E336: Why You Feel Like You Need Alcohol to Relax (Alcohol and Stress)

0:00Amanda D. D. Roberts: A lot of us drink because we wanted to relax. You get through the workday, deal with everyone who needs something from you, finish whatever you can around the house, and finally have a little time to yourself. But being done for the day doesn't mean that you feel done. You're still thinking about everything that happened, what you didn't finish, what you have to do tomorrow, or something someone said that bothered you. You're probably exhausted, but you can't settle down. And alcohol gives you a way to change how you feel without having to figure out why you feel that way. It makes your thoughts less important.

0:36Amanda D. D. Roberts: You feel less bothered by things. You can sit on the couch without mentally going through everything that you still need to do. When something gives you that kind of relief, it makes sense that you would want to keep using it. And soon enough, you start looking forward to the end of the day because that's when you finally get to take a break. But how you feel after a drink doesn't tell you everything about what alcohol is doing. If you only look at the period when you feel relieved, it's easy to conclude that alcohol helps you manage stress. You were tense, you drank, and you felt better. What's harder to figure out is whether repeated drinking is contributing to how you feel during the rest of your day.

1:19Amanda D. D. Roberts: Would you feel this stress without alcohol in your life? Would relaxing still be this difficult? Or has drinking become part of the reason that you feel like you need to drink? We can't answer these questions just by noticing that a drink feels good. We have to look at what happens to the systems in the brain and body that respond to stress. Researchers have found differences in how those systems function in people who binge drink or have alcohol use disorder, and it's more complicated than simply having too much cortisol. What your body is doing before something stressful happens, how it responds when that thing happens, and how you feel about it are different parts of the picture.

2:00Amanda D. D. Roberts: In this episode, I'm going to explain what the research tells us about alcohol and your stress system, why short-term relief doesn't necessarily mean that drinking is helping you cope over time, and how stress can become connected to the motivation to continue drinking. So let's start with what happens when you drink after a stressful experience because understanding why alcohol feels helpful is part of understanding why we become so attached to it. I used to have one cat, Rudy, who you've probably heard meowing in the background of many of my episodes, and recently I adopted a tiny little orange cat named Liza.

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4:01Amanda D. D. Roberts: alcohol can change the hormonal response after a stressful experience if you drank to relax you weren't necessarily imagining that something happened. We don't have to pretend that alcohol never gave you any relief to understand why relying on it became a problem. A study published in 2016 looked at what happened when 24 healthy men drank either alcoholic beer or alcohol-free beer immediately after two stressful lab tasks. One involved public speaking and mental math while being evaluated, and the other was the Stroop task. The researchers weren't just asking people to imagine having a stressful day.

4:44Amanda D. D. Roberts: They put them in situations that were designed to produce measurable stress response and then looked at what happened afterwards. And the alcoholic beer contained about 26 grams of alcohol, which is just about two standard drinks. The researchers were measuring cortisol and the hormone that comes from the pituitary gland and tells your adrenal glands to release cortisol. So cortisol and then the hormone that comes before cortisol. After the stressful tasks, these hormones declined more in the men who drank alcoholic beer than the ones who drank non-alcoholic beer. And alcohol didn't change their heart rate, so the finding was specific, it affected the decline in these stress hormones, but it didn't change every measure of the stress response.

5:34That gives us evidence for an immediate hormonal effect, but it didn't tell us whether those men became better at managing stress, whether drinking every evening would have the same

5:44Amanda D. D. Roberts: effect, or how they would feel the next day. We can't use a short-term decline in cortisol to answer those questions. And this is where it's easy to make a much bigger conclusion than the evidence supports. You feel stressed, you drink, and you feel better, so you decide that alcohol helps you relax. That may describe your experience during part of the evening, but it doesn't tell you whether drinking is making your life more manageable overall. You can get relief without becoming more capable of handling the situation that made you want relief. Drinking can make an uncomfortable conversation feel less important for a few hours, but it can't tell you whether you need to address it, accept it, or stop analyzing it.

6:28So when we talk about alcohol and stress, we need to look at more than whether you felt better after a drink. We have to look at what happens with repeated drinking, what your stress system is doing in between drinking sessions, and whether your response to stress changes over time. So to understand what changes with repeated drinking, we first need to understand what it means for the stress system to become dysregulated.

