The idea of alcohol as a kind of “social lubrication” is nothing new. It can make someone feel more confident and relaxed, as well as lessen the social anxiety that many people feel in a party setting anyway.
Unfortunately, while alcohol may often feel like a great way to unwind, in the long run, it can contribute to not only feeling more stressed, anxious, or depressed but also can make those feelings harder to deal with without the help of alcohol. This progression is what leads to abuse, dependence, and eventually addiction.
There is plenty of talk about the physical damage that prolonged heavy drinking can do to the body, but people may not be as aware of the mental effects of long-term alcohol abuse, which can be debilitating, potentially permanent, and even fatal.
Chronic alcohol abuse can literally change the way the brain is hardwired, disrupting key brain function and inducing symptoms associated with mental disorders from depression to dementia.
Chemically speaking, alcohol is what is known as a central nervous depressant, meaning that it slows down activity in the central nervous system. It does this by targeting a chemical in the brain called gamma-aminobutyric acid (GABA). GABA is a neurotransmitter that controls feelings of stress, anxiety, and other related moods and blocks the signals that cause us to feel these things from reaching the brain. Basically, this means that GABA calms you down.
When someone consumes alcohol, it mimics GABA and activates the brain’s GABA receptors into overproduction. This is why drinking is associated with feelings of relaxation and a lowering of inhibitions. Too much GABA is also what causes effects like slowed movements, slurred words, and slowed breathing.
But while its main effects are on GABA, alcohol has been found to affect more than 100 different receptors within the brain, in part because many of these systems are all closely interrelated. Alcohol decreases activity in key areas of the brain, including the prefrontal cortex, which is responsible for decision-making, rational thought, and preventing aggressive behavior, all things that are impacted by alcohol use.
However, it is the dependence on GABA that occurs when someone has been regularly abusing alcohol for a long period of time that contributes to many of the harmful mental effects associated with heavy alcohol use. When the brain has become dependent on alcohol to supply the calming effects of GABA, it begins to produce less and less of it naturally.
Eventually, it reaches the point that when someone stops drinking, the brain becomes starved of GABA and the individual is left struggling with intense feelings of anxiety, panic attacks, and more. This problem will only increase as someone’s tolerance to alcohol grows, and they need more and more of it to experience the same calming effects.
As previously mentioned, alcohol causes significant changes in so many parts of the brain, so it is no wonder that chronic alcohol abuse can have such a wide range of serious negative mental effects, some of which can be potentially irreversible if not treated soon enough.
While occasional and moderate drinkers are likely to experience short-term mental effects while they are drinking, such as memory impairment and judgment problems that can promote risky behavior, these generally vanish after they are drinking and the alcohol has left their system.
On the other hand, when someone has been chronically abusing alcohol, they can experience problems with normal brain functioning even after they have attained sobriety.
What this means is that the mental effects of alcohol are, at this point, no longer caused by the drinking itself, but by the brain damage that the prior drinking caused.
Some of these effects include:
Alcoholic neuropathy is a brain disorder that can cause the brain to lose control of a wide range of key functions, such as urination and bowel movements, and can also lead to loss of muscle control and erectile dysfunction in men.
Additionally, chronic alcohol abuse can cause symptoms of many different mental health disorders to manifest, including:
And, as previously stated, if someone is already struggling with a mental health disorder prior to abusing alcohol, it will only serve to make it worse and exacerbate the symptoms.
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One extremely serious negative mental effect that long-term alcohol abuse can cause is actually not done through any direct contact between alcohol any chemicals in the brain. One of the physical effects of chronic alcohol abuse is a deficiency of thiamine, also known as Vitamin B1. Thiamine is an essential nutrient for all the body’s tissues, including brain tissue. However, it is not something the body produces naturally but is instead typically found in foods like chicken, grains, nuts, and, beans.
While someone with an alcohol use disorder is already more likely to be lacking in proper nutrients and substituting alcohol for food, chronic abuse also interferes with how the body absorbs thiamine, reducing thiamine uptake and preventing cells from absorbing enough of it. Without enough thiamine, a person can develop what is known as Wernicke-Korsakoff Syndrome (WKS).
WKS is a brain disorder that is actually two separate conditions occurring at the same time, Wernicke’s Disease, which is what people with thiamine deficiency will develop first, and Korsakoff’s Syndrome, which is what Wernicke’s Disease usually develops into. Wernicke’s Disease is caused by lesions on the brain as a result of the lack of thiamine, and generally include the following symptoms:
If someone is not treated for Wernicke’s Disease and continues to abuse alcohol, then it can quickly progress to Wernicke-Korsakoff Syndrome, which comes with even more potential permanent damage to normal brain function, including:
Confabulation is a symptom common to memory disorders such as dementia or Alzheimer’s Disease, where someone’s brain makes up exaggerated stories to fill in gaps in their memory. Unlike lying, this is not something a person is in conscious control of; in fact, they are usually not aware that what they are saying isn’t true.
Depending on how far WKS has advanced, its effects can be reversed through treatment involving regular administration of thiamine, as well as treatment for alcohol use disorder, as this is the number one cause of thiamine deficiency in people. If WKS is left untreated, it can become fatal, usually due to irreversible brain damage or blood poisoning.
We’ve already illustrated that the mental effects of alcohol abuse can include both the creation of mental illness symptoms and the worsening of ones that are already present. Unfortunately, it can often be difficult for doctors to accurately tell the difference between the two due to the fact that alcohol use disorders and mental health disorders can often have a cyclical relationship.
What that means is that while chronic alcohol abuse can cause many serious mental health issues, it is also often the case that a person develops an alcohol use disorder as a way of self-medicating mental illness that is already present.
It can be almost impossible at first to differentiate between something like an independent anxiety disorder and symptoms of anxiety caused by alcohol abuse, especially because in many cases someone may have been drinking to self-medicate without even realizing it.
It is only when someone undergoes detoxification from alcohol that the difference can become clear. When someone does an alcohol detox, the psychological symptoms of depression, anxiety, and more will begin to fade on their own within a few weeks as the individual goes through withdrawal.
However, if someone is still struggling with the symptoms of a mental health disorder after they are finished with withdrawal and abstaining from alcohol use, then it is soon apparent that, in addition to an alcohol use disorder, they have what is known as a co-occurring disorder.
When someone has a co-occurring disorder, then they need dual diagnosis treatment, which is having their addiction treated at the same time as the accompanying mental health disorder. If just one is treated and not the other, neither problem gets solved.
If a person with an alcohol use disorder and an anxiety disorder only gets treated for their addiction, then they are extremely likely to relapse in order to cope with their anxiety. On the other hand, this individual will not be able to make any kind of progress treating their anxiety if they keep making it worse by drinking. Both issues must be treated at the same time.
If you or someone you care about is battling with an alcohol use disorder, Delphi Behavioral Health Group can provide you with resources and support at every level of the treatment process, including helping to find the treatment program that’s right for you or your loved one.
Gowin, J., Ph.D. (2010, June 18). Your Brain on Alcohol. Retrieved June 5, 2018, from https://www.psychologytoday.com/us/blog/you-illuminated/201006/your-brain-alcohol
National Institute on Alcohol Abuse and Alcoholism. (2002, November). Alcoholism and Psychiatric Disorders. Retrieved June 5, 2018, from https://pubs.niaaa.nih.gov/publications/arh26-2/90-98.htm
National Institute on Alcohol Abuse and Alcoholism. (2004, October). Alcohol's Damaging Effects on The Brain. Retrieved June 5, 2018, from https://pubs.niaaa.nih.gov/publications/aa63/aa63.htm