Mental health and alcohol – a link for all to think about

That wee pick-me-up may not do you any good, writes Alison Douglas

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 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, improving access to mental health services and making them more efficient, effective and safe.

An estimated one in three Scots is affected by a mental health problem each year, with depression and anxiety the most common. 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 with 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 a reason 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, these feelings are not 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, badtempered or miserable.

Usingalcoholtocopewithemotions or regulate mood can cause prob- lems 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.

There are much better ways to cope with stress than reaching for the bottle. 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 counsellor who can offer techniques to anticipate and manage stress will also help.

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 affect self-esteem.

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

One in four of us exceeds 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 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.

People diagnosed as having problems with both alcohol and mental health have complex needs. It is important that they receive appropriate support but too often there is a gap in support and service provision. Innovative approaches such as Milestone, Penumbra’s alcoholrelated 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 this is not undermined by its 22 per cent reduction in direct funding for alcohol and drugs prevention, treatment and support services. The potential impact of this on vulnerable people is of real concern.

There is a strong inequalities dimension to both mental health problems and alcohol harm. People 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, than people 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 cut alcohol consumption – such as tackling price, availability and marketing – will contribute to the Scottish Government’s vision of good mental health for all.

If you are concerned about your own or someone else’s drinking, speak to your GP or contact an local alcohol support service. Find your nearest alcohol service at www.alcohol-focus-scotland. org.uk/alcohol-information/findan-alcohol-service.

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