My psychiatrist: “How many drinks did you have last week?”
Me: “… 10? 12?”
This was me two years ago during an appointment with my then-new psychiatrist, doing the mental math tallying up the happy hours, dinners out, and Saturday beer fest I had attended the week prior. Truth was, I had no idea for certain how many drinks I’d had, and my guess was likely conservative. What I knew for sure was that, when my glass became empty, I’d order another round.
It’s the price you pay (or I thought you had to pay) for an active social life in New York City. Both literally, with cocktails routinely topping $20 each, and figuratively, at the expense of your health. I felt guilty about imbibing so much in the first place—I knew it wasn’t good for my liver or my overall wellness. But the greatest toll was on my mental health.
I’d wake up on Sunday mornings with a bad case of hangover anxiety, also called “hangxiety.” Alcohol affects various neurotransmitters in the brain. This is why you might feel relaxed and “let loose” after a couple of drinks. But it can also lead to jitters, irritability, and yes, anxiety the next day as your brain tries to readjust. Of course, since alcohol lowers your inhibitions, you might also feel angsty about those late-night texts you sent and the random Instagram stories you replied to.
In my case, I often worried that I’d said or done something stupid after that last mezcal margarita. Or that my increased heart rate was a symptom of a heart attack. As I reached my mid-30s, my hangovers grew worse, the next morning panic attacks became more frequent, and my sleep was wrecked.
Still, I couldn’t imagine having a social life in NYC without alcohol. My entire world outside of the cubicle revolved around it: meeting up for bevs with friends, open bars at press functions, splitting a bottle of wine at dinner with my husband. I’d even mix up a “dressing drink” when getting ready to go out.
People like me—who drink a lot in social settings but don’t have an alcohol-related diagnosis —don’t always connect excessive booze with crap mental health. But there can be a significant link. “It doesn’t have to be that you have a substance abuse disorder for your alcohol use to be impacting your mental health,” explains Naomi Torres-Mackie, Ph.D., a clinical psychologist at Lenox Hill Hospital and head of research at The Mental Health Coalition.
“Alcohol use on a more social-casual basis interrupts your sleep,” she says. “When your sleep is interrupted, your mood is impacted. It’s harder to get into a deep REM sleep, and a lot of people experience early waking when they use alcohol. And that adds up to exhaustion and low mood.”
But these aren’t the only issues. “Alcohol use can lead to depression, even on a clinical basis,” Dr. Torres-Mackie continues. “Alcohol shifts chemicals in the brain, it shifts hormones. It can increase impulsivity, which can lead to suicidal behaviors and increased risky behaviors. The aftermath of risky behavior can really lead to regret.”
I knew this. I’ve spent years working as a health reporter and editor. I was well aware that alcohol is a depressant and can negatively impact your mood. Which is particularly not ideal for someone with a mood instability disorder like bipolar 2, which I have.
But I loved the ritual of drinking. I loved experimenting with liquor and liqueurs and holding stemmed glassware. Listening to the “pop” of a new bottle of Prosecco or the first sip of a hazy IPA at a craft brewery. Perusing cocktail menus to find something festive that gave me a buzz before the buzz.
I enjoyed drinking and getting drunk. Until it didn’t serve me anymore.
The Binge-Drinking Trap
My mental health care team has confirmed I don’t struggle with alcohol use disorder (AUD). But I do fall into the category of binge drinker, defined for women as having four or more drinks on occasion—a number I often topped on a Saturday.
When Binge-Drinking Is Actually Alcohol Use Disorder
Some key symptoms of AUD as outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) include:
- Drinking more or longer than you intended.
- Trying unsuccessfully to cut back or stop drinking more than once.
- Spending a lot of time drinking, being sick from drinking, or getting over other aftereffects.
- Wanting a drink so badly you can’t think of anything else.
- Find that drinking (or getting sick from drinking) often interferes with taking care of your home or family, or leads to job troubles or school problems.
- Continuing to drink even though it’s causing issues with family and friends.
- Cutting back or giving up on activities that used to be important to you in order to drink.
Therapist Amanda White, LPC, who herself overcame alcohol issues and calls herself a “retired party girl,” coined the phrase “disordered drinking” to refer to the spectrum people can be on with alcohol.
“We can go through phases in life where we do have an unhealthy relationship with alcohol and it doesn’t necessarily mean that you’re an alcoholic and can never drink again,” says White, executive director of the Therapy for Women Center in Philadelphia and host of the Recovered-ish podcast. “Just as a term like ‘disordered eating’ doesn’t mean you don’t have an eating disorder.”
