The prevailing myth of alcoholism is that it has something to do with alcohol. The name came about when excessive alcohol consumption was the most commonly recognized substance abuse problem. However, what we commonly call alcoholism is really a closely matched pair of disorders that, when manifest together, give rise to stereotypical alcoholic behaviour.
The first of these paired disorders is addiction disorder, and it is one that affects many people: cigarette smokers, coffee drinkers, and drug addicts of any stripe. This is characterized by a physiological dependency on a substance that can also lead to a psychological dependence. People with addiction disorders have tremendous difficulty resisting the substance upon which they have become addicted and often exhibit withdrawal symptoms when they try. People who develop alcohol dependency can drink in a variety of ways: some drink daily, some binge, and some combine daily drinking with binge drinking.
The second disorder is a personality disorder characterized by low self-esteem, self-loathing, and feelings of worthlessness. This too is present in many people, particularly those who tend toward depression. People with this disorder have difficulty finding anything enjoyable, positive or interesting in life, and grow up feeling unloved and unwanted. These habits of mind become rigorously entrenched and leave sufferers with a permanent sense of self pity and victimhood.
Combined, these disorders feed one another and create the behaviours most commonly associated with alcoholism. Interestingly, the substance being abused is not necessarily alcohol in people who are most commonly called alcoholics. Some abuse drugs, food, gambling, work, or even sex. The key is that the substance or activity is a self-administered soporific for the deep emotional pain that those who suffer from the personality disorder feel. The feelings of despair and worthlessness are temporarily numbed by alcohol, cocaine, orgasm, or endorphins. However, when they return, they leave the sufferer in profound despair coupled with a deepening sense of self-loathing spurred by the use of the substance.
Even more unfortunately, the psycho-physiological addiction creates the symptoms of withdrawal that make the continued substance abuse necessary. Having no other way to quell the sense of sadness and self-pity, alcoholics continue to satisfy their addiction disorder while exacerbating their personality disorder. This is the horrible paradox of this disease: servicing the addiction worsens the symptoms of the personality disorder; treating the personality disorder worsens the withdrawal of addiction.
In the end, alcoholics usually die of their addiction yet the tattered remains of their families usually are left with the memories of the terrible burden of the personality disorder. Alcoholism, which, as noted, is merely a label of convenience, is the only diseases wherein the symptoms harm the sufferer and the people around them. It is truly a social disease.