How Does Alcohol Affect You Emotionally

Alcohol initially has a positive effect on emotions, increasing confidence and providing stress and anxiety relief [1]. 

Conversely, long term alcohol use causes depression, anger and anxiety [2].

Mental & Emotional Effects Of Alcohol

Alcohol, Emotions, & Pre-Existing Mental Health Issues

Alcohol consumption while suffering from a mental health disorder causes difficulty maintaining abstinence, and may increase the risk of attempted suicide.

Of an estimated 589,000 people who are dependent on alcohol in the UK, around a quarter have a pre-existing mental health condition [9].

The effects of drinking can mimic disorders such as antisocial personality disorder, as both cause aggressive behaviour, sadness and irritability.

Specific Mental Health Conditions, Emotions, And Alcohol

Anxiety

Marsh et al found that anxiety decreased after alcohol consumption, but increased the day after drinking, which is linked to an increased risk of alcohol use disorder [11].

Alcohol consumption increases gamma aminobutyric acid (GABA) levels, resulting in short term feelings of calm.

However, the brain becomes reliant on alcohol (nerve receptors become habituated) leading to the need to consume increasing amounts of alcohol to maintain the same emotional state [12].

Depression

Wu et al found that participants with childhood depression were twice as likely to abuse alcohol in later life [13].

Alcohol also lowers the effectiveness of antidepressants, worsening symptoms of depression, resulting in users relying even more on alcohol [14].

The National Institutes of Health Clinical Centre found that alcohol breaks down serotonin faster than in non drinkers, leading to depression [15].

Post Traumatic Stress Disorder

Brooks Holliday et al found that post traumatic stress disorder causes alcohol misuse amongst veterans [16].

PTSD causes an increase in alcoholism for its sufferers, women being 2.5 times more likely and men being 2 times more likely to develop both disorders concurrently [17].

A theory proposed by Khantzian is that individuals with PTSD self medicate using alcohol to numb symptoms of PTSD [18].

Using Alcohol To Manage Emotions

Thomas, Thevos and Randall found that 23% of patients being treated for alcoholism also suffered from social anxiety, which only affects 7% of non drinkers, suggesting a correlation between the two.

Social anxiety sufferers use alcohol to avoid physical symptoms, such as sweating and heart palpitations [19].

Alcohol, Emotions And The Cycle Of Addiction

The cycle of addiction has three stages, each affecting the emotions differently.

The stages may occur from over the course of weeks or month to several times a day:

During this emotional cycle, the brain becomes addicted to the reward chemicals it gets from alcohol.

Alcohol also suppresses self-generated neurotransmitters being produced in the brain, meaning alcohol is now required by the brain to function correctly, causing constant cravings [21].

Unintended Effects Of Alcohol On Emotions

Alcohol acts as a disinhibitor, weakening neurotransmitters (GABA) that restrain against impulsive and dangerous behaviours, such as aggression [22].

The disinhibiting effect of alcohol also causes the user to be less concerned about consequences of actions, e.g. legal and physical repercussions of violence.

Alcohol is involved in 50% of all violent crimes in the UK [23].

Alcohol causes depression, and is a factor in 43% of suicides [24].

Does Alcohol Make You Sad?

Short-term, alcohol causes excess free dopamine and serotonin[3], resulting in feelings of happiness during intoxication, but increased feelings of sadness during hangover.

Why Does Alcohol Bring Out Emotions?

Increased emotions when drinking alcohol are due to:

Does Alcohol Cause Mood Swings?

During active drinking, alcohol drives both excess and deficiencies in multiple neurotransmitters.

However, during hangover, the brain must redress these balances by downregulating and upregulating production of neurotransmitters, and the number of receptor sites.

During this normalisation period, the corresponding lows and highs in available neurotransmitters which regulate mood activity, will cause mood swings.

Emotional Effects Of Alcohol In Long Term Addiction

Long term alcoholics stop experiencing the same positive feelings as casual drinkers, and either start to experience negative emotional effects, or develop tolerance.

O'Daly et al found that alcoholics struggle to process emotional responses of others, exacerbating social isolation, and further dependence on alcohol [26].

An alcoholic's personality will alter when their drinking continues for long periods of time, as they become dependent on alcohol and require it to function [27].

Effects on the personality of long term drinkers include:

Recovering these longer term changes in behaviour usually only occurs following primary care rehabilitation that tackles the underlying drivers of addiction, and a comprehensive aftercare follow up programme, adhered to closely.

Those At Greater Risk Of Emotional Reaction To Alcohol

The Ethnicity and Alcohol Review in 2010 states that ethnic groups such as women from South Asian ethnic groups are being reported as having higher rates of alcohol use, which as they are expected to be abstinent, indicates drinking alcohol as a result of negative emotions and becoming hidden drinkers [33].

Ashton et al surveyed a group of drinkers to ascertain their emotional response to alcohol, with the exception of aggression, women reported experiencing more emotional responses than men, with 18-24 year olds reporting the most emotions when drinking [34].

Emotional Response Relative To Alcohol Intake Level

Emotions, Alcohol, & Addiction Treatment

Recovering alcoholics experience turbulent emotions as the body attempts to normalise levels of serotonin and dopamine, regulating mood [37].

Combined with the loss of emotional numbing that alcohol provides, and negative emotional effects of withdrawal, addiction treatment may cause an increase in negative emotional effects.

When going through treatment, alcoholics may experience dry drunk syndrome, which has similar symptoms to active drinking [38].

If alcohol addiction begins as a way to cope with unmanaged emotions, these emotions will return during recovery, as well as other emotional side-effects resulting from alcoholism itself [39].

Extremes Of Emotional Response To Alcohol

Ness et al found that alcohol was involved in 58.4% of self harm cases in England [40].

Larkin et al found that alcohol consumption causes self harm cases, as well as suicidal attempts and acts [41].

Drinking may cause an increase in impulsive behaviour, as well as releasing pent up emotions, causing the desire to want to self harm or commit suicide [42].

Melson et al, in a study of 1546 adults, found that from those who self harmed, frequent heavy drinking was a factor in 95% of cases [43].

Emotional Response To Alcohol vs Other Substances

Substances such as cocaine or amphetamines are classed as stimulants, as they increase blood pressure and heart rate, as well as causing insomnia, anger or paranoia [44].

(Read about amphetamine detox here.)

Conversely, alcohol is a depressant, causing decreased heart rate and blood pressure, as well as drowsiness [45].

Stimulants increase dopamine levels, causing short-term increased happiness, whereas depressants reduce the function of the central nervous system leading to negative emotional states [46].

Positive Emotional Responses To Alcohol

Weiss et al found that among 165 students, alcohol use was linked to stressful yet positive situations, such as starting a new job or going on a first date [47].

Research suggests that drinkers see humour appreciation as one of the top benefits of drinking, as well as enjoying social interactions [48].

Geiger et al found that participants were happier when drinking alcohol than not drinking alcohol [49].

Casual drinkers are likely to experience positive emotions as alcohol produces dopamine and serotonin, whereas long term alcohol abuse lowers blood sugar and causes dehydration, resulting in increased negative emotions [50].

Alcohol, Emotions, And The Brain

Alcohol alters the brains' reward pathways, resulting in alcohol cravings, eventually leading to the brain being unable to function without it (alcohol dependence) [51].

Alcohol abuse also affects the hippocampus, the part of the brain that regulates emotions, causing reduced ability to control emotions [52].

When consuming alcohol, gamma aminobutyric acid levels are increased, producing feelings of calm.

With repeated intoxication over time, the brain becomes reliant on alcohol, leading to alcohol abuse disorder [12].