Ask the Psychiatrist: Are You Fooling Yourself About Alcohol?

“We are living in a time that is quite stressful,” says Rachel V.F. Rohaidy, M.D., a board-certified psychiatrist at Baptist Health Primary Care. “Talking about alcohol is very important because, culturally and socially, alcohol is always a part of our life.”

As students leave home for the first time and head off to college, it’s easy for them to learn maladaptive behaviors. Dr. Rohaidy says that drinking has become almost a normal part of many college and university settings, and dangerous amounts of drinking can become ingrained in college culture. “Then, as we get older and mature into adulthood, we realize that drinking is also a regular part of adult life and that alcohol consumption is the norm at celebrations, happy hours with coworkers, tailgating parties and even at family meals.”

Alcohol consumption is part of our socializing process, Dr. Rohaidy says. “It’s where we learn that alcohol enables us to do things we would not normally do.” For example, she notes, “some people find it easier to approach a person they’re attracted to when fortified with alcohol.”

There are also less obvious examples of how we are socialized to encourage alcohol consumption, according to Dr. Rohaidy. “When I first become a mom, I attended mommy support groups where we talked about the stresses of being a new mom AND we brought our own wine,” she recalls with a laugh.

How we drink – the drinking progression
Wine is a social lubricant that relaxes you, Dr. Rohaidy says. “We have that one glass, and then we have that second glass, and then things start to change.” As our blood alcohol level increases, she says, we feel less stressed. “We begin to become ‘loosey-goosey’ and everything is funnier.”

As we drink more, we start slurring our words and stumbling as the alcohol begins to affect our motor skills. “Then we go into the dark phases of alcohol where we don’t remember what we did or the fight that we got into,” Dr. Rohaidy says. “Then it goes away, and we forget about it.”

Neurological changes occur when we drink too much, according to Dr. Rohaidy. “Neurotoxicity begins to occur when you experience giddiness and happiness, you’re failing all over yourself, and you’re mumbling your words.”

She cautions that alcohol is extremely toxic and that, over time, one can start to see how it affects every single cell and organic system in the body.

How much is too much?

The U.S. Department of Agriculture defines heavy drinking in men as five or more drinks at one time or 15 or more drinks over the course of one week. For women and adults over 65, it is defined as “four or more drinks on one occasion or eight or more drinks over the course of one week.”

Alcohol content varies depending on the type of alcoholic beverage you drink. According to The National Institute on Alcohol Abuse and Alcoholism, a standard drink contains around 14 grams (0.6 ounces) of pure alcohol.

• 12 ounces of beer, or one bottle at 5% ABV (alcohol by volume).
• 5 ounces of wine at 12% ABV.
• 1.5 ounces of hard liquor (gin, rum, tequila, vodka or whiskey) at 40% ABV or 80 proof.

Although the American College of Cardiology recommends one glass of wine daily for women and two glasses of wine daily for men to maintain a healthy heart, Dr. Rohaidy says she doesn’t believe that this is necessarily good advice.

In terms of its effect on your body and mind, “Daily drinking can begin to look more like chronic drinking levels,” Dr. Rohaidy says. She urges people to be cognizant of what happens when they drink and what they’re putting into their bodies. “Alcohol is not really a health drink,” she says with a smile. “What we are introducing into our body to relieve tension is doing us more harm than good.”

Dr. Rohaidy cites a long list of side effects and physiological changes that can result from heavy drinking that includes:

• Rising blood toxicity levels.
• Increased blood pressure; circulation issues to and from your heart.
• High cholesterol levels, which change the cells in the liver and the pancreas. 
• Changes in the way your body process sugar, which can lead to diabetes and obesity.
• A decrease in your immune system’s ability to fight off viruses such as Covid-19 and other illnesses.
• White blood cells become sluggish and less efficient, allowing bacteria and other viruses to enter your body.
• Upper and lower respiratory problems, including pneumonia.
• Changes in your bone production – your body heals slower because the cells are sluggish.
• Reproduction processes weaken, as erectile disfunction can occur in men with heavy alcohol use.
• Higher rates of infertility, menstruation issues, and changes in hormone levels.
• Higher risk of breast cancer for women who drink wine.
• Increased risk of jugular, mouth and throat cancer for men.
• Circulatory systems, including heart trouble, arrythmias and myocardial infarction (heart attack). Also affects the cells of the heart muscle, which can lead to stroke and high blood pressure.
• Digestive systems; vitamin deficiency; gum disease and decay; gastritis, and acid reflux.

In a recent Baptist Health Resource Live program – “Alcohol: How Much is Too Much?” – a panel of medical experts discusses the range of physiological and psychological effects from excessive alcohol consumption.

Risk Factors for Alcohol Use Disorder

Dr. Rohaidy says that there is a genetic component to alcohol use disorders, and children are at higher risk if they have a parent or grandparent with the disorder. “We can’t really change the genetics, but we can change how we approach relieving stress,” she adds.

Trauma, psychiatric illness, depression and anxiety disorders can contribute to alcohol use disorder, according to Dr. Rohaidy, as can neurological and psychiatric symptoms for people affected by Covid-19.

She reminds patients that the body works as a whole, “Everything that affects the brain affects the body – they’re not separate,” she says. “Every single system in the body is negatively affected by excessive drinking,” Dr. Rohaidy says. “I’m not talking about a moment in time, I’m talking about daily, chronic, all-the-time drinking.”

Look at Drinking Differently

To help mitigate and control some of the anxiety, depression or low feelings you may be currently experiencing – and decrease your need to drink – Dr. Rohaidy suggests trying these tips:

• Join/form a friend group. “Get together, cook, bake, do something the group will enjoy that doesn’t include alcohol,” Dr. Rohaidy advises.
• Tell others you don’t feel like drinking now. “People are very supportive,” she says.
• Pencil in time to meditate or to take that 10-minute walk. 

It’s Not Easy – Seek Help

Dr. Rohaidy acknowledges that people are dealing with a lot of long-term effects from the pandemic – isolation, stress, work life issues and home life issues. “A lot of people are struggling,” she says.

“Talking about how stressed we are is generally taboo,” she adds. “However, if you’re struggling with something, think about reaching out to a medical professional, a primary care physician or a therapist. Talk about what is going on.”  

Today, telemedicine platforms such as Baptist Health Care On Demand have made it easier than ever to connect with people who can help you, Dr. Rohaidy notes. “We’re grateful for Zoom and other platforms that have allowed people to seek help during the pandemic.”