Alcohol and mental health: effects, risks and getting support

Units of alcohol are a way of measuring how much actual alcohol someone is drinking. Drinks contain different amounts of alcohol – the same volume of beer, wine, and a spirit like vodka will contain different amounts of alcohol, as they all have a different percentage of alcohol in them. Units also help us keep track of how much alcohol we’re drinking if we drink from different sizes of glass, bottle, or can.

Units are how the UK government gives guidelines, because units apply to everyone, whatever type of alcohol they’re drinking.

The NHS website has a helpful guide on alcohol units, as well as information about how to work out the units in a drink from the information on the bottle.

It can be helpful to think about units if you’re drinking in different situations, for example, at parties where people might be drinking stronger drinks or mixing drinks themselves without measuring the alcohol.

The UK government has guidelines for people of all genders about limits, spreading drinking out, and having alcohol-free days.

While there are long-term risks of regularly drinking more than in the guidelines, it’s also important to think about single occasions of drinking alcohol too.

If you drink too much or too quickly, you’re exposing yourself to more risks. Some of these risks can seem lower stakes (like a hangover or feeling anxious the next day), but others are serious – for example, losing control (or not thinking things through) and getting involved in violence, damaging your relationships, or being involved in accidents (which can cause serious injuries and even death).

If you’re trying to stick to the low-risk drinking guidelines, it might be helpful to think in advance about how many times you might want to drink during the week – and how much you’re going to drink each time. It’s best to do this while you’re sober, as once you start drinking, you’ll be less able to think things through. 

If you’re going out three times, for example, you could think about how you’ll split your units over the week and how many drinks you’ll therefore drink each time. 

Equally, if you know you’ve got several stressful days (or a few different celebrations) coming up, can you think of ways to relax and unwind without drinking alcohol? 

 Don’t forget that having several drink-free days a week is a good way to cut down your alcohol consumption. 

If you’re planning to drink, it’s a good idea to check in with yourself and how you’re feeling.

If you’re feeling sad, low, anxious, or angry, for example, then there’s a real risk that alcohol may make those feelings worse, so you might be more likely to enjoy your plans if you don’t drink. If you drink while you’re struggling, you might also end up making decisions you regret because alcohol affects your ability to think things through.

Nowadays, we have more drink options that ever before. If you swap some (or all) of your alcoholic drinks for low- or no-alcohol options, you’ll drink less overall.

You can find all sorts of low-alcohol drinks, including beers, ciders, and spirits.  The Drinkaware website has more information about alcohol-free drinks, including the difference between low- and no-alcohol options – this page also includes information about calories, which some people might want to avoid.

You could also explore drinks that are always alcohol-free, like mocktails or other soft drinks. Some people might stick to these alcohol-free drinks all night, whereas others might have a mocktail or soft drink between every alcoholic drink. This is a great way to pace yourself and avoid drinking too much too fast – and it can also help you stay hydrated.

You can also think about other ways to drink less alcohol, in addition to buying fewer drinks. If you drink spirits, for example, it obviously makes a difference to order a single instead of a double. With other drinks, you could opt for a smaller serving (like a half-pint of beer or a small glass of wine) or choose an option with a lower alcohol percentage.

Apps can be a really helpful way to track how much alcohol you’re drinking on a night out, or to keep track of the alcohol-free days you have during a week.

Lots of the apps designed to help people track their alcohol intake also track calories, and you can’t always turn this feature off. Some people might find this helpful when thinking about their drinking, while others might find it triggers unhealthy thoughts or behaviours.

Apps can make it easier to track your alcohol consumption (and they often have other helpful features) – but you can also use a note on your phone, or even pen and paper, if you find apps that mention calories aren’t good for your overall wellbeing.

Some people can have a great time in a club or bar without drinking any alcohol, whereas others find these sorts of spaces challenging if they’re trying to stay sober.

Depending on where you live, there will be different options for socialising in the evening – many bigger cities have late night dessert places or cafes, or you could head somewhere that involves an activity like bowling or an escape room. 

You might have heard that eating a meal before drinking (especially one with carbohydrates like pasta, rice, or potatoes) will ‘line your stomach’.

There’s some logic behind this – if you eat before you drink, the alcohol will move through your body (and thus be absorbed) more slowly, and there’s some suggestion it can help your body get rid of alcohol too.

This means it’s a good idea to make sure you’ve eaten enough throughout the day before you start drinking alcohol.

Remember, though, that eating enough or ‘lining your stomach’ doesn’t mean it’s any less risky to drink beyond the government guidelines.

One of the best ways to reduce the short-term risks associated with drinking alcohol is to make sure you’re drinking around people you can trust.

