By: Patrice Levinson, MSN, FNP-C, Family Nurse Practitioner, Student Health Services, and Mental Health First Aid Instructor
“Sobriety was the greatest gift I ever gave myself.” – Rob Lowe
Drinking alcohol is a common way for people to try to feel good. Alcohol consumption can release endorphins (hormones that improve a sense of well-being), suppress prefrontal cortex brain activity, decrease inhibitions, and improve social bonding. Some people also drink alcohol to try to cope with stress and negative feelings, or even to self-treat a mental health problem. If you drink alcohol, that does not mean that it will cause you to suffer from a mental health disease. But alcohol consumption may make you feel worse – not better. Here’s how drinking alcohol can affect your mental health.
In our Mental Health First Aid (MHFA) course at Mason, we discuss how to recognize the signs and symptoms of mental health concerns and crises. Sometimes being heard and knowing that resources are available is the stimulus for people to seek care, and to improve their mood, energy, motivation, and concentration. So, we talk about the stigma surrounding mental illness and how we can encourage people to talk about their mental health struggles. Substance use disorders – including alcohol use – are the types of mental health concerns that are the most difficult for people to talk about and recognize.
Why Alcohol isn’t an Effective Treatment for Anxiety, Depression, or Sleep Difficulties
People with underlying anxiety are more likely to increase their alcohol use when they are feeling stressed. They feel like alcohol helps them cope with stress and negative feelings. However, drinking alcohol also depletes the neurotransmitters that naturally help to decrease anxiety levels. This can eventually cause alcohol tolerance, so that a person will need to drink more alcohol in the future to obtain the same level of anxiety relief. Then it becomes difficult for the person to know the exact amount of alcohol necessary to relieve anxiety. Complicating this situation is the fact that alcohol acts as a depressant – thus the person’s anxiety may return quickly after the initial euphoria from the first drink.
Even though we may think that alcohol can help us feel less depressed, studies actually show that regular alcohol drinking – even moderate drinking – can lead us to feel more depressed. Consuming alcohol depletes the brain’s stores of the neurotransmitter serotonin. The cycle of drinking alcohol causes decreases in serotonin levels, which causes more alcohol consumption, which then leads to further drops in serotonin levels. That’s the reason people can experience symptoms of depression after drinking alcohol. In addition, alcohol depresses the central nervous system, which has a disinhibiting effect. This break down of inhibitions can amplify underlying feelings of anxiety, depression, or anger, as well as inhibit the person’s use of effective coping strategies. It can also cause a person to be more likely to act on any suicidal or self-harm thoughts and feelings.
Another factor to consider is that drinking alone can result in worsening depression. According to an article from The Atlantic.com, “… in the rare experiments that have compared social and solitary alcohol use, drinking with others tends to spark joy and even euphoria, while drinking alone elicits neither—if anything, solo drinkers get more depressed as they drink.”
Alcohol helps people fall asleep, though, right? Alcohol is a sedative that targets the GABA receptors in the brain. Increasing GABA activity is what is responsible for the calming effect of alcohol. However, alcohol is rapidly absorbed and cleared by the receptors in two to five hours. Have you ever woken up after an evening of drinking and felt hyper-alert in the middle of the night? This explains that feeling. If you drink in the evening and wake up at night, your REM sleep is suppressed. This night of poor-quality sleep results in low daytime energy. Self-treating the low morning energy with caffeine and then adding more alcohol that evening to help you relax and counteract the effects of the caffeine can result in a downward spiral. You may find that you are never getting a good night’s sleep. If you have a drink in the evening, try to give yourself several hours before going to bed to lower the concentration of alcohol in your bloodstream, which may be less disruptive to your sleep cycles.
People with either anxiety or depression mental health disorders who drink alcohol heavily can show rapid improvement in their mood when they decrease or eliminate drinking. But you don’t have to have an anxiety disorder or clinical depression to experience the negative effects of alcohol. Even if you’re just a social drinker with moderate levels of alcohol consumption, you can suffer symptoms of anxiety or depression, or sleep problems.
Think about How You Drink
The Stress in America report presents these practices and questions to help us think about how we drink:
- Make a note of when you are drinking alcohol. What time of the day is it? Did something stressful happen? Are you bored?
- Pay attention to how you feel when you are drinking. How do you feel the following day?
- Think about substituting drinking alcohol with another activity that doesn’t make you feel worse later.
- Make the goals you set for yourself specific and attainable. If you’re trying to drink less, determine a specific number of days when you drink and determine how you would like to limit the drinks you have on those days. (For more information, check the National Institute on Alcohol Abuse and Alcoholism’s description of drinking levels.)
- Find an accountability buddy. Telling a close friend or family member about your goals can help you stay on track to reach those goals. Your buddy can check on your progress, identify unhealthy habits, and help you change behaviors.
One of the tools healthcare providers use to help people think about their drinking and guide them toward positive change is called SBIRT, which refers to survey, brief intervention, referral, and treatment. SBIRT is an evidence-based early intervention program that helps bridge the gap in integrating mental health care and medical care. This tool is used in primary care offices, emergency rooms, mental health care offices, and school-based health care. People often don’t recognize if their substance use is affecting their anxiety, depression, or sleep. SBIRT uses motivational interviewing to facilitate these conversations and direct people to effective treatment.
Self-Care Strategies to Use Instead of Alcohol
What are other self-care strategies that you can practice instead of reaching for alcohol? The Partnership to End Addiction created this list of protective factors:
- Develop a good social support system.
- Create positive self-talk.
- Practice problem-focused coping skills.
- Work on having high self-esteem.
- Develop your emotional well-being (which may include receiving effective treatment for another mental illness or for emotional struggles).
- Bond with your community.
- Encourage community substance use prevention programs.
- Look for positive things to do for fun.
- Encourage your friends and family when they engage in positive social activities.
- Engage in regular work or school attendance.
- Build a supportive, connected family network.
- Although you can’t control this, the absence of tobacco or substance use in your family is also a protective factor.
You can drink mindfully, and experience greater well-being, by: assessing how you feel after drinking – or how you feel after not drinking; learning about how alcohol affects your levels of anxiety, your mood, and your sleep behaviors; making intentional choices about drinking; seeking professional help when you need it, and practicing nurturing self-care strategies.
Additional Resources
- The WebMD.com article “What to Know about Alcohol and Mental Health”
- The National Institute on Alcohol Abuse and Alcoholism article “Mental Health Issues: Alcohol Use Disorder and Common Co-Occurring Conditions”
- The Jed Foundation.org article “Understanding the Mental Health and Drinking Connection”
- The American Psychological Association article “Understanding Alcohol Use Disorders and their Treatment”
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