Reducing harm caused by alcohol


Alcohol and mental health are closely linked

Thanks to See Me and others there is increasing openness and awareness about mental health issues in Scotland and an emerging political consensus that we need to do more. 

The Scottish Government recently consulted on a new ten year vision which emphasises the importance of good mental health for all and supporting people to look after themselves to stay mentally and physically healthy. The focus is on acting early when problems emerge, and improving access to mental health services and make them more efficient, effective and safe.

It is estimated that one in three Scots are affected by a mental health problem each year, with depression and anxiety the most common illnesses.  Having been touched myself, I joined the Board of Penumbra, an innovative Scottish mental health charity that supports more than 1,000 people a week in their recovery and is a pioneer in employing people who have first-hand experience to provide peer support.   

But there’s a clear overlap with my day job too.  Alcohol and mental wellbeing are closely linked. Often one of the main reasons for drinking alcohol is to change our mood - or our mental state. Pouring a drink is a reward after a hard day; we might feel that we need or deserve a drink having got through a busy week, or if we’re feeling a bit low, a drink is a ‘pick me up’.

While alcohol might help us to unwind or feel relaxed at the time, these feelings are not long lasting.  Alcohol disrupts our sleep, leaving us tired and irritable. It can affect our memory, both in the short and long-term. The day after drinking we may find it hard to concentrate and can feel anxious, bad-tempered or miserable.

Using alcohol to cope with emotions or regulate mood can cause problems because alcohol is a depressant. Drinking a lot dulls the 'feel good' systems in the brain so more alcohol is needed to achieve the same effects. In the long run, drinking can reduce mental wellbeing and contribute to feelings of anxiety and depression, rather than relieving them. Drinking too much can become a harmful coping mechanism.

Better ways to cope

There are much better ways to cope with stress than instinctively reaching for the bottle. Regular exercise is one of the best ways to keep a healthy body and mind, along with eating well and getting adequate sleep. Sharing worries with family and friends or talking to a trained counsellor who can offer techniques to anticipate and manage stress will also help.

Of course, there are many reasons why someone drinks too much. Stressful experiences like divorce or job loss can lead people into excessive drinking, but drinking too much can also cause problems in relationships and work. It may also contribute to financial worries or even involvement with the law. And knowing we’re drinking too much can be stressful in itself, affecting self-esteem.

Heavy drinking can also lead to impulsive, irrational behaviour. There are strong links between alcohol misuse, self-harming behaviour, suicidal thoughts and completed suicides. The link to suicide in young men was one reason why the Chief Medical Officers have reduced the guideline for men to the same level as women - no more than 14 units of alcohol per week.  

One in four of us are exceeding these drinking guidelines, increasing our risk of mental health problems, high blood pressure, cancer and liver disease. Fourteen units is the equivalent of six pints of beer, a bottle and a half of wine, or half a bottle of spirits. It is best to spread this evenly across the week rather than drinking it all at once.

The guidelines also caution that some groups of people are more likely to be affected by alcohol and should be more careful of their level of drinking on any one occasion for example, those on medication that may interact with alcohol, or where it may exacerbate pre-existing physical and mental health problems.

Alcohol and mental health services

People diagnosed with co-occurring alcohol and mental health problems have complex needs. It is important that they receive appropriate support to address both problems but too often there is a gap in support and service provision.  Innovative approaches such as Milestone, Penumbra’s alcohol-related brain damage unit in Edinburgh, remain exceptional.  And sadly the stigma experienced by many of those with mental health problems can be compounded if people also have addiction issues.  

The Scottish Government’s investment in mental health is welcome.  But it is vital that this is not undermined by their 22% reduction in direct funding for alcohol and drugs prevention, treatment and support services. The potential impact of this funding cut on vulnerable people is of real concern.

There is a strong inequalities dimension to both mental health problems and alcohol harm. People living in the most deprived areas are eight times more likely to need hospital treatment for alcohol and three times more likely to spend time in hospital as a result of mental illness, compared to people living in the least deprived areas. Tackling both in a way that recognises their complex and mutually reinforcing relationship will help to reduce health inequalities in Scotland.

Evidence-based action to reduce alcohol consumption - such as tackling price, availability and marketing – will contribute to the Scottish Government’s vision of good mental health for all.

Alison Douglas, Chief Executive, Alcohol Focus Scotland

If you are concerned about your own or someone else’s drinking, speak to your GP or contact a local alcohol support service. Find your nearest alcohol service

Breathing Space is a confidential phone line for anyone feeling low, anxious or depressed: 0800 83 85 87