Can alcohol cause anxiety and depression?

Published June 2024 | 5 min read
Expert contributors Dr Sally Hunt, clinical psychologist and senior lecturer at the University of Newcastle; Associate Professor Shalini Arunogiri, clinical director of Turning Point and the Hamilton Centre
Words by Angela Tufvesson

Alcohol and mental health problems are closely linked – and each can make the other worse. Learn how to recognise the signs and where to go for support.    

Benn Vennker had his first alcoholic drink at just 13 years old. “At the time, I was unaware I was living with quite a bit of anxiety as a young fellow growing up,” he says. “Alcohol was a great tool to help me cope with that, and as life progressed it became my main tool for managing mental health.” 

By the time he was 23, Benn was drinking every day – a pattern that persisted for 10 years. Benn watched as siblings and friends moved forward with their lives and says that feelings of depression and suicidal thoughts “became a regular feature” on top of his anxiety.  

“There were plenty of days I drank to excess, but it wasn’t necessarily huge, excessive amounts of alcohol every day,” he says. “It was that I needed to drink every day to feel normal and relaxed because the internal dialogue was pretty awful.  

“I was trying to manage my anxiety and mental health issues with alcohol, which was making the mental health issues worse, and it just kept going round and round.” 

While it can provide a momentary mood boost, alcohol disrupts chemicals and processes in the brain over the long term – the effects of which can be more serious if you have a mental health condition like anxiety or depression. In a nasty vicious cycle, mental health problems can make alcohol use worse, and alcohol use can make mental health problems worse.  

Breaking the cycle can make a big difference to your sleep, as well as your health and wellbeing. Eventually, Benn sought help, first from his parents and then at a treatment centre. Now, he’s married with two children and works as a drugs and alcohol counsellor. “I don't need a drink to go out and have fun anymore,” he says. “I've adopted new strategies to manage my anxiety and mental health.” 

Can alcohol cause anxiety and depression? 

The relationship between alcohol and mental health can be complex, and it can go both ways. Research shows people who drink alcohol are more likely to develop mental health conditions. Likewise, people with mental health conditions are more likely to drink at risky levels (including binge drinking) than people without these conditions.  

Statistics from the Australian Institute of Health and Welfare show 37% of people with mental health conditions drink at unsafe levels, compared with 32% of people without a mental health condition.

“Once those two processes are happening, they make each other worse,” says Dr Sally Hunt, a clinical psychologist and senior lecturer at the University of Newcastle. “Mental health conditions and alcohol use conditions tend to co-occur at rates that are greater than you'd expect to see randomly in the population.”

She says a typical example is developing a habit of drinking alcohol to relax after a stressful day or to combat anxiety in social situations. “Then people think they can only relax or go to a party if they’re drinking, so it becomes a vicious cycle of drinking to cope, then having to cope with your drinking.”

On top of that, notes Dr Hunt, if a person has anxiety or depression they are more susceptible to alcohol use disorder. Teens and first-time drinkers are also at a higher risk of starting heavy alcohol use. Generally, first-time drinkers feel the effects of alcohol more strongly than those who are familiar with alcohol. This is because when we drink, receptors in the brain release dopamine, the chemical responsible for pleasure. However, the more your body is used to drinking alcohol, even in small amounts, the less dopamine the body releases.

Alcohol use and dependence is more common in men, but women are less likely to access support due to barriers like stigma and discrimination.

Hangxiety and the link between alcohol and mental health

Alcohol is a depressant. It slows down processes in your brain and central nervous system, which can make you feel more relaxed in the short term – but these effects wear off quickly. If you have a lot to drink, the next day you might feel stressed and panicked.

This is hangover anxiety, or ‘hangxiety’, explains Associate Professor Shalini Arunogiri, clinical director of Turning Point and the Hamilton Centre, which offers integrated care for people with mental health and substance use conditions.

“What happens is you have the opposite of an intoxication effect,” she says. “It’s a rebound effect of feeling more stressed and more anxious as your brain works to restore its chemical balance after the previous evening.”

Over time, alcohol can use up and reduce the chemicals, or neurotransmitters, in your brain that it needs to ward off anxiety and depression. This can make you want to drink more to relieve difficult feelings.

“You end up in a cycle where you're using the alcohol to ameliorate [to improve] low mood or high anxiety levels, but actually what you're treating is withdrawal from alcohol itself,” explains Assoc Prof Arunogiri.

Common signs alcohol may be affecting mental health

Australian guidelines recommend drinking no more than 10 standard drinks a week and no more than four standard drinks on any one day. Crucially, Dr Hunt says these are recommended levels for minimising risk – not levels for safe use.

“Alcohol is a type-one carcinogen just like nicotine and on its own is responsible for at least 15 different cancers,” she says. “There is no safe amount of alcohol.”

Some studies have found that people who binge drink are more likely to have symptoms of depression, but Dr Hunt says drinking at risky levels can look much more subtle.

“People who open a bottle of wine with dinner most nights or wouldn’t consider going out to a restaurant and not ordering a glass of wine – these are the people who sometimes think their drinking is fine because they’re not drinking to get drunk or embarrassing themselves,” she says. “But they are still drinking consistently, and they’ve maybe forgotten what it feels like to not drink.

“You don't need to be that stereotypical image of somebody who can't stop drinking to have a problem with drinking or for drinking to be negatively impacting you.”

Support for alcohol and mental health

If you’re concerned about how your relationship with alcohol may be affecting your mental health or vice versa, Assoc Prof Arunogiri suggests taking a week off drinking and seeing how your brain and body feel.

“If you’re finding it really hard to stop, or you can't keep away from drinking for a week, that's a reasonable sign that it might be problematic for you,” she says.

Dr Hunt adds that it can also be helpful to reflect on the ways alcohol may be affecting your mental health and your life as a whole.

“Has alcohol become a need rather than a want or something that you like? Could you imagine going to a party and not drinking? Could you imagine Friday night without drinking?” she says.

Keen to make a change? Having alcohol-free days each week and increasing them gradually is a good place to start.

“If you’re drinking five nights a week, one or two glasses of wine or one or two beers each time and you’re still within the guidelines, but only just, increasing alcohol-free days gives your brain a break and time to recuperate,” says Dr Hunt.

Professional help from your GP or a psychologist can also be helpful, especially if you’re drinking at high levels or every day. For those with limited access to a GP or eligible HCF members who prefer online appointments, our partnership with GP2U offers easy and convenient telehealth access to a qualified professional at a reduced price^*.

Assoc Prof Arunogiri says there are medications that GPs can prescribe that can help people cut down their drinking.

“For some people, it might not be safe to completely go cold turkey,” she says.

A mental health check-up can address any concerns and connect you with appropriate support tailored to your needs. HCF’s HealthyMinds Check-in gives eligible members^{^} easy access to a telehealth consultation with a PSYCH2U psychologist, who’ll help to connect you with services to improve challenges such as anxiety and depression.

Change your relationship with alcohol

Hello Sunday Morning has a mission to change the world’s relationship with alcohol. Its flagship program, Daybreak, is a digital service that you can access as an app on your smartphone. It gives you an anonymous and supportive environment to set alcohol behaviour-change goals with the support of a like-minded online community. You can also use the app's Drink Tracker to monitor your drinking habits for personal, health or financial reasons. No matter how busy you are or where you live, Daybreak is accessible at any time on a smartphone with no waiting lists, so you can get support, when you need it⁺.

Separately, HCF members may have access to additional mental health support.

If you're struggling and need to speak to someone now, you can also call Lifeline on 13 11 14.