By Jim Harvey
Alcohol, in popular culture, has been depicted in interesting ways. Take, for example, the little brandy casks around the necks of Saint Bernards – the huge and gentle dogs formerly used as rescue animals in the Swiss Alps. The brandy was designed to be a remedy to warm poor, shivering mountaineers caught in harsh weather.
In movies and literature, characters often resort to “drowning their sorrows” in a drink. This is portrayed as a perfectly normal and understandable way to medicate heartbreak and loss. And what of the hero in a tale faced with some daunting task? He simply has a small drink to “steady the nerves”, and he’s right back on track. Suitably emboldened and fortified, he is good to go!
What these situations have in common, is that they all feature alcohol used to make people feel better. It’s medicinal. Whether a person is cold, tired and distressed, mournful, or on edge, there’s nothing a little alcohol can’t put right. By the way, in case you’re wondering, giving a swig of liquor to someone who’s cold is a terrible idea. (And, incidentally, Saint Bernards, bless them, never carried liquor. The famous British animal painter, Edward Landseer decided, in 1820, that it would be fun to depict dogs rushing around high mountains bringing a stiff drink to stranded travelers – so he did, and the idea stuck. Thankfully, our man never had access to social media.) Alcohol temporarily dilates blood vessels, sending blood closer to the skin. There’s a short rush of illusory warmth, but the blood is actually taking heat away from the core. Then the blood vessels constrict again, and the person is left colder than ever.
The distraught lover in the story, overcome with sadness and self-pity, who cries “woe is me” and reaches for the bottle, may well succeed in entering a fuzzy, ethanol-induced space of lessened anguish. But most of us find our hangovers the next day pretty miserable. And our sorrows have generally not gone anywhere – indeed, they are usually more than happy to welcome us back with open arms.
As we can see, so far, alcohol isn’t looking like the panacea it’s cut out to be. But how about the guy who’s jittery and stressed, you may ask? That, in fact, is the only situation where alcohol might provide genuine – though highly temporary – relief. Alcohol is a depressant which, in spite of what the word seems to suggest, does not mean that it causes depression. (It can contribute to it, certainly, but for reasons we shall discuss soon). A depressant ‘depresses’, or slows down, the activity of the brain and central nervous system. As a result, it has a mildly sedative effect. Sedation reduces agitation. Which is a good thing, right?
Well, perhaps not. And this leads us nicely on to our topic of the day. Depression and anxiety are heavy emotions, that can plague people relentlessly. They can be difficult enough to manage when they’re just recurrent feelings. But for some people, depression and anxiety aren’t just feelings. They are a medical condition. The Anxiety and Depression Association of America states that anxiety disorders affect 40 million adults aged 18 and older each year (2022). Depression is hardly less of an issue. In 2021, 21 million Americans had at least one major depressive episode (defined as at least two weeks of inability to function normally due to
Where there are mental wellness issues, alcohol frequently rears its ugly head. It is a fact that with Major Depression Disorder, Anxiety Disorder, OCD, PTSD and many other mental health conditions, alcohol often somehow finds its way into the mix. But it’s not a simple equation. Anxiety and depression are not synonymous, and though they often go hand in hand, this is not always the case. And alcohol can enter the scene before or after mental health issues begin to
In short, the relationship between alcohol and depression is a complex one. More so, in fact, than family dynamics in a Pedro Almodovar movie. So, in the interests of simplicity, let’s start by looking at how and why alcohol can aggravate, or even cause, depression and anxiety.
Alcohol and Depression
- Alcohol gives people a buzz and makes them feel upbeat, relaxed, less inhibited, and so on, by a simple mechanism – it causes a temporary change in brain chemistry. Specifically, it increases levels of the neurotransmitters serotonin and dopamine – ‘feel-good chemicals – in your brain. As a result, you end up like Nina Simone– “feeling
- Perhaps you’ve already experienced a bit of a rush, after a hit of caffeine or sugar, and then felt a slump not long after. This is similar to what happens with alcohol – if you drink a fair amount, the next day, your serotonin and dopamine levels will be depleted, lower, in fact, than they should be. Everybody reacts differently, of course, but gloom,
despondence and bleak thoughts are generally par for the course.
