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Alcohol and Mental Health

Alcohol can interact with mental health problems in various ways:

People with mental health problems are at particular risk of experiencing problems relating to alcohol;
People diagnosed as having an alcohol dependence problem are also more likely to suffer from other mental health problems;
There is a high correlation between alcohol dependence and Posttraumatic Stress Disorder (PTSD). Eighty eight percent of veterans with a DVA accepted disability of alcohol dependence have a coexisting mental health condition, most commonly PTSD.

Depending on the type of mental health problem, alcohol can:

lead to poorer outcomes;
make the symptoms worse;
increase the risk of alcohol dependence;
interact in a harmful way with the medications prescribed for that problem, and/or with other drugs;
contribute to worse moods in the longer term;
result in disrupted sleep that may trigger some mental health problems.

Anyone with a mental health problem should therefore discuss their alcohol intake with their doctor.

People with a mental health problem need to be extremely careful with alcohol
If they do drink:

They should take particular care to stay within the Low-Risk Guidelines.
They should consult with their doctor or pharmacist about possible side-effects.
They may need to consider not drinking at all, if they find it difficult to keep their drinking within these guideline levels; and to stop drinking entirely if symptoms persist.

Low-Risk Guidelines
For men	For women
No more than 4 standard drinks a day on average and no more than 6 standard drinks on any one day These drinks should be spread over several hours One or two alcohol-free days per week To avoid intoxication men should have no more than 2 standard drinks in the first hour and 1 per hour after that	No more than 2 standard drinks a day on average and not more than 4 standard drinks on any one day These drinks should be spread several hours One or two alcohol-free days per week To avoid intoxication women should have no more than 1 standard drink per hour

Carers can encourage people with a mental health problem to stay within guideline levels, or to abstain if necessary.

Ways in which alcohol can make mental health problems worse

There is clear evidence that drinking above the levels set in the Guidelines can lead to poorer outcomes for people who have a mental health problem:

In particular, people who are depressed and sometimes drink excessively are at much greater risk of self-harm and suicide, especially if they also drink regularly above guideline levels.
There is also some evidence that alcohol use is associated with poorer outcomes for people suffering from schizophrenia, and that even low risk drinking can worsen the symptoms of this condition.
Alcohol can interact in harmful ways with most of the medications prescribed for mental health problems, even at low levels of drinking (1-2 standard drinks).
Alcohol can cause disrupted sleep. Even one or two drinks may result in reduced sleep quality and early morning waking; and disruption of sleep can be a trigger for a variety of mental health problems.
Heavy drinking can also make symptoms worse for people with milder degrees of anxiety and depression.
Many veterans report the misuse of alcohol to cope with the symptoms of PTSD.

Links between alcohol dependence problems and other mental health problems:

With some mental health problems, the risk of alcohol dependence is significantly increased, particularly where the person drinks to relieve anxiety or change their mood.
There is also considerable evidence that people with a mental health problem are more likely than the general population to have an alcohol misuse or dependence problem.
Alcohol misuse is itself a causal factor in a number of mental health conditions including alcoholic psychosis, alcohol dependence syndrome and alcohol-related dementia.

The relationship between alcohol use and anxiety is complex:

Alcohol can provide temporary relief for people experiencing significant anxiety, and people with significant alcohol dependence have reported that alcohol helps to reduce their anxiety.
However, while alcohol consumption may bring some relief from anxiety or stress in the short-term, it can worsen mood in the longer term, especially with continued drinking over two days or more, and/or at higher levels of consumption.

Adapted from:
Australian Department of Health and Ageing, Australian Alcohol Guidelines Fact Sheets www.alcoholguidelines.gov.au

Principal source:
National Health and Medical Research Council (NHMRC) (2001). Australian Alcohol Guidelines: Health Risks and Benefits. NHMRC, Canberra.

Other sources:
Alcohol in Australia: Issues and Strategies. (2001) Commonwealth Department of Health and Aged Care, Canberra.

National Alcohol Strategy: A Plan for Action 2001 to 2003-04. (2001) Commonwealth Department of Health and Aged Care, Canberra.

People with mental health problems are at particular risk of problems with alcohol.

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