Holiday Drinking and Your Mental Health: A Guide from a New Jersey Psychiatry Practice

Labyrinth Psychiatry Group · Published November 2, 2026 · Prepared by the practice’s editorial team · Clinical review by Dr. Salvatore G. Savatta pending

The short answer

Alcohol feels like it helps at a party. It costs you afterward. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) lists anxiety and irritability among the typical symptoms of a hangover, and explains why: “when the buzz wears off, people can feel more restless and anxious than before they drank.” It calls this a mini-withdrawal. The symptoms peak when blood alcohol returns to about zero and “can last 24 hours or longer.”

In plain terms, a December of drinking does three things, each from NIAAA’s pages:

• Mood and anxiety rebound. The calm you felt at 9 p.m. is borrowed; the brain pays it back the next morning.
• Sleep breaks. “People may fall asleep faster after drinking alcohol, but their sleep is fragmented, and they tend to wake up earlier.”
• The repair is slow. Even moderate doses “may alter the physiology of sleep, for instance by reducing the duration of rapid eye movement sleep,” and the changes can be “recovering only after 30 or more days of abstinence.”

Stack three or four of those evenings into one week and you get a run of mornings with worse mood, shorter sleep and more anxiety than the week before. For someone treating depression or anxiety, that is the thing the treatment is trying to fix, moving in the wrong direction.

Why December is different

NIAAA’s holiday page says it plainly: the holidays are “a time when some people are more likely to drink beyond their limits than at other times of the year.” It adds two warnings. Alcohol’s effects start before you notice them: decision-making “already diminished long before they show overt signs of intoxication.” And they outlast the last drink: “alcohol continues to affect the brain and body long after the last drink has been finished.”

The definitions that matter, from NIAAA’s drinking patterns page:

• A standard drink is “any beverage containing 0.6 fl oz or 14 grams of pure alcohol.” Holiday pours are rarely standard. Rethinking Drinking suggests asking the host “not to ‘top off’ a partially filled glass.”
• Binge drinking brings blood alcohol to 0.08 percent or higher: “five or more drinks (male), or four or more drinks (female), in about two hours.”
• Heavy drinking is “five or more drinks on any day or 15 or more per week” for men, and “four or more on any day or eight or more drinks per week” for women.
• High-intensity drinking is twice the binge threshold: “10 or more standard drinks … for males and eight or more for females.”
• Who should avoid alcohol completely: NIAAA’s list includes people who “take over-the-counter or prescription medications that interact with alcohol.”

That last line is why a psychiatry practice is writing this. Many people who see a psychiatrist take a medication on NIAAA’s interaction list. A week of office parties can push an ordinary drinker past the binge line without anyone calling it that.

Alcohol, depression and anxiety: the rebound

The pattern clinicians watch for is described in NIAAA’s Core Resource on Alcohol: “Alcohol may appear to relieve anxiety in the short term, but over time, heavy drinking and repeated withdrawal can escalate both the anxiety symptoms and maladaptive drinking.” It applies without a diagnosis too. “Even among patients without an anxiety disorder, anxiety-like symptoms can occur after a single heavy drinking episode (sometimes described in the popular press as ‘hangxiety’) and can increase between drinking episodes.”

For depression, the same source gives numbers. Among people with major depressive disorder, co-occurring alcohol use disorder “ranges from 27% to 40% for lifetime prevalence.” And “depression screening scores often rise and fall in tandem with AUDIT-C alcohol screening scores.” For people who already have a mood disorder, the warning is stronger: long-term exposure to alcohol “may lead to a more severe clinical course, with longer duration of mood episodes, poorer cognitive function, and higher risk of suicide.”

The sleep piece has been measured. A laboratory study summarised in the Korean Journal of Family Medicine found that after drinking, “rapid eye movement (REM) sleep was suppressed during the first half of the sleep cycle followed by an increase during the second half.” That rebound is the 3 a.m. wake-up after a party. NIAAA’s advice when patients report insomnia, early waking or fatigue is to “screen them for heavy alcohol use.” It also notes that shifting sleep timing on weekends can mean “chronic circadian misalignment,” and December is a month of shifted weekends.

