Alcohol and Mental Health

Learn about what alcohol really does to your brain in our comprehensive guide.

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Last updated: Dec 27th, 2023
Alcohol and mental health

Many people enjoy drinking alcohol; it can positively impact the drinker’s mood and make them feel confident and more relaxed, even if it's only for a short while. However, despite its temporary feel-good benefits, it can adversely affect a person’s mental health in the long run, such as by making depression symptoms worse.

From memory loss and learning difficulties to anxiety and even suicide, heavy and frequent alcohol drinking has been linked to numerous mental health problems. This is because drinking alcohol can interfere with the normal workings of the brain, altering the chemicals (neurotransmitters) that help us maintain optimal mental health. So, the more a person drinks alcohol, the less able they may be to deal with stress, anxiety, and other mental health conditions.

With about 63% of Americans partaking in this popular substance, alcohol’s effects are an important topic to cover. In this guide, we delve into all the information you need to know about how alcohol can affect your mental health.

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How alcohol affects your brain chemistry

You may have heard that alcohol is a depressant, and that's true. Like every other depressant, alcohol can disrupt your brain's delicate chemical balance and alter what you feel, how you think, and what you do — potentially affecting your overall mental wellness in the long term. However, that's only one part of the explanation as to how alcohol can affect the brain's chemistry. To get the full picture, we'll need to discuss neurotransmitters.

Neurotransmitters are chemical messengers that are responsible for transmitting signals among brain nerves (neurons) that control behavior, emotion, and processes. When you feel good after a drink or two, that’s because the alcohol has suppressed the release of certain neurotransmitters. For example, glutamate is an excitatory neurotransmitter that triggers brain activity and increases energy levels. The effect of alcohol inhibiting glutamate release is altered synaptic plasticity, affecting your memory and ability to learn.

Alcohol can also increase the brain's production of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that reduces energy levels and increases sedation. The effects alcohol has on both glutamate and GABA are what lead to common signs of intoxication — and the more alcohol in your system, the more symptoms emerge.

Dopamine is a "feel good" neurotransmitter that increases as you drink more alcohol. As your dopamine levels rise, your brain’s hormones signal feelings of pleasure and enjoyment. However, with more drinks, dopamine levels will reach an all-time high and start diminishing. Over time, and with continued drinking, this can make you require more and more to feel as good — this leads to further tolerance, depression, and, potentially, dependence as your brain expects to experience that higher level of dopamine.

Can alcohol cause anxiety?

Anxiety is a normal reaction to stress, and many people experience it at some point in their lives. (External triggers often cause stress, and anxiety is defined as persistent worry even when there isn’t a stressor.) For example, it's okay to feel anxious as you step on the stage to speak to a crowd or as you await your laboratory results. Usually, anxiety goes away after the stressor has been removed, but, for some people, anxiety may also linger for so long that it causes you distress and affects your daily life. This is when normal anxiety becomes an anxiety disorder.

If you're experiencing persistent anxiety or stress, a glass of wine might seem tempting to calm your nerves. However, alcohol can’t fix emotional problems or mental health concerns; it’s only acting as a temporary fix, not a treatment of the root cause of your anxiety.

Since the effects of alcohol wear off quickly, you may be tempted to continue drinking to mask your stress and anxiety. As you increase your alcohol intake and become more reliant on it for relief, your tolerance levels also increase. With time, you'll need larger amounts of alcohol to get the feeling you desire. This is often the blueprint for alcohol dependency, which further worsens your anxiety.

Excessive use of alcohol affects the amygdala, the area of your brain responsible for managing negative emotions. Amygdala functional anomalies have been discovered in brain imaging investigations of people with alcohol use disorders. Too much alcohol can make you less capable of handling stress healthily, thereby triggering anxiety. And hangovers can also trigger or worsen anxiety.

The cycle of alcohol and depression

Just like anxiety, people experiencing depressive episodes often find them overwhelming and unmanageable. To quell these feelings, some people drink alcohol to make them feel better, but, as with anxiety, this doesn’t get to the root of the problem and only acts as a temporary band-aid with the potential to make things worse.

Studies have shown that people with alcohol dependence are 3.7 times more likely to also have major depressive disorders. In fact, depressive disorders are among the common mental disorders discovered in people with alcohol use disorders. Seeing as alcohol directly affects the areas of the brain that manage emotions, this makes a lot of sense.

Drinking and depression is a vicious cycle, as heavy drinking can lead to depression, and depression can trigger alcoholism. First, alcohol lowers serotonin levels in your brain (serotonin is a neurotransmitter that regulates your mood). Since drinking too much decreases its ability to balance your mood, your chance of developing depression significantly increases.

