Is Alcohol Bad for Your Brain? Understanding the Impact of Alcohol on Cognitive Health

Alcohol Abuse and Brain Health

Research shows that people with alcoholism have smaller brain sizes compared to those who don’t¹⁰. Long-term alcohol consumption can also lead to a decrease in gray matter and white matter¹¹ in the frontal cortex. This might be because alcohol has neurotoxic effects on nerve cells, which can contribute to neuronal damage and increased vulnerability to alcohol-related brain damage (ARBD) like dementia. 

While it is possible to develop a few different alcohol-related brain disorders, two of the most severe include Wernicke syndrome and Korsakoff syndrome. Both are associated with thiamine (vitamin B1) deficiency and alcohol abuse¹². Thiamine helps the brain turn sugar into energy. With thiamine deficiency, brain cells cannot generate enough energy to function properly, which causes a myriad of physical and mental difficulties.

Wernicke syndrome 

Alcohol’s destruction to neurons and cell communication in the peripheral and central nervous systems can prompt the onset of ​​Wernicke syndrome. Wernicke’s encephalopathy can have a severe and sudden onset and involves ophthalmoplegia¹³, which is paralysis or weakness of eye muscles. It also includes ataxia, weakened muscle control in their arms and legs, and confusion. Wernicke’s encephalopathy usually precedes the onset of Korsakoff syndrome¹⁴. 

Korsakoff syndrome 

Alcohol abuse can inhibit learning new information, remembering recent events, and long-term memory processing. Over enough time, this can progress into Korsakoff syndrome. Korsakoff’s psychosis causes damage to the brain’s thalamus and hypothalamus¹⁴, which can lead to confusion, memory problems, coma, and irreversible brain damage. 

If you or someone you know is experiencing these symptoms, visit your primary care practitioner immediately. If the situation feels life-threatening, call 911 and/or take them to an emergency room and stay with them until they have medical help. If you live outside of the United States, you can find your country’s emergency number in this list¹⁵.

Neurotransmitter Disruptions

Alcohol primarily interacts with the reward and stress systems in the brain¹⁶, which includes dopaminergic, serotoninergic, glutamatergic and GABAergic neural circuits. A neural circuit has a series of neurons that send chemical signals to one another. 

As you drink, your brain releases more dopamine, endorphins, and serotonin and suppresses Gamma-Aminobutyric Acid (GABA) and glutamate release. These disruptions in normal functioning greatly affect your mood, behavior, and cognition. 

Alcohol’s impact on dopamine levels is a key factor in the formation of alcohol dependence¹⁷. Dopamine is not only the “feel good” hormone, but it’s also the motivation and incentive-based hormone. Your brain begins to reinforce unhealthy drinking habits because your dopamine levels rise when consuming alcohol, so, without alcohol, your brain will begin to crave that dopamine boost again. This spurs the dangerous cycle of chasing the high.

Image from the Indian Journal of Human Genetics¹⁶

Mental Health and Alcohol

Alcohol and mental health are closely intertwined, and the relationship between the two is complex. Some people are more vulnerable to alcohol abuse because of preexisting conditions. In contrast to those who drink responsibly or abstain, those who abuse alcohol—especially adolescents and those with long-term exposure—are more likely to develop depression or other psychological conditions. 

The prevalence of anxiety, depression, and other mental disorders is significantly higher among those with alcoholism¹⁸ compared to the general population. For many, this is due to using alcohol as self-medication for the uncomfortable emotions associated with these mental disorders. Chemical changes in the brain from alcohol, such as the disruption of neurotransmitters crucial in maintaining good mental health, also contribute to and worsen existing symptoms. 

If you have co-occurring disorders, finding specialized care for all conditions is essential because of their complicated relationship. You’re actually more likely to recover from each condition if the alcoholism and the co-occurring mental health disorder(s) are individually addressed and treated¹⁸. Explore professional treatment options with your doctor to get to the root cause of your co-occurring disorders. 

Adolescents’ Vulnerability to Alcohol’s Effects

According to the National Institute of Alcohol Abuse and Alcoholism, roughly 35% of adolescents (ages 12-20) have tried alcohol¹⁹. And this number likely doesn’t include the many teens who didn’t report their drinking. Alcohol use during these crucial years can disrupt normal brain maturation²⁰ and increase the risk of cognitive impairments because of restricted blood flow in certain brain regions and electrical activity. 

Adolescents are also more prone to risk-taking behaviors²¹, which drinking only exacerbates. Alcohol greatly affects the prefrontal cortex, which is the decision-making area in the brain that is still developing for adolescents. They could be more likely to make bad decisions and get into trouble if they’re drinking, such as getting into a car crash while driving under the influence. 

If your child is in these pivotal years, have an open conversation with them. Being open-minded and honest with them, and actively listening to their experiences without judgment, will create trust. Your child may be more likely to listen to your advice if you approach these conversations with empathy and the desire to learn from each other.

Can the Brain Recover?

So, is it possible for your brain to recover from alcohol’s damage? In many cases, the answer is yes. It is a resilient organ that can heal. Your brain has something called neuroplasticity, which means your nervous system can change, positively or negatively, to stimuli²². So, while your neuroplasticity can negatively change from alcohol abuse, it can also positively adapt in recovery. 

Recovery from alcohol abuse is complex, and it can vary depending on factors like genetics, age, and overall health. The best way to recover is to stop drinking; however, this should be done over time with a tapering plan. Attempting to stop drinking “cold turkey” is dangerous and could cause serious implications. 

For this reason, recovering with professional guidance is essential. Medical professionals can ensure that the detoxing process goes as smoothly as possible. And tapering off alcohol will decrease the likelihood of withdrawal symptoms.
Alcohol shouldn’t be running your life. Your health matters. Begin your journey towards sobriety today by browsing rehabs that specialize in alcohol treatment.