Alcohol and Depression
well-researched information for the public
For anyone who is
worried about themselves, a friend or a relative.
About this leaflet
This leaflet is written for:
- anyone who feels depressed and thinks they
may be drinking too much
- anyone who thinks they may be drinking too
much and feels depressed
- friends, family or colleagues of anyone
who is both depressed and drinking.
It contains some basic facts about alcohol
and depression, how to help yourself, how to help people you care
for, how to get further help, and where to find more
Alcohol and us
More than 9 out of 10 people in the United
Kingdom drink alcohol. For most of us it is part of our culture and
we feel comfortable with it. Moderate drinking doesn't cause many
problems. However, over the last 30 years, the UK has become
wealthier and alcohol has become cheaper. We are starting to drink
at a younger age and then drinking more. In the UK:
- About 1 in 3 men and 1 in 6 women will develop some sort
of health problem caused by alcohol
- Around 1 in 11 men and 1 in 25 women are physically
dependent on alcohol.
How does alcohol affect us?
Alcohol tastes good to most adults although
not, usually, to children (although drinking is starting younger).
It can help you to relax, which can make it easier to talk to other
people, especially if you are a bit shy. The downside is that it
can make you unfit to drive, to operate machinery and affects your
ability to make decisions. It also dulls your perception to a
greater or less extent, depending on the amount of alcohol
If you go on drinking, your speech starts
to slur, you become unsteady on your feet and may start to say
things you may regret the next day.
If you drink even more, most people start
to feel sleepy, sick or dizzy. You may pass out. The next day you
may be unable to remember what happened while you were
Becoming dependent on
Alcohol can be a very effective way of
feeling better for a few hours. If you are depressed and lacking in
energy, it can be tempting to use alcohol to help you keep going
and cope with life. The problem is that it is easy to slip into
drinking regularly, using it like a medication. The benefits
soon wear off and the drinking becomes part of a routine. You start
to notice that:
- instead of choosing to have a
drink, you feel you have to have it
- you wake up with shaky hands and a feeling
- you start to drink earlier and
- your work starts to suffer
- your drinking starts to affect your
- you carry on drinking in spite of the
problems it causes
- you find you have to drink more and more
to get the same effect (tolerance)
- you start to ‘binge drink’ (see below)
- other things have less importance than
Alcohol can lead to:
- psychosis - hearing voices when
there is nobody there
- dementia - memory loss, rather like
- physical - damage organs, such as the
liver or brain.
What is the connection between depression and
We know that there is a connection –
self-harm and suicide are much more common in people with alcohol
problems. It seems that it can work in two ways:
- you regularly drink too much including
(including ‘binge drinking’) which makes you feel
- you drink to relieve anxiety or
- Alcohol affects the chemistry of the
brain, increasing the risk of depression.
- Hangovers can create a cycle of waking up
feeling ill, anxious, jittery and guilty.
- Life gets depressing – arguments with
family or friends, trouble at work, memory and sexual
How much alcohol is too much?
Some drinks are stronger than others. The
easiest way to work out how much you are drinking is to count the
‘units’ of alcohol in your drinks. 1 unit is 8 grams /10 ml of pure
alcohol - the amount in a standard 25 ml measure of spirits, a half
pint of 3.6% beer or lager, or a 100 ml glass of 12% wine (see
If a man and woman of the same weight drink
the same amount of alcohol, the woman will end up with a much
higher amount in the organs of her body. So the safe limit is lower
for women (14 units per week) than for men (21 units per week).
What about younger people?
Young people in the UK drink to have fun,
to have the experience of losing control, to socialise more easily
with others, to feel sexier – and because their friends do. Around
a third of 15-16 year olds binge-drink three or more times a month
- more than in most other European countries. Alcohol seems
to have the same depressant effect in younger people as it does in
adults. Around a third of young suicides have drunk alcohol before
their death, and increased drinking may have been to blame for
rising rates of teenage male suicide.
