The relationship between alcohol and mental health is complex. Some people may drink alcohol to relax or help cope with daily stresses; however, alcohol is a depressant drug 1 that can cause anxiety and increase stress. Alcohol can negatively affect thoughts, feelings and actions, and contribute to the development of, or worsen, existing mental health issues over time.
In summary, while alcohol might be a common coping strategy, it is not an effective solution. Alcohol is a depressant drug that can affect our mental health and wellbeing and damage our bodies over both the short and long-term.
Alcohol slows down the central nervous system. The central nervous system controls thoughts and how your brain talks to your body. The most immediate effects of alcohol are on the brain 1, affecting the way you think, feel and behave.
Research indicates some people, including young people, drink alcohol to help them cope with stress, anxiety and depression, or situations they would otherwise find difficult to manage.123
While a glass of wine or a beer after a stressful or difficult day might help you relax, in the long-term it can contribute to increased stress, anxiety and depression, and increase overall alcohol use. This is because alcohol changes the brain and this leads to depleting the chemicals in our brains that help reduce anxiety naturally. As a result, we can be left feeling even more stressed, anxious or depressed, and then feel we need more alcohol to help cope with these overwhelming feelings of anxiety.2
Research has found that those who reported self-medicating their mood by drinking alcohol have a greater likelihood of developing alcohol dependence.45
Alcohol also impacts our ability to process thoughts and make rational decisions, which can lead to an increased likelihood of violence or aggressive behaviour.1 This is because alcohol can make you less self-reflective, less able to process multiple cues and decrease your ability to resolve conflict. 16
Our mental health and wellbeing is affected by many factors, including alcohol use.10 Alcohol use can play a role in the development and progression of mental health conditions. People with, or who are at-risk of, a mental health condition, are more likely to use alcohol, and may have worse symptoms after drinking.1
Of Australians aged between 16 and 85 years of age, one in five (20%) will experience a mental health condition, and one in twenty (5%) will experience an alcohol or other drug use issue in any year.11
Experiencing alcohol or other drug dependence with one or more diagnosed mental health condition(s) is common in the community.12 It has been estimated that at least 30-50% of people with an alcohol and/or other drug issue also have a mental health condition.13
In addition to all its other negative effects, alcohol, even when consumed at low levels (one or two drinks a day), can interact negatively with most of the common medications commonly prescribed for mental health conditions, including antidepressants.1
The relationship between alcohol and mental health issues, such as depression and anxiety, has been summarised below:
Individuals experiencing clinically significant alcohol problems are frequently observed to be experiencing depression and anxiety, and similarly people experiencing clinically significant depression and anxiety are frequently observed to be experiencing alcohol problems.14
The National Health and Medical Research Council recommend that for anyone who is under treatment for a mental health condition, to discuss their alcohol use with a health care professional.1
Because the relationship between alcohol use and mental health conditions goes both ways, a person who is dependent on alcohol is more likely to develop a mental health condition, and having a mental health condition can also increase the likelihood of developing alcohol dependence.412 For example, for those who experience alcohol dependence, the risk of depression doubles.15 Similarly, people with anxiety and depressive disorders are more than four times more likely to experience alcohol dependence, compared to people who do not experience those disorders.16
Healthy coping strategies are those that help deal with feelings of stress, anxiety and depression and can lead to long-term improvements in our mental health and wellbeing. Here are some strategies you might like to try as an alternative to alcohol to help improve your mental health and wellbeing:
Suicide is the leading cause of death for Australians aged 15-44 years.17 While the most common and significant risk factor associated with suicide is a mental health condition,18 someone who experiences both a mental health condition and alcohol dependence is at a greater risk of suicidal behaviour.19
Alcohol use is a risk factor in suicide and evidence has consistently shown that mood and substance use dependence, including alcohol, are the most common disorders related to suicide.2021
It has been suggested that alcohol may lead to suicide in people who have no history of mental health issues. This is likely to be due to the intoxicating effect of alcohol which reduces inhibitions. This in turn can generate suicidal thoughts and increases the likelihood of these thoughts being put into action, often on an impulse.21
The more alcohol consumed, the greater the risk of suicide.22People have approximately seven times increased risk for a suicide attempt soon after drinking alcohol, and this risk further increases to 37 times after heavy use of alcohol.15
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Mental health support
The Mental Health Emergency Response Line (MHERL) is available 24/7 for anyone in the community experiencing a mental health emergency. This includes support for individuals, families/carers, members of the general public or health professionals.
