Featuring Jonathan Avery, MDReviewed by Alexandra Schwarz, MD | December 31, 2022

You commonly hear debates about whether alcohol (especially wine) is “good” or “bad” for your health, but the answer isn’t always simple. In small or moderate amounts, alcohol is typically safe for the average person, and can even come with some minor health benefits.

However, when drinking becomes excessive, your brain can start to depend on it at levels that are damaging to your mental and physical health. “They can't function without it. They're damaging their liver and their brain, and they can't sort of survive without alcohol being a part of their body,” says Jonathan Avery, MD, director of Addiction Psychiatry at Weill Cornell Medicine and NewYork-Presbyterian Hospital.

Alcohol Withdrawal: Why It’s So Hard to Quit

Many people who struggle with alcohol often have “narratives” about why they must continue to drink, according to Dr. Avery. The person may know they are drinking more than what's recommended, but the narratives help validate the habit. These reasons are often things like drinking to help with sleep or to deal with anxiety.

“It can feel at first that it helps for those things, but all our data shows that when you're drinking regularly ... you're actually just medicating withdrawal,” says Dr. Avery. “It increases your odds of insomnia, of anxiety, and so the very thing that you think it's helping for, it's actually making worse.”

Because alcohol is a depressant, your brain learns to adapt to the constant exposure of a depressant by producing its own stimulants, like serotonin and norepinephrine. These stimulants have an adrenaline-like effect on the body. As a result, many alcohol withdrawal symptoms are a sign of overstimulation, like tremors and irritability.

Furthermore, because alcohol has become a way to cope, when you take it away, your insomnia or anxiety might actually get worse temporarily. Not only are you experiencing withdrawal symptoms, but you've lost your way of coping with discomfort or difficult emotions. Anything that you've been medicating with alcohol will suddenly be felt at full force.

“Once you're in recovery, these things get better, and so it's been shown, for example, four months out from an alcohol problem, a lot of the anxiety that exists right at the period of stopping has gone away,” says Dr. Avery.

What to Expect During Recovery

“Alcohol withdrawal symptoms range from mild to more severe,” says Dr. Avery. The symptoms of alcohol withdrawal include:

Hangover-like feelings
Tremors
Anxiety
Irritability
Depression
Seizures
Hallucinations
Confusion or delirium

“When you've been drinking heavily, it's advisable to not stop on your own, in fact, and to have medications that can help wean you off of the alcohol,” says Dr. Avery. “Otherwise, you're gonna get that really severe state of delirium.”

Recovery Is Worth It

The early days of recovery are some of the hardest, and getting over that initial hurdle can be daunting. You might even wonder if recovery is worth it, since the “end result” may be a life with no alcohol.

“The narrative that people often have for struggling with alcohol or even misusing alcohol, is that they can't have a rewarding, fun life without it,” says Dr. Avery. “What I tell patients is, ‘I promise you, if you trust me, if you stop, those relationships will actually be better, and actually, they're not as good as they could be … because of the drinking.'”

In other words, while not drinking may change the way you hang out with your friends or how you “let loose,” a life with an alcohol use disorder isn’t as good of a life as it could be. In the end, you may find that sobriety is less of a “loss” and more of a “freedom” from alcohol.

References

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