If you decide to set yourself limits (around how much you drink or spend, or what time you’ll head home, for example), you can ask your friends to support you. It’s ultimately your responsibility to stick to your plan, but communicating in advance means your friends can be aware. This means they can avoid being accidentally unhelpful (for example, by suggesting you have another drink or buying everyone extra drinks) and gently remind you of your commitment. What do you from there is up to you.

Making sure you’re with trustworthy friends also means that you can count on the people around you if things do go wrong – for example, if you drink too much (or are a victim of a crime like spiking), or if there’s an issue with your transport home.

Having friends around you can be especially important if you know that alcohol can affect your mental health, or if it would be helpful to have your friends’ support to spot any ‘early warning signs’ of symptoms of your mental health condition.

Regardless of how much you’re planning to drink, if you’re going out in the evening or at night, it’s always sensible to plan how you’ll get home.

What this looks like will depend on where you live, but it might include things like making sure your phone is charged, knowing your public transport options (and whether you need a back-up plan in case you miss the last bus or train or there are unexpected cancellations), or finding out if you need to pre-book a taxi.

It’s also a sensible idea to talk to the people you’re going out with. How will you make sure everyone sticks together, and gets home safely at the end of the night? Do you have a back-up plan?

It can be difficult to find the right words to start conversations about alcohol. If you’re worried about someone’s drinking, it’s understandable to want to help (and to keep them safe) – but you might be worried about upsetting them or ruining your friendship.

There’s no perfect way to start a conversation around drinking, but there are some things that might help.

First, remember that your friend might view their alcohol use differently to you. Just because you see their as drinking is unsafe or unhealthy, it does not mean they will agree.

Understanding that you might start the conversation with different points of view can help you communicate more effectively.

Lots of people find it helpful to notice things and gently point out facts without any judgement.

For example, if a friend is drinking when no one else is, you could just say something like ‘I don’t think we’re drinking now’. Comments like this can sometimes help people to get another perspective on their situation.

Of course, in some situations, you might want to be more direct. For example, if someone’s ended up in A&E after drinking, you might want to point out any patterns in their alcohol use, tell them about their concerns, and suggest you work together on how you can have a fun night out without them putting themselves at risk.

Avoiding judging your friend or showing that you’re angry can make it easier for people to engage in a conversation with you – but even if you do everything perfectly, they might not be ready or able to talk about things with you.

This is OK, and it is never your ‘job’ or responsibility to ‘make’ someone take accountability or get support. Even if you don’t have a helpful conversation with them, pointing out what you’ve noticed can still be helpful for them in the long-term.

As a friend, you are not (and cannot be) responsible for someone else’s wellbeing, no matter how much you care about them. Your responsibility is only ever to be a good friend – not to ‘treat’ your friend’s alcohol problem or to persuade them to get professional support.

What being a good friend looks like can differ depending on your specific friendship and the situation you are in, but it can be as simple as being there and helping people stay safe if they’re in difficulty (for example, by getting them home or to hospital if they’re unwell), or making sure you’re spending time in alcohol-free spaces or spaces with good non-alcoholic drink options.

As a friend, you can’t be responsible for your friend’s recovery. You can tell them about local organisations (and national helplines), but you can’t force them to get support, or to make changes even when they are accessing support.

If you start noticing things are unsafe, it might be that you have to talk to other people too. Depending on how well you know someone, it might be that you talk to their parents or carers, or that you tell a youth worker or teacher about your concerns so they can also help your friend (and you).

Setting boundaries means deciding on what your limits are and what you are and aren’t comfortable with doing.

Setting boundaries with a friend who has a tricky relationship with alcohol can be as simple as telling them what you will (and won’t) do while you’re spending time together. For example, it’s OK to set limits like agreeing to an activity (like going to the cinema or going to a gig) while setting the boundary that you won’t get drunk with someone.

It can also look like choosing not to do certain activities with someone to look after yourself (and your friendship). For example, if you know they’re going to a bar or club, you can tell them you don’t want to join and make other plans. Sometimes, this can be easier than trying to battle with them or control how they spend their time.

Sometimes however, things reach a point where people feel they have to tell their friend they can’t spend time together while their drinking is such a problem.

Even with the best boundaries, supporting a friend who has a problematic relationship with alcohol can be challenging.

Lots of local alcohol services (and national helplines) recognise this and offer support to friends and family members of people who misuse alcohol. If you don’t want to contact a local service or helpline, or aren’t sure what’s available near you, you could also talk to a trusted adult such as a parent or carer, youth worker, or lecturer.

It might feel strange to talk about something that’s affecting your friend, but you can focus on your own feelings and experiences of supporting them (and keep your friend anonymous). Talking to someone else can help you organise your own thoughts and feelings and make a plan, so you feel more confident about the decisions you’re making.