6:53Amanda D. D. Roberts: And this doesn't necessarily mean that your cortisol is always high or your body is constantly producing a dramatic stress response. Your stress system can change in a few different ways. One of the main systems involved in the stress response is the hypothalamic-pituitary-adrenal axis, or the HPA axis. When your brain detects a threat or a challenge, your hypothalamus starts a sequence of signals that eventually tells your adrenal glands to release cortisol. And then cortisol helps mobilize energy and prepare you to respond to whatever is happening. Once the challenge has passed, cortisol should decline and the system should return to baseline.

7:37And there are several parts of this response. You have the baseline before anything stressful happens. stress reactivity, which is how much cortisol changes in response to a stressor, and then recovery, which is how quickly it returns to baseline. A 2020 study compared 62 recently detoxed people with alcohol dependence with 68 healthy controls.

8:03Amanda D. D. Roberts: And the researchers measured cortisol in two ways. First, they looked at cortisol in the participants' hair, which gave them an estimate of cumulative cortisol secretion during a period that included active drinking and withdrawal. And then after withdrawal was over, the participants went through a stress test so that researchers could measure cortisol before and after a stressful experience. The former drinkers had higher hair cortisol concentrations suggesting greater cumulative cortisol secretion during the period that included drinking and withdrawal, but then during the lab stress test after detoxification was over, their cortisol levels were lower both before and after the stressor compared to the control group that didn't have a problem with alcohol.

8:53And this is why it's not really helpful to reduce the relationship between alcohol and stress to alcohol raises cortisol. Sometimes alcohol increases parts of the stress response and sometimes it appears to reduce part of the response. Cortisol is not a direct measurement of how stressed you feel either. You can have a smaller cortisol response and still feel anxious, overwhelmed, and desperate for relief. And likewise, you can also have elevated cortisol without feeling panicked. The hormonal response, your emotional experience, and your behavior are all related, but they're not interchangeable.

9:32When the stress system is dysregulated, its activity

9:35Amanda D. D. Roberts: may not match the situation in the way that we would expect. The system may be more active when nothing significant is happening, and then less responsive when a challenge or a threat occurs. Over time, alcohol becomes part of the regulation process. The body becomes activated, alcohol changes the state and your brain learns that drinking is how activation ends. Eventually, we start interpreting ordinary stress as something that we can't tolerate because we're so used to shutting things down as fast as possible. And then we get fewer opportunities to experience stress rising, passing, and resolving without alcohol.

10:18And this doesn't mean that alcohol caused every stressful feeling you ever had. We all have demanding jobs, unhappy relationships, financial pressure, anxiety, trauma, or responsibilities that are genuinely overwhelming. Getting sober doesn't make these things disappear, but alcohol can become mixed into the way that you respond to those problems, which then makes it difficult to separate the original stress from the pattern of repeatedly using alcohol to manage it.

10:48Amanda D. D. Roberts: And you don't have to drink every day or have hardcore binges for there to be differences in how your stress system responds. Studies comparing binge or heavy drinkers with moderate drinkers have found the same types of patterns, including stronger cravings and a smaller cortisol response to stress. For example, a 2019 study looked at binge and heavy drinkers compared to moderate non-binged drinkers. None of these participants had alcohol use disorder, which is important because we're great at minimizing how bad our drinking is and what consequences we've experienced. So then we put people that do have a problem in an other.

11:33Every participant completed three sessions. In one, they listened to a personalized description of a stressful experience from their own life. Then they listened to a personalized alcohol scenario, and in the third, they listened to a neutral relaxing scenario. Afterwards, alcohol was placed in front of them for what they thought was a taste test, but the researchers were really measuring how much they drank. And they also measured craving and cortisol throughout the experiment. Both groups drank more after the stress and alcohol scenarios than they did the relaxing scenario, so context obviously matters.

12:14Thinking about stress or alcohol increases the motivation to drink, but this effect was stronger in binge and heavy drinkers. They experienced more craving in response to both stress and alcohol cues, and then those cravings predicted how much alcohol they drank during the taste test.

12:33Amanda D. D. Roberts: The binge and heavy drinkers also had lower cortisol responses overall. And within this group, a more blunted cortisol response predicted greater alcohol consumption after the stress scenario. And again, a smaller cortisol response doesn't necessarily mean that these people were less stressed. The binge and heavy drinkers had stronger cravings and drink more even though their hormonal response was lower. So their subjective experience, motivation to drink, and cortisol response weren't all moving in the same direction. The researchers described this as a combination of sensitized craving and a blunted cortisol response.

