The relationship between alcohol and stress relief is a lot more complicated than conventional wisdom holds
In mid-March, when the reality of Covid-19 was setting in across the United States, alcohol sales soared. According to figures quoted by Bloomberg News, beer and wine sales surged 32% and 47%, respectively. Sales of hard liquor and cocktail mixes rose even more. Facing the prospect of extended stay-at-home restrictions, it seems that many Americans were in a hurry to stock their home bars and liquor cabinets.
This was a surprise to no one. Hard times call for hard drinks, as almost every down-and-out film hero can attest. And Hollywood tropes aside, the belief that alcohol can help a person “unwind” or “take the edge off” is a common one in the United States and Europe.
“There’s a widespread assumption that alcohol reduces stress,” says Michael Sayette, PhD, an alcohol researcher and professor of psychology and psychiatry at the University of Pittsburgh. He says the average consumer believes this, and so do many doctors, according to clinician surveys. He also says the notion that alcohol “calms the nerves” is an ancient one. In some of his work, Sayette quotes the Greek poet Alcaeus, who wrote, “We must not let our spirits give way… Best of all defenses is to mix plenty of wine, and drink it.”
These old and persistent beliefs have some truth behind them. “Alcohol is an anesthetic,” meaning it dulls pain, says Rajita Sinha, PhD, founding director of the Yale School of Medicine Stress Center. “And physiologically, alcohol affects the body’s stress pathway in a very potent way.” She explains that alcohol can in some cases blunt the brain and body’s response to a stressful event.
Alcohol can facilitate the action of GABA, and this may partly explain why a drink at the end of a frantic day can calm anxious thoughts.
A 2011 study in the journal Alcoholism found that, immediately following a public-speaking task, the blood levels of the stress hormone cortisol tend to spike. But when people in the study were given the equivalent of two alcoholic drinks immediately following the public-speaking task, this cortisol response was dampened. A 2009 study in the Journal of Abnormal Psychology found that raising people’s blood alcohol content (BAC) to a level of 0.08% — the threshold for impaired driving charges in many states — reduced their “startle reflex” in response to anxiety-provoking electric shocks.
There’s also evidence that alcohol can strengthen the action of certain neurochemicals in ways that mimic the effects of anxiety-reducing pharmaceutical drugs, such as Valium or Xanax. “Alcohol has similar effects as benzodiazepines — they both modulate the GABA-A receptor,” says Manoj Doss, a postdoctoral research fellow at the Johns Hopkins Center for Psychedelic and Consciousness Research. He explains that GABA is the brain’s main “inhibitory” neurotransmitter, meaning it tends to turn down brain activity. Alcohol can facilitate the action of GABA, and this may partly explain why a drink at the end of a frantic day can calm anxious thoughts.
While these study findings support the belief that alcohol can reduce stress, there’s a lot more to the story. “We now have 50 years of laboratory research that suggests it’s far more complicated than one would believe,” Sayette says. “What we’re finding is that it’s not one size fits all. We’re still answering questions such as under what conditions, and for whom, does alcohol work to alleviate stress.”
According to a 2011 review in Behavioral Neurobiology of Alcohol Addiction, heavy drinking can actually cause the blood’s cortisol levels to rise, rather than fall. Also, heart rate and blood pressure both tend to increase with heavy drinking — especially as the body breaks down alcohol and its toxic byproducts flood the bloodstream. The amount of alcohol that constitutes “heavy drinking” varies from one person to the next. But Sayette says that longtime drinkers who frequently turn to alcohol to manage stress likely have different responses to it than light or infrequent drinkers.
“If you’re consuming quite a few drinks to reduce stress and you do this all the time, what happens is that you start to alter your brain chemistry,” he says. “The brain’s normal non-alcohol state begins to change, and in some cases it may become a more anxious one.” This new anxiety baseline can fuel further drinking, and so there’s a snowball effect where stress and alcohol feed off each other, Sayette says.
“If you believe alcohol will make you feel relaxed, then as soon as you open that bottle of wine or put that drink to your lips, you’ll probably start to feel relaxed.”
Yale’s Sinha echoes these points and says that when someone is accustomed to drinking away stress, they may feel anxious or antsy when they can’t have alcohol. They may also need more and more booze to experience the calming effects that once enjoyed after a single drink. “There’s very little data to show that the anti-stress effects of alcohol are sustained,” she says.
But what about the drinker who has a single cocktail or a glass of beer or wine following a stressful day? Sayette says the pharmacological effects of this amount of alcohol — for better or worse — are probably minimal. “Most of the research over the years has been done with intoxicating or near-intoxicating doses of alcohol, and the amount of alcohol in single drink, or even two, is below the level of alcohol associated with intoxication,” he explains. Some of the above research suggests that, at these levels, alcohol may help lower some markers of anxiety or stress, but any benefits are going to be small.
Much of alcohol’s stress-combating allure may stem from people’s attitudes and behaviors while drinking. “If you believe alcohol will make you feel relaxed, then as soon as you open that bottle of wine or put that drink to your lips, you’ll probably start to feel relaxed,” Sayette says. In other words, there’s a psychological element at work. He also points out that many people engage in naturally calming rituals when they drink. They settle into a comfortable chair or turn on some music. They stop checking their email and talk with friends or housemates. “Drinking is often the catalyst for these other relaxing behaviors,” Sayette says.
The take-home message seems to be that, for some people, alcohol in small doses can help reduce stress. On the other hand, if you’re consistently trying to drown your stress in alcohol, your drinking may be counterproductive — and could eventually turn harmful.