Day 10 – Why can alcohol make me feel good and make me feel bad? Alcohol, the brain and emotions

Alcohol and your brain

In today’s post we dig a bit deeper into the brain, and what alcohol can do to it. We’ll start with a bit of background on how our brains work.

Because alcohol is a small molecule, it is able to interact with many of the neurotransmitter systems in the brain.

Neurotransmitters are brain chemicals that communicate information throughout our brain and body. They are involved in essential functions like heart rate, breathing, and digestion, and affect mood, sleep, concentration, and weight. Neurotransmitters can get out of balance for a variety of reasons – including alcohol, poor diet, stress, drugs, and caffeine.

Although you might often hear people say “alcohol is a depressant”, the reality is that alcohol affects us in all sorts of ways, both through its stimulating properties and its depressant properties.

Some of the key neurotransmitter systems which alcohol interacts with, and the effect of alcohol on them are:

GABA Alcohol affects the GABA system in a manner similar to Valium, causing relaxation and drowsiness. This is what is referred to as alcohol’s ‘depressant’ property.
Endorphins Alcohol affects the endorphin system in a manner similar to opiates, acting as a pain-killer and giving an endorphin ‘high’.
Glutamate It is alcohol’s effects on the glutamate system which lead to staggering, slurred speech, and memory blackouts.
Dopamine The brain has several dopamine systems, one of which is associated with ‘reward-motivated’ behaviour. Most types of pleasurable activity, including substances that have the potential to lead to dependence, increase the levels of dopamine on the brain.
Norepinephrine Also known as noradrenalin. Alcohol causes a release of norepinephrine in the brain, which is associated with the flight-or-flight response. It can increase restlessness and anxiety, and raise heart rate and blood pressure. This is one reason why alcohol can act as stimulant and not just as a depressant.
Adrenaline Alcohol causes the adrenal glands to release adrenaline – another reason why alcohol has stimulant properties.

Alcohol and depression

Alcohol’s effect on the GABA system is responsible for its depressant effects. Here the term “depressant” refers to a class of substances (more accurately “depressogenic drugs”) which slow down the central nervous system – it does not refer to substances which cause depression. This feature of slowing down the central nervous system is one ‘reward’ that people who are stressed or anxious can get from alcohol (hint: warm baths, walks outside, breathing exercises and meditation can also have this effect!).

Heavy drinking can also lead to symptoms of depression because of another chemical in the brain – serotonin. This chemical helps regulate our mood, but regular heavy drinking will lower serotonin levels and our mood along with it.

The relationship between alcohol and depression is fairly complex, and although alcohol can induce depression in some long-term heavy drinkers, some people claim to use alcohol as an “antidepressant”, and some people with depression say that they drink simply to escape from the dark feelings of that depression.

Double-dip depression

Because alcohol affects so many of the neurotransmitters in the brain, it will interfere with medication that is routinely prescribed to treat anxiety or depression. So not only might alcohol be increasing your depression symptoms, you won’t be getting the full benefit from any medication you are taking to help. Some medication is also particularly dangerous in combination with alcohol.

You also won’t get as much from any counselling or therapy sessions if you go with a hangover, and if you are regularly drinking in the evenings, you probably won’t be practicing the skills and techniques and homework exercises that a therapist might suggest you do in-between sessions.  

It is for this reason that most therapy and counselling services, especially those on the NHS, as well as GPs, will advise people seeking help for depression or anxiety to cut down on alcohol before receiving any other treatment – whether medication or therapy or a combination of both.

Alcohol and anxiety

It is quite common for people to use alcohol to reduce feelings of anxiety and stress or when they feel nervous in social situations. There is even some logic to this because of alcohol’s sedating and depressant effects on the central nervous system. However, over time there is an increased risk of tolerance developing, meaning more and more alcohol will be needed to get the same anti-anxiety effect.

Alcohol can also make anxiety worse because of how it lowers serotonin and neurotransmitters. People can experience increased anxiety as the effect of the alcohol wears off. “Alcohol-induced anxiety” sometimes lasts several hours after drinking.

Another cause of anxiety is hangovers – symptoms like headaches, nausea, low blood sugar and dehydration can all make a person feel more anxious the following day.

Someone who is already concerned about their drinking is likely to be ruminating on that too, and hating themselves for how much they drunk the night before. They may also feel anxious about any texts or posts they might have sent whilst drinking, vague recollections of conversations and arguments, and not remembering how they got home.  

Which came first, the chicken or the egg?

I know it can be frustrating to be told (or feel that it is implied) that your drinking is causing your depression or anxiety, or making other problems worse. Many people believe that these are root causes, for which alcohol has become somewhat of a solution or coping strategy. They are often correct – I have worked with clients with crippling depression, anxiety, suicidal thoughts, trauma, and OCD, all of whom came to use alcohol primarily as a way of coping with their extreme symptoms and emotions. Many of these symptoms are still there once they have quit alcohol and they need to be committed to learning and practicing other coping strategies from that point on.  

Perhaps it seems like it would make more sense to first treat or resolve these ‘root causes’ and get help to relieve the symptoms with therapy and medication – maybe you would rely less on alcohol less as a result of doing this.

Unfortunately, due to alcohol’s effect on mood and emotions, and its interference with the effects of medication and benefits of therapy, it does make more sense to cut back on alcohol – or even stop completely for a bit as you are all doing – to be able to get a more accurate ‘read’ of your symptoms first.

For people who think they might be depressed or have an anxiety disorder, taking a month off booze can help you to disentangle the temporary side-effects of drinking with genuine, more permanent symptoms – not only of depression and anxiety but of grief, stress, memory problems, and other mental health concerns.

Endorphins – the “feel-good factor”?

If we are going to present a balanced view, we also need to consider what happens in the brain that people find pleasurable about drinking.

Some research has shown that light to moderate drinking releases endorphins (‘feel good chemicals’) in the part of the brain often called “the reward centre” or “pleasure center”.

Endorphins are produced naturally in the brain and get their name from “endo” meaning internal to the body (rather than from an external source), and “morphine” because the effect is like that of morphine – relieving pain, reducing anxiety, and making a person feel good.

This endorphin-release has been used to explain the so-called ‘runner’s high’ that people get from exercise and other pleasurable activities (alcohol is not the only way of getting this feeling!).

The danger of this is that, from an evolutionary perspective, we are motivated to pursue activities that feel good and avoid those that don’t. So the feelings of reward from the pleasant sensation of a few drinks can quickly become reinforcing, causing some people to drink more heavily to ‘chase’ that good feeling. This in turn can lead to unhealthy drinking habits and even addiction over time, as tolerance to alcohol develops and more is needed to get the same effect.

But not everyone who enjoys the feeling from one or two drinks ever goes on to drink more heavily or develop a drinking problem, and we don’t exactly know why some people drink more heavily than others. This is why it is wise to exercise moderation with alcohol, to reduce the risk of dependence developing – something to consider for when the MOB is over.

Some exercises for diffusing emotions

Below are two handouts of exercises I regularly use with my clients and encourage them to practice. I have used these with people who are struggling with addiction or are now sober, as well as athletes, and in health and lifestyle coaching.

These can be used when you experience an emotion that you would normally drink on – although I suggest you try using them at first when the feeling is not too intense and when you wouldn’t usually drink, so you can practice and get more confident using them.

Your actions for today

  • Reflect on whether you are using alcohol to cope with issues such as depression and anxiety. Is it actually helping long-term? What is your mood like the morning after you have had a drink?
  • Watch this video from October 2015, in which we discuss feelings, moods, and stress.
  • Visit the Facebook group and tell us your thoughts about how alcohol affects your mood.  

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