Episode six

00:00:05 Fiona Spence 

Hello and welcome to our podcast series focusing on food, well-being and mental health, run by NHS Fife Nutrition and clinical dietetics mental health and learning disability team. 

00:00:16 Fiona Spence 

My name is Fiona Spence, I'm a registered nutritionist and today I'm joined by Jenna Scott, who's a dietitian in today's podcast we're going to be talking about. 

00:00:25 Fiona Spence 

Alcohol and how it can impact on our mental health. We're going to unpick the myths and the facts. 

00:00:31 Fiona Spence 

Now, we've already met Jenna in a previous podcast when we looked at caffeine, but just for those who haven't heard of Jenna, I'll let you have a wee introduction. 

00:00:42 Jenna Scott 

Hi there, I'm Jenna Scott. I've worked in NHS Fife as a dietitian for over 13 years. I've worked in a variety of different specialities and now work in the mental health and learning disabilities team, working with adults with a learning disability. 

00:00:58 Fiona Spence 

Thanks for coming back to do another podcast, Jenna. I really appreciate it. And so in today's episode we're going to be talking about alcohol. 

00:01:07 Fiona Spence 

So can you tell us a bit of background about where does alcohol come from? 

00:01:12 Jenna Scott 

An alcoholic drink contains ethanol, and that's a type of alcohol produced by the fermentation of grains. 

00:01:19 Jenna Scott 

Fruits or other sources of sugar that act as a drug. 

00:01:22 Fiona Spence 

So you mentioned the word drug there and we often hear about stimulants and depressants when discussing alcohol. Is alcohol classed then as either of these and what does this mean? 

00:01:34 Jenna Scott 

Alcohol is a depressant, and you may hear people refer to the effects of alcohol as a downer, and this is where the depressant part comes in. 

00:01:44 Jenna Scott 

And a bit of background to that is that we've got neurotransmitters and these are like little chemical messengers in our brain. 

00:01:52 Jenna Scott 

And then we have depressants which are drugs that lower these neurotransmission levels. So when we use a depressant, this in turn reduces neurotransmission and then. 

00:02:03 Jenna Scott 

Cnd impact on our mood negatively. 

00:02:05 Fiona Spence 

That's interesting, and I suppose people often link alcohol with making them feel good, but I suppose the reality then can actually be very different. 

00:02:14 Jenna Scott 

Yeah, definitely. Alcohol is often linked to lifting 

00:02:18 Jenna Scott 

Our moods and when we drink alcohol, our brain releases dopamine, which you may have heard referred to as the happy hormone. 

00:02:26 Jenna Scott 

And what dopamine does is makes you feel more energised. 

00:02:30 Jenna Scott 

But after the initial effects of this dopamine, alcohol can quickly slow us down, and it's seen as more of a depressant than a stimulant, especially if you are drinking larger quantities. 

00:02:43 Jenna Scott 

And previously discussed alcohol can disrupt the balance of neurotransmitters, which are these chemical messengers that we were talking about and this then affects the way that we feel and our thoughts and behaviour. 

00:02:57 Fiona Spence 

Which that makes complete sense, doesn't it? I mean, if you've got something that is a stimulant and depressant. 

00:03:03 Fiona Spence 

All in one, then. The fact that it's messing with your hormones so much and having you coming up and down, you'd be like an emotional roller coaster.  

00:03:12 Jenna Scott 

Yep. Definitely and you can see obviously that first initial high that you get from the alcohol, but then it quite quickly. 

00:03:21 Jenna Scott 

Leads to that depressant effect after. 

00:03:23 Fiona Spence 

And with the depressant effect happen, and could that happen quite quickly or are we looking at, you know, this is the sort of hangover time the next day? 

00:03:32 Jenna Scott 

Everyone does react to alcohol differently, so how alcohol impacts one person can be very different from someone elses experience and this is influenced by lots of different factors. So what sex you are, your weight and your individual alcohol tolerance. 

00:03:48 Jenna Scott 

Since some people may get more of a stimulating effect from alcohol, while others more feel the depressant side of alcohol. 


I suppose your. 

00:03:57 Fiona Spence 

Environment would be a big part of it as well. 

00:03:59 Fiona Spence 

Do you know like if? 

00:03:59 Fiona Spence 

You are, I suppose, if you're surrounded by music and dancing and there's. 

00:04:03 Fiona Spence 

That sort of. 

00:04:04 Fiona Spence 

Upbeat all around you.  you've got that side of things, but then you've also got people who. 

00:04:09 Fiona Spence 

Will drink on their own and people are in. 

00:04:12 Fiona Spence 

You know it's a. 

00:04:13 Fiona Spence 

Completely different environment and I suppose the environment would change. 

00:04:17 Fiona Spence 

How you behave around like how you behave when you're having alcohol. 

00:04:23 Fiona Spence 

Does that make sense? 

00:04:24 Jenna Scott 

Yeah, absolutely. And I think it's worth noting that there is evidence as well that those who experience more of the stimulating effects from alcohol are at higher risk of alcoholism, which you can see make sense as well. 

00:04:37 Fiona Spence 

That does make sense 'cause, of course, if it's something that makes you feel good, you're going to want more of it. 

00:04:42 Jenna Scott 

Yep, absolutely. 

00:04:44 Fiona Spence 

And alcohol can be such a big part of people's lives, you know, and I think we'd be naive not to think that it isn't. 

00:04:50 Fiona Spence 

In this country. 

00:04:51 Fiona Spence 

Particularly, uhm people drink for a wide range of reasons, whether it's celebrating, socialising, commiserating or drowning our sorrows. 