On the other hand, people with depressive disorders have a higher likelihood of self-soothing with alcohol. This harms the brain by worsening depression, which can trigger people to drink more. In other words, depression and alcohol use disorder often coexist, with one worsening the other.

It’s worth noting that most physicians advise against drinking when taking antidepressants. This is because some regularly prescribed antidepressants appear to raise the risk of relapsing into heavy drinking if taken by someone trying to withdraw from the substance.

Psychosis, self-harm, and suicide

In the chart below, we cover three other mental health concerns that have links with alcohol use disorder — psychosis, self-harm, and suicide.


Psychosis isn’t a condition in itself but rather “a collection of symptoms” that involve losing touch with reality in some way. These symptoms can include things like delusions, hallucinations, paranoia, illogical thinking, or acting inappropriately. People with psychosis may also experience sleep disruption, social withdrawal, lack of motivation, and anxiety.

According to the National Institute of Mental Health, an estimated 15-100 people out of every 100,000 develop psychosis each year. And while there’s no single cause of psychosis, this mental health concern has been linked to genetic conditions and other mental illnesses such as bipolar disorder, severe depression, schizophrenia, and the misuse of alcohol.


Self-harm is also called nonsuicidal self-injury (NSSI). NSSI is defined as the purposeful harming of your own body without suicidal intent. Some examples of self-harm include cutting, burning, scratching, hitting, and more. Often, those who self-harm use more than one method.

For some, self-injury can provide a sense of relief or a way of taking back a sense of control over a situation. Regardless of the reasons for self-harming, the calming effects are temporary, and it can make the painful emotions feel worse once the calm fades off. It's important to note that self-harm has been associated with multiple mental health conditions such as anxiety, depression, and alcohol use disorder. And alcohol can lower inhibitions, which may increase the risk of self-harm.


The Centers for Disease Control and Prevention (CDC) defines suicide as “death caused by injuring oneself with the intent to die.” Suicide is one of the leading causes of death in the United States; in 2021, the CDC recorded 48,183 suicide-related deaths, which amounts to one every 11 minutes. As with several other mental health concerns, like depression and anxiety, suicide has been linked to alcohol use disorder.

Note: If you or someone you care about is in a crisis, please contact the suicide and crisis lifeline by texting or calling 988.

It’s worth noting that while alcohol misuse can cause or contribute to these concerns, they may also be symptoms of alcohol withdrawal in those who are dependent. This is because the body and mind can react strongly to suddenly cutting off the substance they’ve grown to rely on to adapt to stressors. Alcohol withdrawal symptoms can be life-threatening, and that's why rehab or professional assistance can be necessary for some people aiming to break the habit.

Signs of alcohol dependence and how to limit drinking

If you’re concerned about alcohol use disorder, here are some telltale signs to look out for:

  • It’s difficult to limit or reduce the amount of alcohol you drink, even if you want to.
  • You feel strong urges or cravings to drink alcohol.
  • Even if you know your alcohol use is causing difficulties, it feels impossible to stop.
  • Alcohol is leading to issues fulfilling your obligations at school, work, home, or with family and friends.
  • You experience withdrawal symptoms like sweating, shaking, and nausea when you try to stop drinking.
  • You drink in secret or downplay how much you drink in general.

According to the U.S. Dietary Guidelines, adults who drink should limit it as follows:

  • Women and AFAB individuals should limit their drinking to one or less in a day.
  • Men and AMAB people should try to keep their alcohol consumption to two or less in a day.

The National Institute on Alcohol Abuse and Alcoholism also clarifies that binge drinking should also be avoided; this is defined as drinking that brings your blood alcohol concentration to 0.08% or higher. On average, this happens after a woman has four or more drinks or a man has five or more drinks within roughly two hours.

And heavy drinking, or heavy alcohol use, includes binge drinking and is defined as:

  • For men, drinking five or more drinks in a given day or 15+ per week.
  • For women, consumption of four or more drinks on any day or eight or more per week.
  • In its definition of heavy alcohol use, SAMHSA includes the criterion of binge drinking on five or more days in the past month.

How to handle stressors without alcohol

Many people struggle with alcohol dependence because they're looking for ways to deal with stress, anxiety, and depression. Unfortunately, alcohol is an unhealthy coping mechanism that's capable of worsening your problems. The good news, though, is that there are numerous effective and healthy ways to cope.


