In the constant chaos and commotion of mom life, stress has become an unwelcome companion for many of us. It's not uncommon for mothers to turn to alcohol as a means of coping with the pressures of our daily lives. However, understanding the relationship between stress, alcohol, and its potential side effects is crucial for making informed choices about our mental and physical well-being.
In our culture, we use alcohol for many reasons: to celebrate events, to become more social, to remember or to forget, to numb out, or to cope with certain emotions or situations that we would otherwise find difficult to manage. Most women drink alcohol to relieve stress - viewing alcohol as a temporary relief or escape. (Men typically drink alcohol to feel more sociable). All of us react to stress in various ways. Stress can make us have difficulty concentrating or feel scattered. Stress can contribute to changes in our eating habits - too much, i.e. binge eating, or too little, a loss of appetite.
Stress can create muscle tension and headaches. I noticed more jaw clenching at work when I was stressed. When stressed, I always felt tired, sometimes unable to relax. I began to have daily tension headaches. Some days I felt like I had low energy, unusual for me, a high energy person. And my stress caused me to have problems sleeping, even when I felt exhausted.
A confession: During my last few years of neonatology practice caring for sick babies in the NICU, I was drinking alcohol nightly to control my stress. I found myself looking forward to that glass of wine as I was driving home from the hospital. I was “burned out” during that period, so I drank to relax and numb-out. Then I began to recognize that alcohol made me feel worse - usually the next morning.
Like so many others do, I discovered that alcohol provided me with a temporary sense of relief from stress, but it did not address the root causes of my chronic stress and burnout. I found myself relying on alcohol as a coping mechanism, just like so many other women are today.
I noticed that my nightly drinking of wine made me more irritable and impatient. My frequent alcohol use led to trouble concentrating, increased depression, and mood swings.
I began to read more about stress and alcohol use. I learned that high levels of stress can reduce our brain's normal response to alcohol, specifically the dopamine response in our brain's reward center. Alcohol is a depressant which can disrupt the balance of neurotransmitters, like serotonin, in our brain. In this way, it can worsen anxiety. Drinking alcohol makes it HARDER for us to deal with stress. This is the paradox. We drink to relieve stress, but the drinking makes our symptoms worse.
I began to realize that alcohol was having a serious impact on my mental health and was contributing to my feeling depressed. I did not personally struggle with anxiety, but many mothers do. And, in fact, we may feel more anxious after the alcohol wears off. Anxiety induced by alcohol use can last for several hours, or for a day, after drinking.
Excessive alcohol consumption is known to negatively affect our mental health. Research shows that people who drink alcohol are more likely to develop mental health problems. Alcohol use is associated with generalized anxiety disorder, panic disorder, and social anxiety disorder. Alcohol use disorder is associated with major depressive disorder and bipolar depression. There is a relationship between PTSD and alcohol use.
Drinking is also associated with an increased risk of chronic physical conditions including liver disease, cardiovascular disease, and several different kinds of cancer. And the more you drink, the research suggests, the higher your risk of developing these illnesses. Your liver tolerates mild alcohol consumption, but as our intake of alcohol increases, it leads to disorders of the metabolic functioning of the liver. Alcoholic liver disease may result, a condition that covers a wide spectrum from fatty liver to alcoholic hepatitis to alcoholic cirrhosis (irreversible damage).
Recent genetic analyses have suggested a causal link between alcohol intake and increased risk of cardiovascular disease, however there are differences in risk depending on our level of alcohol intake. Low-to-moderate alcohol use may mitigate certain cardiovascular risk factors affecting atherosclerosis and inflammation, but any positive aspects of drinking must be weighed against serious physiological effects, including cellular dysfunction, changes in circulation, inflammatory response, and oxidative stress.
In addition, alcohol consumption has been associated with at least six different kinds of cancer, including those of the breast, liver, colon, throat, mouth, and esophagus. A recent NYT article written by Dana Smith reviews further how alcohol consumption is bad for your health.
Knowing that alcohol was harmful, I discussed my concerns about my drinking with my psychiatrist. She suggested that I try to cut down on my drinking. She instructed me to make a list of the pros and cons of my drinking. The cons were a long list. The pros quite a bit shorter. I became more mindful about my drinking, especially the day after drinking two or three glasses of wine.
I studied some tools available on Moderation Management, a non-profit organization that helps people to learn controlled drinking, a kind of harm reduction training. I kept a diary of how much and when I drank, and I took a self-test on drinking. This program helped me to reflect on my behavior and come up with a system to cut down. I learned what I could do instead of drinking, like reading, writing, needlework, and playing piano. Being more intentional about when and why I chose to drink did encourage me to consume less alcohol.
I began to see that the disadvantages of my drinking were consistently greater than the benefits of my drinking, but I continued to drink some wine while I noticed these patterns. I discovered that I felt better in the evenings when I was on call in the hospital (up at night in the NICU) not drinking anything alcoholic while at work.
Rosamund Dean published her book, Mindful Drinking in 2017. She wanted to become more intentional about her relationship to drinking instead of seeing alcohol as a habit or a crutch. In her book, she combines scientific expertise with practical advice to become more mindful about and decrease your drinking.
A NYT article by Dani Blum in 2021 also discusses this mindful drinking approach. I learned how to pay attention to how alcohol made me feel, both in the moment and the day after. I examined what alcohol offered me, and what it took away. However, for a while, I remained frustrated and unhappy at my inability to effectively cut down on my drinking.
By observing the motivations behind my desire to drink, I began to evaluate whether I might benefit from quitting drinking entirely. By becoming more mindful about my drinking I was able to experience the benefits of drinking less – which improved my mood, my sleep, and my productivity. It also reduced my stress and anxiety.
I often thought about the pros and cons of drinking and making mindful decisions, being aware, and making small adjustments over time. Sometimes, I could stop drinking for a week, or two weeks, or even a month, and feel better as a result, but then relapse into a weekend of drinking.
My husband is a wine drinker also, so there was always wine in the fridge. Having alcohol around is difficult to ignore. Plus, drinking alcohol was our habit. I was proud of myself for quitting for some period, but felt more guilty for any relapse, even a small, short one. I seemed to slip back to drinking every time.
When I began to identify the issues that were causing my stress, and to do the work necessary to modify those, then I began to feel better. When I felt better, I found myself drinking less. Drinking less made my symptoms improve, in a noticeable way. Ultimately, I decided that I needed to quit drinking entirely. Once I stopped, I noticed major benefits of cutting out alcohol.
First, my sleep improved. Studies show that even a low amount of alcohol—less than one drink for women and less than two for men—can negatively impact sleep quality. I performed better mentally with on-line games, in mahjong, and in my writing. (I had retired from medical practice by then.) My overall mood improved, and with better sleep came improved focus and energy.
I experienced less indigestion and acid reflux. I like to think that I am reducing my risk of cancer, cardiovascular disease, and dementia. I did not lose extra weight, but some people do report a drop in weight after removing the empty calories consumed when drinking alcohol.
This essay is not to provide you with healthy alternatives to manage your stress. You probably know what these are already - mindfulness techniques, like meditation and yoga, adequate exercise, proper sleep, and seeking support from friends, family, or professionals.
My goal was to share my struggle with alcohol use and my journey to understand and overcome it. Cutting back on drinking and stopping alcohol altogether is not easy, but it is doable. You can do it, too, if you want to. But, you are the only person who can make that decision.
Thank you for this beautifully written article, Dr. Landers. I appreciated your personal journey as well as the resources for moms who might be interested in more mindful approaches to drinking. Such an important topic for all women!