00:05:00 Jenna Scott 

Yeah, you know, we may drink to try and change our moods and to. 

00:05:04 Jenna Scott 

Feel more relaxed. 

00:05:06 Jenna Scott 

Outgoing, confident. However, the effects of alcohol are only temporary, and as it wears off, we often feel worse because of how the alcohol withdrawal affects our brain and our body, and this can affect us long after alcohol has being consumed. 

00:05:21 Jenna Scott 

You know, some people can have the fear for days after a drinking session. 

00:05:27 Fiona Spence 

I like how you mentioned the fear. 

00:05:29 Fiona Spence 

It's probably something people are quite aware of. 

00:05:31 Fiona Spence 

But I think as well, you know, is it just in our country or our culture? 

00:05:37 Fiona Spence 

But I mean, for as long as I can remember, there was always the hair of the dog, and as soon as 

00:05:42 Fiona Spence 

You know, that might not mean anything to a lot of people listening, but actually if you did go out the night before and the next day it was like instead of getting over it and being hungover, you would just keep on drinking.  

00:05:54 Fiona Spence 

Which is insane, really. 'cause that then just prolongs it. 

00:05:57 Fiona Spence 

You have an even more, think of the, like I mentioned earlier, the emotional rollercoaster that you set yourself on to. Yeah. 

00:06:04 Jenna Scott 

Yeah, I know. And I think it's whether you can stomach it the next day as well, depending on how much you've had the night before. 

00:06:08 Fiona Spence 

That's true. 

00:06:10 Fiona Spence 

So so like I mean I've obviously mentioned you know like in our country, in our culture and stuff, but I mean I suppose in the UK what, what are the recommended levels. 

00:06:19 Jenna Scott 

So it has recently changed. Actually, it used to always be that men had a higher recommended level of 21 units, but it's been changed so that both males and females should be aiming for 14 units per week. 

00:06:31 Jenna Scott 

And that's spreading drinks over three or more days and aiming for some alcohol free days each week as well. 

00:06:38 Jenna Scott 

But I think as well, 14 units for some people isn't huge amounts and it does add up quite quickly. So for example something like a pint of beer would have 2.3 units in it. 

00:06:51 Jenna Scott 

Obviously depending on the strength of the alcohol as well. 

00:06:55 Fiona Spence 

I mean you think about that spread over a week? 

00:06:57 Fiona Spence 

Do you know like some people might have a pint everyday? 

00:07:00 Jenna Scott 

Yeah, Yep. So then that’s your, you know, you think it's only one drink, but actually that's you almost over your recommendation for the week if you've had a pint a day. 

00:07:10 Jenna Scott 

And I think as well we also forget about the calories side of things of alcohol as well. So it is empty calories. 

00:07:16 Jenna Scott 

And so we don't always think about what we're drinking in terms of calories and how that can impact our physical health. 

00:07:21 Fiona Spence 

Yeah, it's like you said, you know, they're empty. You're getting no nutritional value out of this at all, other than it just being you're loading up on calories. Yep, and you're getting no benefit from it. 

00:07:29 Jenna Scott 

Yep, Yep. So, yeah, like a pint could have over 180-200 calories. 

00:07:36 Jenna Scott 

Your glass of wine. Would you know a small glass of wine which is 175 mls? 

00:07:42 Jenna Scott 

Could have a 2.3 units, 160 calories. So, and there's probably very few of us that say no to the to the large when we're offered it. 

00:07:51 Jenna Scott 

So yeah, it's just bearing all these things in mind about how much actually are you having when you are drinking. 

00:07:57 Jenna Scott 

And when we are out and you know which we're out in pubs and things and restaurants again that when you are having a glass of wine, are you really thinking about your unit intake? 

00:08:08 Fiona Spence 

I'm not. 

00:08:09 Jenna Scott 

I don't think so, and actually I find it interesting if they ask at your GP and things like 

00:08:14 Jenna Scott 

How much do you drink? Are you within the recommended level? I would always say yes, but actually I don't have the evidence or the knowledge to back that up. 'cause I don't actually know how much I'm drinking. 

00:08:22 Fiona Spence 

And it can vary 

00:08:23 Fiona Spence 

Yeah, you know, I know that they ask you on average, and I suppose if you do have quite a habitual way of drinking, then you would know. But if you don't, and it is a bit sporadic and like you say, it's for celebrations or whatever, don't really have an average. 

00:08:37 Jenna Scott 

The Drinkaware website has got a good calculator to add up the total units that you're having, so even trying to do that every so often just to raise your awareness and kind of measure. 

00:08:46 Fiona Spence 

I'm not even aware if when you're in a restaurant or pub or anything is there any indication of what the units are? Is there? 

00:08:51 Jenna Scott 

I think there probably depends on venue to venue. Some of them may have the units next to the drink. 

00:08:59 Jenna Scott 

But I don't know if they all do. 

00:09:04 Fiona Spence 

That's interesting. So we'll be looking at. So you were mentioning there 2.3 units would be in one pint of beer. 

00:09:12 Jenna Scott 

Yeah, yeah. 

00:09:13 Fiona Spence 

A pint of cider 2.6 units. 

00:09:17 Fiona Spence 

And what would be like there's. So there's like a measure of spirit. What are we looking at? 

00:09:23 Jenna Scott 

So it's probably lower than a lot of the other alcoholic drinks that we include. So it would probably be about a unit and 60 calories. 

00:09:32 Jenna Scott 

But things like 

00:09:32 Fiona Spence 

So that's for a 25 ml measure and a lot of pubs now will be 35ml won't they? 

00:09:36 Fiona Spence 

Yeah, yeah. So, yeah, so we have to be mindful that there is, you know, there's more units there than even we might think. 

