The Neurobiology of Drinking

Posted on October 17, 2019 by Cash Freitas, One of Thousands of Health and Fitness Coaches on Noomii.

In early 2019 a very close friend told me she was taking a 30-day break from alcohol by reading Annie Grace’s The Alcohol Experiment. I was impressed by her decision, and very doubtful I could ever do the same. But curiosity got the best of me and I read it.

And then my whole life changed.

I went from a daily drinker to a person who may have a drink every month or so. If you had told me this would happen even a year ago I would have laughed in disbelief. “Ten years of steady drinking doesn’t just stop,” would have been my first thought. But one of the absolute truths I have learned in this process is the brain is insanely powerful. Not only did I take control of my drinking, but I did it without waging a battle of willpower, without feeling deprived, without having to white-knuckle it through each day and night.

I did this by retraining my brain to create new habits and by resolving the cognitive dissonance that I carried for so long. Cognitive dissonance is the feeling of conflict that you experience when your thoughts, beliefs, or behaviors contradict one another (1). The competing beliefs that “alcohol relaxes me”, “everyone drinks”, and “alcohol isn’t bad for me” got in the way of my logical understanding of the detrimental effects of alcohol on the body, mind, and spirit. By becoming aware of and examining these opposing beliefs and desires I was able to resolve the years of conflict and put my mind to rest, resulting in the death of my drinking habit.

This experience is a testament to the amazing plasticity of the brain. Plasticity, or neuroplasticity, refers to the brain’s natural ability and propensity to change and adapt throughout an individual’s lifespan. It is the reason people are able to heal from years of habitual alcohol use and return to a healthy, well-functioning stable state of mind. Below, I will describe all the ways alcohol changes the human brain, even with occasional moderate drinking. I will also explain why there is always a reason for hope, because no matter how long you have been drinking, once you remove alcohol from your life your brain and body start healing immediately. More on that later. First, let’s talk about some of the very common effects alcohol has on our brains.

Brain Fog

Brain fog: sure, it’s not the most technical of terms. But I know you know what I mean. Anyone over the age of thirty can relate to this, and the feeling is especially apparent when you’re a drinker. I don’t mean the buzz you get right after you have a drink. I mean the resulting feeling after a day or night (or a decade) of drinking, when you are listless, slow, and have a hard time putting two coherent thoughts together. When there’s no amount of caffeine that can get you through the day, and not even a full night of sleep can help you cut through the fog.

Brain fog was one of the main reasons I was forced to examine my drinking. At the time I stopped, I was about 10 years into a pretty sturdy drinking habit. I had a toddler, a husband, and a full-time job (still do, thank goodness). And despite having those things, I was pretty certain I could no longer blame any of them for my bone-deep exhaustion. Each day I felt as though I was wading through mud, physically and mentally. I couldn’t account for it: the midnight baby feedings had long passed. Work was work…but it wasn’t usually stressful or demanding. My husband and I shared equal responsibilities over the home and child-rearing. Why, then, did I feel like I had just woken up from a coma every day? Once I kicked the booze, it all became pretty obvious. I was lost in Brain Fog.

Dr. Mike Dow, a cognitive-behavioral therapist, describes brain fog as the product of a chronically undernourished, chemically imbalanced brain (2). When three key chemicals – dopamine, serotonin, and cortisol – are out of balance, it is nearly impossible for us to feel good. The excess use of “brain-altering substances” such as alcohol contributes to this imbalance (please refer back to Part 1 of this blog post for details on how alcohol affects dopamine and cortisol). In sum, dopamine overstimulates our brain, which causes an amplification of the stress hormone cortisol to restore chemical balance. When these chemicals are out of natural balance our emotions, energy, and mental processing all slow down, making it hard to feel alert, clear-headed, and emotionally in-tune.

Brain fog is a term for the general slowing down of the brain’s various processes. The frontal lobe, the cerebellum, and the cerebral cortex are some of the areas that scientists have found, through experimental studies, are particularly altered under the influence of alcohol. Each of those regions is responsible for unique functions, and so the effects of alcohol on those regions become apparent in different ways. Below we will look at those in more detail.

