The drunkest I’ve ever been, I was in my twenties. I stood in a graffiti-covered bar bathroom stall one moment and then lay crumpled in a heap on the dirty floor the next. I’d just gone through the biggest heartbreak of my young life, and the advice I followed was to get drunk. All night, as I forced myself to drink, scenes from movies, shows, especially K dramas, played through my mind—the tragic protagonists throwing back shots to ease their pain.
This is what you’re supposed to do when you’re sad, I thought. This was the lesson repeatedly drilled into my head both by the media I consumed and in my own daily life. Yet, for me, alcohol didn’t work at all. The next day, I felt worse. Still in pain, I had slept terribly and felt ill. Emotionally, I recognized I was in an even darker place. Over time, I noticed even a small glass of wine at dinner was disrupting my sleep, causing a domino effect, a drain on my energy level and wellbeing.
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Why is alcohol so often (mis)used as a method of coping with mental health struggles?
Ruby Mehta, Director of Clinical Operations at Tempest and licensed therapist who is a member of the sober community, explains that while alcohol provides a pleasant boost by releasing dopamine, serotonin, and other “feel good” chemicals to the brain, it is very short-lived.
“As soon as the alcohol begins to digest in the body, it becomes harmful,” says Mehta. “You end up with a depletion of these chemicals, which make you feel depressed and anxious.”
The more frequently a person drinks, the more likely they are to become deficient in these neurochemicals as a baseline because the body works to adjust for the spikes.
When chronic alcohol use becomes a coping mechanism, the brain will produce even lower levels of these “feel good” neurochemicals, which exacerbates mental health conditions like depression and anxiety.
The Myth About Alcohol and Sleep
Quality sleep is key to good mental health; it is essential in preventing and managing anxiety, depression, and maintaining wellness in people who live with mood disorders and other mental health conditions.
While many people self-medicate with alcohol to help them fall asleep, a 2018 study published in the National Institute of Health reported that “low amounts of alcohol (fewer than two servings per day for men or one serving per day for women) decreased sleep quality by 9.3%, while moderate amounts of alcohol (two servings per day for men or one serving per day for women) decreased sleep quality by 24%, and high amounts of alcohol (more than two servings per day for men or one serving per day for women) decreased sleep quality by 39.2%.”
According to Sleep Foundation, drinking alcohol before bed can suppress REM sleep, cause more sleep disruptions, and intensify insomnia symptoms, which can lead to excessive sleepiness the next day. A harmful cycle is set in motion for many who use alcohol for its short-term sedative effects to fall asleep, who then consume caffeine and other stimulants during the day to remain alert, followed by more drinking to wind down again.
Also worth noting is that the body builds a tolerance for the effects of alcohol fairly quickly, necessitating more alcohol before bed to be able to fall asleep, worsening the negative impact on mental health.
“When I was drinking, I often woke up in cold sweats, uncertain if I was just really anxious or if it was a result of drinking too much. Likely it was both,” shares Mehta. “While I still deal with anxiety today, my symptoms rarely, if ever, reach the intensity of when I was drinking excessively.”
How Alcohol Decreases the Effectiveness of Mental Health Medications
Alcohol’s adverse impact on the effectiveness of medications is not widely known or acknowledged, even though concerns about antidepressants or anxiety medications not working properly are common. SSRIs (Selective Serotonin Reuptake Inhibitors) is the most common group of medications used to treat anxiety and depression. They work to increase and regulate the amount of serotonin in the body.
“[If] you’re taking medication to balance your serotonin levels and then alcohol is messing up your serotonin levels, creating artificial highs and lows, [the medication] is not going to work,” explains Mehta. “The medication is not strong enough to counter the effects of regular alcohol use.”
Similar reasoning holds true for why alcohol should not be mixed with mood stabilizers. Dangerous side effects from drug interactions may also occur.
How Binary Thinking Can Hurt Us
Many of us fall into binary thinking when it comes to mental health, and the same goes for alcohol use. In other words, the perception is either you have a problem or you don’t, but the issue is often more complex than that. The stigma around mental health conditions and alcohol use disorder also contribute to this “us versus them” thinking, which can prevent people from accessing the help they need.
Alcohol use can have a negative impact on a person’s mental wellbeing even when their usage doesn’t raise alarm socially or cause physical withdrawal symptoms. Self-medicating with alcohol can delay someone from seeking proper treatment for their mental health which can lead to co-occurring conditions of alcohol use disorder in addition to the pre-existing untreated mental health condition, making the recovery journey even harder.
From Awareness to Recovery
“Biologically, it [can be] really hard to convince ourselves that alcohol is not what we want,” Mehta points out. People don’t typically associate the emotional downturn with alcohol; instead, they are prone to focus on the upturn that comes with drinking. “It takes a lot of awareness to counteract the effects of biology, chemistry, and neurochemistry that are saying, do this, get more.”
Judgment and decision-making take place in the prefrontal cortex. Excessive alcohol use weakens this part of the brain, making the midbrain, which is responsible for impulse and reward, much more powerful and active.
“When you’re caught up in a cycle, it’s hard to recognize ‘every time I drink, the next day I wake up and feel more demotivated, anxious, and depressed’,” says Mehta. A higher level of processing is often required to notice this cause and effect. Allowing the prefrontal cortex time to heal by taking a break from drinking will let more rational parts of the brain work better.
Mehta also advises, “Deep breathing, mindfulness meditation, and cutting back on stress to the extent that you can are ways that can help.”
Don’t Forget Self-Compassion
Impaired judgment resulting in regrettable decisions or embarrassment from unsuccessful initial attempts to cut back are just two of many examples of how alcohol is a master at feeding the shame monster and why it is vital to practice self-compassion and self-care during recovery.
Because alcohol is so often used as a coping mechanism (though counter-effective in the long run), coming off of alcohol can temporarily exacerbate anxiety and depression symptoms.
“If we stop drinking, our emotional health typically improves after a period of time,” Mehta assures. “However, if you notice [your mental health] is not improving or is getting worse, it is a good idea to get additional support from a therapist, psychiatrist, or peer support group.”
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Even though society will tell us that alcohol is a useful and effective way to alleviate the symptoms of the various mental health issues we might experience, research shows that, in the long term, alcohol use does more damage. Other coping mechanisms are safer, readily available, and effective.
If you’re struggling with mental health and questioning your relationship with alcohol, please know that you’re not alone. There’s help out there, and Tempest might be part of the solution. Check out how membership might help.