00:09:43 Fiona Spence 

I think depending on like where you are, where you're drinking, it's all different. 

00:09:46 Jenna Scott 

Yeah, and I think things like cocktails are a lot more popular than they've ever been as well. And some of those, depending what's in them, could be up to 5 units per cocktail and even as close to. 

00:09:57 Fiona Spence 

The amount of juice they put in it as well 

00:09:58 Jenna Scott 

Yeah, 550 calories in some of them, so. 

00:10:02 Fiona Spence 

That’s a meal 

00:10:03 Jenna Scott 

Exactly. So it's the equivalent to a meal that we're having. 

00:10:05 Jenna Scott 

But we just don't view alcohol in the same way you know as we would food when it comes to the calorie contents. 

00:10:12 Jenna Scott 

And so yeah, I think using things like apps and the calculators online every so often just to check in and see what are you drinking on average. 

00:10:21 Fiona Spence 

Even if it were just out of curiosity, yeah. 

00:10:23 Jenna Scott 

Yeah, so you, you know, you can see how it adds up quite quickly. As we mentioned, just over 8 pints would be your 14 units or a bottle and 1/2 of Prosseco, 14 single spirits. 

00:10:35 Jenna Scott 

And again, that's going back to that. Is it a 25 ml or a 35 ml measure? 

00:10:40 Jenna Scott 

As well, or the equivalent would as well be 6 1/2 glasses of wine. 

00:10:45 Fiona Spence 

And that's not house measure glasses of wine. 

00:10:48 Jenna Scott 

Yeah. And I was going to say, obviously it depends on the percentage of alcohol as well. 

00:10:52 Jenna Scott 

There will be some difference there depending on percentages of alcohol too. 

00:10:57 Fiona Spence 

But you can purchase online these measurement glasses so that if you were 

00:11:01 Fiona Spence 

If you did drink in the house and you do want to be more conscious, you can buy these. I don't know if you would get them off the drinkaware website. 

00:11:07 Fiona Spence 

But they have the measurement glasses or like plastic tumblers, and when you pour your drink in, it gives you a measurement of how many units you're having. 

00:11:16 Fiona Spence 

But you can also get the used to be like a little cardboard round calculator thing. And you used to be able to put in what you were drinking. It would tell you exactly how many units. Yeah as well, so little handheld things that you can have with, yeah, yeah. 

00:11:29 Fiona Spence 

If you were conscious enough. 

00:11:31 Jenna Scott 

And that's what the app is on the drinker website. So you can actually put in what you've had and the strength of the drink you've had and it will tell you the units that you're having. 

00:11:39 Fiona Spence 

Yeah, the little paper wheel. That's too old school now, isn't it? 

00:11:43 Jenna Scott 

Got to move with the times all about technology. 


I've been left behind 

00:11:48 Fiona Spence 

So we discussed that. You know, everyone reacts to alcohol differently and there's variation and how we metabolise it too, though, isn't there. 

00:11:57 Jenna Scott 

Yeah, and it is worth bearing in mind that it takes roughly one hour to metabolise 1 unit of alcohol. Obviously this can vary from person to person as well. 

00:12:09 Jenna Scott 

And I guess you need to consider about the drink drive limits. And I would say for most people it's the next day. 

00:12:16 Jenna Scott 

You know they have lowered the limits in Scotland as well so everybody processes alcohol differently so it's best to be mindful if driving is involved and there is advice regarding driving the morning after you’ve has alcohol. 

00:12:29 Jenna Scott 

On the drink aware website too, so it's definitely worth having a wee look there if you're needing some more information. 

00:12:35 Fiona Spence 

I'm guessing police Scotland will probably have information on their website as well. 

00:12:38 Jenna Scott 

Yeah, I would imagine so, yeah. 

00:12:39 Fiona Spence 

We can maybe have a wee look at that 

00:12:40 Fiona Spence 

So how much, do we really want to know this? But how much are we drinking as a nation? 

00:12:46 Fiona Spence 

And has this been impacted by the pandemic at all? I'm guessing the answer... yeah, yeah. 

00:12:52 Jenna Scott 

It has in different ways, though I guess than we would expect.  So in 2021 Scots bought enough alcohol for adults to drink at least 18.1 units per week, so this is obviously above the recommended level. 

00:13:06 Jenna Scott 

But it is also based on the whole adult population. So there will be a proportion of that that don't drink that are also included in that. 

00:13:14 Jenna Scott 

So it’s probably closer to about 11.3 litres of alcohol per person roughly in a year. 

00:13:21 Fiona Spence 

I can't visualise it at all 11.3 litres. I'm trying to think of a big juice bottle. What's that? 

00:13:27 Fiona Spence 

How many litres is in a big bottle, you know? 

00:13:29 Fiona Spence 

The big tall, juice bottles 

00:13:30 Jenna Scott 

Yeah, and it's pure alcohol. 

00:13:34 Fiona Spence 

It's like, so if we had a 2 litre bottle of juice, which is the big tall ones, and we're looking at 11.3 per person per week. 

00:13:42 Jenna Scott 

Of pure alcohol.  So it's not even like a pint added in. 

00:13:43 Fiona Spence 

Right. So there's, I mean there's a visual that's tried. I'm a very visual person. I need to think of things like that. 

00:13:50 Jenna Scott 

And actually it was a total of 43 million litres of pure alcohol that was sold in Scotland alone. 

00:13:56 Jenna Scott 

The volume of alcohol sold per adult in Scotland was 4% higher than our neighbours in England and Wales. 

00:14:02 Fiona Spence 

And this is just during the pandemic. 

