People with anxiety and depression are more likely to report an increase in drinking during the COVID-19 pandemic than those without mental health issues, according to a new study by researchers at NYU School of Global Public Health published in the journal Preventive Medicine. While drinking grew the most among younger people, older adults with anxiety and depression saw a sharper increase in their risk for harmful alcohol use.

“This increase in drinking, particularly among people with anxiety and depression, is consistent with concerns that the pandemic may be triggering an epidemic of problematic alcohol use,” said Ariadna Capasso, a doctoral student at NYU School of Global Public Health and the study’s lead author.

People often drink to cope with stress and traumatic events; a 2002 study found that a quarter of New Yorkers increased their alcohol consumption after the September 11 terrorist attacks. COVID-19 has created many stressors, including isolation and the disruption of routines, economic hardship, illness, and fear of contagion, and studies suggest that people are drinking more during the pandemic.

Individuals with existing mental health conditions are particularly susceptible to increased alcohol use during stressful events. To understand the pandemic’s impact on this population, NYU researchers created and administered an online survey in March and April 2020, using Facebook to recruit U.S. adults from all 50 states. The researchers asked participants about their alcohol use during the pandemic, gathered demographic information, and measured symptoms of depression and anxiety based on self-report.

Of the 5,850 survey respondents who said that they drink, 29 percent reported increasing their alcohol use during the pandemic, while 19.8 percent reported drinking less and 51.2 percent reported no change. People with depression were 64 percent more likely to increase their alcohol intake, while those with anxiety were 41 percent more likely to do so.

Drinking behaviors varied by age. In general, younger adults under 40 were the most likely to report increased alcohol use (40 percent) during the pandemic, compared to those 40-59 years old (30 percent) and adults over 60 (20 percent). However, older adults (40 and older) with symptoms of anxiety and depression were roughly twice as likely to report increased drinking during the pandemic compared to older adults without mental health issues.

“We expected that younger people and those with mental health issues would report drinking as a coping mechanism, but this is the first time we’re learning that mental health is associated with differences in alcohol use by age,” said study author Yesim Tozan, assistant professor of global health at NYU School of Global Public Health.

The researchers support increasing mental health and substance use services during COVID-19–using telehealth to overcome barriers to accessing care–and actively reaching out to people with mental health issues who may engage in unhealthy drinking in response to stress. They also recommend tailoring public health messaging by age group to more effectively communicate the risks of excessive alcohol use.

“Lessons we’ve learned from previous disasters show us that intervening early for unhealthy substance use is critical and could help lessen the pandemic’s impact on mental health,” said Ralph DiClemente, chair of the Department of Social and Behavioral Sciences at NYU School of Global Public Health and the study’s senior author. Additional study authors include postdoctoral associate Joshua Foreman and doctoral students Shahmir Ali and Abbey Jones of NYU School of Global Public Health.