More than just keeping your body in shape, exercise can also significantly improve your mental wellness by helping you fight depression and stress. When you partake in physical activity, your brain releases feel-good endorphins and other natural brain chemicals that lift your mood. Like alcohol, exercising takes your mind off your troubles and can provide you with a feeling of relaxation afterward.

Fortunately, unlike alcohol, working out isn’t associated with an increase in depression. This makes it a healthy coping mechanism you can incorporate into your daily life. Another good thing about physical activity is that it doesn't have to be strenuous. Activities like gardening, taking a walk, and washing your car can still provide you with benefits.


Meditation for depression and stress helps you relieve symptoms by altering the way you react to how you feel. It can help your brain to sustain its focus when negative emotions and thinking intrude. By helping your brain ignore negative stress sensations, your way of thinking can change over time, directing your mind to more positive thoughts and ensuring that your brain functions optimally under stress.


There is a strong connection between depression and sleep disorders. Like alcohol and depression, sleep and depression have a bidirectional relationship. Studies have shown that people with insomnia have a much higher risk of slipping into depression than others. In fact, almost 75% of depressed people also struggle with sleep. As such, the more you can get a good night's sleep, the better your chances of fighting depression and stress.

According to the CDC, people 18 and older need to sleep for seven or more hours every night. When you sleep, various brain activities increase and decrease as you enter various sleep stages and complete your sleep cycle. These activities are known to improve mental and emotional health. If you have trouble sleeping, little lifestyle changes like exercise, maintaining a comfortable atmosphere, and avoiding large meals before bed can help.

Eat a healthy, balanced diet

Your mental health, to a large extent, is reflective of what goes into your body. Nutritional deficiencies can increase your risk of mental illnesses, especially depression and schizophrenia. As such, experts encourage people to ensure adequate intake of food items rich in selenium, vitamin D, omega-3s, zinc, proteins, probiotics, antioxidants, and B vitamins. Some healthy foods that can help with this include walnuts, oily fish, whole grains, milk, eggs, fruits, and dark leafy vegetables.

Besides nutritional deficiencies, eating more of certain kinds of food can also have a negative impact on your mental health. For example, an excess of processed foods has been associated with an increased risk of depression.

Work around your triggers

Coping with anxiety and depression may be helped by understanding your body, recognizing what triggers you, and trying to avoid excessive stress. For example, if boredom triggers your anxiety, you can try to plan ahead to prevent it by scheduling activities or starting a new, engrossing hobby.

Other healthy activities that can help you cope with stress and depression include spending time with friends and family, engaging in entertainment, volunteering, and more.

Resources for you or your loved one

If you or someone you know has alcohol use disorder (or you suspect it), there are many resources and support groups dedicated to helping you through the process. Below, we’ve compiled several resources that can help you or your loved one find assistance or more information on the recovery process.



Additional information and other resources



Innerbody uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Merz, B. (2017). This is your brain on alcohol. Harvard Health Publishing.

  2. The Jed Foundation. (n.d.). Understanding the Mental Health and Drinking Connection. The Jed Foundation.

  3. Centers for Disease Control and Prevention. (2022). Alcohol Use and Your Health. CDC.

  4. Banerjee, N. (2014). Neurotransmitters in alcoholism: A review of neurobiological and genetic studies. Indian Journal of Human Genetics, 20(1), 20-31.

  5. Saad, L. (2022). What Percentage of Americans Drink Alcohol? Gallup.

  6. National Library of Medicine. (n.d.). Alcohol. MedlinePlus.

  7. Cleveland Clinic. (2022). Neurotransmitters. Cleveland Clinic.

  8. Pal, M. M. (2021). Glutamate: The Master Neurotransmitter and Its Implications in Chronic Stress and Mood Disorders. Frontiers in Human Neuroscience, 15.

  9. Bell, R. L., Sari, Y., & Rahman, S. (2019). Alcohol and Central Glutamate Activity: What Goes Up Must Come Down? Neuroscience of Alcohol, 453-461.

  10. Huys, Q., & North London Mental Health Partnership. (n.d.). The unhealthy mix between alcohol and mental health. Camden and Islington NHS Foundation Trust.

