How Alcohol Affects Mental Health and Well-Being

Alcohol often is seen as a “social lubricant” or a way to unwind after a long day. However, its effects on mental health and overall well-being are far more complex than many realize.

While moderate drinking may seem harmless, the line between casual use and problematic patterns can blur quickly. From increased anxiety and depression to disrupted sleep and cognitive changes, alcohol’s impact on mental health can be profound and far-reaching.

Here, Dr. Muhammad Awais Aftab, a psychiatrist on the Medical Staff at Southwest General Health Center, discusses how alcohol affects the brain, mood and emotional resilience—shedding light on the crucial connection between drinking habits and mental wellness.

What Effect Does Alcohol Have on the Mind and Body?

Alcohol has both short- and long-term effects on the brain. In the short term, it increases GABA and dopamine activity, which produces calming, pleasurable feelings and reduces inhibition. However, it also suppresses glutamate, leading to adverse effects such as poor memory, slurred speech and impaired coordination.

As blood alcohol levels drop, a rebound effect can occur, causing irritability and fatigue. While occasional moderate use poses little risk, frequent heavy drinking disrupts brain chemistry over time, increasing the risk of mental health issues and physical health problems.

“From a medical point of view, it's difficult to say that any amount of alcohol is completely safe. Even small amounts of alcohol present some degree of risk, both in terms of mental health risks as well as physical health risks,” cautions Dr. Aftab. “For example, the amount of alcohol we consume is linked to increased risk of cancer.”

The Danger of Mixing Alcohol with Psychiatric Medications

Combining alcohol with psychiatric medications, especially those with sedating effects such as certain antidepressants, mood stabilizers and antipsychotics, can lead to excessive drowsiness, impaired functioning and an increased risk of accidents. Regular alcohol use also can reduce the effectiveness of medications such as antidepressants and anti-anxiety drugs.

These risks are even greater in older adults, where the combination can contribute to memory problems, dementia and falls. Additionally, alcohol-related dehydration can increase the risk of lithium toxicity in those taking mood stabilizers such as lithium.

“The general recommendation, again, is to minimize alcohol use as much as possible,” states Dr. Aftab. “I tell most patients that if they use alcohol judiciously, a few times a month in reasonable amounts, that poses little interference with their psychiatric medications—in most cases. It starts becoming a problem if they're drinking most days of the week or they're drinking large amounts. That is where the interaction with medications becomes more concerning.”

Connection Between Alcohol Use and Mental Health Issues

Alcohol and mental health issues such as depression and anxiety have a bidirectional relationship, each can contribute to the other. People with depression or anxiety are more likely to develop alcohol use problems, and those who misuse alcohol are at a significantly higher risk (two to three times) of developing these mental health disorders.

Some individuals use alcohol to self-medicate emotional distress, but this often worsens symptoms over time. Chronic alcohol use alters brain chemistry, reducing natural dopamine function and leading to emotional numbness, low mood and increased risk of long-term depression and anxiety. Healthier alternatives include prescribed psychiatric treatment and therapy.

Red Flags to Watch Out For

Warning signs of problematic alcohol use include increasing irritability, anxiety or depression, especially if alcohol is needed to feel "normal" again. Other red flags are escalating consumption over time; relying on alcohol to cope with stress, sleep or social situations; and experiencing memory issues, blackouts, trouble concentrating or declining performance at work and in relationships. Withdrawal symptoms during periods of not drinking also can indicate alcohol dependence and may require clinical attention.

“Those are all signs that an alcohol use problem or an alcohol addiction is brewing. In that case, the person needs help to manage their alcohol use,” advises Dr. Aftab. “The best starting point is talking to one's primary care physician because primary care physicians are trained to screen for and assess these initial difficulties. Then they can provide additional details about safe drinking, moderate drinking and refer people to the appropriate resources.”

Help Is Available

For individuals experiencing active alcohol withdrawal, the emergency room is the safest place to receive immediate care. For ongoing alcohol addiction, psychiatric services are available to explore treatment options, including medication and counseling.

Southwest General’s Oakview Behavioral Health Services offers specialized addiction counseling and intensive outpatient programs (IOPs). These structured programs typically run several days a week and provide group therapy, education and supportive resources to help individuals begin and maintain recovery from alcohol or other substance use disorders.

To schedule an appointment or to learn more about our behavioral health services, visit www.swgeneral.com.