The Link Between Stress and Alcohol

Drinking to Relieve Stress May Actually Compound the Problem

NIAAA Stress Chart
Alcohol Changes the Body's Balance Point. NIAAA

Life can be full of stress. Situations arise in everyday living that cause us to experience sadness, anger, fear, anxiety and excitement. Physiologically, stress is defined as anything that challenges the body to function in its usual fashion.

Injury, illness, or exposure to extreme temperatures can cause stress to the body. Grieving, depression, fear and even sexual activity can cause psychological stress.

The human body has developed a complex and extensive process of adapting to harmful or dangerous situations created by stress to keep a physiological balance, a state known as homeostasis.

When the body experiences stress, or even perceived stress, it mobilizes a variety of physiological and behavioral changes via the nervous and endocrine systems to achieve a goal of maintaining homeostasis and coping with stress.

Many people who experience stressful situations or perceived threats will turn to alcohol to cope with that stress. The problem with that is alcohol itself can cause stress on the body's physiological balance.

Researchers have found that alcohol takes a psychological and physiological toll on the body and may actually compound the effects of stress.

Drinking alcohol may seem to provide some relief - positive feelings and relaxation - in the short term, but as stressful events continue long-term, heavy alcohol consumption can lead to medical and psychological problems and increase the risk of developing alcohol use disorders.

Common Types of Stress

Researchers have identified four main categories for causes of stress:

  • General-life stress
  • Catastrophic events
  • Childhood stress
  • Ethnic minority stress

General-Life Stressors

Some examples of general-life stressors include major changes like moving, starting a new job or getting married or divorced.

Illness, a death in the family or problems at home or work can also be significant causes of stress.

Drinking too much alcohol can cause some general-life stress, such as losing a job, causing relationship problems or causing legal problems.

Catastrophic Events

Studies have found that alcohol consumption increases within 12 months following a major disaster, either manmade or natural. Some studies have found that alcohol abuse disorders increase after catastrophic events like September 11, Hurricane Katrina, or the Oklahoma City bombing.

However, other studies have found that catastrophe-induced increases in alcohol consumption tends to wane after a year and other studies have found no increases in alcoholism following major disasters.

Childhood Stress

Maltreatment during childhood - emotional, sexual or physical abuse or neglect - can have long-lasting effects, resulting in a significant percentage of all adult psychopathology.

Abuse during childhood increases the risk for alcohol use disorders in both adolescence and in adulthood.

This is particularly true for children who grow up in alcoholic homes, researchers report.

Ethnic Minority Stress

Stress resulting from a person's minority status can range from mild to severe and can be emotional or physical. Stressors can range from being overlooked for promotion on the job to becoming the victim of a violent hate crime, for example.

Determining how much minority-related stress is linked to increased alcohol consumption has been difficult for researchers to determine due to other risk factors among minority groups - such as drinking patterns and differences in alcohol metabolism.

Coping With Stress

When the body experiences stress, it quickly shifts its normal metabolic processes into high gear, relying on the intricate hypothalamic–pituitary–adrenal (HPA) axis system to change the levels of hormonal messengers throughout the body.

The HPA axis system targets specific organs to prepare the body to either fight the stress factor or to flee from it - the body's fight-or-flight response.

The hormone cortisol plays a important role in the body's response to stress by increasing energy by increasing glucose levels and by increasing nutrient supplies by mobilizing fat and protein metabolism.

A healthy body's response to stress includes a quick spike in cortisol levels followed by a rapid decrease in those levels when the threat or stress is over.

Stress and Resilience

Resilience is the ability to cope with stress. Someone who is resilient is able to adapt to the psychological and physiological factors involved in the body's stress response.

Research has found that people who have a positive, optimistic outlook and have good problem-solving and coping skills tend to deal with stress effectively.

On the other hand, people who exhibit impulsivity, novelty seeking, negative emotions and anxiety - traits also linked to an increased risk for substance abuse disorders - have difficulty dealing with stress.

People who do not handle stress well and are therefore at risk for developing alcohol use disorders include:

  • Those with a history of family alcoholism
  • Children whose mother drank during pregnancy
  • People who experienced childhood abuse or neglect
  • Those with other mental health issues

Alcohol's Effect on the Stress Response

The body's HPA systems works hard to maintain a delicate physiological balance, but when alcohol is added to the mixture it puts the body at even greater risk for harm.

Alcohol causes higher amounts of cortisol to be released altering the brain's chemistry and resetting what the body considers "normal." Alcohol shifts the hormonal balance and changes the way the body perceives stress and changes how it responds to stress.

Alcohol prevents the body from returning to its initial hormonal balance point, forcing it to set a new point of physiological functioning (see image above). This is called allostasis.

The establishment of a new balance point puts wear and tear on the body and increases the risk of serious disease, including alcoholism.

Alcohol and Cortisol

Studies have found that cortisol interacts with the brain's reward or pleasure systems which can contribute to alcohol's reinforcing effects - forcing drinkers to consumer greater amounts to achieve the same effect.

Cortisol also can promote habit-based learning, increasing the risk of becoming a habitual drinker and increasing the risk of relapse.

Additionally, researchers have linked cortisol to the development of metabolic disorders and to the development of psychiatric disorders such as depression.

Alcohol’s Role In Stress

Studies have found these factors of how stress relates to alcohol use:

  • 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

Stress and Alcoholism Recovery

Stress can continue to have an effect even after someone stops drinking. The HPA axis, the system that deals with stress response, has been traced to symptoms of alcohol withdrawal.

Many newly sober people begin drinking again to relieve the symptoms of withdrawal. Therefore researchers are trying to develop medications that will return balance to the body's stress-response system to alleviate alcohol withdrawal symptoms and help prevent relapse in recovering alcoholics.

The research into the relationship between stress and alcohol can help healthcare providers by identifying patients who are most at risk of alcohol relapse in early recovery and help patients deal with how stress can motivate them to drink.

Sources:

National Institute on Alcohol Abuse and Alcoholism. "The Link Between Stress and Alcohol." Alcohol Alert Accessed January 2016

National Institute on Alcohol Abuse and Alcoholism. "Alcohol and Stress." Alcohol Alert April 1996

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