Alcohol and the Hijacked Brain: Why They Can’t Think, Remember, or Decide Like They Used To

 This week on Doc Jacques: Your Addiction Lifeguard, we’re taking a clear-eyed (but not doom-and-gloom) look at how alcohol hijacks the brain—why memory goes missing, logic goes offline, and families feel like they’re arguing with a wall. You’ll learn what’s really happening under the hood, why “just explain it better” doesn’t work, and how to stop wrestling the damaged brain while still throwing a lifeline when your loved one is ready. 

Transcript

SPEAKER_00 0:00

It's time again for Doc Shock, your Addiction Life Guard Podcast. I am Dr. Jockey Burkert, a psychologist, licensed professional counselor, and addiction specialist. If you are suffering from addiction, misery, trauma, whatever it is, I'm here to help. If you're in search of help to try to get your life back together, join me here at Doc Shock, Your Addiction Life Guard, the Addiction Recovery Podcast. I wanted to be real clear about what this podcast is intended for. It is intended for entertainment and informational purposes, but not considered help. If you actually need real help and you're in need of help, please seek that out. If you're in dire need of help, you can go to your nearest emergency room or you can check into a rehab center or call a counselor like me and talk about your problems and work through them. But don't rely on a podcast to be that form of help. It's not. It's just a podcast. It's for entertainment and information only. So let's keep it in that light, alright? Have a good time, learn something, and then get the real help that you need from a professional. This episode is meant for family members, loved ones of addicts and addicts, both, not just one or the other. Because today's topic is about how alcohol affects the brain, the hijacking of the brain through alcohol. And just exactly what is going on when that occurs. So let's get started. Um families often observe something when they're dealing with an alcoholic uh client that I have, or they're they're talking to me about it, and they often say things like, um, they're they're not the same person anymore. You know, but they they've changed. They don't remember conversations. They make decisions that make absolutely no sense. And the reason for that is not because they're trying to be arrogant and defiant, it's because alcohol has affected their ability to function, their brain. It's affecting their brain. They're not stubborn, it's not a lack of intelligence, it's not necessarily a manipulation attempt. It can be, but it's probably not. The alcohol physically altering the structure and the function of the brain is what's going on. That's what this is. So you're arguing with the addiction. You're not talking to somebody who makes sense because you're not talking to the person. Well, let's talk about how that happens. So, alcohol is a poison. Ethanol is attacking the brain. It attacks the brain's command center, the prefrontal cortex, specifically attacking that part of it. And the function of the prefrontal cortex is judgment, decision making, impulse control, personality, the ability to evaluate consequences. And what alcohol does to that part of the brain is it shrinks and weakens the uh prefrontal cortex over time. Now, it doesn't happen with just one or two exposures to alcohol in high amounts. That it that's not going to cause print permanent uh issues, or not at least as they're drinking because of their drinking. That takes a significant amount of time. So if the person's been an alcoholic and they've been engaging in alcoholic uh drinking to blackout or extremely heavy drinking for a couple of years, uh two, three, four, five years, this is when this happens. And unfortunately, that's a lot of times when I get introduced to the person, they've been drinking like that. Um there's a lot of support scientifically about what happens with the brain, and thanks to advances in medicine, we really can see this now. Um brain imaging studies show reduced volume in that prefrontal cortex and the long-term alcohol user. So fMRIs and MRIs, uh, we can see that there's an actual volume reduction in that part of the brain. The NIH, not the NIH, National Institute on Alcohol Abuse and Alcoholism, NIAA, they confirmed that alcohol impairs executive functioning through a lot of research. Uh the CDC, NIH, they they all do research on this, and that's what they're finding. So, what that translates to in real life is people who have alcoholism and it's long term, they make reckless decisions, they promise to stop and genuinely believe they're going to, but then they don't follow through. Sometimes they choose short-term relief over catastrophic long-term consequences because that's what their brain is telling them to do. This is the brain that I'm talking about that is dysfunctional because of that prefrontal cortex problem. So they're not deciding freely anymore. That part of the brain that makes those decisions, it's been it's been chemically handcuffed. It's it's been chemically altered and impaired in a way that makes it almost impossible a lot of times for people to make good decisions. The the other thing that happens is, and and we've all kind of encountered this with people who uh drink, and maybe you black out. Maybe you have experienced that. But there's memory damage, the hippocampus, the part of the brain that holds memory. Um, it forms new memories, it stores recent events, um, connecting emotional meaning to experiences. It's it's the part of the brain where the feel-good part happens. Like that's where the feel-good thing occurs. Like you you enjoy spending time with somebody, or you, you know, that's that's what that is. So the connecting of that emotional meaning to the experience, and sometimes bad as well, um, but that's where it happens, is in the hippocampus. And that's a little small part of the brain, but it's amazing that that is where that's where memory is. But what alcohol does to that part of the brain is it interferes with the brain's ability to form