Alcohol and severe mental illness

It’s safest to not drink at all while you’re planning a pregnancy, but if you’re finding this hard, there’s lots of help out there.

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Alcohol

What are the risks of drinking alcohol during pregnancy?

Mental illness and alcohol

Alcohol or antidepressants?

Find your triggers

How can I get help to stop drinking?

Getting support with giving up alcohol

Alcohol

When you drink, alcohol passes from your blood through the placenta and to your baby. If  you are trying for a baby, you can become pregnant very quickly, so if you are drinking there is a chance that you will be drinking when you are pregnant without knowing about it. This is why it’s best to stop drinking alcohol if you are having sex and not using contraception.

Some people with mental illness use alcohol to help them cope with their symptoms or with difficult feelings. If you’re drinking too much, it can harm your health and make your mental illness worse. You may start to depend on alcohol to cope with daily life.  

If you are dependent on alcohol, or cannot control how much alcohol you drink, it will affect how well you are able to look after a child. That’s why it’s important to get help with this before becoming pregnant if you can. If that isn’t an option because you are already pregnant, be honest with health professionals, they can help you to give up alcohol.

What are the risks of drinking alcohol during pregnancy?

Drinking alcohol during pregnancy can harm your baby. It puts them at risk of fetal alcohol spectrum disorder (FASD).

FASD can cause serious physical and mental problems for your baby. Their joints, bones and muscles may not develop as they should. They may also have problems with behaviour, learning, communication and social skills later on.

Drinking during pregnancy also increases the risk of:

• miscarriage
• premature birth
• having a baby with a low birth weight.

Learn more about the risks of alcohol in pregnancy.

Mental illness and alcohol

Alcohol and depression are linked. Some people with mental illness use alcohol to help them feel better. It might make you feel better for a little while, but heavy alcohol use makes you feel worse in the long run. Regularly drinking alcohol makes depression more likely.

As well as making you more depressed, drinking alcohol to feel better can also make other problems worse. For example, it can leave you unable to take care of your children, which makes you feel worse about yourself, which can make you want to drink to forget. This becomes a vicious cycle. You may start to be addicted to alcohol, and crave it more and more.

If you know you are addicted to alcohol, please scroll down for support.

Alcohol or antidepressants?

Alcohol is not safe in pregnancy. Some people think that using alcohol is a safer way of coping with mental illness symptoms than taking antidepressants in pregnancy, but this simply isn’t true. If you’re drinking too much, it can harm your health as well as your baby's health and make your mental illness worse.

If you are worried about taking mental health medication, always speak to a doctor about it. They will work with you to find a treatment that is best for you and for your baby's health.

Find out what you would talk about in an appointment with your doctor about planning a pregnancy.

Find your triggers

It can help to think about what triggers your drinking. You can then try to avoid those triggers.

Triggers are things that make you want to do something (like smoke, drink or take drugs). They are often based on habit. Perhaps every Friday you have a drink after work. The alcohol makes smoking feel like a good idea, so you smoke as well.

The first trigger is that it’s the end of the week.

The second trigger (for smoking) is drinking alcohol.

Once you've worked out your triggers, see how you can change your life to avoid them. For the example above, you could find something else to do after work on a Friday, maybe a movie night with a friend instead of heading to the pub.

Or, if you really don't want to give up your after-work drinks, make a conscious plan about what to drink when you are in the pub on Friday, like a mocktail or a fruit juice.  

The charity With You has more information on triggers.

How can I get help to stop drinking?

Some people know they are drinking too much, but don't feel able to talk about it. Cutting down or stopping on your own can be hard, and you may need help.

Talk to your GP or mental health specialist, or your midwife if you have one. They won't judge you and they can put you in touch with more support if you need it. They may give you the name and phone number of a midwife or doctor who’s an expert in caring for pregnant women who are drinking too much.

Your midwife or doctor should be able to answer any questions you may have about how your drinking might affect your pregnancy, and whether your baby is likely to need any extra care. They can also help you cope with any feelings you may have about your drinking.

Let them know if you need any help with your antenatal appointments, such as texts to remind you about them, or help with transport.

If you depend on alcohol, and get withdrawal symptoms when you don’t have a drink, it’s important to get medical help to slowly cut back. Don’t stop drinking without speaking to your doctor, midwife or local alcohol treatment service, as doing so can be dangerous.

Signs that you depend on alcohol may include:

• having a strong desire to drink
• keeping drinking even when you know it’s harmful
• losing interest in other activities.  

Withdrawal symptoms may include:

• shaking
• sweating
• feeling or being sick  
• feeling anxious
• not being able to sleep.  

If you have other children at home, you might sometimes struggle to look after them if you are dependent on alcohol. But there is help available.

If you or your children already have a social worker or early help worker, you can ask them to check in more often to see how you are all doing. If not, your midwife can offer you advice and help.

Getting support with giving up alcohol

If you’re finding it hard to give up alcohol, talk to your mental health team, GP, midwife or pharmacist. They will not judge you and will want to support you.  

You can get free specialist support from your local alcohol treatment service. Find contact details for services in England here. You can also find details for support organisations in Scotland, Wales and Northern Ireland.

Drinkline is the national alcohol helpline. If you're worried about your own drinking or someone else's, call this free helpline on 0300 123 1110 (weekdays 9am - 8pm, weekends 11am - 4pm).

Alcoholics Anonymous (AA) is a free self-help group. Its "12-step" programme involves getting sober with the help of regular support groups.

Take a look at our pregnancy planning tool for more tips for a safer pregnancy.