Signs of Drinking Too Much Alcohol: Physical, Behavioral, and Mental Warning Signs

The signs of drinking too much alcohol often develop gradually, making them easy to miss until they become significant.

What You'll Discover:

• Physical signs that indicate excessive drinking.

• Behavioral changes that suggest a problem.

• Mental and emotional warning signs.

• How tolerance and dependence develop.

• What quantity of drinking is considered "too much."

• How to assess your own drinking honestly.

• What options exist if you recognize these signs.

According to the Centers for Disease Control and Prevention, excessive alcohol use causes approximately 140,000 deaths per year in the United States. Many people who drink too much don't recognize the signs because their drinking doesn't match stereotypical images of alcoholism. Understanding what to look for helps you evaluate your own situation or that of someone you care about.

Physical Signs of Drinking Too Much

The first thing to know is that your body often shows signs of excessive drinking before obvious life consequences appear.

Short-term physical signs:

• Frequent hangovers affecting your functioning

• Poor sleep quality despite feeling tired

• Waking up with headaches, nausea, or shakiness

• Dehydration and dry mouth

• Digestive issues (acid reflux, stomach pain, irregular bowels)

• Increased tolerance (needing more alcohol for the same effect)

Longer-term physical signs:

• Unexplained weight changes

• Facial redness or puffiness

• Bloodshot eyes

• Poor skin condition

• Elevated blood pressure

• Abnormal liver enzymes on blood tests

• Fatigue that doesn't improve with rest

• Weakened immune system (getting sick more often)

Withdrawal-related signs:

• Anxiety when you haven't had a drink

• Shakiness or tremors

• Sweating unrelated to exercise or heat

• Racing heart

• Difficulty sleeping without alcohol

• Irritability that improves after drinking

Something to consider is that withdrawal signs indicate physical dependence. If you experience these when you stop drinking, your body has adapted to regular alcohol consumption.

For more on physical effects, see our article on effects of alcohol on the brain.

Behavioral Signs of Excessive Drinking

Behavioral changes often accompany physical signs and may be more noticeable to others.

Drinking patterns:

• Drinking more than you intend to

• Difficulty stopping once you start

• Drinking faster than others

• Always finishing your drink quickly

• Having "pre-drinks" before events

• Drinking alone regularly

• Hiding how much you drink

Planning and preoccupation:

• Looking forward to drinking as the highlight of your day

• Planning activities around drinking opportunities

• Feeling anxious about situations where alcohol won't be available

• Making sure you never run out of alcohol at home

• Thinking about drinking frequently

Consequences:

• Missing work or responsibilities due to drinking or hangovers

• Neglecting hobbies or activities you used to enjoy

• Spending more money on alcohol than intended

• Relationship conflicts related to drinking

• Making poor decisions while drinking

• Regretting things said or done while intoxicated

Failed attempts:

• Setting limits and repeatedly breaking them

• Trying to cut back without success

• Making rules about drinking that don't stick

• Promising yourself or others to drink less, then not following through

If it seems like you've noticed several of these behaviors in yourself, that pattern is worth examining.

Mental and Emotional Signs

Excessive drinking affects brain chemistry in ways that impact mood and mental health.

Mood changes:

• Increased anxiety, especially when not drinking

• Depression or low mood that worsens over time

• Irritability and mood swings

• Emotional volatility

• Feeling worse overall despite drinking supposedly helping

Cognitive effects:

• Memory gaps during drinking episodes

• Difficulty concentrating the day after drinking

• Brain fog that doesn't clear

• Slower thinking

• Trouble with decision-making

Psychological patterns:

• Using alcohol to cope with stress, anxiety, or sadness

• Drinking to numb uncomfortable emotions

• Feeling unable to relax without alcohol

• Defensiveness when someone mentions your drinking

• Rationalizing or minimizing your consumption

So, why does alcohol seem to help with anxiety but things get worse overall? The short answer is that alcohol provides temporary relief while disrupting the neurotransmitters that regulate mood. The net effect over time is increased anxiety and depression.

