Alcohol and mental health

Introduction

How alcohol affects the brain and the varying mental side effects that can result from excessive drinking.

Contrary to what many people think, alcohol is not a stimulant – it actually works by depressing brain function. So while small amounts of alcohol might temporarily improve your mood, drinking excessively usually has the opposite effect.

A poll by the Mental Health Foundation of 1,000 people found that nearly eight in ten who drink say it makes them feel more relaxed. Other common reasons for drinking include feeling ‘happy’, ‘more confident’, ‘less anxious’ or ‘less depressed.’

Whilst these findings might be expected, a fact that is less understood, however, is that people who drink heavily are far more likely to suffer from mental illness.

This is one of the conclusions from the ‘Cheers?’ report, also from the Mental Health Foundation (1) The study - subtitled ‘understanding the relationship between alcohol and mental health’ - found that alcohol can provoke both depression and intensify existing mental health problems.

Anxiety and depression

Alcohol can temporarily relieve some negative thoughts and feelings because it alters the chemistry of your brain. That’s why some use drinking as a prop to help ‘cope’ with life or stress. But over the long term, heavy drinking can magnify problems and make life more difficult.

Bridget O'Connell, head of information at Mind, the National Association for Mental Health, points out that in situations where alcohol dependency and mental illness are both present it adds up to a complex picture.

"Some people who experience mental distress may turn to alcohol as a way of 'self-medicating’ and this can result in dependency that may worsen their symptoms,” she explains.
“However, alcohol is a depressant and in some cases it can be difficult to know which problem started first, and which symptoms relate to alcohol and which relate to their mental health."

This kind of ‘self-medicating’ with alcohol can be counter-productive. Increased alcohol use changes the psychology of the brain and reduces its ability to deal with anxiety naturally. This can lead to more alcohol being needed to experience the same reduction in anxiety.

Similarly with depression, levels of serotonin – a chemical in your brain that helps to regulate your mood – are depleted through regular drinking. That means feeling more depressed, and probably drinking more to deal with it. A vicious cycle.

“In the long term a heavy drinker will need more and more alcohol to cope with their feelings,” says Simon Lawton-Smith, head of policy at the Mental Health Foundation.

“Long term heavy drinking changes the chemistry of the brain and there is a significant link between heavy drinking and suicide.”

Suicide, Self-harm and Psychosis

It is estimated that up to two thirds of suicides in the UK are linked to excessive drinking. As many as 70% of successful male suicides are alcohol related, according to the Mental Health Foundation (2).

As well as suicide, alcohol and self-harm are also linked. A survey of self-harm patients at Scottish accident and emergency departments (3) found that nearly two thirds (62%) of males and half (50%) of females had consumed alcohol immediately before or while self-harming.

Dr Ken Checinski is a consultant psychiatrist and senior lecturer in addictive behaviour at St George's Hospital Medical School, University of London. He says when people drink alcohol their impulsivity is increased. This can be linked to extreme behaviour, including self-harm and suicide.

“Most people that self-harm have taken substances, and that usually involves alcohol,” Checinski explains. “Alcohol often makes people lose their inhibitions. It increases impulsivity, which might lead them to take actions they might not otherwise have taken, including self-harm and suicide.

”Drinking more than 30 units per day (the guideline daily amount for men is 2-3 units) 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.

“Alcohol withdrawal symptoms in people who become addicted to alcohol are very dangerous, with 5% of mortality associated with untreated alcohol withdrawal,” says Checinski.

Memory and brain

Alcohol can also damage your memory and brain function. After only a few drinks your memory can be impaired and your brain processes slow down. Larger quantities of alcohol can lead to short-term memory failure or ‘blackouts’. Drinking heavily over a long period of time can also have long-term effects on memory.

Alcohol affects many parts of the brain and the brain doesn’t regenerate very much if at all,” he adds. “With long-term heavy drinking, recalling old memories and laying down new ones can become more difficult.”

There is particular concern about the effects on younger drinkers because the brain is still developing until the age of 18 or 19.

“People who start drinking at a young age, sometimes 12 or 15 years-old, are more at risk of mental impairment,” Checinski concludes.

For more information view our alcohol, mental health and wellbeing factsheet.

If you’re worried that drinking is affecting your mental health, contact your GP. You can also call Drinkline on 0800 917 8282, a free confidential helpline (open 24hrs a day, 7 days a week).