00:14:04 Jenna Scott 

This was in 2021. 

00:14:06 Jenna Scott 

So in terms of the pandemic. The figures in 2020 were similar to 2021 but they were the lowest recorded and this is obviously due to the COVID restrictions that were in place. A lot of licenced premises were closed, however the supermarket and other off licence sales went up. 

00:14:26 Jenna Scott 

And accounted for 85 to 90% of the total sales across 2020 and 2021. 

00:14:32 Fiona Spence 

Oh, wow.  That’s quite significant. 

00:14:34 Jenna Scott 

Basically, yeah. So a lot of peoples drinking habits changed and some reduced their intake because they weren't going to the pubs and that was normally part of their routine. 

00:14:44 Jenna Scott 

And while others alcohol intake increased because they were drinking more at home than it than they normally would. 

00:14:51 Fiona Spence 

Thinking about mental health as well. 

00:14:54 Fiona Spence 

That for a lot of people to know the introduction of more alcohol into their home environment, maybe it was a way of coping and there was a huge amount going on at that time and. 

00:15:07 Fiona Spence 

For a lot of people who may feel quite lost. 

00:15:08 Jenna Scott 

Yeah. And I think, you know, a lot of it was boredom as well. We weren't going anywhere, we weren't seeing people. 

00:15:14 Jenna Scott 

And I think as well. 

00:15:16 Fiona Spence 

Real stress of the situation. 

00:15:18 Jenna Scott 

Yeah, it goes back to what you were saying about measures. When you're out and you're drinking, it is measured for you, whereas when you’re home pour it yourself? 

00:15:25 Fiona Spence 

It's good old house measures, isn't it? Yeah. 

00:15:30 Jenna Scott 

More than we would. 

00:15:30 Jenna Scott 

Normally get around. 

00:15:30 Fiona Spence 

It’s when someone else is pouring it for you. 

00:15:32 Jenna Scott 

Yeah, but yeah, in Scotland we are drinking more than the rest of the UK, so and it's probably about 36% more than the recommendation of 14 units and. 

00:15:43 Fiona Spence 

Do you think that's just a culture thing? Why is it? You know why are we so different? 

00:15:51 Jenna Scott 

I don't know because we've probably got more restrictions around alcohol in place as well with things like the time limits in the shop, so you can only purchase between 10:00 AM and 10:00 PM in Scotland, but also that we've got a higher unit price as well, a minimum unit alcohol price than the rest of the UK. 

00:16:10 Fiona Spence 

And clearly that doesn't discourage us at all. 

00:16:13 Jenna Scott 

Yeah. And you know the Scottish Government have been trying to seek ways to cut alcohol consumption in an attempt to reduce alcohol related deaths and hospital admissions and but I think probably there needs to be more done because it doesn't seem to be impacting on the figures that we're seeing in terms of the drink levels in Scotland. 

00:16:33 Fiona Spence 

I know and I think, UM, if anybody has ever visited an accident emergency for whatever reason at the weekend, there's always a significant amount of evidence that it’s alcohol induced. Yeah, there's police officers on duty and it's not very pleasant. 

00:16:49 Jenna Scott 

Yeah, you're totally right Fiona you are right. 

00:16:51 Fiona Spence 

And Brits are often linked in the media with binge drinking. Like we know that. And binge drinking is a big part of our culture today, and it has been for some time. But we know how it impacts our physical and mental health. 

00:17:06 Jenna Scott 

Yeah, in the UK or cultural relationship with alcohol is usually an all or nothing approach. 

00:17:13 Jenna Scott 

And binge drinking, I think, is often a social expectation. And I know when I've been out you'll often hear people ask if someone isn't drinking, are you OK? 

00:17:21 Jenna Scott 

Is everything alright? Are you not drinking? 

00:17:22 Jenna Scott 

And often we can be pressurised into drinking more as well. 

00:17:29 Jenna Scott 

27% of UK drinkers report regular binge drinking. And you are right that binge drinking is often linked to harmful impacts on our physical health, but it does also impact on our mood and our mental health as well. 

00:17:42 Jenna Scott 

There is a strong link between alcohol and certain mental health disorders and those with certain psychiatric diagnosis are more likely to become alcohol dependent than the average person. And we know alcohol can lead to anxiety and depressive symptoms too. 

00:18:02 Jenna Scott 

Higher alcohol intake, so excessive alcohol intake is also linked with vitamin deficiencies as well, including vitamin B. 

00:18:10 Jenna Scott 

Which can influence our brain function and that kind of links back into what we were talking about earlier about the neurotransmitters and this can obviously impact on our mood and our overall mental health. 

00:18:22 Fiona Spence 

Which is really sad, isn't it? Because actually you know, when we’re  talking about people and patients with mental health conditions that they're so vulnerable as it is and 

00:18:35 Fiona Spence 

If there can be influence in their environment around their alcohol intake and actually it can make them plummet or make it even worse, it's pretty horrific, you know, 'cause then it gets even more difficult to get out that cycle. 

00:18:47 Jenna Scott 

Yeah. And it is definitely a vicious cycle. And you know, you can see that from what we're talking about, about that dopamine, so when you're first drinking alcohol, you get that hit, it makes you feel good. And then as that wears off, you're then getting that depressant where you're, you know, if your moods already below, it's only going to make things worse. 

00:19:05 Fiona Spence 

And especially when there's medication involved and the interaction with medications.  We have to be very mindful of that. 

00:19:12 Jenna Scott 

A lot of these medications, as you say, interact with alcohol as well. So a lot of them, you probably shouldn't be drinking alcohol when you are prescribed certain medication. 