If your winters already run low, read our guide to seasonal depression in New Jersey. The clock change and the drinking season overlap, and the two are easy to confuse.

Alcohol and psychiatric medication, class by class

This table quotes NIAAA’s Harmful Interactions table, MedlinePlus drug pages and one FDA label. It is a reading list, not an instruction. NIAAA’s own framing: “Alcohol and medicines can interact harmfully even if they are not taken at the same time.” The decision about your medicine belongs with the clinician who prescribes it.

Two notes from the same sources. Monoamine oxidase inhibitors (tranylcypromine, phenelzine) with alcohol “may result in serious heart-related side effects,” NIAAA says, with a blood-pressure risk from tyramine, “a byproduct found in beer and red wine.” And if drinking itself has become the problem, there are medicines for that. NIAAA’s treatment page describes naltrexone, which “helps reduce the urge to drink,” acamprosate, which “decreases the negative symptoms that are sometimes felt during abstinence,” and disulfiram. MedlinePlus says naltrexone “is used along with counseling and social support.” They exist, and an evaluation can discuss them.

“Holiday heart”

The term comes from cardiology and is about the heart’s rhythm. A 2024 StatPearls review defines holiday heart syndrome as “cardiac arrhythmias following a period of binge drinking, often observed during weekends and holidays.” It was first described in 24 patients admitted with atrial fibrillation “after engaging in a weekend binge of alcohol consumption.” One line matters for occasional drinkers: it “can also occur in individuals who rarely or never consume alcohol but occasionally engage in binge drinking.” A 2025 review of 11 studies “consistently demonstrated a strong association between binge drinking and AF onset.” A racing or irregular heartbeat after a night of drinking is a reason to be seen by a medical doctor, and a reason to mention the drinking.

When December drinking is a signal

Clinicians screen with three questions, the AUDIT-C. Ask them of yourself before the season, not after it:

1. “How often did you have a drink containing alcohol in the past year?”
2. “On days in the past year when you drank alcohol how many drinks did you typically drink?”
3. “How often did you have 6 or more (for men) or 4 or more (for women and everyone 65 and older) drinks on an occasion in the past year?”

Each answer scores 0 to 4, for a total of 0 to 12. The Department of Veterans Affairs and Department of Defense consider the screen positive at “5 points or greater.” The third question asks about occasions, not averages: “Never” scores 0, “Less than monthly” 1, “Monthly” 2, “Weekly” 3, “Daily or almost daily” 4. A heavy December still puts points on that question even when the rest of the year is quiet, though no single answer makes the screen positive on its own, and the VA adds that a positive AUDIT-C “should never be the sole criterion for entering an alcohol diagnosis.”

Signals that go beyond a score, each from the sources above:

• Anxiety or low mood the morning after drinking; NIAAA says hangover symptoms “can last 24 hours or longer” (the mini-withdrawal).
• Sleep that starts fast and breaks at 3 or 4 a.m. on drinking nights (NIAAA, and the REM rebound).
• A racing or irregular heartbeat after a heavy night (holiday heart).
• Drinking “to make you more comfortable in social situations, manage moods, or cope with problems,” which Rethinking Drinking names as the reason to find other ways to cope.
• No progress after trying to cut down. NIAAA: “If you haven’t made progress in cutting down after two to three months, consider quitting drinking altogether, seeking professional help, or both.”

Family events, social anxiety, and what to do instead

NIAAA’s clinical resource defines social anxiety disorder as “extreme fear of situations involving the possibilities of scrutiny by others or embarrassment.” A family dinner is exactly that situation for many people. The drink before the door is a coping strategy. NIAAA’s point: alcohol “may appear to relieve anxiety in the short term, but over time, heavy drinking and repeated withdrawal can escalate both the anxiety symptoms and maladaptive drinking.” The alternatives below are NIAAA’s, from Rethinking Drinking and its holiday page:

• Set goals before the invitation, not at the bar. “Decide how many days a week you want to drink and how many drinks you’ll have on those days.”
• Keep track. “Making a note of each drink before you drink it may help you slow down when needed.”
• Know your “no.” “Have a polite, convincing ‘No, thanks’ ready. The faster you can say no to these offers, the less likely you are to give in.”
• Plan for the trigger. “If certain activities, times of day, or feelings trigger the urge, plan something else to do instead of drinking.”
• Ride the urge. “Accept it and ride it out without giving in, knowing that it will soon crest like a wave and pass.”
• Eat, and drink something else first. NIAAA’s host tips: offer “water, juices, sparkling sodas,” and food, which can reduce the peak level of alcohol in the body “by about one-third.”
• Get home without driving. “Anyone getting behind the wheel of a car should not have ingested any alcohol.”

