A brief overview
I usually focus these posts on the spirituality of the 12 Steps as a path of recovery from alcoholism and codependency, but today I’ve decided to look at a little medical research on this disease. You already know that chronic alcohol abuse causes brain damage – some of it permanent. Whether your brain can rebuild itself with prolonged abstinence depends upon the severity of the damage as well as correlated factors such as genetics, nutrition, and your life habits in sobriety.
Alcoholism Shrinks Your Brain
This is an indisputable fact. Prolonged abuse of alcohol shrinks all areas of the brain, causing the condition known as “wet brain.” All wet brain really means is that, as the brain tissue shrinks, the vacated areas, known as ventricles, fill with fluid to compensate. It doesn’t mean you become a drooling idiot. (My father developed it late in life and remained quite sharp.) Rather, the condition simply indicates that all functions of your brain have been compromised, so that you’re less aware, less physically able, less emotionally engaged, and less intelligent overall than you would be with a healthy, non-alcoholic brain.
But, hey, no big! The buzz is worth it, right?
According to one hypothesis, shrinkage (i.e., atrophy) of the cerebral cortex and white matter, as well as possible atrophy of basal forebrain regions, may result from the neurotoxic effects of alcohol… Alcoholics who are susceptible to alcohol toxicity may develop permanent or transient cognitive deficits associated with brain shrinkage.[i]
What is “neurotoxicity”? It’s medi-speak for toasts your brain cells. They don’t necessarily die, but the dendrites connecting them are damaged or lost, so the cells occupy less area. But hey – at least they’re still kind of there, right?
As you can see, when it comes to brains, plump is better. The graph on the right may seem a little confusing if you’ve gotten bombed enough times – or, heck, even if you haven’t. The straight line represents a normal brain. The blue line shows shrinkage of regions in a young alcoholic brain, and the yellow line shrinkage in an older alcoholic brain. (By the way, who the hell drinks only 20 gallons of alcohol in their whole life? Seriously? Even 625 gallons wouldn’t be nearly enough for my addict!)
Parts of the Brain Most Vulnerable
Everybody knows that when you’re fucked up, you temporarily lose coordination, short-term memory, and sound judgment. But who cares? Not much of a price to pay for not hating yourself for a bit, right? Of course, getting hammered also fries your behavioral inhibitions, emotional intelligence, and the ability to accurately read social cues – none of which can even compare, obviously, with the tremendous relief of no longer feeling terrified to converse with other human beings because you’re suddenly irresistibly hot and charming.
That said, it only makes sense that prolonged exposure to alcohol would eventually damage the parts of the brain responsible for those very functions.
Neuroimaging studies of living brains point to increased susceptibility of frontal brain systems to alcoholism-related damage… The frontal lobes, connected with all other lobes of the brain, receive and send fibers to numerous subcortical structures. The prefrontal cortex is considered the brain’s executive—that is, it is necessary for planning and regulating behavior, inhibiting the occurrence of unnecessary or unwanted behaviors, and supporting adaptive “executive control” skills such as goal-directed behaviors, good judgment, and problem-solving abilities.
In other words, the motherboard of your brain starts to malfunction. As alcoholism progresses, this can lead to the chain of bad choices that screw up an alcoholic’s entire life. Because it only makes sense that as self-restraint abates and good judgment declines, egotism and selfishness jump in to take up the slack.
Disruptions of the normal inhibitory functions of prefrontal networks often have the interesting effect of releasing previously inhibited behaviors. As a result, a person may behave impulsively and inappropriately – which may contribute to excessive drinking.
In other words, the more you injure your brain by drinking, the more likely you are to say, “aw… fuck it!” and drink more. Other excellent ideas include hooking up with other sick people, engaging in unethical/destructive behaviors, and royally screwing over the people you love.
Because actually, you only kind of love them. To be honest, loving them is only a vague memory. Why is that?
Alcoholics may seem emotionally “flat” – i.e., they are less reactive to emotionally charged situations… Impairments in emotional functioning that affect alcoholics may reflect abnormalities in [the right hemisphere or] other brain regions which… influence emotional processing, such as the limbic system and the frontal lobes.
How many alcoholics know that feeling of not being able to feel? When my grandmother died, when my husband walked away, when my partner shut the door on my begging – I knew I ought to feel something, but I didn’t. Not much more than, “Hmm… that sure sucks!” Who knew my limbic system was screwed up? Really, by the end I could feel only one thing: when I was pouring the drink, when I was chopping the lines, when it seemed I was winning the conquest, I felt, “YES!”
Alcohol directly stimulates release of the neurotransmitter serotonin, which is important in emotional expression, and of the endorphins, natural substances related to opioids, which may contribute to the “high” of intoxication and the craving to drink. Alcohol also leads to increases in the release of dopamine (DA), a neurotransmitter that plays a role in motivation and in the rewarding effects of alcohol.
The trouble is, the brain recognizes this overload of pleasure transmitters and tapers its production of each as a result. In other words, you feel like shit without a drink; in fact, severe neurotransmitter imbalances my cause you to develop “seizures, sedation, depression, agitation, and other mood and behavior disorders.”
The brain, of course, isn’t the only organ on the team to get fucked by alcohol. Every part of the body suffers, but hardest hit is your liver. We all know the liver’s ability to remove toxins from the bloodstream gets compromised as alcohol overtaxes it. But did you know this?
These damaged liver cells no longer function as well as they should and allow too much of these toxic substances, ammonia and manganese in particular, to travel to the brain. These substances proceed to damage brain cells, causing a serious and potentially fatal brain disorder known as hepatic encephalopathy, which can result in mood and personality changes, anxiety, depression, shortened attention span, and coordination problems, including… hand shaking…[ii]
I think I might’ve had a spot of that…
Well, that’s about the end of my rollicking review of alcoholic brain damage. Missing from this account, of course, is the self-destructive spiritual illness that makes us not give a shit whether we’re killing ourselves, because life’s worthless anyway.
The good news is that studies also show all these physical processes can be reversed by long-term abstinence, while the spiritual malady – thank god! – can be cured via the 12 steps. A healthy body is really just the means to an end – usefulness and the joy of living, which we’ve been granted in sobriety.
[i] Except where noted, quotations are taken from “Alcoholism and the Brain: An Overview,” by Marlene Oscar–Berman, Ph.D., and Ksenija Marinkovic, Ph.D. See http://pubs.niaaa.nih.gov/publications/arh27-2/125-133.htm