Don't rely on alcohol to reduce stress

Increased alcohol drinking may help to relieve stress in the short term, and is therefore often observed in people under stress. Unfortunately, stress and alcohol are a dangerous combination in the long term, as stress can make alcohol drinking a habit with devastating consequences.

Stress is part of life

As the Austrian philosopher Karl Pöpper has said: “Life is solving problems”. Or something along these lines. Basically, he acknowledged the fact that problems, big and small, occur frequently, and that these have to be dealt with.

Problems, almost per definition, cause stress. As we have explained elsewhere on the Stressinsight website, stress is a condition of the body that allows you to cope with a stressor successfully. Stressors are the problems that cause stress. Stress is therefore beneficial, because it helps to solve problems by providing the necessary focus and energy.

However, too much stress can be harmful and an uncomfortable feeling that you want to get rid off as soon as you can. Many people who are in a state of prolonged stress turn to alcohol to cope with that stress. The problem with this is that alcohol itself can cause stress, so that the drinking of alcohol worsens stress even further.

Stress and alcohol consumption

To many, the drinking of alcoholic beverages to reduce stress seems like a good idea. This is because drinking alcohol can provide some stress relief in the short term. However, as stressful events continue and stress becomes chronic, alcohol consumption may get out of hand. Heavy alcohol consumption can lead to medical psychological and physiological problems and increases the risk of developing alcohol use disorders.

Drinking alcohol to relieve stress can lead to health problems on top of the stress-related problems. Alcohol consumption to relieve stress is therefore a bad strategy.

Some indications that stress and alcohol consumption influence each other are the following:

• Men and women who report high levels of stress drink more
• Stressed men are 1.5 times more likely to binge drink than women
• Men are 2.5 times more likely to have alcohol use disorders

What is stress precisely?

To understand why people turn to the bottle when they are stressed, we first have to realize what stress is precisely from a physiological point of view.

All mental and physiological systems (for example the digestion, body temperature regulation, storage of new memories in the brain, defense against bacteria and viruses) in the body operate best at a certain setpoint. This reflects the optimal conditions in the body, and any deviation from this optimum, or homeostasis, causes stress. Stress has therefore been considered for more than 150 years now as a condition of the body in which one or more systems do not work properly because they are out of balance or equilibrium. This is caused by problems that we have to deal with, such as problems at work, tensions within the family, or financial worries. The stress reactions help to solve the problems, and bring systems in the body back to equilibrium.

Scientists have realized over the last 35 years of research that the body’s setpoints are not static, but can change. This is because physiological demands can change. For example, the body of elderly works differently from the body of children. Your body functions differently in the morning than in the evening. Or they may operate differently when you live in a cold or a warm climate.

The operating range in which equilibrium may be reached and the organism’s ability to increase or decrease body functions to a new equilibrium when needed is known as allostasis. The amount of work the body has to do to reach a new equilibrium, or to re-establish to the old one, during stress is known as the allostatic load. This basically reflects the wear and tear on the body, which can predispose the individual to disease, especially during chronic stress. When the allostatic load is too big, the body cannot find an appropriate setpoint, which equals disease. This is why chronic stress leads to disease.

Interestingly enough, the scientists who have developed the concept of allostatic load (McEwen and Stellar) used the use of alcohol during stress as a prime example of increasing the allostatic load on the body during stress! In other words, alcohol makes it more difficult for the body to find a balance in which organs and cells function best, and this increases the risk of developing disease.

How alcohol affects the reward and stress systems in the brain

In the allostatic load model, alcohol drinking can be viewed as both a reward and a stressor. This is because alcohol acts on the brain’s reward system and promotes dopamine (the pleasure hormone) in the brain on the one hand, and activates the hypothalamus-pituitary-adrenal axis (HPA-axis) on the other hand to increase the concentration of the stress hormone cortisol in the blood. In this model, alcohol lowers the setpoint for pleasure and creates a bad mood state. The stress systems have to fight to bring this setpoint back to normal.

Alcohol has many effects in the brain that may mask the effects of the stress it causes. For example, alcohol increases the inhibitory tone in the brain, making it less active so that you may feel more calm in the short term. And, as said, it enhances the release of dopamine and natural opiates, making you feel good.

