[Music] when people drink no matter who you are initially there's that shutting down of those prefrontal cortical circuits there's a gradual shutting down of the circuits that control memory but then people divide into these two bins and these two bins are the people who after more than a couple of drinks start to feel sedated and the people who after more than a few drinks do not start to feel sedated now of course there's going to be differences created by how quickly people are drinking whether or not they're combining different types of alcohol the types of
alcohol Etc but in general that can predict whether or not you're somebody who has a predisposition for alcoholism or not one also very interesting finding is that alcohol changes the relationship between What's called the hypothalamus and the pituitary gland and the adrenals now the hypothalamus is a small collection of neurons about the size of a large Gumball sits above the roof of your mouth and it houses neurons that are responsible for some incredible aspects of our behavior and our mindset things like rage things like sex drive things like temperature regulation very primitive functions including appetite
thirst Etc alcohol because it can go anywhere in the brain remember it's water and fat soluble has effects on the hypothalamus the hypothalmus normally provides very specific signals to What's called the pituitary gland this is a little gland that actually sticks out of the brain but it receives instructions from the hypothalamus and then the pituitary releases hormones into the bloodstream that go and talk to your adrenals your adrenal glands sit right above your kidneys in your lower back and the adrenals release as the name suggests adrenaline also called epinephrine and also a molecule called cortisol
which is involved in the kind of longer term stress response has some healthy effects too on the immune system okay so the hypothalamic pituitary adrenal axis I know that's a mouthful you don't need to remember the names but the hypothalamic pituitary adrenal axis maintains your physiological balance of what you perceive as stressful and what you don't perceive as stressful people who drink regularly so this again could be just one or two drinks per night or it could be somebody that drinks just on Fridays or just on Saturdays or maybe just on the weekend two to
four drinks well those people experience changes in their hypothalamic pituitary adrenal axis that result in more cortisol more of this so-called stress hormone being released at Baseline when they are not drinking this is really important people who drink a bit and when I say a bit I don't mean one or two sips or even a glass of wine every once in a while I mean again people that are maybe having one drink a night with dinner and maybe on the weekend a few more again I offer a bunch of different patterns to explain how it
could also be two or three drinks on Friday or six drinks only on Saturday well all of those groups experience increases in cortisol release from their adrenal glands when they are not drinking and as a consequence they feel more stressed and more anxiety when they aren't drinking this is a seldom talked about eff of alcohol because so often we hear about the immediate effects of alcohol right and we've been talking about some of those effects effects like reducing the amount of stress I mean how many times have we heard somebody say oh I need a
drink and then they have a drink and they're like calm down now they can shake off the thoughts about the day's work they can start to think about things in a maybe more grounded or rational way or at least they believe that or they can somehow just relax themselves well while that very well may be true that it can relax them when they are not drinking that level of cortisol that's released at Baseline has increase substantially again this relates to a defined neural circuit between brain and embody and it has to do with the ratio
of cortisol to some of the other hormones involved in the stress response we'll provide a reference to the study that describes how all of this works for those of you that really want to delve into it but let's go back to this issue of those who are prone to alcoholism versus those who are not remember there are people who have genetic variants that meaning genes that they inherited from their parents that make it more likely that they will become alcoholics but there are also people who drink often Who start to experience this increase in alertness
the longer they drink across the night part of that effect we think is because of changes in this hypothalamic pituitary adrenal axis so alcohol is kind of a double hit in this sense it's causing changes in our brain circuitry and neurochemistry that at the time in which we're inebriated are detrimental and it's causing changes in neural circuitry that persist long past the time in which we're experiencing the feeling of being TI Tipsy or drunk now again I don't want to demonize alcohol I'm not saying oh you know if you have a glass of wine now
and again or you drink a beer now and again or even have um you know a mixed drink now and again or a shot that that's necessarily terrible for you I certainly do not want that to be the message what I'm saying is that if people are ingesting alcohol chronically even if it's not every night there are well recognized changes in neural circuits there well Rec ized changes in neurochemistry within the brain and there well recognized changes in the brain to body stress system that generally point in three directions increased stress when people are not
