Dr. Sarah Wakeman
Appearances
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I'm seeing people in their early 30s with cirrhosis in the hospital. And I think those are like some of the most heartbreaking cases because people thought like this wasn't on their bingo card. They did not even think this was a concern. You know, they were drinking heavily. They thought it was their social circle was doing the same thing.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And then all of a sudden they're in their late 20s, early 30s in the hospital and liver failure. And, you know, there's very little we can do at that point other than an organ transplant, which is a huge deal and not something that's accessible to everyone.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, and there's actually a lot of studies showing this. So between, you know, 2010 and 2020, there's been a significant increase in alcohol related liver failure, especially amongst women. and younger and younger people. And even just after the onset of COVID, we saw somewhere around a 25% increase in alcohol-related death after the onset of the pandemic.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So the pandemic was hard for many reasons, but it certainly increased alcohol use across the country and with that, liver disease and liver failure.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
How does alcohol impact the kidneys? So alcohol, one of the main effects that people have probably experienced is it makes your kidneys less sensitive to a hormone your body produces called ADH or antidiuretic hormone. And so you pee more. So if anyone's ever noticed that when they drink, they sort of pee a lot more.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And it's not because you're hydrated, because that's what I thought is why you pee more is because, oh, I just have more liquid in me, but it's actually because it's blocking a hormone. Exactly. So even irrespective of how much volume you've drank, you pee more because of this blocking of the effect of a normal hormone function in your kidney.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so that can lead to dehydration, which is one of the many reasons you feel really crummy the next day because you get dehydrated from drinking. What about the gut microbiome?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah. So alcohol, I think there's growing research on how it impacts the microbiome. Certainly, again, at heavy levels, it seems to harm the microbiome. And we see this in patients with liver disease, but also just the impact of alcohol itself. The kind of two main things it does, one is it creates more leakage in your gut. So people may have heard of kind of leaky gut.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You know, the walls of your intestine become more porous so that things that aren't meant to come out of your intestine do and can actually cross the blood-brain barrier. So this whole idea of kind of the brain-gut axis. is a really growing area of research and knowledge. So alcohol can do that.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
It can also change the makeup of your microbiome itself, as can high fat, high sugar, white flour, sort of the Western diet. But there's now a lot of studies showing that that some of the modifiable things, if you want to improve your gut health, are decreasing your alcohol consumption and steering away from that kind of Western diet of high fat, high sugar, high carb.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You know, I'm sitting here listening to you and I'm thinking, why the hell do I even drink this stuff? Yeah, I think it is important to understand sort of what are the risks that we often don't talk about and assume that this is, you know, harmless thing that's just a part of life. My personal perspective is that every health behavior exists on a spectrum.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And it's really important to understand sort of what is that spectrum? Where do I fall? And then what are my personal health goals? And actually stopping to sort of think, how does alcohol fit in my life? Like, what do I like about it? What do I not like about it? What am I worried about it? What is this amount of alcohol doing to my health? Is there any health benefit to drinking alcohol?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
My opinion is that we shouldn't be thinking of it as a health benefit. So I would never, as a doctor, say to a patient, I think you should start drinking a glass of wine a day for your health. We used to people used to say that, you know, again, this idea of a glass of red wine is healthy. I think that framing is wrong.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I think that doesn't mean that you can't drink any alcohol and we should talk through that. But thinking of it as a health promoting behavior is probably not the best way to frame it. Now, there are many things we do in life that the safest thing would be to do none of it.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So if your goal is to have zero risk, you should probably never drive your car, never go skiing, never fly in an airplane, never eat bacon, never go out in the sun. And people aren't going to live that way. So I think it's really important to understand what are the risks? How does this fit into my overall life? And when should I be concerned?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And how can I actually make changes to decrease those risks? So if you're finding that you are really stressed in your life and you're reaching alcohol as a stress reliever, it's probably not going to be a healthy way of coping with that and may lead to longer term problems.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And especially if you're trying to live a life where you're being more mindful or more present or present for your kids or your partner or you're trying to get in shape and you want to wake up in the morning to exercise. If you're drinking every night, you're probably going to feel not refreshed in the morning. You're going to notice that you don't have the same exercise capacity.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So I think just figuring out sort of how this ritual, alcohol, what role it plays in your life. And it doesn't have to be that you stop drinking entirely. And I think that's a really important message because that may not be the goal for people.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
But if you are feeling like maybe this is causing some problems to me, maybe this is actually counterproductive to my other health goals, making some changes, cutting back, taking a break. Those are all really healthy ways that you can start to really explore your relationship with alcohol.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah. So from a research standpoint, high risk drinking would be if you're having more than 10 ounces of hard alcohol a week or 35 ounces of wine in a week for a woman or for anyone over 65. So above that, we start seeing health risks like increased risk of dementia, impact on your liver, your digestive tract and other serious conditions.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, and I think there's so many important points buried in that. So first, we all lie. I tell my dentist I floss every day. I don't. We want people to like us and approve of us. So I sort of expect people will lie to me, especially if they don't know me. And for most people, because of the tremendous stigma around substance use disorder, there's a lot of shame and worry.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
For many people, their experience has not been that good things happen to them when they share that they're having a problem with alcohol or other drugs. And so as a doctor, I feel like it's on me to earn someone's trust and also to educate them.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I mean, there's nothing more heartbreaking to me than when I see someone in the terminal stages of liver failure, for example, from alcohol, and no one has told them beforehand what the risks are, that this could happen, what sort of lower risk drinking looks like.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