In the long term, dopamine levels fall, so that more drinking is necessary to reduce feelings of stress. This is when the setpoint for mood and reward really drops. Also, the brain tries to adapt to repeated elevations of stress hormones that are caused by alcohol. This adaptation in the brain underlies the allostatic change that has been associated with heavy drinking. New, less favorable setpoints are reached with much effort, so that the allostatic load is high. This poses threats to brain health, and is reflected by a less efficient stress response when new problems are encountered.

In summary, low doses of alcohol in non-alcohol-dependent persons produce rewarding effects that seem to reduce stress. In reality, alcohol stimulates the release of stress hormones. Chronic and heavy alcohol consumption give rise to even more stress, which takes a heavy toll on the body (high allostatic load). The high allostatic load reflects the cost that comes with the continuous efforts to adapt to alcohol use. Drinking to reduce stress is a double-edged sword and should be avoided completely.

Cortisol makes alcohol use even worse

The stress hormone cortisol helps to restore equilibrium in essentially each and every organ in the body. The brain is no exception to this. In fact, the brain is one of the most important parts of the body where cortisol does its work.

As mentioned earlier, alcohol increases the release of cortisol in the blood. It will next enter the brain, where it does everything it can to restore processes to reach their previous setpoints or helps to establish a new one. This helps to get the stress away.

Wonderful as this may seem, not everything is rosy. Scientists think that cortisol can stimulate the reward system in the brain, especially during the use of drugs, including alcohol. Cortisol itself would therefore have a rewarding effect, and would thus promote the use of alcohol. Drinking to relieve stress starts a vicious cycle of increased alcohol use and stress levels that reinforce each other.

Furthermore, cortisol can stimulate the formation of habits. Such habit-based learning would make alcohol intake a routine, so that drinking is further promoted and alcoholism can develop.

At a first glance, it seems a bit awkward that cortisol would have rewarding properties. After all, cortisol should help to resolve a problem that puts the body in a condition of stress. Why should this be rewarding? You are supposed to feel bad!

Scientists have been puzzled by this question, but have recently come up with a reasonable answer that is rooted in the evolution of the stress system in vertebrates (animals with a backbone: fish, amphibians, reptiles, birds and mammals). They think that under natural conditions (for example, during conflicts with other animals) the rewarding effects of cortisol may counteract the aversive effects of aggression. This allows the animals to cope better with threatening situations, and recover more quickly from a fight with another animal.

The interactions between stress and cortisol on the one hand, with reward and dopamine on the other hand, have also been found in humans. Researchers have studied the effects of amphetamine and found higher cortisol levels in response to amphetamine administration. Imaging of the brain revealed increased activity of the reward system as well. It is very likely that alcohol would do the same thing as amphetamine, and this would probably apply to other drugs as well.

Summary of the interactions between alcohol consumption and stress

Let’s summarize the complex interactions between alcohol intake and stress. We have discussed that the HPA-axis, one of the body’s stress systems that produces cortisol, works hard to maintain a delicate physiological and mental balance. But when alcohol comes into play, the body is at greater risk for harm.

Alcohol causes higher amounts of cortisol to be released. This alters the brain’s chemistry and activity, and resets what the brain considers to be “normal”. This changes the way the body perceives stress and changes how it responds to stress.

Studies have found that cortisol interacts with the brain’s reward or pleasure systems, so that alcohol has rewarding or reinforcing effects. This forces people to drink more over time to achieve the same rewarding effects, and this leads to more cortisol production by the HPA-axis. Cortisol will then promote habit-based learning, so that drinking becomes a routine and increases the risk of relapse when you want to stop with heavy drinking.

Diseases caused by heavy drinking are related to the fact that alcohol prevents the body from returning to its initial equilibrium, forcing it to set a new, less favorable, equilibrium for physiological and psychological functioning of the body and the brain. Cortisol stimulates this, but at the same time also fights against it, as it will try to bring the body back to its initial equilibrium. The body gets into a state of chronic stress, which can lead to mental disorders such as depression.

Conclusion

Drinking alcohol with the aim to relieve stress may seem an effective strategy in the short term, due to the reinforcing effects of the stress hormone cortisol. In reality, drinking puts the body in a condition of chronic stress that aggravates over time. While drinking the occasional glass of wine is in itself not a problem, alcohol consumption when you are stressed should be avoided at all costs. A better strategy is to find ways to deal with the stressor effectively, so that the need for alcohol consumption to feel better will not present itself.