In my case, I didn’t think I had a real issue with alcohol because I only binge-drank when out with friends, getting caught up in the moment and losing track of how many drinks I was ordering. I could always stop drinking once I started and never felt like I “needed” alcohol or craved it. I (fortunately) never found myself in dangerous situations while drinking or had it interfere with my relationships or career.
Instead, I embraced weekend binge drinking as something many childless adults do as a social activity. According to a study published in 2023 in the journal Addiction, women age 35 who didn’t have any children (*raises hand*) are at the highest risk of binge drinking and AUD. And research from the National Institutes of Health found that binge drinking was at its highest recorded prevalence ever among people aged 35-50. In 2022, nearly 30 percent of people in this age group reported binge drinking, compared to 23 percent in 2012.
While I’m sure some people might consider my past drinking habits as problematic, I didn’t feel any different from my friends or peers. If anything, I was often the more tame one, going home before midnight while others continued to stay out until the bars closed. It’s a comparison trap a lot of drinkers fall into—“at least I’m not as bad as X”—but it just didn’t seem like a problem. In Manhattan (and likely other cities), getting totally sloshed is as normalized as stealing someone’s cab.
Binge-drinking was so intertwined with my life and what I thought I needed to have a good time. At that psychiatry appointment years ago, my doctor assessed the prescription medication I was taking for bipolar 2, the mood stabilizers Latuda and Lamictal. He recommended I have no more than two drinks within 24 hours and six drinks a week total. He didn’t elaborate on the specifics of why, but Latuda comes with an alcohol warning: Booze can lead to increased sedation and drowsiness.
I did the polite thing and said, “Ok, I’ll try,” knowing full well I probably wouldn’t. At the time, the six-drinks-a-week thing felt impossible. I didn’t drink every day, but I had a wedding coming up in Utah where I would be staying in an Airbnb with my closest high school friends and our partners. The wedding reception was at a whiskey distillery. I couldn’t imagine cutting myself off after only two drinks while my friends ordered round after round. How could I bar-hop while sipping on seltzer?
To make a long story short: I did binge-drink in Utah. And again, on and off on the weekends when I was back in NYC. Last year, I attended a bachelorette party in Chicago with a dozen girls that entailed three nights in a row of binge-drinking. I drank so much one night, I don’t remember how I got home.
I tried to brush those missing hours off as a harmless causality of bachelorette-partying. But I was fending off the negative mental spiral that often followed a blackout: taking inventory of every moment from the night before and ruminating over the poor decisions I possibly made.
It happened again at the wedding a month later, where I spent the reception, the after party, and the after-after party completely fuzzy. That Sunday, on the drive back home to attend my niece’s First Communion, I had a full-on panic attack in the car.
I imagine these panic attacks were from the after-effects of alcohol, as my brain neurotransmitters (called GABA receptors) tried to rebalance my central nervous system, and it doesn’t help that I’m already prone to anxiety. I would feel a sense of anxiety come on suddenly, and my heart rate would increase. I would worry that this fast heartbeat was a sign of a heart attack or some other severe health complication. And then my breath would become shallow, and it would be hard to inhale fully. My mind would race so fast I couldn’t think clearly.
I was convinced these physical manifestations of anxiety would somehow lead to my death. I’d get an overwhelming sense of fear and doom, like the end was near. Since I don’t have a prescription for Xanax or another benzodiazepine (often taken to come down from a panic attack), I would just have to try and calm myself down and wait it out. That Sunday, I had my husband pull over in a Walgreens parking lot so I could get out and walk around to get some fresh air.
A couple months later, I had another blackout at one of my favorite Manhattan dive bars. I took one too many free mini-shots of Jameson (the bar’s signature) and woke up in my bed, the final hours of the night unaccounted for.
I finally started to wonder what was the point in having a “fun night out” if I couldn’t even remember how it ended. Even though I always made it home and (luckily) never found myself in dangerous or destructive situations, the whole routine of going out, getting hammered, and regretting it the next day was losing its luster.
My sleep, which I know is important for my mental health, was becoming more unpredictable. The night after binge drinking, I would pass out and wake up not well rested. The next night, even if I didn’t have anything to drink that day, I would still often wake up at 2 or 3 in the morning, anxious and wide-eyed for hours.
