6 Signs of an Unhealthy Relationship with Alcohol

Sad Asian woman sitting at a window and wondering if she's drinking too muchImage via Anthony Tran/Unsplash

It’s not easy making the first move toward evaluating your drinking patterns, especially if you don’t feel comfortable talking about it with your friends, family members, or your therapist. This is really personal stuff, and you have every right to approach it in whatever way feels right.

Maybe you landed here because you’re wondering what it even means to have a “drinking problem.” Maybe you noticed you’ve been drinking a lot more during the ongoing pandemic. Or maybe you’ve been considering going alcohol-free for a while now. Whatever brought you here, you’re here—and that means a lot.

“It’s important to remember that as you’re investigating your drinking pattern, you are sensing that there is some suffering in there somewhere,” says Annina Schmid, MA, a feminist counselor who helps people recover from drinking, using, and disordered eating. “You are already doing something about that by looking into it more. It’s already happening.”

Keep reading for six indicators of unhealthy drinking and words of wisdom from three experts.

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1. You drink often and heavily.

It’s not uncommon for different people to have different levels of alcohol tolerance, but there are pretty objective criteria used by leading clinical bodies to establish guidelines for what counts as “too much.”

The National Institute on Alcohol Abuse and Alcoholism (NIAA) defines “heavy drinking” differently depending on assigned sex at birth:

  • For those assigned “male” at birth, “heavy drinking” means having more than four drinks on any one day or a total of more than 14 in a week.
  • For those assigned “female” at birth, “heavy drinking” means having more than three drinks on any one day or a total of more than seven in a week.

You may have two immediate questions here:

  1. What’s considered one drink? A 12 oz beer, an 8-9 oz glass of malt liquor, a 5 oz glass of wine, and a 1.5 oz shot of distilled spirits (vodka, tequila, gin, etc.) are all considered one drink.
  2. Why are the amounts different for different biological sexes? According to the Centers for Disease Control and Prevention (CDC), for most people assigned “female” at birth, there are biological differences that increase how much alcohol is absorbed and how long it takes for the body to break it down when they drink. Basically, more alcohol gets into the body and stays there for longer, so less alcohol is necessary to see a negative impact on health.

Regardless of what sex you were assigned at birth, is it possible to drink heavily without it being an issue? 

“If you have a chronic heavy drinking pattern, it’s relatively rare to not have any impact,” explains Dr. Sean Luo, MD, PhD, an addiction psychiatrist in New York. “Typically, when you have chronic heavy drinking, psychological and physical health are impacted.” Dr. Luo says that these impacts may include anxiety, sleep disturbances, or other medical consequences—ones that aren’t necessarily seen from the outside.

2. You drink to counteract negative emotions.

We’ve all been there: You get home after a long, stressful day, and cozying up with a glass of red wine feels like the perfect remedy. That immediate boost of endorphins and serotonin that comes with drinking might feel great at the moment, but an increasing dependence on alcohol to cope could actually intensify feelings of anxiety or depression.

What’s more, avoiding stressors in your life might make it more difficult to really deal with them and make it more difficult to feel the good stuff when it happens. 

“We need the negative emotions in order to experience the positive,” says Erica Lubetkin, LMHC, NCC, a New York-based licensed mental health counselor passionate about reducing the stigma surrounding addiction and mental health. “If we’re numbing the negative, we may not enjoy the positive as much.”

So, what’s a healthier way to cope with negative emotions? 

“Expressing how you’re feeling and what you need and setting appropriate boundaries around those needs is key,” Schmid says. “This can start in therapy or counseling if you feel alone and isolated or with friends and family if you feel mostly safe already.” 

Talking with people you trust about how you’re feeling instead of trying to distract yourself from the emotions can help you better tackle whatever’s going on.

3. Your drinking interferes with your life.

“Drinking is a problem when it causes problems,” Schmid explains. These alcohol-fueled issues may pop up in relationships, at work, with your family, or with your health. Basically, these are the kinds of issues that get in the way of you living the best version of your life.

