Dr Zak Uddin has answered two questions from readers about mental health and alcohol consumption.

Thank you to the two readers who wrote in about their mental health concerns. As always, my advice is given in good faith, in line with current guidelines and treatment. However, it cannot act as a substitute for consulting your own doctor.

My mood is up and down, sometimes I’m happy, a lot of the time I’m down. How do I know I’ve not got bipolar, and not just depression – Kerry, 23

Dr Zak: For anyone suffering depression, this may be punctuated by periods of feeling optimistic, or that things are all right in general.

This is normal. Indeed, for those with subthreshold symptoms, you are unhappy for a prolonged period, typically over a year, such that you fit the criteria of being sad more than you are happy.

True bipolar affective disorder is less common than depression and is marked by vast swings in mood from the depths of despair and feeling suicidal, through to episodes of mania. Bipolar affective disorder was previously referred to as manic depression.

In mania, you may be so elated you feel like you are invincible. Grand plans are often made. You may behave much more confidently than your normal state. You may engage in risky behaviour including sexual promiscuity, spend money you do not have and feel like you do not need sleep.

To those around you, it may be obvious that you are in a manic, or hypomanic episode, if your behaviours are slightly less erratic.

The phases of mania and depression can be that drastic that they switch within a very short space of time. This is known as rapid cycling bipolar disorder.

Depression can be difficult to treat, and requires patience on both from both the individual suffering and those who are helping them. Within it there will be points of happiness, hopefulness about the future, and indeed great positivity. The hope is that treatment will make you feel happier more often than you feel sad.

However, bipolar affective disorder may not respond to traditional treatments for depression. If you recognise the symptoms of bipolar in yourself, it is worth raising these concerns with whomever is looking after your mental health.

I have anxiety and have been prescribed an antidepressant. My GP advised me to cut back on my alcohol, but I find it helps me to relax. Rob – 45

Dr Zak: While sometimes acceptable in moderation, it must be remembered that alcohol is a depressant. This is often in quantities smaller than you might expect.

Alcohol competes with antidepressants for the same receptors in the brain, hence your medication may not work as well, if at all.

We are now aware that there is no safe level of consumption for alcohol. The government advises a recommended weekly allowance of 14 units, spread out over the week, with several alcohol-free days. Yet only one unit of alcohol a day can increase your risk of some cancers.

Aside from the physical and mental health aspects, using alcohol to relax would be seen as a maladaptive coping mechanism, similar to smoking. While certain aspects of the medical profession previously advised that you should not give up smoking during a period of stress, it is now agreed by all that there is no good time to start, and every reason to stop.

There are many other ways of relaxing and reducing levels of anxiety that are not only good for the body, yet can also be pleasurable.

Walking, picking up a hobby, or joining a support group will give you much greater rewards and a sense of empowerment, far greater than reaching for a drink when you feel stressed.

While it would be a very unpopular suggestion that you should banish alcohol completely, it should not be relied on to keep you calm.

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