The holidays may not seem complete unless you toast the season with some eggnog, mulled wine, peppermint schnapps or champagne. But you may want to think before you drink if you have ADHD.

There may be more opportunities than usual to drink during the holiday season, among family gatherings, celebrations with friends, office parties and New Year’s Eve festivities. And you may gravitate toward the bar if you think that alcohol helps you relax or calms your racing brain. But people with ADHD are more likely to have problematic relationships with alcohol.

“ADHD is a disorder of self-regulation,” says Ari Tuckman, PsyD, a psychologist based in West Chester, Pa., who specializes in treating adults and teens with ADHD. “People with ADHD tend to get more caught up in the moment. (They) may struggle with self-monitoring, like, ‘How many drinks have I had? How am I?’ (And) the fun of having another drink beats out ‘I have to drive myself home’ or ‘I have to go to work tomorrow.'”

Drinking may also worsen ADHD symptoms.

“ADHD affects executive functioning, which are abilities that help us make plans, problem-solve, organize and take tasks from thought into action,” says Jeremy Schumacher, a Milwaukee-based licensed marriage and family therapist who treats patients with ADHD and has ADHD himself. “Alcohol can cause impairment in all of these areas, especially if it is used in excess.”

Drinking may slow down cognitive processes, which may make people more impulsive or emotionally dysregulated, Schumacher says. It may also lead to increased time blindness.

A link between ADHD and alcohol problems

People with ADHD often have a lack of impulse control. That means they are at risk for — among other things — binge eating and gambling. They are also at risk for binge drinking and alcohol use disorder — though it’s not a direct cause-and-effect relationship.

“All of this adds up to ADHD being an increased risk of substance abuse, as that lack of planning leads to more binge drinking or not sticking to a predetermined cut-off point,” Schumacher says. “(But) the average person with ADHD does not need to avoid drinking or be scared that it will inevitably cause issues.”

People who take medication to manage their ADHD are less likely to have problematic drinking experiences.

“Using a stimulant to treat your ADHD gives you more of that response inhibition,” says Tuckman, who co-chairs the Children and Adults with Attention-Deficit/Hyperactivity Disorder, or CHADD, Conference Planning Committee. “It helps you be more aware of what you’re doing. It helps you pause words, speaking or acting. It helps you manage the stress of your day more effectively.”

It’s possible to drink responsibly if you have ADHD, but you may need more parameters than your friends who don’t have ADHD.

“The ADHD brain won’t structure itself, but it will benefit from having a structure,” Schumacher says. “Being intentional with drinking and alcohol consumption goes a long way in mitigating any risk factors and keeping alcohol from creating problems.”

How to enjoy alcohol in moderation if you have ADHD

You can feel confident raising your glass this holiday season, if you map out what you’ll do at social gatherings before you arrive:

• Approach holiday parties with a plan. Decide ahead of time what you will and won’t do. “’I can have this many drinks over this amount of time,'” Tuckman says. “If you don’t have a specific plan, things are just going to happen.”

• Pay attention to what you’re drinking. Don’t just count drinks: Note the percentage of alcohol in a craft beer and the size of a wine glass. One large goblet may hold two drinks’ worth of wine. Reach for non-alcoholic beverages between drinks to avoid drinking too much.

• Find an accountability buddy. If you’re concerned that you may need a reminder to honor your intentions, enlist your partner or a good friend. “Having someone who can support you in your decision-making, call attention to your behaviors or help you process any emotions you’re struggling with helps create a safety net to stick to your plan,” Schumacher says.

• Check in with yourself at the party. Before grabbing another cocktail, think about how you’re feeling, what your mood is like and why you want another drink. “It’s not about right or wrong answers so much as it’s about how to make wise, considered choices,” Tuckman says.

How to successfully avoid alcohol if you have ADHD

At most holiday parties, socializing is the main event, not drinking. But some gatherings are more heavily focused on alcohol. If you’re invited to a party where you know you’ll be one of the only sober people, Tuckman says, “the first question here is: Is this party even a good idea for me to go to?” Decline an invitation if you’ll feel uncomfortable or pressured to drink against your wishes.

At parties where drinking is secondary to chatting and snacking, it’s possible to have a pleasant evening out, if you plan what to do ahead of time:

• Prepare a scripted response. Know what you’ll say if someone offers you a drink. “Keep it simple — just a straightforward ‘No thanks, I’m not drinking tonight,’ or ‘I’m on a bit of a health kick, so I’ll stick to water,'” Schumacher says.

• Bring the host non-alcoholic options. Find an alcohol-free beverage that speaks to you, then sip on that at the party. “The market has never been better for alcohol-adjacent drinking, with non-alcoholic craft beers, seltzers and mocktails all being more widely available than ever before,” Schumacher says.

• Take the pressure off yourself. Are you worried that friends, relatives or colleagues will notice that you aren’t drinking and urge you to hit the bar? Most people care more about what they’re doing, not what you’re doing. After you attend one social engagement without drinking, it may become easier to do it again.

Recognizing that you may have a problem with alcohol

People with ADHD should pay attention to how they feel and what they do when they drink. Be mindful when you notice changes to your habits.

“If you feel like you’re drinking more than you feel comfortable with,” Tuckman says, “when other people seem to be uncomfortable when you’re drinking, (if) you regret the amount that you drank or things that you did while you were drinking — those are all big red flags.”

Some signs that you’re drinking too much may seem obvious, but you may not make any changes if you aren’t tuned into your needs.

“Blacking out, experiencing memory loss or having major regret about your behaviors while drinking are also signs that you’re overdoing it,” Schumacher says. “Even having hangovers is your body’s way of saying that there was too much alcohol in your system.”

If you’re concerned about your alcohol intake, talk to a therapist who sees patients with ADHD.

“A therapist who specializes in working with ADHD (patients) will be helpful in creating a plan that works well for your specific brain, not just applying cookie-cutter advice that works for the average person,” Schumacher says. “Structure is helpful to the ADHD brain, even if ADHD brains struggle to self-regulate. So a therapist who can help you to think outside the box and build something that works well for you is what will work best.”