drinking diminished mood and feelings of well-being when people are not drinking and as you'll soon learn changes in the neural circuitry that cause people to want to drink even more in order to get just back to baseline or the place that they were in terms of their stress modulation and in terms of their feelings of mood before they ever started drinking in the first place so again I don't want to De demonize alcohol but I do want to emphasize that there are long-term plastic changes meaning changes in neural circuitry and hormone circuitry that across a
period of several months and certainly across a period of years of the sorts of drinking patterns I described which I think for most people are going to sound like pretty typical right I I mean nothing that I described so far was about drinking a case a night or or about binging on alcohol in the way that we often hear about it in the news these are pretty common patterns of of alcohol consumption I mean all you have to do is board a transatlantic flight or actually go to an airport on a Sunday afternoon in a
sunny area of the US and you know people are having three four five six beers Etc again personal choice is personal choice I'm not telling you what to do but it's very clear that those sorts of drinking patterns are changing neural circuitry and they're changing hormone circuitry and I'd love to be able to tell you that they're changing them for the better but they simply are not they're actually changing them for the worse and worse is defined as making people less resilient to stress higher levels of Baseline stress and lower mood overall so what happens
when alcohol gets into the brain that makes us feel Tipsy or drunk and in some people makes people feel really especially energized and happy well alcohol is indiscriminate in terms of which brain areas it goes to again doesn't bind to particular receptors but it does seem to have a propensity or an affinity for particular brain areas that are involved in certain kinds of thinking and behavior so one of the first things that happens is that there's a slight at least after the first drink or second drink there's a slight suppression in the activity of neurons
in the prefrontal cortex this is an area of your neocortex that's involved in thinking and planning and perhaps above all in suppression of impulsive behavior here so if you go to a party and they're serving alcohol and people are consuming drinks what you'll notice is that a few minutes into that party the volume of people's voices will increase and that's because people are simply not paying attention to their voice modulation as other people start speaking more loudly other people are speaking more loudly we've all had this experience right of going to a party and then
you step outside for a moment you go oh my goodness I was shouting you come over the next day you got a sore throat might be that you picked up some sort of bug some virus or something but often times it's just the fact you've been shouting all night just to heard because as the prefrontal cortex shuts down people stop modulating their their level of speech quite as much also notice that people start gesticulating more people will start standing up and sitting down more they'll start walking around more if there's music on people might spontaneously
start dancing all of this is because these areas of the prefrontal cortex normally are providing what's called top- down inhibition they are releasing a neurotransmitter called Gaba onto various parts of the brain they're involved in impulsive motor behavior and thought patterns and as you shut down the prefrontal cortex that gabaergic suppression of impulses starts to be released so people will say things that they want to say without so much forethought about what they're saying or they might do things that they want to do without really thinking it through quite as much or they might not
even remember thinking it through at all or experience I should say thinking it through at all we haven't talked about blacking out yet in the effects of alcohol on memory but as long as we're there I'll just tell you that alcohol has a very strong effect in suppressing the networks that are involved in memory formation and storage this is why often times we forget the events of a night out if we've been drinking one of the more important things to know about the effects of alcohol in the brain is this disruption and top- down inhibition
but also that areas of the brain that are involved in flexible Behavior sort of considering different options like I could do a or I could do B I could say this to them or I could say that I could say it in that way or I could say it in this way this might be a little more impactful those brain areas basically shut down entirely and people just tend to say what they want to say so the key thing to understand is that when people drink the prefrontal cortex and top- down inhibition is diminished that
is Habitual behavior and impulsive behavior starts to increase now what's interesting is this is true in the short term so after people have one or two maybe three or four drinks but it's also true that the more often that people drink there are changes in the very circuits that underly habitual and impulsive [Music] behavior
