Alcoholism and emotions are inextricably linked. It is the reward system that creates the urgency of the motivation to drink. But a subsequent effect locks our addiction in place and gives us the illusion that we are drinking to relieve loneliness, anxiety, depression, fear or poor-self-image.
The primary effect of alcohol on the brain is that it slows it down and a secondary effect is that it causes extra serotonin to be released. Serotonin is what makes us feel happy, relaxed, and sociable when we drink and these are the upsides of alcohol. But the slowing down causes loss of judgement, loss of balance, slurred speech and so on, and when we drink regularly and heavily then our brain adjusts the way it operates to try to combat these dangerous effects of alcohol. What happens is that our brain boosts release of a several chemicals. This speeds up our thinking, increases our alertness, and makes us more ready to respond to danger. The changes are made to try and keep our brain working optimally and collectively these changes are called becoming “alcohol-tolerant”. The changes work fine when we are drinking; they reduce the impact that alcohol has on us (which is also why we have to drink more to get the same effect) but they are applied wholesale, throughout the day, so these chemicals are still at work when we are sober. This leaves us feeling on-edge as though we are expecting something bad to happen, with an agitated mind, restless, and anxious. But alcohol-tolerance doesn’t just increase anxiety; it affects our mood as well.
When we drink then our brain is tricked into releasing serotonin and this is what makes us feel happy, sociable and relaxed. But if we drink regularly then our brain recognises that it is getting more serotonin than it ordered and it slows down its release. Just like the other changes that come with alcohol-tolerance it applies this change throughout the whole day which means that most of the time there is less serotonin released in our brain than should be. This causes our mood to be lowered except at the times when we drink. The combined effect of alcohol-tolerance is that our mood becomes depressed, we have a racing mind, we become less sociable and we are anxious, worried, restless, irritable and lonely. But there is one thing that will fix all of these problems, and that is to have a drink, because drinking lifts all of these feelings back towards normal. Once we have become alcohol-tolerant then we need to drink to make ourselves feel normal!A drink will relax us again, make us more sociable, and make us happier. Once we have become alcohol-tolerant then we feel the effects of its changes fully when we are sober; we feel miserable, stressed, alone etc. So we drink to fix this and our brain creates new drinking triggers for each of these emotional states. Once this happens then we start to drink to relieve our fear, anxiety, loneliness etc. because we are now triggered to drink whenever we experience these emotions. But these emotions are themselves now launched in response to being sober. This is where the illusion “I drank because… fear/ anxiety/ stress/ depression/ loneliness” comes from. It is an illusion because these emotions are themselves caused by being sober once our brain has adapted to defend itself from regular drinking. We might once have drunk to relieve anxiety, or to escape the distress of some traumatic event, but we are now also triggered to do so whenever we are sober and this causes our drinking to escalate further. When our drinking increases then our brain responds by intensifying the defensive measures of alcohol-tolerance and every aspect of our life seems to worsen. If we carry on drinking then we become so depressed that we can no longer even drink enough to make ourselves happy and alcoholics often describe this as “alcohol stopped working for me”.
Once in this position we are trapped. The reward system strengthens our drinking triggers every time we act on them and we have now added some catastrophic new ones; we have added triggers for every form of distress. Fear, anxiety, loneliness, worry, confusion, frustration and hopelessness all acquire drinking triggers and the consequences of alcohol-tolerance make it inevitable that these triggers will fire whenever we are sober. They fire because these triggers are activated whenever there is no alcohol in our bloodstream. As soon as we are sober we experience these emotions and are immediately triggered to drink again. This is where the motivation to drink in the morning comes from.
Once the reward system enters into a runaway state with respect to alcohol then our alcohol-tolerance locks it into place and our entrapment is complete. We end up drinking to relive the symptoms that are caused by drinking and these symptoms present themselves whenever we are sober. But drinking more makes the symptoms of alcohol-tolerance even more severe, so we drink more in response to them which makes the symptoms worsen further and a spiral down into hopelessness becomes inevitable.