00:19:22 Fiona Spence 

So why is it that alcohol drives anxiety and depression? What is the mechanism behind this? 

00:19:30 Jenna Scott 

Excessive alcohol intakes are linked with some vitamin deficiencies. So just as I just mentioned about the vitamin B, and this can influence on our brain function and our mood, and then in turn it can lead to anxiety and depressive symptoms. We need that vitamin B6 to produce serotonin, and you've maybe heard of serotonin before, it's a neurotransmitter that's associated with happiness. 

00:19:55 Jenna Scott 

So if we've got a vitamin B deficiency, that can then reduce the rate of serotonin production and therefore impact on our mood. 

00:20:05 Jenna Scott 

Other vitamins like B2, 9 and 12 are required to produce other neurotransmitters like dopamine and noradrenaline, which research has shown also 

00:20:16 Jenna Scott 

Impacts on our mood, so getting a bit technical here, but excessive alcohol intake can increase oxidative stress and the production of inflammatory markers, which can then exacerbate feelings of anxiety and depression. 

00:20:29 Jenna Scott 

And from the research available, it's not clear whether problem drinking leads to anxiety and depression or vice versa. But what is clear is that alcohol is involved. 

00:20:39 Jenna Scott 

You know, alcohol problems and depression, anxiety are linked. 

00:20:42 Fiona Spence 

Just to go back, when you're talking about oxidative stress, you know, we're talking about our cells in our body and 

00:20:48 Fiona Spence 

The production of inflammatory markers we're talking about things that cause inflammation in the body, and I'm sure people be aware of that. Yeah. So you can see that it is a vicious cycle, isn't it, of using alcohol to dull the way we're feeling that longer term, making our mood worse. 

00:21:04 Jenna Scott 

And a lot of people are stuck in this cycle. There was a recent survey taken in the UK and 88% of people reported drinking to relax. 

00:21:12 Jenna Scott 

45 said that it made them feel less anxious, and 30% reported that it made them feel less depressed. 

00:21:20 Jenna Scott 

So these are big numbers and low to moderate doses of alcohol are shown to temporary mask feelings of anxiety. But going back to those neurotransmitters which I have been harping on about. 

00:21:33 Jenna Scott 

Alcohol can deplete your neurotransmitters which the brain uses to naturally reduce these feelings, and often this can lead to the need to drink larger quantities of alcohol to get those feelings. 

00:21:47 Fiona Spence 

And people won't be thinking about that. 

00:21:50 Fiona Spence 

You know the complexities of it and your brain function and things, but I suppose that's why we're doing this podcast. 

00:21:56 Fiona Spence 

It's to raise the awareness of the effects of alcohol that, you know, like it's not just about having a drink. 

00:22:02 Fiona Spence 

And being hungover, actually, there's a huge amount else going on in your body at that time, and the massive impact that this that this can have on you. 

00:22:10 Jenna Scott 

Yeah, and these are things we don't think about. 

00:22:13 Jenna Scott 

And but if this does happen over a prolonged period, then it can lead to anxiety, especially in those that maybe have pre-existing anxiety or kind of underlying anxiety. 

00:22:24 Fiona Spence 

And there's other things going on as well. Do you know if people are, you know, we previously talked about caffeine and if you're putting, you know, caffeine and alcohol in the mix around about the same time and anxieties. So this is it's a bit of a recipe for disaster. 

00:22:39 Fiona Spence 

Isn't it? 

00:22:39 Jenna Scott 

Yep, Yep. And you know, as you can see from that cycle that we've spoken about, about getting that good feeling when you're taking in alcohol. 

00:22:47 Jenna Scott 

And then it plummets, especially the next day when you're feeling the effects of the withdrawals, so you can see how people get hooked into that cycle of making themselves feel better by having alcohol. 

00:22:57 Jenna Scott 

But really, it's masking, masking the problem for them. And we know underlying anxiety can lead to increased alcohol use. Increased alcohol use can elevate these feelings of anxiety, so it's easy to see how people are trapped in this cycle of using alcohol to boost the way they're feeling. 

00:23:15 Jenna Scott 

But unfortunately, in the long term it makes things worse. 

00:23:19 Fiona Spence 

And people will be using it to mask things as well. You know, mask masking from the reality of what is really going on in life. 

00:23:24 Jenna Scott 

Yeah, yeah. 

00:23:25 Jenna Scott 

And you know you think you use alcohol as self-care, but the reality is often that if we reduce our alcohol intake, it's more of a an act of self-care than drinking and removing alcohol won't fix all problems suddenly overnight, but if you are drinking heavily, reducing your intake. 

00:23:46 Jenna Scott 

Is likely to give you more of a chance to actually work on your physical and your mental health, as well as your relationships in some cases as well. 

00:23:53 Fiona Spence 

You know, that's such an important thing to bring up because, yeah, although we're talking about, you know, single person and you know people who use alcohol and people who like to have a drink or maybe think about their change. 

00:24:04 Fiona Spence 

Actually, for families and in relationships, alcohol can be so destructive. You know, it changes somebody's personality, it can change the way they behave. People can be really unpredictable. 

00:24:18 Fiona Spence 

It's just, you know, it can be really destructive, and not just for that one person, but everybody around them, and you won’t be aware of that 

00:24:24 Jenna Scott 

Yeah I think you’re right, it doesn't just affect the person that is struggling with alcohol. It's all the people around them too that it can impact. 

00:24:34 Fiona Spence 

And actually, talking about struggling with alcohol, you may not even think of it yourself 

00:24:38 Fiona Spence 

You know, it might just be a habit that's very hard to break. You may not be alcohol dependent or may not think you're alcohol dependent. 

