Understanding the Mental Health and Drinking Connection

By Peg Rosen

For many of us, drinking alcohol socially can lighten our mood, reduce the stress we feel, and can even help us feel closer to others—at least for a while. While the short term relaxation and mood enhancing effects of alcohol may not lead to misuse for many people, for some of us it does. For some of us, persistent desire for the short-term mood lifting effects of alcohol leads to heavy drinking over long periods of time which, in turn, can have negative consequences on mental health, like worsening depression or anxiety.

Because of this, it’s important to understand how alcohol can affect your mental health—and what to do if you feel like alcohol is impacting your health negatively.

How Alcohol Impacts our Health

Drinking regularly or heavily can be part of an unhealthy cycle of coping with mental health issues. Many people with alcohol use disorders use alcohol as a way to manage mental health challenges. The fact is, however, that drinking too much can actually make those challenges worse.

Alcohol and Depression

For example, if someone is experiencing depression, they may drink as a way to cope—and at first they may seem to feel better. But drinking too much alcohol often increases symptoms of depression which can then lead to more drinking or other drug use in an attempt to reduce worsening depression. Drinking more alcohol to manage worsening symptoms only continues the cycle.

Here are some of the ways that alcohol can make depression worse:

• Alcohol interrupts sleep. Sleep problems are closely linked to depression. Using alcohol can also negatively affect your sleep patterns, which in turn can increase symptoms of depression like exhaustion and difficulty concentrating.
• Alcohol interferes with medication. If you are on medication to treat depression, alcohol reduces the effectiveness of antidepressants and can increase other side effects like drowsiness, which can be dangerous.
• Alcohol can increase risky behavior. In addition to making depression symptoms worse, drinking alcohol can lower your inhibitions and increase your impulsivity—which can put you in risky or dangerous situations that may impact your mood.
• Alcohol can increase suicidal behavior. Misusing alcohol while you are depressed increases the risk of suicide attempts.

Even if you are not already struggling with depression, research shows that misusing alcohol can increase risk of developing depression in the first place. To disrupt the cycle and the toll it takes on mental health, you need to reduce or stop your alcohol use and learn to cope with depressive feelings in healthier ways.

Alcohol Impacts Our Physical Health

In addition to impacting mental health, misusing alcohol can have serious effects on physical health over time, too. These include but are not limited to:

• Increased risk of diseases like cirrhosis or liver disease and certain types of cancers.
• Higher risk of dangerous behavior, like getting into fights, driving drunk, or engaging in risky sexual behavior as a result of lowered inhibitions.
• Loss of coordination or control, like loss of balance, slurred speech, and blurred vision, which can make even normal behavior more risky.
• Disrupted brain development, since excessive drinking at an early age can interfere with healthy brain development. This can have a number of negative consequences, including an even greater risk of a serious  alcohol use disorder.
• Increased risk of death. In addition to increasing risky behavior, drinking too much can suppress your gag reflex and cause you to pass out, increasing the risk that you may choke or stop breathing.

How Much Alcohol is Too Much?

What do we mean when we talk about drinking “too much”? Alcohol use is common among adults: research shows that more than 85 percent of adults have used alcohol at least once, and more than half of adults have had a drink in the past month. But because alcohol use is so common and is socially accepted in many circles, sometimes it’s hard to know when casual drinking becomes something more serious.

Binge Drinking

Binge drinking is a pattern of drinking that brings a person’s blood alcohol level to 0.08. Typically, this means having four or five drinks over a two-hour period. Binge drinking is most common among adults ages 18 to 34, but younger teens binge drink too: nearly 20 percent of high schoolers have reported engaging in binge drinking. And teens and young adults under the age of 21 who drink alcohol have reported binge drinking larger amounts of alcohol.

Heavy Drinking

Heavy drinking can take a few forms. Heavy drinking can mean binge drinking over five or more days in one month. It can also mean consuming a certain amount of drinks in a week: typically, for men it’s defined as having fifteen or more drinks, and for women it’s defined as having eight drinks or more. Around 6 percent of adults have reported heavy alcohol use in the past month. That number is higher among college students: more than 8 percent of students between 18 and 22 report engaging in heavy drinking.

Alcohol Use Disorder

The majority of people who engage in binge drinking or heavy drinking do not have an alcohol use disorder —what used to be called alcoholism or alcohol dependence. But it is possible that using alcohol can trigger a genetic predisposition to an alcohol use disorder.  If you are concerned that someone you know who binge drinks or drinks heavily may be developing an alcohol use disorder, watch out for these signs:

• The inability to limit their drinking, even when they talk about wanting to drink less
• Continuing to drink despite consequences in their personal or professional life
• Increased tolerance, or needing to drink more to feel the same effects
• Withdrawing from hobbies, activities, or social groups they used to enjoy
• Drinking in situations where it’s dangerous to do so, like driving or operating machinery
• Spending a significant amount of time either drinking or recovering from drinking
• Wanting a drink so badly they can’t think of anything else

When and How to Seek Help for Alcohol Use

Issues with alcohol fall on a spectrum. Even if a drinking problem doesn’t seem severe at first, if left untreated it can get worse and lead to more serious consequences. It’s never too early to address concerns with alcohol use—or concerns with mental health issues that might be affected by alcohol use.

If you are starting to feel like you need help to manage your alcohol use, ask yourself:

• Is my alcohol use impacting my ability to function in everyday life?
• Has my mental or physical health been negatively impacted by my alcohol use?
• Have my relationships been impacted negatively by my alcohol use? Have my friends, family, and other people I trust shared concerns about my drinking?

If you answered “yes” to any of the questions above, it’s time to seek help. There are many treatment options available for both managing alcohol use, including:

• If you are in college, take our alcohol and substance misuse screening questionnaire to find resources available on your campus.
• Check out our resources on how to manage issues with drugs and alcohol.
• Reach out to someone you trust, like a friend or family member, and ask for their support in finding treatment.
• Find a therapist or counselor that specializes in substance use issues, or find a support group or 12-step meeting.
• Reach out anonymously to SAMHSA’s National Helpline.
• Get connected to treatment options near you through the SAMHSA Behavioral Health Treatment Services Locator.
• Text “START” to 741-741 or call 988 to have a free and confidential conversation.

Many of the treatment options available for alcohol misuse will also help you learn healthier coping skills for mental health challenges that are related to drinking, such as depression. Since mental health challenges and substance use problems occur together so often, it is important to address both when seeking treatment.

Learn more about alcohol use and changing your drinking:

How Do I Know If I Have a Drinking Problem?

I’m Worried About My Drinking. Do I Have to Stop Entirely?

How Do I Get Help with Drinking Too Much?

How Do I Tell My Parents I Might Have a Drinking Problem?

Is Binge Drinking That Bad?

10 Steps to Cut Back on Drinking

How Are Problems with Alcohol Treated?