Decision making, executive functioning (AKA adulting)

Executive functioning is a fancy way of describing all the things one must do as a productive responsible human. It refers to our ability to use our highly evolved frontal lobe of the brain – the region of the brain that sets us apart from other mammals, allowing us to create and survive in our complex human society. Alcohol alters neurotransmitter activity in the frontal lobe, a part of the brain that helps us manage our behavior, emotions, and physical activity (5). As we consume it, it changes the way our neurons naturally connect, fire, and communicate, which over time can impede our hard-won ability to do things like making good decisions for our self and our family, plan into the future, control impulses, and in general, do the adult things we need to do for survival. It also diminishes the natural motivation we have to complete the important (though sometimes mundane) tasks that make up our life: going to work, paying bills, feeding the children, etc. When your brain is addicted to (aka habitually seeking out) a substance, most of its energy goes into finding that substance. This causes a lack of motivation to complete tasks that don’t involve drinking alcohol.

.This showed up in my life in small but frustrating ways. At work, especially in the afternoon, my mind would go to what I would drink that night, taking my focus away from the meeting, project, or colleague in front of me. At home, already exhausted from the full day, it was nearly impossible for me to be present with my child and husband until I had a drink in my hand. And after that drink or two, making dinner and preparing for the next day tumbled far down to the bottom of my priority list. This simply made everyday life a slog – something I had to suffer through, rather than enjoy. Once I removed alcohol from this routine I was of course still tired, but it wasn’t that bone-deep exhaustion type of tired from before. I was better focused at work, more present with my family, and instead of crashing toward bedtime, I had the energy to write, read, and meditate before bed. This meant I was able to complete the tasks of everyday life with less of a struggle and know that when I finally went to rest, I had accomplished another day – not suffered through it. (I also slept better…but that’s a story for another time.)

Learning and Processing New Information

Have you ever gone to a trivia night at a bar? If so, you know how silly the whole concept is: people becoming steadily more inebriated while challenging themselves to recall obscure and inane facts about the world AND work as a team. Thinking while drinking is HARD. And there’s a good reason for it. Alcohol impedes the functioning of the cerebral cortex, the key region of the brain responsible for processing and understanding new information (5). Long term alcohol use (including moderate use – about 2 drinks per day for women and 3 for men) can have long-lasting effects on our ability to learn and process new information, acquire skills, and complete unfamiliar or complex tasks (6). Organizing ideas and objects, understanding what you see in front of you, and focusing on details are all highly important skills involved in learning something new. And these are exactly the higher-order tasks that are impaired when your brain is under the influence of alcohol or has been in the past few days or weeks.

A recent study showed that alcohol can help consolidate previous learning, pointing to a connection between the number of drinks consumed and the ability to recall information the day after drinking (7). However, it is easy to be misled by this headline. Researchers believe this is the result of alcohol causing the brain to shut down prematurely and become unable to learn more information in a given setting, causing the person to fall asleep. Because we do a lot of learning in our sleep, these folks begin the process of synthesizing information sooner than if they not been drinking. However, this novel finding (in such a small study) does not account for the more global effect that alcohol has on the brain’s ability to intake, synthesize, and remember the learned knowledge. This leads to the final points about brain shrinkage and memory loss.

Brain Shrinkage and Slowing of Brain Growth

Scientists used to believe that as we age into adults, our brains stop growing due to the natural dying off of old brain cells. We now know the opposite is true: that our brains continue to grow new brain cells well into adulthood (3). New brain cells mean greater potential for continuous learning and adapting throughout our adult life. However, we are working against this when we imbibe alcohol regularly. In fact, brain scans show that even moderate drinkers experience brain shrinkage in the area of the brain responsible for cognition and learning (5). Brain volume shrinks in proportion to the amount of alcohol consumed, so the more one drinks, the more the brain shrinks (4).