00:24:45 Fiona Spence 

You may not be an alcoholic or do you know have any other issues, but actually your habits might be becoming quite disruptive in your family life. 

00:24:53 Jenna Scott 

Yeah, yeah. And I think. 

00:24:54 Fiona Spence 

It's very hard to change. 

00:24:55 Fiona Spence 

A habit. It's it's hard. 

00:24:57 Jenna Scott 

And I think going back to, you know, think about your family life, it's then if you are drinking heavily. 

00:25:03 Jenna Scott 

Maybe even just at the weekends, but then you're in bed all day the next day because of the hangover that you get as a result, you know? 

00:25:09 Jenna Scott 

So it does it. It's not just the long term effect, I guess for people that are binge drinking and things as well, maybe just at the weekend they don't see as a problem, but it's then you know taking up time for them. 

00:25:21 Fiona Spence 

Yeah, so now you've talked of the dreaded hangover and the fear for the next day. 

00:25:26 Fiona Spence 

So let's get techie here. What is it that causes the hangover? 

00:25:31 Jenna Scott 

So I think we all know the signs of a hangover. 

00:25:33 Jenna Scott 

I know that I've been there and there's nothing worse when you wake up and the children are screaming and you've had too much to drink the night before, your heads banging, your mouths all dry. But going back to the composition of alcohol that we spoke about at the start of the podcast. 

00:25:47 Jenna Scott 

Ethanol. So ethanol is the chemical in alcohol, which is a toxic chemical, and it works in the body as a diuretic, and a diuretic is something that makes us pass more urine 

00:26:00 Jenna Scott 

So you can then see that you become dehydrated as a result, and hangovers can vary from person to person, but usually the normal symptoms would be things like your headache. Tiredness, nausea and dehydration is the main cause for the hangover. 

00:26:16 Jenna Scott 

And the fear a I guess the fear can be caused by feelings of anxiety fuelled by those brain chemicals being impacted by alcohol not remembering what happened the night before. Feelings of regret. Alcohol actually turns off our inhibitions and makes us more relaxed and confident. 

00:26:34 Jenna Scott 

And because alcohol is a depressant, our coordination can become slower, and this can lead to us becoming more clumsy. 

00:26:43 Jenna Scott 

And as the brain process slows down, your memory can become impaired. As we said, on average your liver breaks down one unit of alcohol per hour. 

00:26:52 Jenna Scott 

So if you are drinking above this level, your blood alcohol levels increase and the higher your blood alcohol level, the more switching off effect we see with the brain. 

00:27:02 Jenna Scott 

The brain can also stop recording into our memory store and so when we wake up the next day with blanks about what you said or did, and this can increase anxiety and worry. It also impacts on the ability to have a deep sleep, which isn't good for our mental well-being either. 

00:27:18 Fiona Spence 

I think there's so many people that can relate to that, you know, even if you've not been drunk as such. 

00:27:22 Fiona Spence 

But had a few drinks and say you're not used to it. 

00:27:24 Fiona Spence 

You go to bed that night. Just don't sleep like you would normally and you could even actually be in bed for longer than a normal night sleep. 

00:27:32 Fiona Spence 

But your quality of sleep's completely changed hasn't it. 

00:27:34 Jenna Scott 

Yeah, yeah, absolutely. And you can see it sometimes if you've got a tracker watch having a look at the quality of your sleep and the difference between kind of a normal night versus if you've been drinking. 

00:27:45 Fiona Spence 

Yeah, that would be interesting. 

00:27:46 Jenna Scott 

Yeah. And it is just that impact on the deep sleep. So you're not getting that quality of sleep that you usually would. So you're waking up, not feeling as refreshed. 

00:27:54 Fiona Spence 

So how can we reduce the likelihood of a hangover, as this is probably an obvious question? 

00:27:59 Jenna Scott 

Well, yeah, I guess the obvious answer to that would be to reduce the quantities of alcohol you drink. Some other factors are avoiding alcohol on an empty stomach because that can increase the risk of experiencing these hangover symptoms we talked about. 

00:28:13 Fiona Spence 

Having a good meal beforehand. 

00:28:14 Jenna Scott 

Food helps to slow down the rate your body absorbs alcohol. So that's the reason behind that. And but also drinking plenty of water or soft drinks between alcoholic drinks 'cause that can help with the dehydration. 

00:28:29 Jenna Scott 

And stopping drinking earlier on so that you're allowing the process of alcohol breakdown to take place before you go to bed. And another is to drink plenty of water before you go to sleep. 

00:28:41 Fiona Spence 

Back to the impact on mental health. Really high levels of alcohol are linked with psychosis, self harm and suicide. Is that, is that right? 

00:28:50 Jenna Scott 

So it is possible to experience psychosis if you are regularly drinking a lot of alcohol. A psychosis can also be triggered if you're a heavy drinker and you suddenly stop drinking. 

00:29:03 Jenna Scott 

If you are drinking heavily, you should seek support to reduce your intake as there is risks if you suddenly cut alcohol out and go cold turkey. 

00:29:11 Fiona Spence 

Too big an impact? Yeah, just better to reduce 

00:29:14 Fiona Spence 

Than stop altogether. 

00:29:16 Jenna Scott 

Yeah, and I would definitely say to seek support before reducing your intake if you are a particularly heavy drinker. 

00:29:24 Fiona Spence 

And what about the link with alcohol and self harm or suicidal thoughts? 

00:29:28 Jenna Scott 

So it goes back to the way that alcohol makes us lose our inhibitions, and it can make some people act impulsively. 

00:29:36 Jenna Scott 

Which can then lead to self harm and or, in some severe circumstances, sadly suicide as well. 