For other mental health support options, including how your GP can help, visit the Think Mental Health website.
1 National Health and Medical Research Council. (2009). Australian Guidelines to reduce health risks from drinking alcohol. Canberra, ACT: Commonwealth of Australia.
2 Mental Health Foundation. (2006). Cheers? Understanding the relationship between alcohol and mental health. Retrieved from: https://www.mentalhealth.org.uk/publications/cheers-understanding-relationship-between-alcohol-and-mental-health
3 Stapinski, L., Edwards, A., Hickman, M., Araya, R., Teesson, M., Newton., … & Heron, J. (2016). Drinking to cope: a Latent class analysis of coping motives for alcohol use in a large cohort of adolescents. Prevention Science, 17, 584-594.
4 Crum, R., Mojtabai, R., Lazareck, S., Bolton, J., Robinson, J., Sareen, J., … & Storr, C. (2013). A prospective assessment of reports of drinking to self-medicate mood symptoms with the incidence and persistence of alcohol dependence. JAMA Psychiatry, 70(7), 178-726.
5 Turner, S., Mota, N., Bolton, J., & Sareen, J. (2018). Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and Anxiety, 35, 851-860.
6 Graham, K., & West, P. Alcohol and Crime: Examining the link, in Heather, N., Peters T.J. & Stockwell, T. (eds) (2001), Alcohol Dependence and Problems. John Wiley & Sons: Brisbane. 448-449.
7 Ebrahim, I., Shapiro, C., Williams, A., & Fenwick, P. (2013). Alcohol and Sleep 1: Effects on normal sleep. Alcoholism: Clinical and Experimental Research 37(4), 539-549.
8 Mental Health Foundation. (2011). Sleep matters. The impact of sleep on health and wellbeing. Retrieved from: https://www.mentalhealth.org.uk/publications/sleep-report
9Drake, C., Roehrs, T., & Roth, T. (2003). Insomnia causes, consequences and therapeutics: an overview. Depression and Anxiety, 18, 163-176.
10 World Health Organization. (2012). Risks to mental health: an overview of vulnerabilities and risk factors. Retrieved from: https://www.who.int/mental_health/mhgap/risks_to_mental_health_EN_27_08_12.pdf
11 Australian Institute of Health and Welfare. (2019a). Mental health services in Australia. Retrieved from: https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/summary/prevalence-and-policies
12 Hall, W., Degenhardt, L., Teesson, M. (2009). Understanding the comorbidity between substance use, anxiety and affective disorders: broadening the research base. Addictive Behaviors, 34, 526-530.
13 Western Australian Mental Health Commission. (2015). Better Choices. Better Lives. Western Australian Mental Health, Alcohol and Other Drug Services Plan 2015-2025. Perth, WA: Mental Health Commission.
14 Mann, R., Ialomiteanu, A.R., Chan, V., & Rehm, J. (2012). Relationships of alcohol use and alcohol problems to probable anxiety and mood disorder. Contemporary Drug Problems, 39, 24-263.
15 World Health Organization. (2018). Global status report on alcohol and health 2018. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/274603/9789241565639-eng.pdf
16 Boschloo, L., Vogelzangs, N., Smit, J., can den Brink, W., Veltman, D., Beekman, A., Penninx, B. (2011). Comorbidity and risk indicators for alcohol use disorders among persons with anxiety and/or depressive disorders. Findings from the Netherlands Study of Depression and Anxiety (NESDA). Journal of Affective Disorders, 131, 233-242.
17 Australian Institute of Health and Welfare. (2019b). Deaths in Australia. Retrieved from: https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/contents/leading-causes-of-death
18 Western Australian Mental Health Commission. (2015). Suicide Prevention 2020: Together we can save lives. Perth, WA: Mental Health Commission.
19 Brady, J. (2006). The association between alcohol misuse and suicidal behaviour. Alcohol & Alcoholism, 41(5), 473-478.
20 Pompili, M., Serafini, G., Innamorati, M., Dminici, G., Ferracuti, S., Kotzalidis, G., & Lester, D. (2010). Suicidal behavior and alcohol abuse. International Journal of Environmental Research and Public Health, 7, 1392-1431.
21 Sher, L. (2006). Alcohol consumption and suicide. QJM: An International Journal of Medicine, 99, 57-61.
22 Hufford, M. (2001).Alcohol and suicidal behaviour. Clinical Psychology Review, 21(5), 797-811.
Page last updated: 12 November 2019
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