new memories. And chronic use shrinks the hippocampus in size. So if you're drinking alcohol and you're losing the ability to form new memories, think about what that's gonna what's gonna happen to you socially and with your relationships. And and as a family member, what are you dealing with? Somebody who constantly doesn't remember. And they'll say that, uh, or they act like they don't remember because they don't. MRI studies and fMRI studies show smaller hippocampal volume in heavy drinkers. That that part of the brain has shrunk. We can see that now, we can measure that. Alcohol disrupts the glutamate and the GABA balance, and those are the two things that are essential for forming memory. And and when that gets disrupted, it gets it gets kind of tamped down. There's nowhere for the memory that the the experience is going on, but they they cannot retain that information. So what you're seeing as as a family member, what you're seeing is repeating these conversations over and over and over. You're experiencing the person who uh is promising things, they're they're forgetting it. They just forget. They they're forgetting the consequences. You know, so you'll hear things like, don't you remember the last time you did this? This is what happened? And they they're like, I don't, I don't know what you're talking about. Because they really don't remember what you're they don't remember it, they don't know what you're talking about. Blackouts where literally the brain is not recording events. And, you know, if you drink so heavy that you're having a blackout, it's disturbing to us. I I've many times have drank to that point when I was drinking, and it's very disturbing that you can't remember things. There are these gaps, these holes of time where you just don't remember, and you're never going to, because it just wasn't there. So uh they're not your loved one, they're not lying when they say they don't remember. The brain never recorded that information in the first place, so it's not there. It's kind of like trying to save a file on a damaged hard drive. You know, you push the save button, but nothing gets nothing gets stored. It's just gone. And it's permanently gone. Um Another part of things that can happen, and this is this is one that that is particularly frustrating for the alcoholic many times. Um there's a cognitive decline, uh slowed thinking, reduced mental capacity. This is particularly disturbing to people who drink because they get upset about the fact that they can't they can't do the things that they were doing before. So the the functions that are affected are the processing speed of of the information, the ability to concentrate, problem solving, emotional regulation. In other words, being present, it's hard uh for people who have long-term alcohol exposure. And for those of us who have gone through that kind of thing, it's very, very uh upsetting. Now, if you're a person who has alcoholism and you have a history of of alcoholism, and you and you have been earlier in your life, you were functioning at a very high level. I have had in my office many times lawyers, doctors, people that rely on extensive memory of whatever it is that they are doing. And they're not they can't concentrate on it anymore. They don't they don't have the problem solving skills that they once did. Um and that emotional regulation, that's a huge one for the loved ones, because they are just seem like they're so explosive, they're so unpredictable in, you know, just exploding for no reason, um, or just going on these sad crying benches about nothing, uh, really, and they're struggling with this, and you're watching it. And you know, what are you supposed to do to help that? You you can't, because of this exposure to alcohol and what it does in that prefrontal cortex area. And there's a lot of again, this is another one, there's a lot of support uh scientifically for this that we've been able to study for years and years. That chronic alcohol exposure, it damages the white matter in the brain, which is the communication highway of the brain, if you will. So it it damages that white matter that allows different parts of the brain to talk to each other, and that slows information transfer. So can you can you remember that yeah, maybe, but it's hard to figure it out. So what this means is there's slower thinking, but there's confusion, there's poor reasoning, there's emotional overreaction, or or just kind of just a general numbness to emotion that you'll see in somebody who's a loved one that has that. And if you're if you're the alcoholic, you know what I'm talking about, confused and can't can't make the right decisions for just even the most basic things. Um it's very, very difficult to to do. Now, I'm not talking about necessarily um when you're drinking. Okay, I want to be clear about that. It doesn't have you don't have to have a large amount of alcohol in your system that you're experiencing to cause this. I'm talking about when the person is not drinking, this is the effect on the brain. So they they might have a BAC level that's 0.000. But they're still you're still going to have this experience with them. Slow thinking, confusion, poor reasoning, and and it's and it's it's weird for families to experience that because the person that you were talking to is not the same person that they used to be. So families, they often think they can just explain it better to the person. You know, if I just draw out my explanation, say it slower, say it's then it's like the old joke of what do you, you know, if somebody doesn't speak English, if you just yell at them, they're gonna understand English better. No, they don't speak English. Like it's the same thing with with addiction and alcoholism. You're not gonna be able to just explain it better. That's not gonna help. Um if they if you if you say it the right way, this is the one that I this is the way this is what I experience with the families when they come into my office. It's like they're they're they want me to tell them how to say it to the addict, the