There are many things we can be certain of in life and one of those is that some blokes like to have a chat over a beer. It’s also fair to say that life can throw as much misfortune at us as it does fortune. But in this day and age when it is well documented that most men will not talk about their mental health, is having a pint part of the problem, or can it be part of the solution?

There is so much in the media and many academic studies published about how consumption of alcohol is detrimental to our health and in particular our mental health. There are however some studies out there that suggest a moderate amount of certain types of alcohol such as red wine may be beneficial at times. This causes a dilemma in that, am I better to ask a mate to have a beer if I think he’ll open up and talk about what’s distressing him or do I totally avoid the alcohol permissive situation but acknowledge he may end up bottling up his issues (no pun intended). If I can’t stop him from drinking alcohol, should I offer to go for a beer and a chat rather than let him sit drinking on his own, dwelling about the difficulties he’s experiencing?

This debate will be a heavyweight contest with very strong views on both sides, but in the blue corner we have the argument for abstaining completely and supporting the view that alcohol and mental health should never mix. Some of the most common conditions that occur with excessive alcohol consumption include depression, bipolar disorder, and obsessive compulsive disorder (OCD). Alcohol is often used to self-medicate and improve the mood but is very habit forming and people can start to need more alcohol to maintain the ‘happier feeling’. In 2018 the Lancet published two studies showing the best option for our health was an intake of zero levels of alcohol. Heavy alcohol use directly affects brain function and alters various brain chemical (i.e., neurotransmitter) and hormonal systems known to be involved in the development of many common mental disorders so avoiding alcohol will surely prevent this being a factor in developing mental health conditions.

In the Red-On corner we feel drinking responsibly and in moderation is OK. We see it as part of an existing social culture that has existed for many years and will likely remain for many more. Research shows that excessive alcohol consumption in itself does not produce behavioural conditions but acknowledges it can exacerbate mental illness where it already exists. We don’t suggest consuming alcohol to improve health, but rather that in moderation, the disadvantages are balanced against the benefits of the social interaction associated with it. Every time we get in a car we are at risk, but we don’t advocate no driving at all; so why do we do the same with alcohol? In the same year the Lancet published the blue corner’s two reports saying we shouldn’t drink alcohol, the PLOS Medicine journal published a report claiming light drinking was better than zero consumption of alcohol. A further study in 2017 by Oxford University suggested that going for a beer increased our feelings of social connection and subsequently improved our wellbeing.

People who develop both a mental health condition and alcohol dependency have what is termed a dual diagnosis. The signs and symptoms can include social isolation, changes in appetite and sleep patterns, loss of energy and motivation, trouble concentrating and neglecting personal and professional responsibilities. Treatment will need to be a blend of detoxification and rehabilitation providing the person is accepting of their situation and isn’t held back because of stigma and discrimination.

In the same way we will all have individual, unique mental health, we will all respond to the effects of alcohol in an individual way. So, two beers or not two beers remains a very complex question in particular when faced with the dilemma: is having a beer and a chat likely to help or not?