Towards the end of my drinking days, I noticed that I had difficulty thinking clearly.
I was no longer able to tap into my “zone” and do my work. Additionally, I had zero interest in having a remotely complex thought and struggled to function some days on even a basic level.
I forgot things. I had to write everything down because I was incapable of remembering something in the short term for longer than a few minutes.
We often laugh about moments when we walk into a room and have no idea why we came in there, but that was becoming normal.
What the Experts Say About Alcohol & The Brain
It’s common knowledge (or at least, it should be) that when we’re drinking alcohol, our brains become impaired.
We slur, we slow down, we forget things, we blackout, or we make bad decisions.
For heavy drinkers, though, the lasting impact is more severe. Alcohol can impact our brain’s hard-wiring and produce cognitive problems that may persist even in sobriety.
Heavy drinkers are also at risk of impaired intellectual functioning and diminished brain size.
Let’s do a deep dive into what is actually happening in the brain when you drink heavily for extended periods of time.
Thiamine Deficiency in Heavy Drinkers
A common problem in heavy drinkers is thiamine deficiency. Thiamine is your B1 vitamin and it is an essential nutrient for our body’s tissues, which includes your brain.
The only way to get thiamine is to ingest it via food and supplements. It is naturally occurring in meat, pork, poultry, whole grains, nuts, dried beans, peas, and soybeans.
Many of our food is fortified with thiamine because, well, it’s a really important nutrient. It shouldn’t be a problem, but because of what alcohol does to our judgment and digestive health, it can be a very serious one!
Why are drinkers at risk for thiamine deficiency?
As many as 80% of alcoholics have a thiamine deficiency. It’s largely a result of terrible nutrition, which is also common among heavy drinkers.
Additionally, heavy alcohol consumption causes inflammation in the stomach lining with leads to malabsorption of important nutrients, like thiamine.
Signs of thiamine deficiency include:
- Fatigue and muscle weakness
- Loss of appetite
If left untreated (meaning you do not improve your diet and get sober), it can lead to a severe condition called Wernicke–Korsakoff syndrome (WKS).
What is Wernicke-Korsakoff Syndrome?
Wernicke-Korsakoff Syndrome (WKS) is a very serious disease. Actually, it’s more like two diseases in one.
Wernicke’s encephalopathy is a serious brain injury that results from a lack of thiamine.
The symptoms of Wernicke’s include:
- double vision
- a drooping upper eyelid (ptosis)
- up-and-down or side-to-side eye movements
- loss of muscle coordination (ataxia)
- a confused mental state which can lead to combative or violent behavior
It is usually reversible with swift treatment and intervention (including sobriety), but if left untreated, will develop into WKS.
Korsakoff’s Syndrome is characterized by severe short-term memory loss and an impaired ability to learn new information.
Additional symptoms of WKS include:
- difficulty understanding the meaning of information
- difficulty putting words together
Treatment for Wernicke-Korsakoff Syndrome
Diagnosis requires immediate intervention to have a chance at reversing or at least stopping the progression of the disease.
It often requires hospitalization to receive B1 treatments intravenously and requires long term monitoring and treatment for alcoholism.
Alcohol Literally Changes the Structure of Your Brain
When you drink alcohol, it blocks chemical signals between brain cells, resulting in a state commonly referred to as drunk as f*ck.
It’s why you slur your words, make dumb decisions, and move like a blind zombie.
Drink heavily enough for long enough and the brain begins to adapt to these blocked signals, and not in any kind of healthy way.
Neurotransmitters Gone Wild
Neurotransmitters are very important chemical messengers of the brain. They carry, boost, and balance messages between the neurons and cells in our body.
They are the key to everything that makes our bodies work.
So naturally, sustained periods of heavy drinking make them go a bit berserk.
Alcohol inhibits a very important excitatory neurotransmitter called glutamate, which is a real bummer because glutamate does pretty cool stuff like help us learn and remember things.
Then there’s the extremely important inhibitory neurotransmitter GABA.
Alcohol & GABA
Our brains are in a frenzy of activity. GABA helps calm excitable neurons that would otherwise be firing on all cylinders. This is a fantastic process that long-term drinking screws up.
Alcohol increases GABA and decreases glutamate. It also increases dopamine in our brain’s reward system while at the same, decreasing dopamine receptors.
When this happens, the brain adjusts.
