“Drinking To Cope” Doesn’t Work, Even When We Believe That It Does

By Emma Young

Have you ever felt a little anxious or low, and decided that a beer or a glass of wine would help? If so, you’re hardly alone. This exact thought process must play across the country every night of the week. There’s been surprisingly little solid research, though, into whether alcohol does actually relieve these negative feelings. Now new work led by Andrea M Wycoff at the University of Missouri-Columbia, US, concludes that in fact, it does not — and that people who “drink to cope” can even make their symptoms worse.

The study involved 110 participants; 58 were from the general community and 52 had a diagnosis of Borderline Personality Disorder. People with BPD are known to be more prone to drinking problems, and to experience more variable emotions; they are even more likely than the rest of us, then, to view alcohol as a way to manage negative emotions. Some of the BPD participants had in fact been diagnosed with Alcohol Use Disorder. The team chose to include this group to try to capture as much variability in emotional states and proneness to problem drinking as possible in their study.

After completing various questionnaires in the lab, each participant was given an electronic diary. Every day for the next three weeks, they received regular prompts to report on any alcohol consumption, and also to rate levels of various negative feelings, such as being jittery, nervous, downhearted and lonely.

Whenever a participant reported having had an alcoholic drink, they were asked to rate the extent to which whether they’d done this to make them “feel less guilty or depressed” or “feel more relaxed and calm”. At various points over the following three hours, they then rated the extent to which they felt the drink had “relieved unpleasant feelings or symptoms”, and also provided updated ratings of their levels of those various negative feelings.

The team found some clear links between the various self-reports. When a participant had indicated that they were drinking to cope with anxiety or to cope with both anxiety and depression, they were more likely afterwards to report feeling that those unpleasant feelings had been relieved. This seemed to support the concept of drinking to cope, and, indeed, it led the researchers to expect that, for these people, their levels levels of various anxiety and/or depression-related feelings would drop after a drink.

But in fact the team did not find this pattern. Alcohol had no impact on anxiety scores. And when a participant reported that they were drinking to cope with depression, their depression-related feelings actually increased afterwards. For those participants diagnosed with Alcohol Use Disorder, the increases were even more striking.

What might explain the discrepancy between the participants’ belief that the alcohol had helped on the one hand, and their own contradictory self-report score data, on the other? The researchers suggest that if someone expects alcohol to help, this could encourage them to believe that it has — even if their actual feelings have not changed, or even worsened.

People who “drink to cope” are more likely to develop problem drinking. And yet these new findings suggest that the very concept of drinking to cope is a fallacy — at least, in relation to the anxiety and depression-related measures used in this work. 

The team concedes various limitations to the study, mostly to do with factors affecting generalisability. The over-representation of women among the participants (as well as the fact that a large proportion were diagnosed with BPD) certainly means that the results are not necessarily applicable to the general population. However, with regard to gender, earlier research suggests that men are more prone to report drinking to cope, and to have alcohol problems. So if more men had been included, it’s possible that the links would have been even stronger, which the researchers say future research should explore.

For now, though, if the idea that alcohol helps to relieve feelings of anxiety and depression is mistaken, then helping people to appreciate this might also help them turn to other strategies known to help, and not to harm — such as physical exercise. 

Real-time reports of drinking to cope: Associations with subjective relief from alcohol and changes in negative affect.

Emma Young (@EmmaELYoung) is a staff writer at BPS Research Digest