Alcohol and Anxiety: Does drinking really help you relax?
Announcing you need a drink when feeling stressed or worn out is usually met with enthusiastic agreement. Many of us take for granted that drinking eases anxiety and helps us relax in social settings or at the end of a hard day. Especially in 2020, alcohol sometimes feels like a necessary vehicle for coping with an uncertain, and often scary world.
But lately, it seems like our entire society might be developing a bit of a drinking problem. When “Rose all Day” is printed on fitness wear, and so-called “Wine Moms” are said to have influenced the recent presidential election, it's worth looking at whether drinking is doing what we think it's doing. Does alcohol really “take the edge off” our stressful days, or does it make things worse?
According to a recent study released by the RAND corporation and supported by the National Institute of Alcohol Abuse and Alcoholism (NIAAA), drinking has soared during the pandemic. Heavy drinking for women has increased by 41 percent. "The magnitude of these increases is striking," Michael Pollard, lead author of the study and a sociologist at RAND, told ABC television. "People's depression increases, anxiety increases, [and] alcohol use is often a way to cope with these feelings. But depression and anxiety are also the outcomes of drinking; it's this feedback loop where it just exacerbates the problem that it's trying to address."
If you are truly drinking moderately, which the National Institute of Health (NIH) defines as one 5 oz glass of wine or 12 oz beer for women and two for men, and alcohol doesn’t have a noticeable effect on your overall mood or sleep, you are probably staying clear of alcohol’s anxiety-elevating effects. But if you are more than a “one and done” drinker, or are worried that alcohol is affecting your well-being and health, it's worth looking at how it is affecting you.
ALCOHOL AND THE BRAIN
Alcohol has a “biphasic,” or two-phase, effect on the brain. It both increases dopamine levels (leading to feelings of euphoria) and inhibits excitatory neurotransmitters, which slows down your brain functioning. The slowing down of the excitatory neurotransmitter is how alcohol acts as a depressant. Once dopamine levels go back to normal, we're still left with a depressed system, which often leads to another drink to get the dopamine levels back up. The more we drink the less effect alcohol has on our dopamine receptors, but by then our brain has learned to crave alcohol when we're stressed. This interference with our neurotransmitters can increase anxiety, often for the entire day after drinking. This can lead to wanting a drink the next evening to wind down, causing the entire cycle to start over again. Very often cutting out alcohol can lead to a significant decrease in your overall anxiety.
ALCOHOL AND YOUR SLEEP
While the sedative effect of alcohol initially might help us fall asleep, as little as one drink too close to bedtime can wreak havoc on both the quality and quantity of your sleep. Alcohol interferes with our sleep stages, especially REM sleep, the restorative part of our sleep cycle. When alcohol finally leaves your bloodstream, you’re often jolted awake as your nervous system, coming off of several hours in a depressed state, tries to achieve homeostasis by lurching into active mode.
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Sleep is the ultimate self-care activity. The importance of quality sleep in all mental health issues, and overall well-being, cannot be overstated. It is the first line of defense against chronic anxiety and depression. Researcher Matthew Walker, author of the excellent book, "Why We Sleep," says it perfectly, “The best bridge between despair and hope is a good night’s sleep.” Midnight ruminating, 3am wake-ups, night sweats, morning headaches, and brain fog, are all signs that alcohol is impacting your sleep, and bringing along the anxiety you are trying to avoid.
DO YOU HAVE A PROBLEM?
We often have a binary way of thinking about alcohol use - either you’re an alcoholic and your drinking is truly out of control, or there’s no problem at all. But that isn’t an accurate picture. Most people who drink too much are not addicted and wouldn't experience what we typically think of as withdrawal if they stopped. They don’t need treatment or intervention. In fact, it's likely no one around them is worried about their drinking at all. But from a mental health perspective, alcohol is still affecting them negatively.
A friend recently shared that her husband expressed concern that her drinking had increased rapidly over the course of quarantining. She told him, “I know I’ve been drinking too much. This is what I do instead of taking an antidepressant.”
Imagine your doctor suggesting you take a medication that will help with anxiety for about 30 minutes, then will make your anxiety worse. It is also highly addictive. It causes sleep problems, depression, headaches, stomach issues, infertility, and birth defects. Further, it markedly increases your susceptibility to many types of cancer, is associated with reckless behavior and blackouts, and is responsible for more than 95,000 deaths in America (3,000,000 worldwide) each year. Hopefully, you would find a new doctor.
Alcohol as medication is a terrible idea. If your drinking is medicinal, it's time to look for safer, more effective ways to cope. Here are some steps to take if you’d like to shift your alcohol use.
Get real about how much you’re actually drinking.
Bringing attention to our habits is always the first step in changing them. Next time you’re drinking, use a measuring cup to pour out 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of spirits. That’s one drink. Do this with every drink you have in order to keep yourself honest. In a notebook, keep track of how many drinks you have each day, and rate your overall anxiety, depression, and sleep quality.
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Find other ways to relax
The ritual of signifying the end of the day by sitting down with a drink is hard to give up unless we have an enticing alternative. Identify when you will most want a drink, and think about what you could do instead. Swapping in a non-alcoholic drink that you reserve for happy hour can often stand in effectively for alcohol. Reading a book, taking a bath, connecting with a loved one, or even just going to bed early are all proven anxiety relievers.
Take a break
Dryuary is right around the corner, and there are countless free or low-cost programs on-line to offer support and guidance to anyone wanting to take an alcohol time-out. Not drinking at all, for at least a month, is the best way to see how alcohol is affecting your life, and to decide whether it's worth it. Be aware that the more you’re drinking now, the longer it will take your body to truly reset and for you to feel the full impact of going without. A good rule of thumb is one month for every daily drink. If that feels intimidating, start smaller and see if you can add on as you move ahead.
Ideally, keep the time-line open. The idea of a drinking break is to diminish drinking’s importance in your life. If you are counting the days until you can drink again, it will have the opposite effect. If you decide to re-introduce drinking after this period, keep in mind that all habits grow. In the same way we might grow an exercise habit by starting with 15 minutes a day, one daily drink can easily become three without our noticing. Drinking mindfully for the long term will likely require a lot of attention and periodic re-assessment.
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None of the above suggestions replace treatment or a twelve step program. If you experience strong resistance to any of the above steps, it's worth getting curious about the role of alcohol in your life, and whether this is how you want to live. While certain people are natural moderators who never drink more than the suggested amount, the truth is, most people who drink consistently will eventually need to re-evaluate the way they are drinking. There shouldn’t be shame or stigma about wanting to slow down or stop drinking because needing to do so isn’t the exception - it's the rule.