Getting Sober Curious
By September of last year, it was like a light switch went off in my brain. It wasn’t after a blackout or even a hangover. On a random weekday while scrolling Instagram and coming across yet another post on the negative impacts of alcohol, I realized binge drinking wasn’t serving me anymore. I couldn’t point to one benefit I received from having more than two drinks at a time.
I started feeling like my weekend routine wasn’t reflective of the kind of adult I wanted to be or the goals I set for myself, like pursuing creative hobbies outside of work and being productive on my days off. Even if I didn’t meet the criteria of AUD, the fact that I was even questioning my relationship with alcohol was a sign that I might need to change up my drinking habits.
I should also say: I am not sober. I haven’t given up alcohol entirely, and I will still have a drink or two of something I genuinely enjoy if the mood strikes (and if I’ve eaten a full meal beforehand).
For a long time, I think people have had an all-or-nothing attitude around alcohol—either you’re a boozer or you’re sober. And for some people, it really is best for them to abstain entirely, and I applaud them for making that decision. On the flip side, I’m jealous of people who can have a few drinks at a time, even get drunk and have fun (without being destructive), and not feel anxious or ashamed the next day.
But there are a lot of us who sit in the in-between.
In fact, drinking is becoming less popular with each passing generation. One study found that Gen Z is drinking less than previous generations. Per the 2020 report, 28 percent said they abstain from alcohol, an 8 percent jump from 2002. In 2011, 39 percent of high school students reported that they drank alcohol, while only 23 percent said the same in 2023.
The term “sober curious,” often credited to Ruby Warrington who literally wrote the book titled Sober Curious, has been a positive movement for mental wellness, says Dr. Torres-Mackie. Sober curious is aimed at those who don’t necessarily live with AUD, yet are reassessing their relationship with alcohol.
According to a 2023 survey, 1 in 4 Americans know about the sober curious movement, and 34 percent are trying to drink less. Of the reasons people gave for not drinking, 21 percent said they avoid alcohol to improve their mental health.
“[Being sober curious]—just recognizing the impact of alcohol use—is a lot more accessible than the idea of strict abstinence or sobriety,” says Dr. Torres-Mackie. The sober curious movement, she believes, helps normalize abstaining from alcohol or drinking less, since you don’t have to have AUD to be sober curious. And while previously the only treatment for AUD or alcohol misuse was complete abstinence, being sober curious might be more attainable for some.
“Today we’re seeing more of the harm-reduction approach and the sober-curiosity movement where it’s a lot more gray,” she says. “Psychologically speaking, black-and-white thinking can in some ways be comforting, but it’s also not healthy… I see all of this moving more toward gray thinking, and overall it’s a positive thing.”
Therapist White agrees. “If we say you have to be 100 percent sober for the rest of your life, it is so daunting for most people,” she says.
Practicing Mindfulness—With Alcohol
Over the past four months, I’ve chosen to drink more mindfully. I now follow the advice my psychiatrist gave me: no more than two drinks in 24 hours and six drinks total a week. And it’s been a game-changer for my overall well-being, especially my mental health.
These days, it’s not abnormal for me to not drink at all on the weekends, or have only one to two drinks in a week. Of course, I have broken these guidelines here and there.
There have been some days when I’ve had three or four drinks over the span of a few hours. In these scenarios, I’ve chosen drinks with a low ABV (alcohol by volume) level, always make sure I’ve eaten, and still cap the week’s total at six. I also cut myself off when I’ve hit a slight buzz, preventing myself from teetering into drunk territory.
I’m not sure where this mindful drinking journey will take me. I might go weeks or months without drinking. I might give up alcohol entirely. The more nights I’ve spent sober, the less I feel like drinking.
I’m not ruling out that I could get caught up at a party or night out, where I binge-drink and wake up with a hangover.
But for now, mindful drinking has worked wonders for me. I haven’t had a hangover, bout of hangxiety, or panic attack in the last four months. I’m sleeping better than I have in years.
When I’m out with friends, I feel more present and in control and engaged in conversations. Without the buzz of alcohol, I’m actually listening and responding instead of talking loudly and repeating myself. I’m enjoying my friends and my husband and the meals I’m eating, along with my beverage of choice, whether that’s a single glass of Cabernet or a Diet Coke.
I used to think I needed alcohol to not only have fun, but to be fun. That the funniest and most charming version of myself was the one with a few cocktails in her. Who am I if I’m not the fun friend who is always down to go out for margaritas or meet up for a bottomless brunch? Would I still crack jokes and find other people entertaining?
