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Alcohol and Mental Health

Written By: Lisa Keeley
Updated: March 28, 2022
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Awareness of mental health in our society is on the rise, especially in the wake of the pandemic. Many people are struggling with issues like anxiety and depression, and the impacts of trauma or PTSD. Excessive drinking is a common coping mechanism.

Unfortunately, heavy alcohol use tends to make mental health problems worse, and can even create issues where there were none before. Below, we’ll cover the complex relationship of alcohol and mental health, some of the most common co-occurring problems, and how you can break the cycle.

Alcohol and Depression

Alcohol and depression have a complex relationship, due to their tendency to reinforce each other. People drink to feel better when they are feeling sad and hopeless. Yet coming down from alcohol can amplify those negative emotions. In fact, struggling with either alcohol use disorder (AUD) or depression can double a person’s odds of developing the other problem.

Much of this phenomenon is due to chemicals in the brain. Alcohol temporarily boosts serotonin levels, which can improve your mood short-term—while having the opposite effect in the big picture. Low serotonin levels can lead to feelings of depression, low energy, anxiety, decreased self-esteem, sleep disturbance, aggression, and more.

Heavy and sustained drinking can also lead to an increase in the stress hormone cortisol, which plays a role in the “fight-or-flight” response. This state of “high alert” may affect serotonin levels, thus increasing depression.

Finally, even if you are already treating your depression with FDA-approved medication, alcohol may still have a negative impact. Evidence suggests that drinking on antidepressants can increase side effects and make treatment less effective.

Read more: Alcohol and Depression

Alcohol and Anxiety

As with depression and alcohol, anxiety and excessive drinking can form a vicious cycle. Not only do many people drink to manage this condition, alcohol abuse can actually cause anxiety where there was none before. As a result, people who are alcohol dependent are twice as likely to struggle with anxiety, and each condition can make the other more difficult to treat.

As with depression, much of this relates to brain chemistry. When you drink alcohol, it mimics or enhances the effects of a neurotransmitter called GABA, which calms your system. At the same time, it begins to block an excitatory neurotransmitter called glutamate. The result is a feeling of relaxation as your mind seems to quiet down.

But once the alcohol wears off, and your brain seeks to rebalance these chemicals, your mood can shift from calm to anxious. The term “hangxiety” refers to that anxiety, dread, and embarrassment one experiences during a hangover.

For long-term heavy drinkers, the brain may make a permanent shift to compensate for the effects of alcohol, leaving a person feeling more anxious any time they don’t drink. This can create a difficult feedback loop, especially for those who drink to cope with pre-existing anxiety.

Learn more about alcohol and anxiety, and how to treat it.

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Alcohol and Insomnia

Insomnia can do damage beyond just making you feel tired. Lack of sleep can lead to an increased risk for many health problems, including diabetes, heart disease, and obesity. It can also lead to depression.

Some people drink alcohol to help them feel drowsy. And although alcohol can be a sedative that slows down brain activity, research reveals that alcohol generally has a negative effect on overall sleep quality. Studies show that insomnia affects between 35 and 70% of individuals who use alcohol.

Insomnia and sleep disturbance can also be a common symptom of alcohol withdrawal. It is estimated that between 36 and 72% of people in early alcohol recovery experience insomnia. Sleep problems can continue for months or longer when recovering from AUD.

Read more: Alcohol and Sleep

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Alcohol and PTSD

Alcohol addiction and PTSD (Post-Traumatic Stress Disorder) frequently go hand in hand. PTSD is a mental health condition which occurs after a major traumatic event. Approximately 3.6% of US adults have this condition, and it is significantly more common among women than men.

Sufferers of PTSD can experience suicidal thoughts, depression, anxiety, aggression, hallucinations, nightmares, flashbacks, guilt, and shame.

Many people experiencing these symptoms seek refuge from their emotional pain through drugs and alcohol. However, as with other mental health conditions, alcohol dependency can worsen PTSD symptoms and cause uncomfortable side effects.

Read more: Alcohol and PTSD

Alcohol and Other Co-Occurring Disorders

Although the above are among the most common mental health issues linked to alcohol, they are far from the only ones. There are many conditions that may be co-occurring disorders with alcohol addiction—meaning a person may struggle with both at the same time.

These include:

Why People Self-Medicate with Alcohol

If you struggle with any of the above issues, and are self-medicating with alcohol, you are not alone. Studies confirm that self-medication is a common cause of alcohol addiction.

There are many reasons people feel the need to self-medicate, and the common denominator seems to be some kind of physical or emotional pain.

Along with issues like anxiety, depression, there appears to be a strong connection between childhood trauma and addiction. Experiencing grief can be a major drinking trigger, and feelings of shame and guilt often feed the cycle of addiction relapse.

The relationship of alcohol and stress can play a role here as well—many people pour a nightly drink to cope with a difficult job, or a challenging relationship.

No matter the reason, seeking relief or escape from is an understandable instinct. But, in the case of alcohol, this solution is ultimately maladaptive. Although the psychological effects of alcohol can make people feel better in the moment, drinking tends to worsen all of the issues listed above. Learning other coping mechanisms, or seeking medically approved treatment, is always a better route.

Learn more about self-medication, and how to overcome it.

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Solutions and Support For Alcohol and Mental Health

When it comes to treating issues with both alcohol and mental health, an integrated treatment plan is often the most effective approach. The goal is to treat alcohol misuse and manage mental health symptoms at the same time. Strategies can include counseling, behavioral therapy, and prescription medications.

While this type of care has often been difficult to come by, telehealth is making it much easier to access well-rounded support for alcohol use disorder and mental health. Counseling, prescriptions, and non-emergency medical consultation can now be handled remotely, often at much lower cost and with less disruption to your life.

Ria Health is one option that lets you access complete support for alcohol use disorder 100% online.

  • Our experienced coaching team has already helped thousands of members navigate the emotional and mental challenges of sobriety.
  • Our medical team can prescribe a range of medications, including some that can help reduce anxiety and cravings at the same time.
  • Finally, if you need additional mental health support beyond our program, our team can help you find a therapist or other treatment option accessible to you.

Get in touch with us today for more information, or learn more about how it works.

Written By:

Lisa Keeley
Lisa Keeley is a freelance writer who believes in the uplifting power of words. She especially enjoys writing about health, relationships, employment, and living one’s best life. Lisa has a Master’s in Education and previously worked in vocational and educational services. Her articles can be found on Your Tango, Thrive Global, Heart to Heart, Medium, Muck Rack, and on various professional websites.

Reviewed By:

Evan O'Donnell
Evan O’Donnell is an NYC-based content strategist with four years’ experience writing and editing in the recovery space. He has conducted research in sound, cognition, and community building, has a background in independent music marketing, and continues to work as a composer. Evan is a deep believer in fact-based, empathic communication—within business, arts, academia, or any space where words drive action or change lives.
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