Why does this matter? Brain shrinkage and slowed brain growth directly relate to our ability to learn, function, and make sense of our lives. By drinking alcohol we are impeding our brain’s adaptability and plasticity, making it harder to learn, do new things, and recall that which we have already learned. Brain shrinkage also impacts health and life expectancy. Because such atrophy means diminished communication between brain cells and entire regions of the brain, long term effects of brain shrinkage can range from dementia, seizures, and aphasia (the inability to speak and understand language) (9). While these are extreme examples, they are illustrative of the damage being done by steady (and binge) drinking.

Blackouts and Memory Loss

Memory loss is one of the best understood and documented results of alcohol use. The creation of new memories is made possible by the brain’s hippocampus. The hippocampal region also ensures that our short term memories become long term, meaning the creation of our life’s narrative doesn’t just happen magically. It is a sensitive process requiring a well-functioning brain. Alcohol can cause short term and long term memory loss as well as the all-too-common phenomenon of “blacking out.”

A blackout is a short bout of amnesia that can last for minutes or hours, occurring after ingesting even small amounts of alcohol in a short period of time. Scientists have learned recently of the neurological process behind these lapses. They found that “alcohol interferes with key receptors in the brain, which in turn inhibits [the] process that strengthens the connections between neurons and is crucial to learning and memory” (11). Most of us who drink have experienced a blackout. These memory lapses, no matter how brief, can be alarming and dangerous. In adulthood, my drinking was more of the everyday type – two to three drinks a day, over a 3-4 hour period. But when I was in my teens and still experimenting with alcohol, I had at least a couple of incidents of blacking out and I am lucky I came out of them unharmed. As I got older and learned how to better “manage” my drinking habit, I was careful not to reach the point of blacking out, but the memory damage was still occurring.

I was also not immune to the more subtle and insipid memory lapses that are common with regular drinking. Similar to the causes of blacking out, short and long term memory loss is the result of the inhibition of hormones on neurotransmitters described above. These longer-term lapses can also be caused indirectly through alcohol’s detrimental effect on high-quality sleep. Consuming alcohol reduces the amount of REM (Rapid Eye Movement) sleep we can attain, even a few nights after our last drink (12). Our brains rely on this phase of sleep for processing newly gained information, so when we get less REM, we miss out on the results of that cognitive processing. It’s akin to interrupting a software update halfway into its download.

Before I quit, I never made the connection between my habit and my poor memory. I just attributed it to getting old, being tired, or having “baby brain” after the birth of my son. But it became pretty clear after a few months of living alcohol-free that I was causing my own memory loss. Once I came out of my brain fog I could more easily recall what I had for dinner the previous night, where I left my keys, and what we discussed at last week’s meeting. I was even able to recover longer-term memories from years before. It was a sad realization for me, seeing how many memories I had lost through my own actions. But as more time passed and my brain and body healed, I recovered more of my memories, my sleep greatly improved, and my thinking felt sharper and quicker. It was exciting and empowering to know that by simply replacing alcohol with non-intoxicating beverages, I had taken control over my life and started the process of healing my body and brain.

Healing the Brain and Body

And so, we come to the part about hope. While combing through all the research showing the undeniable connection between alcohol and brain damage, it also became clear to me that the brain is an amazingly resilient organ. As I mentioned above, we know that the adult brain continues to grow, adapt, and change throughout a person’s lifetime. Though alcohol impedes this process, once alcohol consumption ceases the brain begins to heal itself immediately.

In an interview, Maria Pagano, PhD, an addiction researcher and associate professor of psychiatry, discussed the benefits of abstaining from alcohol after long term use (5). “After cutting back on alcohol” she said, “damaged regions of the brain can start to ‘light up’ again on brain scans…and we often see improvement only after months of complete abstinence and giving the brain time to heal.”

After just two weeks of abstinence, researchers found that the shrunken areas of the brain begin to grow back, such as the cerebellum, which tends to recover faster than other regions responsible for higher-level cognitive functions (13). Studies have shown that the fewer “detox episodes” a person has had, the more quickly they will regain functions such as short term and long term memory, verbal IQ, and verbal fluency (14).