What about older people?
As we get older, we tend to lose muscle and
to put on fat. Alcohol isn't absorbed by fat, so it ends up in the
non-fatty tissues of the body. So, an older person who is the same
weight as a younger person will tend to have more alcohol in their
vital organs (non-fatty tissues) such as brain, muscles and liver.
This means that alcohol will affect an older person more.
The published weekly safe limits assume
that you spread your drinking out with at least 2 alcohol-free days
per week. This may not be the case – you drink a lot on one
night, but still remain within your ‘safe’ limit if you don’t drink
for the rest of the week. There is now evidence that even a
couple of days of heavy drinking can start to kill off brain cells,
as happens with people who drink continuously.
- Drinking over 8 units in a day for men, or
6 units for women is known as binge drinking.
- In any one day it is best for a man to
drink no more than 3-4 units and for a woman to drink no more than
Binge drinking also seems to be connected
with an increased risk of early death in middle-aged men and
Guide to units of alcoholI
Most of us under-estimate the amount we drink – we don't usually
keep an eye on it by counting units regularly. To
check what is really happening, keep a diary of your alcohol intake
over the course of a week. This can give you a clearer idea
of how much you are drinking. It can also help to highlight any
risky situations - regular times, places and people when you seem
to drink more.
- You regularly use alcohol to cope with
anger, frustration, anxiety or depression.
- You regularly use alcohol to feel
- You get hangovers regularly.
- Your drinking affects your relationships
with other people.
- Your drinking makes you feel disgusted,
angry, or suicidal.
- You hide the amount you drink from friends
- Other people tell you that, when you
drink, you become gloomy, embittered or aggressive.
- You need to drink more and more to feel
- You stop doing other things to spend more
- You start to feel shaky and anxious the
morning after drinking the night before.
- You drink to stop these feelings.
- You start drinking earlier in the
- People around/with
you look embarrassed or uncomfortable.
What if I am drinking too much?
- Set yourself a target to reduce the amount
of alcohol you drink.
- Avoid high-risk drinking situations (check
out your diary).
- Drink lower-strength, though full-taste,
drinks, like 4% beers or 10% wines.
- Work out other things you can do instead
- Involve your partner or a friend. They can
help to agree a goal and keep track of your progress.
- Talk it over with your GP. For many people
this simple step helps them to cut down their drinking.
- Caution: if you are drinking heavily, do not stop suddenly ...
consult your GP.
Some people can stop suddenly without any
problems. Others may have withdrawal symptoms - craving, shakiness
and restlessness. If this happens, ask your GP for help.
Helping depression and stopping drinking
We know that most depressed drinkers will
start to feel better within a few weeks of cutting out alcohol. So,
it is usually best to tackle the alcohol first, and then deal with
the depression afterwards if it has not lifted after a few
After a few alcohol-free weeks, you will
probably feel fitter and brighter in your mood. Friends and
family may find you easier to get on with. If your feelings of
depression do lift, it's likely that they were caused by the
If the depression is still with you after
four weeks of not drinking, talk to your GP about further help. It
may be useful to talk over your feelings, particularly if your
depression seems linked to some crisis in your life. Common issues
are relationship problems, unemployment, divorce, bereavement or
some other loss. Counselling may be helpful.
If the depression does not lift and is
particularly severe, your GP may recommend a talking treatment
called ‘cognitive therapy’ or suggest antidepressant medication. In
either case, you will need to reduce or stay away from alcohol
and go on with the treatment for several months. There are some
medications used to reduce the craving for alcohol, but these don’t
seem to help many people and are usually prescribed by a
If you are worried by the idea of stopping
or cutting down your drinking, or if you just can’t cut down, it
might help to talk with a specialist alcohol worker. Your GP can
tell you about the local services - you can then refer yourself or
ask your GP to refer you.
