Family and Caregiver Schizophrenia Discussion Forum

Questions About Alcohol Use

Hey Everyone.

I’m new here, but I’m dating someone who has been diagnosed as Schizoaffective. We’ve been together for a few years now, but I’m concerned about their drinking habits (have been for awhile). They rely on drinking to cope with anxiety, depression, paranoia, etc., and they drink almost every night. They never get drunk, but I assume it’s because they’ve built up a tolerance. I’m trying to get them to stop drinking, but it’s the only coping skill they have. They refuse to acknowledge that it’s as big of an issue as it is, and any time we discuss it they get unbearably angry. They’ve been told by numerous doctors that they have to stop drinking because of it’s impact on their mental health (it exacerbates the symptoms of schizoaffective), but they’re not adjusting as quickly as they need to.

I’m wondering if other people have faced similar difficulties? How have you dealt with supporting someone who drinks too much?

Welcome szasupport,

Sounds like your someone is self medicating with alcohol. Self medicating is pretty common. Are they on meds for sza? How much are they drinking each night?

What do you see as the negative impact of their alcohol usage at this point? I understand that the doctor has said it can impact their mental health, is it impacting their mental health?

If your someone is an alcoholic - and I realize you aren’t saying that- but if they are, a dual diagnosis of an addiction and a brain disorder is a challenge.

Does the drinking impact your life?

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I’d recommended going to an Al-Anon meeting. Talking him out of drinking rarely works with anyone, especially if it’s for coping with all of those symptoms. Even one meeting for you might help in terms of understanding what you can do for yourself, because despite your concern, a doctors concern, anyone’s! concern, it falls many times on deaf ears and leads to the drinker becoming defensive and upset. Best thing I learned from a meeting was how to detach. I’d prefer alcohol to the other illegal drugs mine gets his hands on. But, he’s unmedicated, and I know there’s zero I can do to change his behavior until he has some insight; so my focus has become medication vs. his drug or alcohol use at the moment. I hope that helps.


Thank you for responding. They are on medications (an antipsychotic and a mood stabilizer, as well as a thyroid medication). Each night they have six beers within the span on 3-4 hours.

I know they have trouble staying asleep throughout the night, their compulsions for self-harm increase with alcohol, and their mood generally gets worse. So I think it’s impacting their mental health. We’ve been to the ER a lot in a few years for psychosis and suicidal behavior/ideation, and each time they have to wait until the alcohol’s out of their system before the doctors speak with them. We’ve never been to the ER when they haven’t been drinking.

The only reasons I haven’t fully believed that they’re an alcoholic is because they don’t have any withdrawal symptoms, and they can, on occasional days, not drink (they average two days a week of not drinking).

It impacts me because I’m their caregiver, so I have to bring them to the ER a lot. It’s also costing a lot of money (that we don’t have). I know I can’t make them stop drinking - nor can I make them want to stop drinking - but I wish they would want to stop. I’m just not sure how to help in these kinds of situations.

Something I found helpful was tracking episodes alongside use. It gave me something tangible to look back on and to identify certain patterns or cycles. I keep a diary of behaviors and then transfer over to a calendar. That gives me a better overview of “what’s changed” and a heads up if things might be deteriorating. Considering he drinks more than he doesn’t, it would make sense trips to ER happened times he was drinking, but maybe there is something underlying that. I’ve seen a liter of vodka disappear in two days time, with zero negatives; and I’ve seen a six pack go within a night and symptoms beginning to present themselves. I would definitely be concerned with reactions to medication as they can cancel each other out, if I understand correctly, besides other health effects. I’m really sorry, it’s difficult to see people you love struggle.


I think Chelsea333’s idea about keeping a log to show them is a good idea - therapists are big on people seeing their own proof.

Also her Al-Anon idea

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Have you thought about starting with a very small switch to a beer with a lower alcohol content? Not an non-alcoholic, but rather just lower alcohol percentage. They probably don’t see withdrawal because those two days you mentioned probably aren’t usually together?

I agree with the Al-Anon idea. Good support there too…

I really don’t think we can manage other people’s drug and alcohol problems (aka self-medicating). If I am in charge of the money, I never give cash. That’s about it as far as what I am willing to take on myself.

Al-Anon helped me quite a bit.

Alcohol can lower or alter the efficacy of some psych meds and it’s really up to the doctors to try and figure out how to get the right meds to people, whether or not they drink. So hopefully people who drink and take psych meds are being honest with their doctors and can get a medication that is not completely contraindicated with alcohol use.


My dad was an alcoholic for 23 years. I remember telling him time and time again that if he would quit drinking his life would be so much better. He quit and then psychosis set in and after petitioning the courts to have him hospitalized he was diagnosed with paranoid schizophrenia. The psychologist at the hospital stated he had probably been self medicating this whole time which is what hid the schizophrenia. Just make sure when and if they do decide to quit drinking that you’re there for support and to get them speedy treatment if need be. Alcohol can he a very good repressor of schizophrenic/or psychotic episodes. They need to have professionals in their corner prepared to stir them the right way.