00:29:43 Jenna Scott 

Heavy drinking is linked to a higher risk of suicidal thoughts and attempts, so if you are having suicidal feelings, you can call the Samaritans free anytime. 

00:29:53 Jenna Scott 

Speak to your GP, call 999 or go to A&E if you've hurt yourself or you're worried and or think that someone else may act on suicidal thoughts. 

00:30:03 Fiona Spence 

Thanks, Jenna, that's helpful. And alcohol and withdrawal. What are the signs? 

00:30:09 Jenna Scott 

If you experience any of the following after heavy drinking then it's likely you are experiencing alcohol withdrawal. So things like hand tremors, nausea, sweating, even sometimes visual hallucinations or seizures in the most serious cases, psychologically you may be 

00:30:29 Jenna Scott 

Irritable, feeling anxious, depressed, restless, or maybe having trouble to sleep. 

00:30:35 Jenna Scott 

If you are experiencing withdrawal symptoms, it is a sign that you are becoming physically dependent on alcohol. 

00:30:42 Jenna Scott 

An alcohol dependence or alcoholism is the most serious form of drinking problem and can lead to a whole range of serious health issues. 

00:30:53 Jenna Scott 

People who are suffering from alcohol dependence may experience strong, often uncontrollable desires to drink, and they'll feel that they're not able to function without alcohol. 

00:31:05 Fiona Spence 

And that’s so different to just habitual drinking isn't, it's just it's much more severe. 

00:31:10 Jenna Scott 

Yeah, yeah. And if you're experience these symptoms several days a week, it is very likely that you are already dependent on alcohol. 

00:31:18 Fiona Spence 

There must have been so many people experienced that during the initial stages of the pandemic when there wasn't access to you know, there wasn't access to alcohol and there wasn't access to supermarkets. You were limited with things. There must have been a huge amount of people really suffering. 

00:31:34 Jenna Scott 

Yeah, yeah. And I I guess probably quite dangerous for some people in in certain circumstances. As I was saying, obviously if you are a really heavy drinker and we're talking excessive levels and then if you do kind of all of a sudden stop your alcohol intake, you can become really unwell and you know, it can be life threatening for some, for some people. 

00:31:54 Fiona Spence 

So what can someone do if they're worried about their drinking? 

00:31:58 Jenna Scott 

If you think you're regularly drinking more than the 14 units per week, which we mentioned is kind of the equivalent to 6 pints of average strength beer or 6 glasses of wine, and that would be 175mls. 

00:32:12 Jenna Scott 

And then it is best to spread it out over the week if you're concerned that your drinking is impacted on your physical or your mental health. There is a lot of support available and what we'll do is we'll ensure that we attach some links to the podcast for listeners so that you can seek support. 

00:32:29 Jenna Scott 

And as we've discussed, if you're physically dependent on alcohol and need to stop drinking completely, stopping suddenly can be harmful. 

00:32:37 Jenna Scott 

So we would stress that you should get in touch with your GP to get medical advice to do this. 

00:32:43 Fiona Spence 

And likewise, if somebody is noticing that a loved one or someone they care about is actually becoming more alcohol dependent, then they could make that step for them I suppose as well.  

00:32:51 Jenna Scott 

Yeah. And, you know, even seeking advice on their behalf. Yeah. 

00:32:56 Fiona Spence 

So we talked about ways to reduce the, you know, the consequences of a hangover, but I suppose we need to discuss ways to reduce our alcohol intake as well. 

00:33:07 Jenna Scott 

Yeah. And I think my main recommendation for this would be to track your intake. The likelihood is most of us are drinking more than than that 14 units per week and I suppose if people are conscious about their health or want to make improvements or anything like that. These things aren't. It's not a big invasion of your, you know, your time to just have something on an app? 

00:33:28 Fiona Spence 

Yeah, and I think there's lots of people track their fitness, track their steps. Yeah, this is just. 

00:33:33 Jenna Scott 

Another thing to add to that. 

00:33:35 Jenna Scott 

And I think even doing it kind of once a month or something based on an average week just so that you've got that awareness and you do know how much you're drinking. 

00:33:45 Fiona Spence 

I think you'd be quite shocked if you saw the units in terms of, you know, when you've got one glass of what looks like liquid in front of you, you'd probably be quite shocked to the calorie content and the units that would be in it. 

00:33:56 Jenna Scott 

You know, yeah, definitely. I mean, I was quite surprised at the cocktails. Like, you know, there's lots of different things going into that. 

00:34:01 Jenna Scott 

But for them to have up to 5 units and one drink, you know, that's three cocktails and you're already over your allowance. Yeah, Yep. And the calories as well, I I think as well, thinking about your habit. 

00:34:06 Fiona Spence 

Also the sugar. 

00:34:14 Jenna Scott 

Often our intake is increased and we don't even really realise, you know, that we are drinking more. I know that during lockdown I was in the habit of drinking more regularly, 'cause I wasn't leaving the house. 

00:34:25 Fiona Spence 

Life changed, hasn't it? You know, we have got some more. Well, we've got a lot more freedom now. Things are a bit more normal now. 

00:34:34 Fiona Spence 

So you would hope that, you know, for a lot of people it was maybe just a temporary glitch, but there will be a significant amount of people where they haven't managed to make this change and that it has become a new way of their life for them and their routine. 

00:34:40 Jenna Scott 

And it can be difficult to break habits as well. 

00:34:50 Fiona Spence 

Because we have got the, you know we've got the economic crisis on our hands as well in terms of energy bills and all the rest of it, so people probably are choosing not to go out again. 

00:34:59 Fiona Spence 

No, not because that they're not having access to places, but actually 'cause they can't afford to go out. 