  11. Cleveland Clinic. (2022). Gamma-Aminobutyric Acid (GABA). Cleveland Clinic.

  12. Duke University. (n.d.). The Alcohol Pharmacology Education Partnership. Duke Express.

  13. Cleveland Clinic. (2022). Dopamine. Cleveland Clinic.

  14. Chiara, G. D. (1997). Alcohol and Dopamine. Alcohol Health and Research World, 21(2), 108-114.

  15. Ma, H., & Zhu, G. (2014). The dopamine system and alcohol dependence. Shanghai Archives of Psychiatry, 26(2), 61-68.

  16. Mayo Clinic. (2018). Anxiety disorders. Mayo Foundation for Medical Education and Research (MFMER).

  17. National Institute of Mental Health. (n.d.). Anxiety Disorders. NIH.

  18. Tomasi, D., Wiers, C. E., Manza, P., Shokri-Kojori, E., Michele-Vera, Y., Zhang, R., Kroll, D., Feldman, D., McPherson, K., Biesecker, C., Schwandt, M., Diazgranados, N., Koob, G. F., Wang, J., & Volkow, N. D. (2021). Accelerated Aging of the Amygdala in Alcohol Use Disorders: Relevance to the Dark Side of Addiction. Cerebral Cortex (New York, NY), 31(7), 3254-3265.

  19. McHugh, R. K., & Weiss, R. D. (2019). Alcohol Use Disorder and Depressive Disorders. Alcohol Research: Current Reviews, 40(1).

  20. Napryeyenko, O., Napryeyenko, N., Marazziti, D., Loganovsky, K., Mucci, F., Loganovskaja, T., & Tsekhmister, Y. (2019). Depressive Syndromes Associated with Alcohol Dependence. Clinical Neuropsychiatry, 16(5-6), 206-212.

  21. Lovinger, D. M. (1997). Serotonin’s Role in Alcohol’s Effects on the Brain. Alcohol Health and Research World, 21(2), 114-120.

  22. Hall-Flavin, D., & Mayo Clinic. (n.d.). Why is it bad to mix antidepressants and alcohol? Mayo Foundation for Medical Education and Research (MFMER).

  23. National Institute of Mental Health. (n.d.). Understanding Psychosis. NIH.

  24. Klonsky, E. D., Victor, S. E., & Saffer, B. Y. (2014). Nonsuicidal Self-Injury: What We Know, and What We Need to Know. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 59(11), 565-568.

  25. State Government of Victoria, Australia. (n.d.). Self-harm and self-injury. BetterHealth Channel.

  26. Sadath, A., Troya, M. I., Nicholson, S., Cully, G., Leahy, D., Ramos Costa, A. P., Benson, R., Corcoran, P., Griffin, E., Phillip, E., Cassidy, E., Jeffers, A., Shiely, F., Alberdi-Páramo, Í., Kavalidou, K., & Arensman, E. (2023). Physical and mental illness comorbidity among individuals with frequent self-harm episodes: A mixed-methods study. Frontiers in Psychiatry, 14.

  27. Centers for Disease Control and Prevention. (2023). Facts About Suicide. CDC.

  28. Pompili, M., Serafini, G., Innamorati, M., Dominici, G., Ferracuti, S., Kotzalidis, G. D., Serra, G., Girardi, P., Janiri, L., Tatarelli, R., Sher, L., & Lester, D. (2010). Suicidal Behavior and Alcohol Abuse. International Journal of Environmental Research and Public Health, 7(4), 1392-1431.

  29. Saitz, R. (1998). Introduction to Alcohol Withdrawal. Alcohol Health and Research World, 22(1), 5-12.

  30. Mayo Clinic. (2022). Alcohol use disorder. Mayo Foundation for Medical Education and Research (MFMER).

  31. National Institute on Alcohol Abuse and Alcoholism. (n.d.). The Healthcare Professional's Core Resource on Alcohol - The Basics: Defining How Much Alcohol is Too Much. NIH.

  32. National Institute on Alcohol Abuse and Alcoholism. (2023). Drinking Levels Defined. NIH.

  33. American Psychological Association. (2020). Working out boosts brain health. APA.

  34. Harvard Medical School. (2017). How meditation helps with depression. Harvard Health Publishing.

  35. Johns Hopkins Medicine. (n.d.). Depression and Sleep: Understanding the Connection. The Johns Hopkins University.

  36. Centers for Disease Control and Prevention. (2022). How Much Sleep Do I Need? CDC.

  37. National Institute of Neurological Disorders and Stroke. (2023). Brain Basics: Understanding Sleep. NIH.

  38. Sathyanarayana Rao, T. S., Asha, M. R., Ramesh, B. N., & Jagannatha Rao, K. S. (2008). Understanding nutrition, depression and mental illnesses. Indian Journal of Psychiatry, 50(2), 77-82.

  39. Harvard T.H. Chan School of Public Health. (2023). Ultra-processed foods may increase risk of depression. The President and Fellows of Harvard College.

  40. American Psychological Association. (2022). What’s the difference between stress and anxiety? APA.