13:17So sensitized craving is really important. It means that stress and alcohol-related situations have become more effective at generating the desire to drink. And blunted cortisol means the hormonal response to those situations has become smaller. So the motivation to drink can get stronger, while part of the physiological response can become less reactive. Remember, cortisol is there to help us deal with stress. It doesn't make us necessarily feel stressed.

13:49Amanda D. D. Roberts: A 2023 study found a similar pattern in 33 binge drinkers and 31 non-binging social drinkers. So participants looked at alcohol and water images during separate brain scans. And researchers collected blood samples to measure cortisol. And after each scan, the participants completed another alcohol taste test. and then the researchers followed their drinking over the next month. The binge drinkers had a smaller cortisol response to alcohol cues than the non-binging social drinkers. Within the binge group, a more blunted cortisol response was associated with drinking more during the taste test and then consuming more alcohol over the next month.

14:39The researchers also found a relationship between cortisol and activity in the ventromedial prefrontal cortex, which is a part of the brain that is involved in evaluating the importance and value of cues. So this doesn't mean a low cortisol response will make someone binge drink, or that everyone who binges has the same stress biology. The two groups did not differ in their baseline cortisol levels. The difference was only in how they responded to alcohol cues. What these studies show is that heavier drinking is associated with a different response to stress and alcohol-related cues, regardless of whether or not you think you fit the criteria for having a problem.

15:26And this may help explain why drinking can start to feel automatic. In the beginning, you consciously

15:34Amanda D. D. Roberts: decide to drink after a hard day because you want to relax. But after enough repetition, stress and the surrounding context can begin generating craving before you've deliberately decided what to do. The cue doesn't have to be a huge crisis either. It can be finishing work, walking into the kitchen, sitting in your usual chair or on your usual couch, feeling irritated with your family or just noticing that it's five o 'clock. If those situations repeatedly end with alcohol, your brain can begin anticipating alcohol as soon as they occur. That's why reminding yourself that alcohol is unhealthy isn't enough to change what happens at the end of the day.

16:19The urge isn't based on what you believe about alcohol. Your brain has learned to anticipate alcohol in that context. And then heavier drinking may also be accompanied by changes in the hormonal response to alcohol-related cues. Plus, the brain gets sensitized to these cues, making them feel more important and urgent.

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18:05Alcohol use disorder isn't only about pursuing pleasure. As drinking becomes more established, alcohol can become increasingly connected to escaping or reducing a negative state. It's not just valuable because it produces relaxation, excitement, or pleasure. It's also valuable because having alcohol means we don't have to feel bad. And similarly, not having alcohol means we do feel bad. This is the shift from positive reinforcement to negative reinforcement as we lose the option to choose not to drink or to choose to stop drinking once we start. Positive reinforcement means that you repeat a behavior because it adds something that you want.

18:48You drink and you feel relaxed, confident, excited, or whatever. Negative reinforcement means that you repeat a behavior because it removes or reduces something that you don't want. You drink because you feel tense, irritable, restless, anxious, or just uncomfortable, and alcohol makes that go away. Both types of reinforcement make drinking more likely to happen again, but negative reinforcement can create the feeling that alcohol is not optional. Alcohol changes our state instantly, so the brain learns that drinking ends discomfort. When alcohol wears off or it's not available, the uncomfortable state remains or returns, and your brain generates more motivation to use the same solution.

19:36Removing alcohol interrupts that loop, but your brain and body still need time and repeated experience to learn that activation can pass without drinking. And then you also have to develop ways to respond to stress that don't depend on shutting it down as quickly as possible. Removing alcohol doesn't immediately return the stress system to whatever it looked like before you started drinking either. Your brain and body need time to adjust, and the circumstances that made you feel stressed are probably waiting for you. A 2017 study followed 41 men after they completed residential treatment. They'd been abstinent for four to six weeks when the researchers brought them in and then measured how their HPA access responded to several different challenges.

20:28After the men left treatment, researchers followed their drinking and ongoing life stress for 24 weeks. Greater life stress was associated with more intense drinking after treatment. It wasn't associated with drinking on more days, but when they did drink, they consumed more alcohol. Among men experiencing higher levels of ongoing stress, greater adrenal sensitivity was associated with more drinks on a drinking day. Your body may still be adjusting to the effects of repeated drinking and withdrawal at the same time that you're returning to the same job, relationship, financial pressure, loneliness, or overwhelming responsibilities.