Sometimes these problems are discovered after some self-reflection, but you may also hear about them from others. 

“Either they realize that they have problems themselves because they’re noticing some kind of functional decline or they’re feeling that they’re no longer in control of their alcohol drinking,” Dr. Luo says, “Or someone else in their lives is presenting them with a problem.”

Wherever a problem associated with your drinking is raised, it’s worth some investigation.

4. You’ve tried to cut back but found it challenging to stop.

Drinking can be so enmeshed in our social or professional lives that it can feel incredibly daunting to part ways with it. For some of us though, letting go of alcohol is even more difficult than we had imagined. Contrary to popular belief, this isn’t a matter of “self-control” or willpower; the brain is essentially rewired to make alcohol extremely challenging to give up.

“Many different brain circuits involving executive control, reward processing, and automatic action are involved in problem drinking,” says Dr. Luo. 

Here’s what that means: The neurotransmitters (chemical messaging for nerve cells) in the brain that regulate our bodies and behaviors, including those brain circuits Dr. Luo mentioned, adapt to heavy alcohol use. Those changes trigger emotional and physical stress when we’re not drinking—and drinking again may feel like the only thing that can provide relief. 

5. You experience side effects if you don’t drink.

Experiencing “withdrawal” symptoms when you’re not drinking can be indicative of the mark heavy alcohol use leaves on your brain and body. Those same neurotransmitter changes we covered in the last section also activate our fight or flight response (the sympathetic nervous system).

“There is an increase in engaging the sympathetic nervous system, which causes an increase in heart rate, body temperature, and blood pressure—and possibly seizure and other symptoms,” explains Dr. Luo. 

Are these alcohol withdrawal symptoms the same thing as hangovers? No. Anyone who drinks enough to feel intoxicated may feel uncomfortable the next morning, but feeling those effects doesn’t mean you’ve formed a dependence on alcohol. While experts are only beginning to understand why hangovers happen, the neurotransmitter changes we’ve been talking about only come into play when there’s a pattern of heavy drinking.

6. You need to drink more than before to feel anything.

This is where alcohol tolerance comes in. The more you drink, the more you’ll need to feel drunk. Why? Those same neurotransmitter changes we keep talking about also decrease our sensitivity to alcohol’s effects. But another way that heavy drinking can alter the ways our bodies function is through changes in the liver. The liver plays a key role in metabolizing (breaking down) alcohol in the body. 

“The idea here is that the body is actually trying to get rid of it as soon as possible because it causes damage,” Schmid explains. “If it can’t get rid of it fast enough, because we consume more than it can work through in a particular time, we end up intoxicated.”

Repeated heavy drinking throws a wrench in the body’s plan. In order to break down the increased levels of alcohol in the body, the liver needs to produce more enzymes. An uptick in liver enzymes means more alcohol is needed in order for it to stay in the body for longer and to make you feel intoxicated.

What You Can Do if These Signs Ring True for You

What you do next is up to you. We hope these signs are a helpful starting point, but we also understand that it might feel overwhelming if you see yourself reflected in them. Making a change, if you want to, is doable—you just need a solid support system of people and professionals you can trust and lean on in difficult times. (That’s what Tempest Membership is here for.)

“There are so many paths to recovery or exploration. You can pave your own or follow in the footsteps of others,” Lubetkin says. “Do what feels right for you and not what you think you have to do based on what others have done in the past. If it doesn’t feel right, don’t do it!”

Whatever path you take, keep these words in mind: “There are many memes that picture recovery not as a straight line, but rather a zigzag graph,” Schmid says. “Try to remember that, should you ever find yourself demotivated and in the dumps, this moment will pass.”

About the Author

Sarah duRivage-Jacobs

Sarah duRivage-Jacobs is a New York-based writer and editor of words dealing with reproductive and mental health. She's currently in the process of getting a master's in community health from CUNY Graduate School of Public Health & Health Policy.

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