If alcohol is going to artificially increase GABA and dopamine as well as decrease glutamate, your brain effectively says, “Well okay then. I guess I’ll produce less of this stuff.”
It changes its chemistry.
When you experience severe withdrawal symptoms, it’s your brain’s way of trying to restore the chemical balance once again. Essentially, your brain chemistry no longer functions properly without alcohol.
Alcohol damages and shrinks the circuits our brain relies on to communicate with itself. The primary areas affected are the cerebellum and frontal lobe.
The frontal lobe is the area of the brain responsible for decision-making, inhibition, judgment, and problem-solving. The cerebellum regulates motor function and coordinates things like balance, posture, speech, and other voluntary muscle activity.
(You can see where alcohol might be problematic here.)
It also does quite a number on our brain’s reward system. Prolonged alcohol abuse changes the chemical structure of the brain in such a way that we become compulsive in our desire to drink.
Alcohol shrinks your brain. Long-term heavy drinking shrinks the gray and white matter in our brain.
The connections that form gray and white matter in the brain are responsible for important things like learning new information, impulse control, and self-regulation.
The more you drink, the more you damage these critically important areas of the brain.
How Shakespearean that alcohol damages the very parts of the brain that we need to use in order to control and quit drinking.
What Happens To Your Brain in Early Sobriety
Here’s a little peek into my own experience.
The first couple of months of sobriety were peppered with emotional ups and downs.
I had peak energy days and total, depressive crashes.
To be perfectly honest, I was not stable. With the additional hormones and pregnancy complications wreaking havoc on my body, it was no wonder.
This is normal.
The brain is scrambling to adjust to this new, alcohol-free environment it had come to rely on. Your brain’s reward system is taking a major hit.
When you first quit drinking, you may experience a state called anhedonia which is a pretty way of saying you feel like life will never be pleasurable or happy again.
It is still hard for me to know what was anxiety and what was hormonal. I felt like my body was trying (and failing) to reboot.
Some days I felt good, but many days I did not.
I wasn’t drinking, but I was so wrecked from all the changes in my internal world that I often came home and retreated to my couch and would remain there until I went to sleep.
In my lower moments, I began to wonder if this was it.
I’d eliminated the hangovers, but was this exhausted, unmotivated woman crashed out on the couch my new, real self?
I was depressed all over again. This was my anhedonia and I was afraid it would last forever.
Other common complaints are brain fog, irritability, insomnia, and increased anxiety.
And then slowly, things got better.
Things Start to Improve
Eventually, I began to notice a marked improvement, even on days when I felt otherwise stressed or frazzled.
My hormones were still all over the place. I cried VERY easily. Headaches invaded my skull several times per day, and I was unable to wake up and function properly without special medication to keep from vomiting (shout out to hyperemesis gravidarum).
Despite all of that, still felt better overall, which is kind of wild to think about.
Even though my pregnant body was ravaged by exhaustion, I was still able to read for at least thirty minutes a day, usually more.
I wrote nearly every day.
Books excited me once again. Ideas started catching fire and I felt better than I had in years, even though I was nauseous 60% of my day and had ceaseless headaches and pregnancy eczema that made wearing clothes feel like a small torture.
How the Brain Starts to Recover From Years of Alcohol Abuse
Within fourteen days, the brain starts to repair itself and retain some of the volume lost from drinking.
That’s good news!
Research has also found that new, healthier neural connections can be made in recovery thus improving cognitive function.
After the first week of sobriety, the cell growth in the hippocampus increases two-fold. Between the first week and first month, increases in gray brain matter and white brain matter start to appear.
If you want to expedite the process, you can use the following lifestyle changes to help rebuild neural connections and restore the gray and white matter to your brain:
- Eat a well-balanced diet of whole foods
- Get enough exercise
- Prioritize sleep
- Meditate. Meditate. Meditate.
Don’t be afraid to get help!
The brain can repair itself. Maybe not as quickly as we’d like, but there is light at the end of this blurry, foggy tunnel.
If you feel overwhelmed, talking to a therapist or counselor can help.
I personally use BetterHelp for counseling and highly recommend it to anyone looking for alternatives to in-person therapy (which is most of us need these days). Please note that Soberish is now proudly sponsored by BetterHelp.
You can click to read more about my decision to get counseling and why BetterHelp was such a good option for me.
As always, feel free to reach out to the Soberish community on Facebook if you’re in need of additional support. We are here for you!