By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
Have you ever told yourself, “I need a drink?”
I’m sure you’ve heard the expression a million times, more or less. When someone has had a rough day and is feeling anxious or depressed, their first reaction is often to reach for a drink of alcohol to cope. Humans have been saying this and doing it ever since alcohol was first packaged so it could be saved for later use.
People who use alcohol to cope rarely ask themselves if the alcohol is really helping. Most people simply assume it is helpful. If you’ve developed a problem with alcohol or if you’re one of those who work in the counseling field, you probably have a strong opinion about the dangers of using alcohol to cope with stressful situations. But until recently, there’s been very little scientific research into when alcohol is helpful and for what problems.
Now we have evidence about drinking to relieve stress.
A recent study by Andrea M Wycoff at the University of Missouri-Columbia, US, looked at the use of alcohol for coping and concluded that not only is it not helpful, but it can also make your symptoms worse.
The study compared two populations, the group drawn from the general population and another group who had been diagnosed with Borderline Personality Disorder (BPD). People with borderline personality disorder are known to be more likely to develop drinking problems. Some of the people with BPD had also been diagnosed with an alcohol use disorder.
One problem with other research of this nature has been the strong tendency to exclude from the research anyone with a substance use disorder diagnosis. Some studies also exclude anyone with a previous mental health diagnosis. Eliminating people who have developed an alcohol use problem from a study on alcohol use problems results in a study that doesn’t inform us much about the connection between using alcohol and the subsequent development of problems.
How were the effects of alcohol on stress measured?
During this study, participants were given an electronic journal. They received periodic prompts to write down in their journal what they were doing, any alcohol consumption, and what they were feeling. They were specifically prompted to report on negative, sometimes called unhelpful feelings.
Whenever someone reported using alcohol, they were asked if they had done this to reduce negative feelings such as anxiety and depression or to increase positive feelings such as feeling calm or relaxed.
Did the alcohol help reduce anxiety and depression?
People who reported drinking to reduce their anxiety, depression, or both did report that they were doing it to reduce those negative emotions. In addition, after drinking, those people were more likely to report that they felt the drink had relieved their anxiety or depression. Initially, the researchers took this as confirmation that drinking alcohol did relieve the discomfort of anxiety and depression.
The facts didn’t confirm the feelings.
Feelings are difficult to measure. There aren’t medical instruments that can directly measure how anxious or how depressed someone is. What researchers resort to are paper and pencil questionnaires. These assessment instruments ask a series of questions about anxiety or depression. Using the same scale at different points in time helps measure increases or decreases in someone’s anxiety or depression.
While many people expected the drink to reduce their feelings of anxiety and or depression, that’s not what happened. Scores on an anxiety inventory did not decline. Instead, scores on depression inventories actually went up, meaning that people who drink to cope with depression end up more depressed, not less.
Drinking to relieve anxiety and depression affects alcoholics more than others.
Even more striking is that many people with an alcohol use disorder, especially those who would call themselves an alcoholic, found that their scores for depression rose even higher than the scores for those without an alcohol use disorder.
Some of the likely conclusions from this research are that repeatedly drinking to control anxiety and depression can result in an alcohol use disorder and that those people with that disorder will find drinking alcohol makes the problem worse, not better. The ability of alcohol to help you cope with anxiety, depression, and stress declines the more you use alcohol and eventually reaches a point where another drink will make your anxiety or depression worse.
An even more important conclusion is that using alcohol to cope with anxiety or depression increases the risk of becoming an alcoholic.
We need to know more about drinking when anxious or depressed.
There are some limitations of this study. It wasn’t a huge sample. It might be possible to find people who were an exception to these results. The sample also had a large percentage of women. Much of the literature about alcoholism and how it develops tells us that women are more likely to develop alcoholism and develop it more rapidly than men if they drink heavily.
The authors note that previous studies limited to men tell us that men are more likely to drink to cope with negative emotions and more likely to develop alcohol problems than women. Presumably, a study of men only would have resulted in an even stronger connection between using alcohol to cope with negative emotions and a subsequent increase in anxiety, depression, and an alcohol use disorder.
What about alcohol and the mentally ill?
The sample had a large number of participants who had been diagnosed with Borderline Personality Disorder, which should underscore an extra warning for those people with BPD to avoid the use of alcohol to regulate their emotions. It’s extremely likely that people with other specific mental health diagnoses would see a similar or an even larger effect.
I’ll be on the lookout for research that studies the effects of using alcohol to cope on subjects who have other diagnoses. From my experiences working in the drug and alcohol counseling field, I would expect to see very similar results among clients diagnosed with mood disorders, anxiety, PTSD, and those suffering from the aftereffects of early childhood trauma. All of this tells me that the more someone believes they need to have a drink to cope with negative emotions, the more likely it is that drinking will lead to more severe and longer-lasting problems.
The takeaway from all this?
Drinking alcohol to cope with negative emotions and stress may feel like it’s working in the moment, but it is likely to make your problems worse.
For more on this topic, please see:
Wycoff, A. M., Carpenter, R. W., Hepp, J., Piasecki, T. M., & Trull, T. J. (2021). Real-time reports of drinking to cope: Associations with subjective relief from alcohol and changes in negative affect. Journal of Abnormal Psychology, 130(6), 641–650. https://doi.org/10.1037/abn0000684
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