Alcohol and Your Relationship With It
Your health and your relationship with alcohol
Yay! We think, ‘It’s Friday, time for Happy Hour! Let the stress of the workweek dissolve, meet with friends, commiserate or share triumphs, and blur the rough edges of reality. Alcohol is the ‘friend’ that eases social anxiety, gives the warmth of relief and freedom, and magically, loosens our inhibitions.
There are many reasons to drink; to enhance our social life, to treat physical or emotional pain, to escape stress, anxiety, fear, loss, grief, loneliness and even boredom. We use it to numb trauma, PTSD, abandonment, isolation, depression, and anxiety.
What alcohol does to the brain:
Alcohol begins to change the structure of the brain after even modest intake. Several factors influence this: genetic predisposition, age of use onset, frequency and quantity of intake. These factors may predict risk of addiction, but it can occur to anyone after chronic use.
Alcohol activates GABA, the inhibitory neurotransmitter that induces calming, relaxing feelings. Initially, this decreases glutamate, the excitatory neurotransmitter that, along with GABA, balances one another to support mood homeostasis. As the body adapts to frequent alcohol consumption, GABA receptors downregulate, and alcohol in greater quantity is needed to achieve calming sensations (tolerance). In response, glutamate upregulates to compensate for this change. Dependence occurs when alcohol is needed to achieve this balance in the absence of GABA.
Withdrawal from alcohol often unmasks upregulated glutamate activity; the excitatory effect produces anxiety, insomnia, and in more serious cases, trembling hands, tremors or even seizures. If alcohol use was excessive over a prolonged period, clinicians recommend medical detox to manage the risks associated with withdrawal.
Reducing Alcohol Intake
Reducing alcohol intake can help us regain awareness about our drinking habits. Noticing our thoughts and feelings about drinking, and identifying triggering ‘people, places and things,’ can target associations that motivate us. If we recognize that trauma, depression, anxiety or ADHD drive our habits, we may seek psychotherapy, EMDR, and or KAP (Ketamine assisted psychotherapy) for support in addressing these issues and substance use disorder.
While gaining insight, we may experiment with alcohol reduction. Taper from daily drinks to every other day; limiting alcohol to weekends, or weekly quotas that taper down. For some, ‘cold turkey’ works best. Recently, 30-day abstention has become popular, revealing benefits like mental clarity, increased energy and time and money saved.
How long does it take for the brain to recover?
There are improvements in brain function within two alcohol free weeks. Because the brain has adapted to alcohol, the healing process may increase anxiety and insomnia. It takes months for glutamate and GABA to rebalance. Cravings are the result of upregulated glutamate. Understanding this, and that cravings are finite, lasting 20 minutes or so, may help to ‘power through’ cravings.
Health improves continually; by 6 months, recovery is significant. For those who drank copious quantities from an early age, it will take a year or longer. Does this mean we can resume ‘drinking moderately?’ Those with historic dependence risk a rapid return to relapse. Tolerance at re-introducing alcohol will be lower, risking overdose. Our personal brain and body chemistry, genetics, habits, and other biopsychosocial factors determine our reaction to alcohol. Regardless of risk, alcohol is a toxin, affecting every organ in the body; the brain, liver, heart, kidneys, and more, and for women, increases the risk of breast cancer by 15-40 % or more. Rather than accommodating alcohol in our lives, we may focus instead on building a healthier lifestyle free of old habits and risks.
Building quality of life
How do we create a new life balance after we address reasons for our alcohol use?
Start with daily structure goals of good nutrition, moderate exercise, and positive sleep hygiene. Small steps count.
Build a supportive social network of friends and family.
Join a support group if desired.
Revisit neglected interests: reading, hiking, cooking, yoga, gardening, journaling. The latter records progress and helps us process difficult emotions.
Plan weekly rewards for progress; a movie, a concert, a hike. With money saved from not drinking, consider a language class and travel. Our improving health helps us gain clarity, agency, and options, and for many, the challenging work it took to get to this place was worth it.
Recommended resources
For a comprehensive and readable overview of addiction and recovery; Healing the Addicted Brain, by Harold C. Urschel, III MD. For women, Beyond Booze, How to create the life you love, alcohol free, by Sarah Rusbatch. For scientific background information, I recommend Andrew Huberman’s Youtube production, What Alcohol Does to your Body, Brain, and Health (https://www.youtube.com/watch?v=DkS1pkKpILY) 08/22/2022
Suggested Sobriety apps: Sober Time; Sober Me, Reframe, NOMO, BACTrack and others.
Ready to begin your sober journey? Contact Del Ray Psych & Wellness to learn how we can support you.