There are many well-known links between alcohol and social health, mostly understood that the former influences the latter in a negative way. Much of this also focuses on heavy drinking, alcoholism, and sometimes the ‘chicken or the egg’ debate about whether mental health complications stem from or create substance abuse problems. But new research published by the Canadian Medical Association Journal suggests that individuals don’t need to suffer from substance abuse for their mental health to be affected; even that simple drink to “take the edge off” can have negative impacts on emotional and mental well-being, the research tells us.  

Alcohol is long believed to have a calming effect on us in a moment of anxiety and drinking is a common tactic used by some people to cope with depression. Going back to that original statement about it temporarily relieving anxiety or depression symptoms, according to the American Addiction Centers, alcohol actually worsens depression over the long term. Excessive drinking can trigger financial consequences as well as impact personal relationships negatively, worsening the initial depression and creating a cycle of abusing alcohol in an effort to reduce depression. Alcohol abuse can also create a physical dependency, which according to WebMD, a third of people suffering from a depressive disorder have a concurrent AUD. Essentially, the onset of one — depression or alcohol abuse — can be a trigger to uncover the other. And in the case of people that are already diagnosed with depression and given antidepressant medications, alcohol use can actually worsen the symptoms. Alcohol directly interferes with many antidepressants, making them less effective or even completely useless for patients. 

While depression can put a person at a higher risk of developing a drinking problem, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the opposite is actually more common — depression often arises as a result of alcohol abuse. Again, it’s a cycle where one influences the other, perpetuating itself. In the case of alcoholism sparking depression, though, quitting drinking is actually a valid tactic for curing depression. It’s expected that depression symptoms will often dissipate after drinking has stopped, and according to a study published in ‘Addiction,’ individuals dealing with an alcohol use disorder or depression are at twice the risk of developing the other condition. The study concluded that depression is more likely to occur as a result of alcohol abuse rather than the other way around. But the causality is confirmed in both directions. The study found links between the neurophysiological and metabolic changes brought about by alcohol abuse and the mechanisms for depression to occur, concluding that abuse of alcohol puts an individual at a significantly greater risk of developing depression than a person who is not abusing alcohol. 

So there’s plenty of proof behind the idea that alcohol abuse induces depression and depression can also induce a substance abuse problem. There is a significant gap between that and an occasional drink or two to relieve anxiety. Even so, the new research published in CMAJ found that those go-to nightcaps or the daily glass of wine aren’t as harmless as many want to believe. 

“Our findings suggest caution in recommendations that moderate drinking could improve health-related quality of life,” Herbert Pang, one of the study co-authors and an assistant professor at the School of Public Health at The University of Hong Kong, said. “The risks and benefits of moderate drinking are not clear.”

Researchers from the study say quitting drinking altogether may be a more reliable (or outright better) way to find calm. They relied on self-reported data detailing the drinking habits and mental health of over 10,000 people in Hong Kong and 31,000 people in the United States. As a control for the study and its true focus on moderate drinking’s impact on mental health, heavy drinkers were actually excluded from the study altogether. 

What they found was that both the men and women who identified as lifetime abstainers reported the highest levels of mental well-being. Beyond that, when the study followed up with participants (two years later for Hong Kong participants and three years later for participants in the United States), women who had quit drinking in the time between surveys also showed an improvement in mental well-being. Men, however, did not show a positive change by quitting. 

“When people get sober, they a lot of times will feel calmer, their anxiety diminishes and there’s less irritability. They just say, ‘Wow, that’s a better place to be,’” said Dr. James C. Garbutt, a psychiatry professor at the Bowles Center for Alcohol Studies at the University of North Carolina, who was not involved in the study. The observation touches on a latent effect of alcohol’s initial ability to calm us in times of stress. After the initial relaxation dissipates, systems in the brain are then activated that make the same anxiety worse later on. The cycle then becomes using alcohol as a tool to alleviate anxiety, which creates more once we realize we’re dependent on it for such a result, and on and on. 

The study didn’t point out why women experienced a boost in mental well-being after quitting drinking while men did not. Dr. Garbutt noted that women have higher rates of depression as well as more adverse physical effects from alcohol consumption than men, which could be factored in explaining the positive swing in the opposite direction without alcohol. Of course, there are countless studies on how moderate and heavy drinking impacts our mental and physical health. A 2018 study reported that less than one drink a day (or over five a week, to be exact) could shorten a person’s life by years. In that study, “a drink” was simply 12 ounces of beer, four ounces of wine, or 1.5 ounces of 80-proof spirits, observing more than 600,000 people starting as far back as 1964, and leading to higher rates of stroke, heart disease, deadly high blood pressure and fatal aortic aneurysms. 

“The paper estimates a 40-year-old drinking four units a day above the guidelines has roughly two years lower life expectancy,” said David Spiegelhalter, a risk expert at Britain’s University of Cambridge who was not involved in the study. “This works out at about an hour per day. So it’s as if each unit above guidelines is taking, on average, about 15 minutes of life, about the same as a cigarette. Of course, it’s up to individuals whether they think this is worthwhile.”