Understanding how our addiction forms and what drives it means that we can focus our effort where it will bear fruit instead of putting our efforts into chasing false causes. We have not become alcoholic simply because alcohol is an addictive substance; that is not the reason. Yes, alcohol is addictive, but it is not addictive to everyone. While normal drinkers might strengthen drinking triggers by regular drinking they also form the counterbalancing drink-avoiding triggers. But we do not. If a regular drinker is using alcohol for relief from some adverse circumstances then their alcohol-avoiding triggers will return their drinking back to a moderated state if that distress ceases. They do not permanently lose the ability to control their drinking like we do. They have an “off” switch, but we do not and we never will. We drink the same alcohol as they do but in us the drinking triggers enter a runaway state and that doesn’t happen to them. It is not the alcohol that they drink is different, and it is not the way that we drink, it is us. This is a fundamental piece of knowledge for recovery. My problem isn’t caused by other people, places or things. It is not what happened in my past, it is not that alcohol advertising that makes me addicted nor is it simply that alcohol is addictive. Other people have problems, other people see the same media promotion of alcohol, and other people drink the same stuff, but only a few become addicted. We are different. But different is not the same as weak, faulty or broken; we are only these things if we make a moral judgement of ourselves instead of an informed one. Our problem is not alcohol itself but the absence of alcohol-avoiding triggers that makes us susceptible to addiction. When it comes to addiction our reward system responds to two internal characteristics that are unusually strong in us: we greatly value the advantages of something over its disadvantages, and we greatly value something now over something later. Lots of people are adventurous and enjoy the thrill of excitement more highly than the risk of things going wrong. And lots of people value something now far more highly than something later; we call this being impatient. But if we have both of these characteristics, and if they are both strongly expressed, then we have a reward system that can behave incorrectly when it comes to addictive substances. It will only poorly make alcohol-avoiding triggers and can get tipped into a runaway condition. There is nothing broken about the way that we value the advantages of something over its disadvantages, that quality in us is not particularly unusual, and neither is strongly preferring something now over something later. Both of these characteristics are expressed strongly in us but fall within the normal range. We are no more “broken” than someone that is unusually tall or unusually short. What we do have however is a conjunction of strong characteristics that together give us a susceptibility to addiction, and if we engage this susceptibility by drinking regularly then it develops into a condition that becomes steadily more severe. Eventually we have to act because if we don’t arrest its progress then its consequences become so damaging that they will destroy us.
When we realise that the problem is within ourselves then we see too that the solution also lies with us. Changing other people does not fix the problem, changing jobs does not fix the problem, moving somewhere else does not fix the problem, and winning the lottery will not fix the problem. All these things do is move us away from a few triggers for a while but we will quickly create new ones for our new circumstances and all our existing triggers still remain exactly as they were. While we may remove ourselves from a few triggers relating to certain places or people that is all we achieve. The other triggers remain in full force; triggers relating to times of the day, triggers relating to adverse emotions, the sight of alcohol, the sounds associated with alcohol, places where alcohol is sold and so on. Changing where we live, our job, or our social circle only prevents a very few triggers from being fired but all the other triggers continue to operate exactly as they did before, so we can’t move away from our addiction because our addiction comes with us. The only way to escape alcoholism is to remove the vigour from our drinking triggers and the way we achieve this is by making them consistently fail to deliver alcohol.
If we are able to sustain our effort to stop drinking then all of the defensive changes that came with alcohol-tolerance become unnecessary and our brain begins to remove them. The first of these noticeable changes is that sleep returns and following that we find that anxiety fades and the agitated churning of our mind calms down. There is nothing we have to do to make the fear, anxiety, restlessness, racing mind and hopelessness disappear. Our brain will slowly correct these as long as we don’t drink.
Success lies in overcoming cravings for a sustained period. The experience of cravings is the same whether this craving comes as a nostalgic notion of how pleasant a drink would be, or whether it comes as the primal scream that demands that we drink now. First we get the urge to drink that has been launched because we have found ourselves in the circumstances of a trigger. The intensity of the craving depends on how many times that particular trigger has been successful in delivering alcohol and how close we are to the circumstances of that trigger. Our brain releases dopamine to motivate us to drink and our attention is focussed on securing alcohol. What we have to do then is to interrupt this automatic process and contradict it. We have to recognise that this urge is not what we actually want to do and that our brain has made a mistake. We have to recognise the unwanted motivation and reject it. We have to do this time after time, hour after hour, day after day and we have to do it successfully every single time. A single failure to intercept and overcome this urge will cause us to relapse. It is an exhausting process at first because the cravings come back to back and beating them seems never ending, but every time we overcome a craving is progress. We gradually reduce the challenge of these cravings by taking the power out of them, one craving at a time, and one trigger at a time. It seems at first that we are making no progress, the challenge seems relentless, but each craving we overcome brings us closer to the point that we can get past them without breaking our stride, and that is the goal with cravings. We can’t stop them completely, the triggers remain forever, but we can reduce their power to a point that the cravings they launch no longer interfere with our day. But unfortunately this general behaviour of triggers is not the whole story when it comes to emotions because the triggers associated with emotions have some qualities that pose additional challenges. Regular triggers are fired by a specific location or occurrence that relates to alcohol, but our emotional triggers are fired depending on how we feel regardless of what has caused the emotion. This means that the normal remedy of moving away from the location of the trigger will not work because the trigger moves with us; we are the trigger. And while a regular drinking trigger will launch a craving that rises to a peak and then passes our emotional triggers may not. For example, if we have a trigger associated with feeling down, a “poor me” trigger so to speak, then it will launch an urge to drink. But when that craving fades it is perfectly likely, unless we have done something to change our mood, that we will still be feeling sorry for ourselves, so a new craving will be launched as soon as the first one has faded. This is enormously difficult to manage because if we do nothing to change how we feel then the cravings will keep coming until our resolve is depleted and we drink. But not only are emotional cravings likely to keep coming they are also going to be very powerful and this is due to a general property of how our brain works.