- Hangovers can make you depressed. Too much alcohol interferes with a great many more bodily functions than just brain chemistry. You can feel shaky, queasy, and emotionally fragile. You may feel fearful or anxious. Headaches, tiredness, sensitivity to loud noises and light, a sluggish liver while it works overtime to detox your body, all of these can make you feel weakened in body, mind and spirit. And, let’s face it, few of us are cheerful when we feel like s__t. We’re down in the dumps, with the exit nowhere in sight.
- Alcohol can release pent-up emotions, as well as trauma, painful memories, or anything that has been repressed or kept bottled up. When inner pain is released, it starts to speak. It wants to have its say in a person’s thoughts and feelings. Before they know it, they can find themselves in a very negative space, with a dark and pessimistic narrative going round in their minds.
- Alcohol interferes with sleep patterns. It can make people pass out, and then wake up at odd hours. It can cause insomnia. And it can certainly ensure sleep is neither restful nor restorative. Poor quality sleep is one of the primary contributing factors to a range of mental health issues, particularly depression and anxiety. Most of us know what it’s like to get only a few hours’ sleep – we rarely feel our intrinsic happiness bubbling to the surface when it happens!
- Finally, alcohol interferes with anti-depressant medications. Since it inhibits their effect, a person can start to feel more depressed once more. Which is to be expected – their meds aren’t working. But alcohol will! At least, this is what a person may think when their relationship with alcohol is problematic. They may drink more, and, yes, for brief moments, well-being returns. And then…everything becomes much more complicated again.
Alcohol and Anxiety
Much of what is true for depression applies to anxiety too. The come down after a few drinks, the physical and emotional effects, can all be anxiety-inducing. But behavioral causes of anxiety are frequent also.
- For some, drinking itself can be a valid reason to be anxious. Especially for people who have embarrassing memories of foolish actions when intoxicated. Even as the alcohol
starts to calm them down, they may start worrying about staying in control. For fear of what they might do if they get really drunk again. Or of what they might have done when
they were last drunk.
- Having alcohol as a crutch for anxiety means people start worrying about access to alcohol. What happens if there’s none around when they need it? Or if they can’t have a
drink, because they’re at work for example? How can they make sure there’s always an emergency supply near at hand?
- How to manage, and retain some control, over drinking habits can be a major cause of anxiety. How to drink so that it relieves anxiety, but doesn’t interfere with responsibilities and duties in everyday life? When can a helpful drink be fitted in without adverse consequences?
- Tolerance to alcohol can cause anxiety: a person can become anxious if alcohol stops working as well as it used to. They start to drink more, but even that only has the desired effect for a while. Any self-aware person should be anxious if they find their drinking habits escalating, but a person prone to anxiety will feel this even more intensely.
Co-occurring disorders, dual diagnosis, and comorbidity are all terms referring to a situation in which a person suffers simultaneously from a mental health concern and a substance use disorder. According to the National Institute on Drug Abuse (NIH), 7.7 million American adults had co-occurring disorders of this type in 2018. Seen from the opposite perspective, a good two thirds of adults abusing substances also had mental illnesses.
In some cases, it can be difficult to ascertain which condition arose first. Similarly, it is hard to establish a definite causal relationship. People do, of course, drink to self-medicate for mental suffering. And, as we’ve seen, alcohol can aggravate, or cause mental health issues. A person may, for example, drink because they are depressed. But excessive drinking can lead to the emergence of a new disorder, in the form of anxiety.
Once a mental health issue has become deeply rooted, and a substance abuse habit entrenched, the toxic marriage of the two results in a condition from which it is very challenging to emerge unaided. It can also create a vicious circle. Mental unease creates a need for relief; which alcohol temporarily provides. But after drinking, or when drink stops working so well, the mental condition gets worse. So a person tries more alcohol, or worse, other drugs, to feel better.
The bottom line is this: legal, safe, and effective medication and therapies do exist for both depression and anxiety. So drinking to cope with them in itself already constitutes dysfunctional use of alcohol. Similarly, if a person is drinking enough to cause anxiety and depression, or worsen a pre-existent tendency towards either, they are drinking too much.
Kembali Recovery Center can Help
Alcohol never makes anything better. And life is systematically simpler without it. At Kembali, we know this. From experience. If you, or someone close, are worried about how you drink, we’re here to help. Contact us today to learn more about our programs. Remember, you never have to do this alone.