What to replace alcohol with at night is one of the most-searched questions of the season. NIAAA’s answer has two parts. The drink: water, juice or sparkling soda. The hour: “fill free time by developing new, healthy activities, hobbies, and friendships, or by renewing ones you’ve missed.” If the nightly drink is doing a job, helping you sleep, quieting worry, getting you through an evening alone, that job is what to bring to an evaluation, and our psychotherapy program is one place to bring it.

Grief, loneliness and the first holidays after a loss

Some people drink more in December because the season is loud and they are not. NIAAA’s Core Resource notes that “since alcohol is readily available, it is commonly used to cope with anxiety,” and its urge strategies start with “talk things through with someone you trust.” Our earlier article on why depression peaks during the holidays covers the holiday blues themselves, and our seasonal depression guide covers low mood that lasts; this page is about the drinking that rides along with them.

How to raise it with your psychiatrist or therapist

NIAAA’s Core Resource tells clinicians that “a timeline of symptoms and behaviors is a key tool for differential diagnosis” and, when patients who drink heavily report anxiety, “it helps to create a timeline with them.” You can bring that timeline yourself:

• What you drink in a normal week, and what a December week looks like.
• Which nights are worst for sleep and mood, and whether they follow drinking.
• When the anxiety or low mood started, and when the drinking did (NIAAA asks for “the ages of onset”).
• Your “longest period of abstinence,” and whether you felt better during it.
• Every medication you take, including the ones you think are unrelated.

Admitting the drinking does not cost you the treatment. NIAAA says clinicians “do not need to wait until patients become sober to start antidepressants if there is evidence of need,” with a check for interactions.

At Labyrinth Psychiatry Group the first visit is an evaluation, not a treatment decision. As our what to expect page describes it, the clinician “reviews symptoms, history, prior response, safety, health factors, preferences, and goals.” The plan that follows “may include medication, therapy, telehealth follow-up, TMS, SPRAVATO/esketamine, another approach, or further assessment.” The practice is led by Dr. Salvatore G. Savatta at 11 Commerce Drive, Lobby Floor, in Cranford, with telehealth for patients across Union, Middlesex and nearby counties. Call 908-336-1187 or use the appointment request form. Insurance and access questions are answered on their own page. Where depression has not responded to two or more adequate medication trials, and drinking was one reason the trials were never adequate, our treatment-resistant depression page explains the evaluation that follows.

Get help now

If you or someone else is in immediate danger, call 911. For everything short of that, these lines are open through the holidays. Each number is quoted from its official page:

• 988 Suicide & Crisis Lifeline: call or text 988, or chat at 988lifeline.org. For “mental health struggles, emotional distress, alcohol or drug use concerns, or just need someone to talk to.” “Available 24/7/365. Your conversations are free and confidential.”
• NJ MentalHealthCares: 866-202-HELP (4357), “New Jersey’s behavioral health information and referral service.” People who are deaf may reach it through 711 NJ Relay. (njmentalhealthcares.org)
• ReachNJ: 1-844-732-2465 (1-844-REACHNJ), “NJ’s 24/7 addiction helpline.” “Each call to ReachNJ is answered by a live person in the first 30 seconds,” and it serves “NJ residents of all ages regardless of insurance status or ability to pay.” (nj.gov/humanservices/reachnj)
• SAMHSA National Helpline: 1-800-662-HELP (4357), TTY 1-800-487-4889, “confidential, free, 24-hour-a-day, 365-day-a-year,” in English and Spanish. (samhsa.gov)

Questions people ask in December