Our brain pays more attention to what’s happening in our mind if it is accompanied by emotion: it remembers them more strongly. It does this because if emotions are present then whatever is happening is particularly significant for some reason. Our brain remembers things more firmly when emotion is high and this makes the action of strengthening a trigger work more powerfully. If we drink in response to a trigger and we do so at a time of heightened emotion then we not only strengthen that trigger, we strengthen it a lot. This means that the drinking triggers we build for emotions are guaranteed to be strong ones, or if they are not then they soon will be.
There are two general routes into addiction. One way is to start drinking and then the slowly strengthening triggers cause us to drink more and more. This brings on the emotional changes caused by alcohol-tolerance and these lock our addiction into place. The other path is that some persistent distress or trauma causes us to drink over an extended period. The need for relief causes us to drink and this causes our drinking triggers to strengthen. Then alcohol-tolerance sets in and this traps us into drinking to relieve the symptoms that are themselves caused by drinking. If at this point the original distress is removed then we still drink because we are trapped by the consequences of long-term drinking. But this does not happen to normal drinkers. This point has been made before but it needs repeating in the context of emotional triggers. If a normal drinker suffers some distress over an extended period then they strengthen drinking triggers and bring on alcohol-tolerance in exactly the same way as we do. But at the same time as they strengthen drinking triggers they also strengthen alcohol-avoiding triggers and this makes them behave quite differently if the distress ceases. Firstly the alcohol-avoiding triggers will often steer them away from drinking excessively (thus slowing further strengthening of the drinking triggers) and this keeps their drinking somewhat moderated. But also, if the cause of the original distress is removed then they have alcohol-avoiding triggers that will spontaneously return their drinking to a regulated level. We do not have that. We do not have effective alcohol-avoiding triggers, so regardless of whether we drank while we were younger and this strengthened over time, or we drank to escape some significant distress or trauma, then the consequence is the same: our reward system enters a runaway state and then the emotional changes of alcohol-tolerance lock addiction into place. In neither case is the amount we drink the root cause of the problem and in both cases the problem is the absence of the alcohol-avoiding triggers. We don’t become alcoholic simply because we drank too much; that is insufficient. We became alcoholic because we drank regularly and we do not form alcohol-avoiding triggers successfully. If our route into addiction was that we were drinking to gain relief from some trauma then counselling that eases this trauma may remove some of that distress but it does not make us able to drink normally again. Yes, it may lift that particular pain from our lives, but it does not create the ability to form alcohol-avoiding triggers, so we remain captured by addiction.
Alcoholism and emotions are tightly bound. If we lack the ability to make effective alcohol-avoiding triggers and then drink regularly, for whatever reason, we will end up in the position that we are compelled to carry on drinking because of the emotional consequences of that drinking. This is what happens to us, but other people have alcohol-avoiding triggers that keep their drinking moderated.
Lacking the normal means to keep our drinking in check explains why we can’t control our drinking, but this does not make us entirely blameless. While we drank we did terrible things; things that brought enormous shame and guilt on ourselves, and things that hurt others. We may have done these because our judgement was compromised by alcohol but we still did them and we can’t ignore this because the shame, guilt, and remorse caused by these all fire drinking triggers when we dwell on them. In the short term these may fire a trigger that breaks our determination to stop drinking, but in the longer term they steadily corrode our resolve.
It is essential that we do whatever we can to relieve the burden of guilt and shame that we carry and that we take steps to mitigate any trauma we have suffered at the hands of others, because failing to do so will result in relapse.