How Tolerance and Dependence Develop

Understanding these mechanisms helps explain why drinking too much becomes self-perpetuating.

Tolerance:

When you drink regularly, your brain adapts to alcohol's presence. The same amount produces less effect, so you drink more to achieve the familiar feeling. This escalation often happens gradually over months or years.

Psychological dependence:

You come to rely on alcohol for certain functions: relaxation, sleep, social comfort, stress relief. Activities that once happened without alcohol now seem to require it.

Physical dependence:

Your body adapts to regular alcohol and reacts negatively when it's absent. Withdrawal symptoms (anxiety, shakiness, sleep problems) occur when you don't drink. Drinking relieves these symptoms, creating a cycle.

These three factors reinforce each other. Tolerance drives increased consumption. Psychological dependence makes not drinking feel incomplete. Physical dependence makes stopping uncomfortable. Together, they can make drinking feel necessary rather than optional.

What Quantity Is "Too Much"?

Medical guidelines provide specific definitions of excessive drinking.

Heavy drinking:

• Women: 8 or more drinks per week

• Men: 15 or more drinks per week

Binge drinking:

• Women: 4 or more drinks within about 2 hours

• Men: 5 or more drinks within about 2 hours

A standard drink:

• 12 ounces of regular beer (5% alcohol)

• 5 ounces of wine (12% alcohol)

• 1.5 ounces of distilled spirits (40% alcohol)

All that said, individual factors matter. Some people experience problems at lower levels of consumption. Genetics, body weight, other health conditions, and medications all affect how alcohol impacts you.

The presence of signs and symptoms matters more than hitting specific numbers. If drinking is causing problems in your life, it's too much regardless of the quantity.

Assessing Your Own Drinking

Honest self-evaluation helps determine whether your drinking has become excessive.

Track your consumption:

For 2 to 4 weeks, record every drink in standard units. Calculate your weekly average. Compare to the guidelines above.

Notice your patterns:

• When do you drink?

• What triggers the desire?

• Can you comfortably skip days?

• How do you feel the next morning?

Try an experiment:

Go 1 to 2 weeks without alcohol. Notice:

• How difficult is it?

• Do you experience any withdrawal symptoms?

• How do you feel physically and mentally?

• What emotions or situations make you want to drink?

Ask yourself honestly:

• Has my drinking increased over time?

• Have I tried to cut back without success?

• Has anyone expressed concern?

• Do I experience consequences from drinking?

• Would I be concerned if someone I care about drank like I do?

For a structured assessment, see our article on do I have a drinking problem.

What to Do If You Recognize These Signs

Recognizing signs of drinking too much is the first step. What you do next matters.

Immediate steps:

• Track your drinking to get clear data

• Tell someone you trust about your concerns

• Schedule an appointment with a doctor

• Consider a trial period of not drinking

Treatment options:

• Medication - Naltrexone reduces cravings and makes drinking less rewarding, making it easier to cut back or stop

• Counseling - Work with a therapist to address underlying issues and develop strategies

• Coaching - Regular accountability and practical guidance

• Support groups - AA, SMART Recovery, or online communities

Why medication helps:

Naltrexone blocks opioid receptors in the brain, reducing the pleasurable effects of alcohol. When drinking is less rewarding, the signs of excessive drinking naturally improve. Cravings decrease. Tolerance may reverse. The cycle weakens.

Naltrexone is taken as a daily 50mg tablet and is available via telehealth for privacy and convenience.

Our article on how naltrexone helps you regain control explains the medication in more detail.

Taking the Next Step

The signs of drinking too much alcohol develop gradually and can be easy to rationalize. Physical symptoms, behavioral changes, and mental health effects all provide information about your relationship with alcohol. Recognizing these signs gives you the opportunity to make changes before problems worsen.

If you want to explore how medication could help you address your drinking, take the online Alcohol Use Assessment to see if naltrexone might be right for you.