Alcohol, mental health and wellbeing
Introduction
Drinking alcohol is linked to both anxiety and depression. A recent British survey found that people suffering from anxiety or depression were twice as likely to be heavy or problem drinkers. Alcohol has also been linked to self-harm, suicide and psychosis.(1)
Apart from affecting your mental health, consuming alcohol also affects your memory and brain function. Soon after drinking alcohol, brain processes slow down. For example, the effect on men’s driving skills is measurable after the consumption of three to four units. At this level of consumption, alcohol is in the bloodstream at around 50mg per 100ml. Women can reach this same concentration by drinking just two or three units.
People often feel rough after a session of heavy drinking, feeling that their memory and thinking is impaired. It’s difficult to be sure whether this is a genuine effect, just part of the folklore about hangovers, or because there is still alcohol in the tissues the next day. Some people, even when they no longer have alcohol in the bloodstream, are probably slightly ‘slowed’ mentally the next day.(2)
Facts and Figures
Anxiety and depression
- Self-harm and alcohol are often linked. In 2006, a survey was carried out among 3,004 self-harm patients at Scottish accident and emergency departments. It found that 62% of males and 50% of females reported consuming alcohol immediately before or while self-harming, and 27% of men and 19% of the women cited alcohol as the reason for self-harming.(3)
- It has been estimated that alcohol plays a part in up to 65% of suicides in the UK. (4)
- Extreme levels of drinking (e.g. more than 30 units per day for several weeks) can occasionally cause ‘psychosis’, a severe mental illness where hallucinations and delusions of persecution develop. Psychotic symptoms can also occur when very heavy drinkers suddenly stop drinking and develop a condition known as ‘delirium tremens’.
Memory and brain
- Drinking 8-10 units per day over extended time periods results in some mental inefficiency; at 11-14 units per day, deficits (reduced brain capacity) are present; at 18 or more units per day, harm can be of the severity seen in someone diagnosed with alcoholism. (5)
- The human brain is still in the process of development until the age of 18 or 19, and it may be more susceptible to damage than the adult brain. In adolescents who regularly drink alcohol, parts of the brain important in planning and emotional control have been found to be smaller than expected.(6)(7)
- Over the age of 65, performance of mental tasks declines less slowly in light and moderate drinkers. However, light and moderate drinking (defined as an occasional 1-2 units) is often associated with other factors which reduce mental decline, such as physical and social activity, a good diet, and better socio-economic standards. (7)
- At advanced age, in residential community homes, a ‘social hour’ with alcohol or a unit of alcohol at bedtime, can improve mental wellbeing. On the other hand, alcohol is also a cause of falls in the elderly because it affects balance.
Progression
Heavy drinking can lead to work and family problems, which in turn can lead to isolation and depression. For heavy drinkers who drink daily, there can be withdrawal symptoms (nervousness, tremors, palpitations) which resemble anxiety, and may even cause phobias to develop, such as fear of going out.
Hospitals see some people who were once high performers mentally and intellectually, but who have severely damaged their brains due to drinking.
One very disabling type of brain damage due to heavy drinking (probably in combination with malnourishment) is when short-term memory fails. This means the individual may not be able to recall where he is, how he got there or what day it is.
Advice and Getting Help
Light or moderate drinking does not harm emotional balance. But heavy drinkers who have run into emotional problems are wise to avoid alcohol completely, because previous patterns often recur.
People prescribed antidepressants, sedatives, analgesics or drugs for epilepsy should avoid alcohol.
People who have damaged the brain should not drink at all.
Older people drinking very lightly don’tneed to stop on grounds of their age or because they fear it might harm their brain.
Heavy drinking sessions should be avoided by everyone, at all ages. If you do drink heavily, try to have a balanced diet, and if you do not, take B vitamin supplements.
If you are concerned about any aspect of your own drinking, or your mental health, your GP will be able to help. You can also call Drinkline on 0800 917 8282, a free confidential helpline (open 24hrs a day, 7 days a week) who can point you towards your local alcohol service. You can also call Drinkline if you’re worried about smebody else’s drinking.
It is important that if you are a heavy drinker and might suffer alcohol withdrawal symptoms, you should NEVER stop drinking suddenly. Instead, cut down a little and get immediate medical advice.
Links
The Mental Health Foundation - A leading UK charity that works to improve services for anyone affected by mental health problems, whatever their age and wherever they live.
CALM (Campaign Against Living Miserably) - Aimed at young men aged from 15 to 35; it offers help, information and advice via a phone and web service. Anyone, regardless of age, gender or geographic location can call the line: 0800 58 58 58.
Breathing Space is a free and confidential Scottish phone line for any individual who is experiencing low mood or depression or who is unusually worried and in need of someone to talk to: 0800 83 85 87.
