'It's usually quiet and easy to hide' - Dr Amir Khan reveals the 5 signs of early alcohol dependency

There's never a bad time to take a look at our drinking habits and assess whether we need to make a change. While many people think that you only need to give up drinking if you have a problem with alcohol or hit 'rock bottom', Dr Amir Khan says the early signs of alcohol dependency are often never as dramatic as we expect.

"A few months ago, I was sharing a room with a few telly colleagues of mine, and we started talking about alcohol. One of them said she would always have a glass of wine each evening when she got home, and another said she did the same. Another one said, they may even have two glasses. I paused and then asked, “But you do have some alcohol free days in the week, too, right?” My question was followed by an awkward silence. None of them did," Dr Khan tells us, as woman&home's resident GP.

"When people think of an alcohol problem, they often picture extremes. But in real life, it's usually much quieter and easier to hide," he says. "Many people who struggle don’t drink every day, don’t drink in the mornings and don’t even think of themselves as having a “proper” problem. But I have come to realise as a doctor, this is one of the most prevalent and least talked about issues in our society today."

Signs of alcohol dependency

1. Needing alcohol to relax

Having a glass of wine or a gin and tonic every night might just feel like a habit, one that, if you need to, you could just give up. But have you tried and found that you can't relax, sleep or feel positive without it? That's a sign, says the doctor.

"One of the earliest signs is needing alcohol for a specific effect, to relax, sleep, feel confident, cope with stress, enjoy a party or to switch your brain off. If drinking feels less like a choice and more like a tool, that matters," he explains.

2. Thinking about alcohol all the time

"Another sign is mental preoccupation," he says. "Thinking about when you'll next drink, planning evenings around alcohol or feeling disappointed if drinking isn't possible."

If the idea of a quiet night in without a drink or meeting up with friends at an event that doesn't involve alcohol fills you with dread, it may be time to cut back on drinking alcohol.

3. Unintentionally over-do it

You might tell yourself you'll only have one, and then "regularly have more than you intended", the doctor says.

This is a sign that you're not able to regulate your alcohol intake and may be relying on it.

4. Your tolerance changes

Changes to your alcohol tolerance levels are another "quiet red flag", says Dr Khan.

"Needing more alcohol to feel the same effect or finding hangovers worse even when you haven't increased how much you drink."

5. Drinking on a hangover

We've all heard the phrase 'hair of the dog' - the Bloody Mary has essentially become a staple in hungover brunches. However, having a bad night of sleep thanks to alcohol, feelings of 'hangxiety' or a low mood after drinking and then using alcohol to alleviate that feeling is a sign of dependency.

"Some people notice sleep, anxiety or low mood worsening the day after drinking, and then drink again to relieve it," he says.

6. Hiding your behaviour

A key sign of alcohol dependency is hiding your drinking behaviour from other people, the doctor says. "Hiding changes from others, topping up glasses, drinking faster than friends, or keeping alcohol at home 'just in case'."

He also says you might feel "defensive if someone comments" on how much you drink, or you might "minimise how much you're drinking compared to others" if you have a reliance on alcohol.

How to deal with early signs of alcohol dependency

"Importantly, having an alcohol problem doesn’t mean losing control of your life. It means alcohol is starting to cost more than it gives," says the doctor. Here are some helpful ways to assess your own drinking behaviour and get help if you need it:

• Find out how much you're drinking: "Track your drinking for a few weeks", advises the doctor. "This can be eye-opening." You can do this with a sheet of paper and a pen, but there are some apps designed to help with exactly this - such as Reframe.
• Set some alcohol-free days: It's time to find your favourite alcohol alternatives and stock the fridge. "Setting alcohol free days, reducing strength or having clear limits can help reset habits," he says. "If cutting down feels harder than expected, that’s information, not failure."
• Seek help: "Talking to a GP can be hugely helpful," says Dr Khan. "We can point you in the right direction. Support ranges from brief advice to counselling, medication or peer support."

What's more, the doctor adds, you don't have to hit "rock bottom" to deserve help. "Recognising a problem early gives you more options, more control, and better outcomes," he says.