alcoholic, in a way that the alcoholic will start to understand it, or even worse, they'll come into my office, they'll bring the alcoholic, and they'll say, you tell him this, because we've been telling him this for two years, and he won't listen to us. And I'm like, okay, you think he can't understand, or he's being oppositional? Which one is it? Uh, because the person that they're talking to, they've known for a long time and they know their capacity. But sadly, the addict is not gonna finally understand if you say it the right way. But the brain receiving the message has been neurologically compromised. Okay, and that's the thing that the lay person, the untrained person in neurology or psychiatry, psychology, they they don't understand that you're you're neurologically compromised. Ironically, uh, I believe that my experience with some physicians is that they don't understand that either. I mean, they scientifically know it, but they still think that they're talking to a patient who, if they just say it, that the patient will follow those instructions. You know, you're causing brain damage, there's neurological uh issues here, and I see your liver panels are elevated, so these uh liver enzymes are way out of whack. You need to stop drinking. As if that's like the magic thing to say that's gonna make them stop drinking. Even physicians will do that. I many times I run into that. Um so there's a there's a part to this about like why logic doesn't work anymore, and it's critical for you to understand this. The addict brain shifts control from the prefrontal cortex, which is logic, to the limbic system, which is survival and reward. And the limbic system is the part of your brain that says alcohol means survival for me. Like alcohol equals survival. I can survive if I have alcohol. And the it doesn't make any sense because the alcohol is destroying their life. So the reason, I know I'm going kind of scientific in this episode, but the reason for that is dopamine reinforcement strengthens alcohol-seeking pathways, right? That's the reward-centered part of the brain. So you're getting a dopamine hit, and dopamine is a hormone that is uh it hits the same receptors as heroin. It's a really strong, feel-good hormone. That reinforces and strengthens that alcohol-seeking behavior. The brain literally prioritize prioritizes alcohol over relationships, career, health, safety, all anything, literally. And that dopamine hit, the thought, thinking about drinking, you're gonna get a dopamine hit. So you're feeling better. And so as a loved one, what you're trying to do is you're trying to negotiate with that part of their brain that's offline, it's not even on, and that's where the frustration lies for family members when they're dealing with this, and it's c it's just it's crazy making when you're experiencing it because you you probably feel like you're going crazy trying to explain something to somebody that should understand this. So, um how is it that somebody can seem normal for you know a length of time in one moment and then irrational the next? It's almost like you're dealing with somebody who's got uh borderline personality disorder. There's a there's a neurological inconsistency because of this damage. The damage is functional, but it's not always visible externally. You can't see it. The brain, the brain is in the skull. We can't see what's going on in the brain. We can see if somebody broke their leg and they're limping around, yes, but you can't see when part of the brain is not working. So some days they seem very clear. And it can be, you know, a number of different reasons that happens, but some days they do seem clear, and then other days they're completely irrational and impulsive and they're disconnected, and it and it confuses families because there's this false hope that kind of sets in when you're thinking about something and you're seeing it, and you see that they seem clear and they seem aware of the problem and what direction they need to go. They the person who's an alcoholic may even they they stop drinking, but they've got this brain damage. But there are these moments where they're like, Yeah, I need help. And so then they'll go to meetings, they'll go, they'll come into my office, they'll they'll come in and they surrender over to the idea of recovery. And then two days later, or that day, or whatever, they're completely irrational, and they're fighting you, and they're they're just acting impulsively, and they're just getting in their car and driving around to the st you know, liquor store, they or they just disconnect. They just they just check out. But it's very confusing because you get this false hope that, you know, hey, they finally get it today, and then the next day they don't. And it's it's again, it's crazy making behavior. Um, so uh there's there's some significant problems here when it comes to long-term exposure to alcohol. There's long-term risk of brand permanent brain damage, and alcohol uh can can do many things to the brain that is very damaging. You can get a form of dementia from it, and you don't have to actually have dementia, it's an alcohol-related dementia. Wernicke-Korsakov syndrome, severe memory disorder. That's another one. Sometimes you can get permanent cognitive impairment. There's just the ability to think is permanently uh affected. Now, the Wernicke-Korsakov syndrome, uh, generally um that's reversible. That's a uh uh thiamine deficiency. That's out the vitamin B. It gets flushed out of the body. Vitamin B is a water-soluble vitamin and drinking flushes that out quickly and whatever. Um you may be, you're probably on a very restricted caloric intake of food that's good for you. Um, so when we give somebody uh high dose vitamin B treatment, the the Wernicke uh Korskoff usually goes away. That syndrome will drop out, but it it does damage the memory cells when there's a bite vitamin B deficiency. Long-term heavy use accelerates brain aging. Now that's not the that's not necessarily the alcohol-related dementia I'm talking about, but it just the