Department of Psychiatry
Penn Behavioral Health

PAH Outpatient Behavioral Health Clinic

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Newsletter: June 2010

Symptoms and Help for Alcohol Problems

Elisabeth Roland, PsyD

According to the U.S. Department of Health and Human Services, alcohol is the most used intoxicating substance in this country, with an estimated 109 million people having used alcohol in the past month.  Drinking alcohol is a common and popular part of many activities in our society.  Dinners are often enjoyed with a bottle of wine or celebrations enhanced with a champagne toast.  It can often be hard to see when your drinking has crossed the line from moderate or social use to a real problem.  Many people drink consistently without experiencing any harmful effects, other than the rare hangover.  Yet millions of others suffer from alcoholism and alcohol abuse, making even an occasional drink unsafe.  Substance abuse experts make a distinction between alcohol abuse and alcoholism/alcohol dependence. Alcohol abusers may have at least some ability to set limits on their drinking; however, their alcohol use remains self-destructive and dangerous.

The effects of alcohol  on the body extend beyond those that are physical (e.g. liver damage).  There are many psychological effects of alcohol that are equally damaging and painful.    For example, while many people associate the drinking of alcohol with partying and having a good time, alcohol is a depressant.  Once it begins circulating in the body, it decreases activity within the nervous system.  When you drink alcohol, you may notice that you have more feelings of depression or that you become stuck in a state of depression as a result of drinking. In addition, as you consume large amounts of alcohol, you may become stressed from the impact of the drug.  While the buzz from alcohol can initially be enjoyable, it can give way to a series of stresses on the system that will manifest psychologically.  Alcohol use can result in restlessness, nightmares, and even overwhelming fear. 

More generally, excessive alcohol use can lead to personality changes.  Your usual interaction style can be altered drastically by an intoxicating amount of alcohol.  You may become selfish, egotistical, or even susceptible to mood swings and aggressive behavior.  These changes are brought on by the effects of alcohol on serotonin in your body.  Serotonin is a neurotransmitter in your body that transmits signals related to mood.  When the effect of serotonin is weakened by an excess of alcohol, chemical imbalances result in aggressive behavior or mood swings.  Another common personality change brought on by alcohol can be a dampening of morals and an increase in impulsivity.  As alcohol affects the body, it works to slow the response rate of the synapses in the brain.  As a result of this slowing down, an individual’s thinking and reasoning can be impaired.  Someone who is intoxicated may be more willing to do and say things than they would when they were sober.  This can be an incredibly dangerous hazard of drinking. 

Just like many other diseases, alcohol dependency is progressive.  Once someone becomes dependent on alcohol, whether or not they are aware of their addiction, they often become obsessed with drinking.  This can lead to a loss of interest in life, isolation, and denial. Denial can be one of the biggest hindrances to getting help for alcohol abuse and dependence. Because the urge to drink is so strong, the mind finds a way to rationalize drinking, even when the consequences are obvious.  Unfortunately, as drinking gets worse, denial often increases. 

There are a number of psychological approaches that are used to treat alcohol abuse and dependence.  The best-known treatment is Alcoholics Anonymous (AA), which treats the addiction as though it is a disease that cannot be cured and has a strong spiritual component.  Two common psychological treatments that have similar effectiveness to AA include Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI). CBT helps individuals to change their drinking behaviors, as well as their risky attitudes and beliefs.  CBT increases the individual’s confidence about his/her ability to resist heavy drinking.  MI recognizes that people with alcohol problems are at different stages of readiness to change their drinking.  MI helps individuals reach a stage where they are more ready to change their alcohol use. 

When someone is too close to a problem, they may not be able to see what it is doing to them in the same way that someone else can.  Therefore, if you have heard from those that you love that you are drinking too much, you should listen to them.  Denial can keep you from accurately seeing your behavior and its negative effects.  Admitting to a serious problem with alcohol can be painful for the whole family, not just the alcoholic or alcohol abuser.  It is important to keep in mind that there is help available.