Treatments for alcohol problems and
depression do help, especially if you can regularly see someone you
can trust - your own doctor, a counsellor or a specialist alcohol
worker or a specialist psychiatrist. Changing your habits and style
of life is always a challenge and can take some time.
Dos and Don’ts of drinking safely
- Do sip your drink slowly – don’t gulp it
- Do space your drinks with a non-alcoholic
drink in between.
- Don’t drink on an empty stomach. Have
something to eat first.
- Don’t drink every day. Have two or three
alcohol-free days in the week.
- Do switch to lower strength or alcohol
- Do (for wine) avoid those ‘large’ 250 ml
glasses in bars and restaurants.
- Do provide interesting non-alcoholic
drinks as well as alcohol if you are having a party.
- Do ask your doctor or chemist if it is
safe to drink alcohol with any medicine that you have been
- Do check your drinking every few weeks
with your drinking diary.
- Do keep to the drinking target (amount of
alcohol per week) you have set yourself.
- Don't binge drink – again, check the
If you just can’t stop drinking, or can’t
keep it to a safe level, you can get help from:
- your general practitioner
- voluntary agencies that specialise in
alcohol problems, such as Turning Point or Addaction
- specialist treatment in the NHS - your GP
who will also know how to contact specialist services
- self help groups, such as Alcoholics
Anonymous or AlAnon.
- Davidson K.M. (1995) Diagnosis of
depression in alcohol dependence: changes in prevalence with
drinking status. British Journal of Psychiatry 166:
NHS Information Centre Lifestyle Statistics: Statistics on alcohol:
England, 2012. The Health and Social Care Information Centre:
- Department of Health (2012) Alcohol needs
research assessment project (ANARP). The 2004 national alcohol
needs assessment for England, Department of Health: London.
- Mcintosh C. & Ritson B. (2001)
Treating depression in substance misuse. Advances in
Psychiatric Treatment vol 7, 357-364
- Raistrick D. (1996) Management of alcohol
misuse within the context of general psychiatry, Advances in
Psychiatric Treatment 2:125-132
- Raistrick D, Heather N and Godfrey C
(2006) Review of the effectiveness of treatment for alcohol
problems. National Treatment Agency, London.
- Treating depression in alcohol misuse
(2008) Drugs & Therapeutics Bulletin, 46: 11-14.
Organisations that can
helpAl-Anon Family Groups
UK and Eire:
Provide understanding, strength and hope to anyone whose life
is, or has been, affected by someone else's drinking. It is a
fellowship of relatives and friends of alcoholics who share their
experience, strength and hope in order to solve their common
Tel: 020 7251 5860; email: email@example.com; A
specialist drug and alcohol treatment charity.
Their addiction services are free and confidential.
Anonymous: Tel: 0800 9177 650; email: firstname.lastname@example.org.
Contact details for all English AA meetings. There is a quiz to
determine whether AA is the right type of organisation for
an individual, and a frequently asked question section about
AA and alcoholism.
Concern: Tel: 020 7566 9800; email:
National agency on alcohol misuse which works to reduce the
incidence and costs of alcohol-related harm and to increase the
range and quality of services available to people with
know your units
Drinkline – National Alcohol Helpline: If
you're worried about your own or someone else's drinking, contact
Drinkline for a confidential conversation. Call free on 0300 123
1110 (weekdays 9am – 8pm, weekends 11am – 4pm).
Choices: have information on alcohol, including a unit
calculator and an iphone app.
Tel: 0207 481 7600; email: email@example.com. A
national health and social care provider, with information and
advice for friends and family.
This leaflet was produced by the Royal College of
Psychiatrists' Public Engagement Editorial Board.
Series editor: Dr Philip Timms.
Expert Review: Royal College
of Psychiatrists' Addictions Patient and Carer Liaison Group
This leaflet reflects the best available evidence available at
the time of writing.
Illustration by Lo Cole: www.locole.co.uk
© August 2015. Due for review: August 2018.
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