brain itself, it starts to age and it accelerates that that that uh that aging problem. So it doesn't just affect your behavior, it accelerates the neurological aging and destruction of the brain. So it's that's why it's important that we get this person into treatment as quickly as possible to try to help minimize that damage. The brain can heal, but it's only gonna heal with abstinence. You it's not gonna heal by reducing the amount of alcohol you're drinking. You have got to stop drinking alcohol. It will kill you. It'll kill your liver, it's gonna do a whole bunch of damage to your kidneys, it's gonna do a lot of damage to your brain, can cause heart problems. There's so many things, diabetes, all kinds of things. But the truth is, the scientific truth is, brain recovery begins within weeks of abstinence. It doesn't take a long time. So if if the person can get into residential treatment, within you know two, three weeks, you're gonna start seeing recovery in the brain. If we were able to scan the brain, we'd see it. Significant improvement can occur over months to years. So if you if you were able to abstain from alcohol for two years, you're going to get a radically different person sitting in front of you and talking to you. We used to think that the brain, once the brain cells were damaged or killed, that they didn't reproduce. Well, we know that's not true now. So the the other thing is that there are parts of brain that can kind of compensate for the ones that are damaged. So neuroplastic. Plasticity allows healing, but only if alcohol stops. So you gotta stop the alcohol. The brain cannot heal while it's still being poisoned by alcohol. So if you are a loved one of someone who is an alcoholic, what what I would like to explain to you is that you've got to stop expecting a healthy brain to exist inside an unhealthy system. Alcohol is damaging the way the person is able to think. Okay? Just keep that in mind. It's not just I'm oppositional or I'm defying what you are saying or I'm ignoring you or manipulating you. You can't expect the person to have that healthy, normal functioning as long as they're poisoning their brain. Families, you you you the loved ones, they they they have got to stop expecting rational decisions. It's not gonna happen. You may get one one day and then four days of nonsense. Consistent insight. Can't you see what you're doing to yourself? No, they can't. Okay. They might for a moment they might agree with you, but the consistency in that, which then drives logical behavior of like, let's move into treatment and get into abstinence and start working on it, that's not going to happen. You also have got to stop with reliable memory. If you're expecting somebody to remember things and they don't even have brain functioning that's communicating experiences of memories or they're blacking out because their brain is being shut down and the hippocampus is not able to retain information, why in the world would you get upset with a person? They're poisoned. If you filled them full of rat poison and they started getting deathly sick, you wouldn't get mad at them because they, you know, they were sick, you'd get help. Well, it's the same thing. So when recovery begins, that's when you'll start getting rational decisions and consistent insight and understanding of self, and then you'll start getting reliable memories. But again, they're probably not going to remember a lot of the stuff that they did. But if they stop, that's when recovery begins, and those things will start to come back. So I want you to I don't want you to have, you know, it's I know it's gonna happen anyway, but you're gonna be just exhausted emotionally and have a whole bunch of false starts. But the reality is there is hope. And I wanna I want to make sure I leave you with that. Alcohol physically damages the brain. The irrational behavior is neurological, not simply poor decision making or b moral weakness or you know, intellig intelligence problems, it's not. Irrational behavior is neurological. Recovery allows healing from that. It recover it allows recovery f uh in in the damage to the brain. But continued drinking guarantees that they're you're gonna you're gonna have somebody that's just further decline. So your loved one is not beyond saving. But they cannot save themselves while alcohol still controls their brain. So your role is not to argue with the damaged brain, don't argue with the addiction. Your role is to stand firm, stay clear, and throw a lifeline to that person when they're ready to grab it. And you don't know when that's gonna happen. Just because you want it to happen may not be the time that it will happen. But when they're ready, and if that means an intervention or it means something else that's more, you know, subtle in that approach, but it's when they're ready. And if you have somebody who's a professional helping you, they can help you decide when is the time that that they're ready. So I hope that you can at least have some uh hope and direction in where to go. And if you're an alcoholic and you you were listening to this, understand the the massive impact that alcohol has on your brain. It's a huge problem. It will kill the body, but it damages the brain and it makes it difficult for you to function and think and be, I'm using my little air quotes, a normal person. It's very hard. Well, I hope you've enjoyed this episode of Doc Shock, your addiction lifeguard. Uh enjoy doing it. I enjoy all these podcasts. If you need help, you can reach out to me. If you like this podcast, please subscribe, give me a like, and maybe tell your friends. Because I love helping people. And the more people I help, the better. And if I help you, great. Let me know that too. But if you need help, go. Go to rehab. Go to the detox. Go talk to a counselor. Please be real, authentic, helpful, well trained help. Don't end your life trying to save your addiction. That's crazy. Kill the addiction so you can save your life. And until next time, this is Doc Shock, your addiction lifeguard. Thank you. See ya.