Samaritans provides confidential non-judgemental emotional support, 24 hours a day for people who are experiencing feelings of distress or despair, including those which could lead to suicide. You can ring the phone line on 08457 90 90 90 or email jo@samaritans.org (they try their hardest to get back to you within 24 hours).
Author: Dr Jonathan Chick, MA MBChB MPhil DSc FRCP(Edin) FRC Psych
Dr Jonathan Chick is a Consultant Psychiatrist at Royal Edinburgh Hospital and a part-time senior lecturer in psychiatry at Edinburgh University.
References
1. Singleton N, Bumpstead R, O'Brien M, Lee A, and Meltzer H. Psychiatric Morbidity among adults living in private households, 2000, London: TSO 2001)
http://www.statistics.gov.uk/STATBASE/Product.asp?vlnk=8258
2. Stephens R, Ling J, Heffernan TM, Heather N and Jones K. A review of the literature on the cognitive effects of alcohol hangover. Alcohol & Alcoholism 2008 Vol. 43, No. 2, pp. 163–170.
3. NHS Quality Improvement Scotland 2007 Understanding Alcohol Misuse in Scotland 3: Alcohol and Self-harm www.nhshealthquality.org
4. Department of Health (1993) Health of the Nation Key Area Handbook: Mental Health. London HMSO
5. Parsons OA, Nixon SJ. Cognitive functioning in sober social drinkers: a review of the research since 1986. J Stud Alcohol. 1998 Mar;59(2):180-90.
6. Heffernan TM, Bartholomew J. Does excessive alcohol use in teenagers affect their everyday prospective memory? J Adolesc Health. 2006 Jul;39(1):138-40.
7. De Bellis MD, Van Voorhees E, Hooper SR, Gibler N, Nelson L, Hege SG, Payne ME, MacFall J.
Diffusion tensor measures of the corpus callosum in adolescents with adolescent onset alcohol use disorders. Alcohol Clin Exp Res. 2008 Mar;32(3):395-404.
8. Chick J. Can light or moderate drinking benefit mental health?, Eur Addict Res 5 (1999), pp. 74–81.
Background Reading
Haynes JC, Farrell M, Singleton N, Meltzer H, Araya R, Lewis G, Wiles NJ. Alcohol consumption as a risk factor for anxiety and depression: results from the longitudinal follow-up of the National Psychiatric Morbidity Survey. Br J Psychiatry. 2005 Dec;187:544-51.
Haynes JC, Farrell M, Singleton N, Meltzer H, Araya R, Lewis G, Wiles NJ. Alcohol consumption as a risk factor for non-recovery from common mental disorder: results from the longitudinal follow-up of the National Psychiatric Morbidity Survey. Psychol Med. 2008 Mar;38(3):451-5.
Alati R, Lawlor DA, Najman JM, Williams GM, Bor W, O'Callaghan M. Is there really a 'J-shaped' curve in the association between alcohol consumption and symptoms of depression and anxiety? Findings from the Mater-University Study of Pregnancy and its outcomes. Addiction. 2005 May;100(5):643-51.
Nady El-Guebaly Investigating the Association Between Moderate Drinking and Mental Health. Ann Epidemiol 2007;17:S55–S62.
Power, B. Rodgers and S. Hope, U-shaped relation for alcohol consumption and health in early adulthood and implication for mortality, Lancet 352 (1998), p. 877.
Caldwell TM, Rodgers B, Clark C, Jefferis BJ, Stansfeld SA, Power C. Lifecourse socioeconomic predictors of midlife drinking patterns, problems and abstention: findings from the 1958 British Birth Cohort Study. Drug Alcohol Depend. 2008 Jun 1;95(3):269-78.
Caldwell TM, Rodgers B, Power C, Clark C, Stansfeld SA Drinking histories of self-identified lifetime abstainers and occasional drinkers: findings from the 1958 British Birth Cohort Study. Alcohol Alcohol. 2006 Nov-Dec;41(6):650-4.
Connor J. The life and times of the J-shaped curve. Alcohol Alcohol. 2006 Nov-Dec;41(6):650-4.
Haynes JC, Farrell M, Singleton N, Meltzer H, Araya R, Lewis G, Wiles NJ Alcohol consumption as a risk factor for anxiety and depression: results from the longitudinal follow-up of the National Psychiatric Morbidity Survey. Brit J Psychiatry 2007.
Graham K, Massak A, Demers A, Rehm J. Alcohol Clin Exp Res. 2007 Jan;31(1):78-88. Does the association between alcohol consumption and depression depend on how they are measured?
- Page last updated by
- Root User, 18 Jun 2010.
- Page checked on
- 19 Sep 2008