21:12You don't have your fastest source of relief, but you haven't developed a different relationship with stress yet. That creates a very vulnerable period when the reasons you want relief are still there, and your brain knows exactly which behavior will provide it and you're not sure what else you can do. And that's why just don't drink is technically correct but it's very difficult. Not drinking protects you from restarting the cycle but you also have to look at the life that you're trying to stay sober in. If you were using alcohol to get through a life that was chronically overwhelming sobriety probably requires more than sparkling water and waiting for the urge to pass.

21:59You may need to reduce something, leave something unfinished, set a boundary, ask for help, have a difficult conversation, or just acknowledge that part of your life isn't working. You may need to practice allowing ordinary activation to pass without immediately turning it off. Those are two different problems. Sometimes the stressor needs to change, and sometimes you need to increase your ability to experience stress without treating it like an emergency. It's difficult to tell which problem you have because alcohol gave you the same response to both. Whether you were facing a genuinely unmanageable situation or just simply feeling uncomfortable for a few minutes, alcohol allowed you to shut your brain off.

22:43Sobriety requires you to make a specific assessment. Is there something in my life that needs to change or do I need to allow this feeling to pass? This is also why I don't want you to interpret difficulty relaxing and early sobriety as proof that alcohol is the right thing to have in your life. You removed the thing that changed your state quickly, but you may still have an altered stress response, a learned association between stress and drinking, and actual problems in your life. So of course you don't immediately feel relaxed. If you spent years teaching your brain that stress ends with a drink, it's going to take repeated experiences to learn something different.

23:27You need opportunities to feel stress without drinking, to respond to actual problems when you do have one, and to discover that activation can pass on its own without alcohol. So what does all of this change about the thought, I need a drink? First, it means you don't have to argue with yourself about whether alcohol helped you relax. It did. Alcohol reduced your awareness of what was bothering you. It made your thoughts feel less important and it slowed them down and it changed part of your hormonal stress response. The relief is one reason that your brain learned that alcohol is very valuable.

24:06However, immediate relief and effective stress regulation are not the same thing. When alcohol starts feeling necessary for relaxation, it's not simply solving a stress problem that exists independently of your drinking. Alcohol probably became part of the problem. Eventually, not drinking may feel stressful because your brain has learned to expect alcohol whenever you feel stressed. So you may start believing that you're someone who can't relax, when what you actually have is one very practiced way of relaxing that makes every other option feel too slow or like too much work. Real stress regulation means waiting for the activation to pass without doing anything to force it away, going to bed, eating, or having a quiet night, setting a boundary and tolerating someone's reaction, or admitting that you're lonely, resentful, overwhelmed, or unhappy with something.

25:04A drink makes all of these problems feel less important for a few hours, but it doesn't tell you which problem you have. Alcohol gave you one response to manage stress. Make it go away as fast as possible. Sobriety gives you the opportunity to become more specific. You can rest when you need rest. Take action when something needs to change. Ask for support when you need connection. And allow activation to pass when nothing needs to be fixed. Learning to relax without alcohol isn't about finding one replacement that changes your state just as quickly. It's about identifying what kind of stress you're experiencing and responding without making the problem worse.

25:48If relaxing feels difficult after you quit drinking, it doesn't mean alcohol was the only thing that worked for you. Your brain practiced one response for a very long time, and now you have to learn a different one. That just takes time and practice. Understanding what's happening can make your experience feel less confusing, but understanding the pattern isn't the same as changing it. You need opportunities to notice your stress earlier, figure out what you actually need, and practice responding differently with support from people who understand why this can be so difficult and maybe people who are working on it alongside you.

26:29This is the type of work that we do inside Living a Sober Powered Life. It's a community for people who have decided to quit drinking and want help making sobriety stick. We meet throughout the week to talk about the patterns underneath drinking, build the emotional skills that alcohol allowed us to avoid, and learn how to handle stress and discomfort without going back to the same solution. You don't have to wait until you're struggling, seriously considering drinking, or until you have some amount of sober time to get support.

27:01Amanda D. D. Roberts: In fact, it's much easier to build these skills before you reach a crisis point. If you want to understand your patterns and create a version of sobriety that feels more stable and sustainable, you can learn more about living a sober-powered life in the show notes. I would love to have you join us, and I will talk to you next week.

27:41You