A month after going alcohol-free, your ability to build, retain, and recall memories comes back as cells in the hippocampus begin to regenerate (10). After 6 months of no drinking, you are much less likely to be triggered by and have cravings for alcohol, which greatly reduces your chances of returning to your drinking habit (14). The greatest recovery can be seen after the 1-year mark. Most people will begin to experience improved memory, cognitive performance, emotional stability, and motor coordination, indicating a regrowth of brain function in all affected areas of the brain (15).

So, dear reader. Please know: wherever you are on the drinking spectrum, there is absolute hope and possibility for your own healing. Once you decide your drinking habit is no longer serving you, you can decide to take action. You will see, with a little distance from your daily habit, that alcohol is likely the thing standing in your way of becoming your best self. As Annie Grace says, it is the “big domino” that once fallen, allows for the next thing, then the next thing to fall away, leaving you with a clear path forward. I won’t say it’s the easiest thing in the world to dismantle a habit that has until this point been your main tool for coping with life. But if you take the approach of “experimenting” with building a NEW habit, you will find you can do it without white-knuckling your way through.

This is the approach I have taken, which worked for me, and which I now teach others. I encourage you to check out Annie Grace’s books and to subscribe to my contact list below, where I will provide new resources, tips, and guidance for walking this life where alcohol is small and insignificant.

So please, set down your drink and join me.

References
(1) (n.d.). Cognitive Dissonance. Retrieved from psychologytoday.

(2) Dow, M. (2015). The brain fog fix: reclaim your focus, memory, and joy in just 3 weeks time. Carlsbad, CA: Hay House, Inc.

(3) Weintraub, K. (2019, March 25). The Adult Brain Does Grow New Neurons After All, Study Says. Retrieved scientificamerican.

(4) Merz, B. (2017, July 13). This is your brain on alcohol. Retrieved from health.harvard.edu/blog.

(5) (n.d.). Here’s What Really Happens to Your Brain When You Drink Too Much Alcohol. Retrieved from Health website.

(6) Katherine Tzambazis, Con Stough, ALCOHOL IMPAIRS SPEED OF INFORMATION PROCESSING AND SIMPLE AND CHOICE REACTION TIME AND DIFFERENTIALLY IMPAIRS HIGHER-ORDER COGNITIVE ABILITIES, Alcohol and Alcoholism, Volume 35, Issue 2, March 2000, Pages 197–201.

(7) Carlyle, M., Dumay, N., Roberts, K., Mcandrew, A., Stevens, T., Lawn, W., & Morgan, C. J. A. (2017). Improved memory for information learnt before alcohol use in social drinkers tested in a naturalistic setting. Scientific Reports, 7(1). doi: 10.1038/s41598-017-06305-w

(8) Wood, AM et al. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet; 14 April 2018; DOI: 10.1016/S0140-6736(18)30134-X

(9) Watson, S. (2019, March 29). Brain Atrophy: Symptoms, Causes, and Life Expectancy. Retrieved from Healthline website.

(10) Keck, R. (2018, March 3). How Does Alcohol Affect the Brain? (It’s Not Pretty). Retrieved from DrAxe website.

(11) Tokuda, K., Izumi, Y., & Zorumski, C. F. (2011). Ethanol Enhances Neurosteroidogenesis in Hippocampal Pyramidal Neurons by Paradoxical NMDA Receptor Activation. Journal of Neuroscience, 31(27), 9905–9909. doi: 10.1523/jneurosci.1660-11.2011.

(12) Khazan, O. (2017, December 15). Even Small Amounts of Alcohol Impair Memory. Retrieved from TheAtlantic website.

(13) (n.d.). Alcoholics Brains Recover Quickly After Detox. Retrieved from LiveScience website.

(14) (n.d.). The Brains Recovery From Alcohol Use Disorder – Neuroscience. Retrieved from RecoverAnswers website.

(15) (2004). Alcohols damaging effects on the brain. PsycEXTRA Dataset. doi: 10.1037/e306622005-001