotional discomfort of intervening.

Symptoms NOT Indicative Of Untreated Alcoholism

Conditions which share symptoms of untreated alcoholism, but are not untreated alcoholism, are:

  • Obesity - often a result of non-alcoholic fatty liver disease [49], which may be mistaken for alcohol cirrhosis
  • Viral infections - e.g. resulting from hepatitis [50] may be attributed to alcoholism in error
  • Damaged immune system - causing primary biliary cirrhosis [51], which may be mistakenly attributed to alcohol use
  • Stress and anger - resulting from  high blood pressure [52], not alcoholism
  • Post traumatic stress disorder - Resulting in pain, sweating, trembling and disturbed sleep [53], often seen in alcoholism
  • Social Anxiety - Resulting in low self esteem, panic attacks, and feeling judged or criticised [54], behaviours often seen alongside alcohol use.

Non-alcoholic liver diseases are common, with 1 in 4 adults having an abnormal build up of fat in the liver [55]. This may trigger an appearance similar to untreated alcohol abuse.

Both alcoholic and non-alcoholic liver diseases cause cirrhosis of the liver, making the diseases' symptoms hard to differentiate. There must be a history of the patient's alcohol intake to diagnose alcohol related liver disease correctly [56].

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About the author

Harriet Garfoot

Harriet Garfoot BA, MA has an Undergraduate degree in Education Studies and English, and a Master's degree in English Literature, from Bishop Grosseteste University. Harriet writes on stress & mental health, and is a member of the Burney Society. Content reviewed by Laura Morris (Clinical Lead).

Last Updated: November 3, 2023