00:35:03 Jenna Scott 

Yeah. And again, it's going back to that.  When you're at home, do you drink more because you are measuring it yourself rather than it be measured out for you? 

00:35:12 Jenna Scott 

And so yeah, I think think about your habits as their patterns with your drinking. Is there ways that you could look to reduce that slightly and see how that helps. 

00:35:25 Fiona Spence 

And the low alcohol versions? I have to say I have had the no is it knows echo, knows echo echo the Prosecco that is alcohol free and it is tasty. 

00:35:31 Jenna Scott 

Nosecco, yeah. 

00:35:35 Jenna Scott 

And there is quite a wide range now of beers, gins and Prosecco, wines and so yeah, just trying different ones to see what you like and I think mocktails are, are definitely one that are increasing in popularity as well. 

00:35:51 Jenna Scott 

So there is ways you know to swap out some of the alcohol that you're having and to reduce it overall. 

00:35:57 Fiona Spence 

Because there's lots of people that don't like juice. 

00:35:59 Fiona Spence 

Do you know if you wanted to go out with friends or if you wanted to go or you were going to have wedding or there's some kind of celebration and you were like don't want to drink, but at the same time I don't like juice, actually having an alcohol free version is something is a bit more tasty and more palatable for you. 

00:36:16 Jenna Scott 

Yeah, or even mixing it. 

00:36:17 Jenna Scott 

So mixing having a white wine soda or a shandy and over some people they would be horrified at the thought of having a lemonade put in their beer, but just wee tips like that or even having 1/2 pint rather than a pint that 

00:36:31 Jenna Scott 

Kind of thing, just to reduce the overall quantities you're having and I think as well thinking of other activities, so instead of the default being going to the pub, could you go to the cinema you know  

00:36:43 Fiona Spence 

It's like we need to change our culture. 

00:36:46 Jenna Scott 

Other activities that don't always need to involve alcohol. 

00:36:50 Jenna Scott 

I think some people find it hard to socialise without alcohol though, and again, that's maybe being a habit of theirs that they drink for the confidence and to be able to socialise. There is club soda, I don't know if you've heard of that before? 

00:37:01 Fiona Spence 

I have never heard of this before. 

00:37:03 Jenna Scott 

And it's a website that gives good tips on socialising, sober and kind of tips for cutting back on drinking. That's a great idea. 

00:37:11 Jenna Scott 

Yeah, NHS have also got tips for cutting back on drinking, and there's obviously the sober October, dry January. 

00:37:18 Fiona Spence 

I know lots of people get involved in that and they feel so much better for it. 

00:37:22 Jenna Scott 

Yeah. Or even seeking family support or support from your friends. So maybe deciding, you know, instead of going out to the pub, we're going to do something different and socialise without alcohol. 

00:37:34 Jenna Scott 

Just to kind of adjust your intake. 

00:37:37 Fiona Spence 

So we are going to wrap up this podcast now and I think it's really important to have a bit of a take home message from you. Jenna, what's your thoughts? 

00:37:45 Jenna Scott 

Yeah. So again, my three top tips, if you like, I think probably think about how alcohol makes you feel. Does it have a positive impact on you or a negative impact? 

00:37:58 Jenna Scott 

And be mindful of when you're drinking, who you're drinking with and the impact that that has on your alcohol intake. 

00:38:06 Jenna Scott 

There might be certain people that impact your intake negatively, so it's being mindful of that, thinking about ways to reduce that. 

00:38:16 Jenna Scott 

And also the main and the most important one is to seek support if alcohol is impacting on you negatively and to seek support as quickly as you can. 

00:38:27 Jenna Scott 

So that it doesn't spiral and become more difficult for you to tackle. 

00:38:31 Fiona Spence 

That is really interesting, Jenna. Thank you so much. And again, you know, your three top tips and your take home message, you know? 

00:38:36 Fiona Spence 

But I think the one that stands out for me, and this isn't against, you know, this isn't anything to do with anybody else. 

00:38:42 Fiona Spence 

Because, like you say, you know everybody feels and reacts on alcohol, so differently. But it's almost being selfish for yourself and your own well-being. And actually, like, you know what? If I'm in that company, I'm more likely 

00:38:57 Fiona Spence 

To drink more or more likely to do these things or behave in a certain way that actually, you know, be selfish and look after yourself and you know, don't put yourself in that situation. It's OK to say, you know what, I'm just going to drink juice tonight or No, I'm going to skip our meeting tonight or I'm not going to, we're not going to have a get together or whatever. 

00:39:16 Fiona Spence 

I'm a bit busy. Or do you know it's actually OK to take a step back and look after yourself and not be peer pressured or influenced by people around you. 

00:39:24 Jenna Scott 

Yeah, definitely. And I think at the end of the day, we're accountable for ourselves. So that pressure, you know, it's down to you. 

00:39:31 Fiona Spence 

But the peer pressure is there, you know, like it doesn't matter what age. You don't have to be a teenager to be suffering from peer pressure. And there's always that kind of influence around you or situations. That's the one that stands out for me the most anyway, I think. 

00:39:44 Fiona Spence 

But like you said, you know, think about how it makes you feel, you know. Is it making you feel positive or negative, you know? 

00:39:49 Fiona Spence 

And what's the environment when you are having alcohol and to seek support? Really important top tips, Jenna. 

00:39:57 Fiona Spence 

Thank you so much for joining me today on this podcast. It’s been wonderful. Thank you, our second podcast together. Thank you. Thank you so much for listening today. We look forward to welcoming you back to another podcast soon. 

00:40:01 Jenna Scott 

Thank you for having me.