One of the most common reasons given for drinking is that it relieves stress. That could be the stress we feel at the end of a working day when we want to relax or the stress caused by specific situations. For example, many people find the first few minutes of a social occasion somewhat stressful, particularly if it involves meeting new people or people with whom we are not well acquainted. I think most people find travelling to be stressful, which is one reason why airport bars are always busy. Weddings can be fraught for some, particularly if there are family tensions from old disputes.
I know that I found that I used alcohol to unwind at the end of the day, whether that was in a hotel bar if I was working away, or at home. It seems undeniable that alcohol helps us to relax, but the truth is much more complex than that.
Alcohol, a central nervous system depressant, alters brain chemistry and affects neurotransmitters, contributing to its relaxing and sedative effects. However, the physiological impact of alcohol is a double-edged sword, with short-term relief often followed by potential long-term consequences.
The initial consumption of alcohol can induce feelings of relaxation and euphoria, probably due to dopamine and serotonin release as part of the reward pathway. It also reduces inhibitions due to its impact on the gamma-aminobutyric acid (GABA) receptors, leading to a calming effect on the brain. The brain also blocks glutamate, an excitatory transmitter in the brain, which also damps down our stress levels. However, to understand how these feelings evolve with time, we need to understand the effect of drinking on blood alcohol content (BAC), the proportion of alcohol in the bloodstream.
The first drink that we take creates a feeling of euphoria as our BAC rises. This lasts for about 20-30 minutes, maybe an hour if the drink is taken with food. All the time that the BAC is rising, the liver is busily trying to metabolise the alcohol to achieve homeostasis, and at some point, the equilibrium point is passed and the BAC starts to fall.
As your BAC falls, the opposite feelings of euphoria start to set in—unease, anxiety, discomfort, tiredness, sadness and depression. These feelings are nowhere near as fleeting as the feelings of euphoria; they may last for up to three hours.
There is, of course, if you have alcohol to hand, a way to remedy this (hepatologists hate this one simple trick), which is to have another drink. This will, temporarily, relieve the discomfort as your BAC is on the rise again, but what goes up must come down, and after another 20 minutes it will start to fall again. If we get on this rollercoaster, we often ride it until we go to bed.
When we stop drinking, the body tries to recover its equilibrium so reduces GABA levels and increases glutamate. The unnaturally low level of GABA and a spike in glutamate increases anxiety, which is why some people report feelings of “hangxiety” – feeling very anxious at the same time as being hungover.
Why don’t we notice this? If we are drinking in the evening, we often juggle our BAC so that it only really starts to fall when we are ‘asleep’. I have used the quotation marks because when we go to bed after drinking we are not really falling asleep; according to sleep expert Dr Matthew Walker, we are sedated. This means that the normal processes that occur when we fall asleep naturally are absent, and we spend the night in a kind of pseudo-sleep that does not deliver the benefits of normal sleep at all. The ‘sleep’ is fragmented, and REM sleep is severely disrupted (REM sleep is a kind of ‘overnight therapy, according to Dr Walker, that is very important for our health, emotional well-being and performance).[i] You will, perhaps, have noticed that people can get very irritable when sleep-deprived.
I am sure this will be familiar to you—I know it was for me. I would wake several times in the night feeling successively worse every time and would often lie awake for hours thinking, “Why did you do this again?” This phenomenon was also very noticeable if I went for a drink at lunchtime. I found that even a couple of drinks with lunch would life me listless and uncomfortable as the afternoon wore on, and the only solution always seemed to be to have a drink in the evening, which was just postponing the suffering until the night and the following morning.
So, yes, we feel that alcohol relaxes us, but it is a short-term fix that leaves us with the choice either just to have one drink, in which case we are going to start to feel even more stressed than before we drank, or keep drinking all night, which will rob us of the effective sleep we needed to regulate our emotional state. Disrupted sleep is a known factor in exacerbating anxiety, creating a cyclical relationship where anxiety leads to alcohol consumption, and alcohol consumption worsens anxiety through its impact on sleep.
Neither of these choices is helping us deal with stress.
Regular drinking also affects the balance of hormones in the body, as it affects the hypothalamic-pituitary-adrenal (HPA) axis, which is the main mechanism for stress regulation. Regular drinkers have been shown to have elevated levels of cortisol and the slope of cortisol decline during the day is reduced.[ii] This is really bad news for the body and puts drinkers at an increased risk of:
· Anxiety
· Depression
· Digestive problems
· Headaches
· Muscle tension and pain
· Heart disease, heart attack, high blood pressure and stroke
· Sleep problems
· Weight gain
· Problems with memory and focus[iii]
So drinking alcohol reduces stress in the very short term (20-60 minutes) but increases it in the medium term as BAC drops, the euphoria wears off and dysphoria kicks in, and the long term due to its effect on the HPA axis.
Psychological Aspects: When We Give Alcohol a Job to Do
So far we have talked about the physical and neurochemical effects of alcohol on the body, but we also have to consider the psychological aspects. Firstly, if we are at the point where we are troubled by our relationship with alcohol, there is another reason to get stressed: the cognitive dissonance we feel with the two warring factions of our brain—one that wants to drink and one that doesn’t. I used to lie awake feeling angry with myself for having drunk too much alcohol or drunk on a day I had intended to keep alcohol-free and worry about my health and why I was unable to keep my promises to myself.
Secondly, if we start to use alcohol as the way that we routinely deal with stress, effectively giving alcohol that job to do for us, then we can lose the ability to deal with stress in any other way. For me, it was my go-to method of stress relief, and while I am sure I understood that there were other ways of relieving stress, such as exercise, going for a walk, playing a game and so on (and I did all of those things at times), those methods required effort, and opening a can of beer seemed more instant, and easier.
I don’t think I was particularly vulnerable to stress—I would guess I was probably somewhere in the middle of the bell curve—but I do recall that before I became alcohol-free, I would be more affected by a stressful day at work, by travelling (I used to do a lot of driving to and from business locations) or by any kind of conflict.
Better Tactics for Dealing with Stress and Anxiety
There are very few of us that can move through life with complete equanimity. Jack Kornfield, in his book, After the Ecstasy, the Laundry, describes the ordinary struggles that even the most enlightened face. At a meeting of Zen Masters, Monks and Meditation Teachers, hosted by the Dalai Lama at his Dharamshala palace, while celebrating the profound benefits they had received from their spiritual journeys, all confessed to dealing with the same struggles we all deal with, such as stress, depression, divorce and family conflict.[iv]
So what are the alternatives to using alcohol to deal with stress? I think these come under two categories—practices to calm and self-soothe and cognitive methods. The first category is highly individual—what may be wonderfully calming for one person might be frustrating and annoying for another! The things that work for me are walking, meditation, yoga, dancing, working out at the gym and taking a long hot shower. The cognitive methods are what we teach people in our coaching sessions and are very congruent with Stoic principles. The basic method is to become aware of the thoughts and feelings that are troubling you, to understand how those thoughts and feelings are making you feel and behave, and finally to try different thoughts to see how that changes how we think and behave. It is also about accepting what we can and cannot change.
There are other tactics for dealing with stress that I will explore in my blogs and social media posts so be sure to subscribe and let me know if you have any questions.
Paul
[ii] The Relationship between Alcohol Consumption and Cortisol Secretion in an Aging Cohort. Badrick et al (2008)
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