Sure, liquid courage did fuel a lot of memorable nights out. But it was also responsible for petty arguments with my partner or friends, leaving earlier than planned because I got too drunk, and spending too much money at bars. I’ve had more fun these last four months than the last four years combined.
It’s refreshing being present and pleasant (like my favorite comedian Heather McMahan says) while out, then waking up the next day with a clear head, energy, and eagerness to tackle my to-do list. I didn’t realize how much of a toll hangover anxiety took on my overall mental health—especially how much time I needed after a night of binge drinking to return to baseline “normal”—until I experienced how much better I feel without it. My moods have been more stable, and I feel a sense of accomplishment for setting my own parameters around drinking and sticking to them.
Before my mindful drinking journey, I never imagined I could go to a comedy show, birthday party, concert, one of my favorite cocktail bars, or a nice dinner out without ordering a couple of drinks. Yet, I’ve now done all of these things completely sober. I didn’t think it would be possible to host a holiday party or go to an open bar event without getting drunk. Yet, I’ve managed to do both while cutting myself off after two.
I haven’t formally told my friends and family that I’ve deliberately cut back on drinking and am choosing to drink more mindfully. So for those of you reading—consider this essay my coming out.
7 Things That Have Helped Me Drink More Mindfully
#1: Returning to my favorite diet sodas
I haven’t been a diet soda fiend much since my college Big Gulp days, but now I regularly order Diet Cokes out and stock my fridge with Fresca and Diet Dr. Pepper. Save me your lectures on artificial sweeteners and the other sketchy additives. I’m a firm believer that they are still not as harmful to your body as ethanol, and a few diet sodas a week are much better than five-plus alcoholic drinks at a time.
#2: Discovering zero-proof alternatives
I’ve visited some cool booze-free shops like The Zero Co in Atlanta, and Boisson and Spirited Away in New York City. I’ve found great alternatives, like Oddbird’s alcohol-removed sparkling rosé, Monday zero alcohol mezcal, St. Agrestis non-alcoholic Phony Negroni, and Best Day Brewing 0% ABV Hazy IPA. I feel like I’m enjoying my favorite adult beverages without the negative side effects.
#3: Asking for mocktails
If you’re at a legit establishment, most bartenders are happy to mix up a mocktail if you offer some guidance (“something with citrus, not too sweet”). Just be sure to tip just as much as you would for a boozy drink!
#4: Ordering a drink I genuinely enjoy
I love a glass of a dry, full-bodied red wine or a pour of sparkling brut in a champagne flute; a well-balanced mezcal cocktail with Tajin on the rim or an Aperol Spritz on a summer day; a double IPA from a craft brewery or a seasonal pumpkin beer in the fall.
If I feel like imbibing, I’ll order a beverage I will genuinely enjoy, drink it slowly, and savor each sip. I care more about enjoying my beverage than the calories I’m consuming. Gone are the days when I’d order multiple vodka sodas to get buzzed as easily as possible.
#5: Making weekend morning plans
I have been scheduling workouts and walks with friends on Saturday and Sunday mornings to hold myself accountable and stick to my fitness goals. There’s nothing worse than trying to get through a workout when you’re hungover, and it keeps me motivated to know I’ll be well-rested when I wake up on weekend mornings.
#6: Reading Drinking Games by Sarah Levy
It’s a beautiful essay collection detailing her troubled relationship with alcohol and her decision to get sober. Even if you don’t relate to having AUD and landing yourself in similar chaotic and dangerous situations, her story of being a millennial woman who spent most of her 20s partying is highly relatable.
Levy articulates how “being down for anything” and having no other hobbies besides working long hours and going out becomes tiresome and unfulfilling in a way I wasn’t ready to yet. Whether you’re reassessing your relationship with alcohol or not, the book includes other insightful essays about body image, disordered eating, and the often fraught relationship we have with respecting ourselves.
#7: Picking up some new hobbies
Like Levy, I spent much of the last 12 years in New York working long hours around the clock at stressful jobs, and my way to blow off steam was partying on the weekends. As I reached my mid-30s (after two layoffs), I was tired of giving so much of my time and self-worth to corporate jobs that didn’t think twice about cutting me loose and throwing me a bone in the way of a few weeks’ severance.
I wanted to channel my creativity, energy, and brain power into other things that brought me joy. Now, I regularly perform stand-up comedy around New York City, have gone all-in on a new fitness program, and upped my freelance writing gigs (this essay is proof!). These endeavors are way more rewarding than spending hundreds of dollars each weekend going out, only to be met with a pounding headache and a bad case of anxiety the next morning.