they've often never had that conversation so we'll see people in their 30s come in they literally die during that hospital admission and you look back and they had touch points with doctors they maybe were drinking heavily and no one stopped to sort of talk to them about it and i think that is a real testament to how in the medical system for so long we have seen substance use and addiction as something separate from the rest of health care is sort of not our job or a behavioral issue or a moral issue or a willpower issue
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
But this is a health condition like any other. And I think the medical system and doctors need to get comfortable talking to patients about it, asking them the right questions, giving them the right education and partnering with people around making healthy changes.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
that you would say these are all indications that this could be a problem yeah that's a great question so i'll run through kind of the checklist that i'm thinking when i'm talking to someone about alcohol so first um you know understanding how much they're drinking just the general quantity and how frequently is important as sort of a proxy for what their risk might be but then the really important questions are um are they drinking more than they want to so are they
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
They may have set an intention for themselves and they're finding they're actually always drinking more or spending more time on drinking or recovering from drinking than they intended. Have they tried to make changes and not been able to? So if you tried to cut back or tried to stop and you actually weren't able to, that's a really important sign that you may have lost control of your drinking.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Are you drinking despite the fact that people in your life are worried about it or your spouse has expressed concern or it's impacting your work or your ability to function in roles that matter to you? Are you drinking despite the fact that it actually makes you more anxious or it's worsening your mental or physical health in some way? And then we often think about
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
craving, which is sort of a strong psychological urge to want to drink. So like you can't get the idea of having a drink out of your mind. That's something that we can see with alcohol use disorder. And then there are two physical symptoms, which is that idea of like, do you need to drink more to get the same effects?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Do you need to drink four drinks now, whereas before one or two would give you that effect? And do you feel sick if you stop drinking? So that's sort of the checklist we run through and I think really gets at those kind of general areas of losing control, using compulsively, using despite consequences and then craving.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, it's a great question. So one really common thing is worsened acid reflux. So if you have heartburn, that's strongly associated with alcohol, which actually relaxes the part of your esophagus that allows acid to come back up. So oftentimes people who are struggling with terrible heartburn and they don't realize that those two glasses of wine are probably having a direct impact on that.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Other things we know that alcohol can make you dehydrated. So you may notice that your skin changes. It impacts how you sleep. So you may feel less rested when you wake up in the morning or wake up in the middle of the night and not be able to fall back asleep. So lots of little sort of day-to-day ways that alcohol may be impacting your health and your experience.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, you'll see a lot of really quick things. So when you'll sleep better and feel more restored, you may lose weight. There's a lot of calories in alcohol. So if your goal is to lose weight, you're drinking a ton of liquid calories. So you may find that that's better.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You may find that your exercise capacity goes up because you're resting more and you're not having hangovers and you're able to exercise in a way that feels different. You may find that you're less irritable and more present for your loved ones, that your mood is actually better over time. Your skin might look better. You're less dehydrated.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Your hormones are more regulated, so you may have less acne. So all of those benefits you can often see in a very short time, and that can be reinforcing as you decide what you want your long-term goals to look like to really see what life is like with less or without alcohol.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, this is, I think, an area of growing research and understanding. And I think people are really interested in sort of drinking during menopause as well and what to think about all of that. A couple things. I think many of the symptoms that people experience during menopause, like hot flashes, will be made worse by any amount of alcohol. Really? Yes, because alcohol dilates your blood vessels.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So you may have experienced if you drink a couple glasses of wine, you actually feel flushed. Yes. Well, it's just going to amplify the experience you're having during hot flashes. So if you're trying to not have hot flashes, drinking is going to be your enemy in that because it's just going to make that worse. Same things like sleep disturbance are really common in menopause.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Mood changes and alcohol may impact all of those. And it can be a tough cycle because you may be drinking because your mood is actually low and you're having a hard time falling asleep. But then alcohol is actually running counterproductive and making those symptoms worse over the long haul. Let's talk a little bit about sleep because. Yeah.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Doesn't alcohol impact your sleep in a very negative way? Yeah. And people may be surprised to hear that because it makes you fall asleep quicker. So often people are like, oh, alcohol helps me sleep because I fall asleep so quickly. But when we think about sleep architecture, there's different cycles to sleep. People are probably familiar with REM sleep is that deep, rapid eye movement sleep.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
But there's different cycles that your body, your brain naturally cycles through in the night. And the balance of those cycles is really important to get restorative sleep, which is when your body rests and heals. And what alcohol does is it changes the makeup of those cycles. So you go more quickly into deep sleep and you have less time in sort of the normal phases of sleep.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so your sleep architecture is disrupted and you don't get that same restful sleep. You may wake up at two in the morning, you know, after you've fallen asleep really quickly, but then you wake up and can't fall back asleep.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Or you may wake up in the morning and just feel not refreshed, even though you were completely, you know, asleep very deeply because your brain is not having the time to restore itself the way that it needs to. I have another question for you, Dr. Wakeman.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, hangover is fascinating, and I think people are still trying to understand exactly what is going on. Loosely defined, what we refer to as hangover often is a constellation of symptoms that include headache, feeling anxious, often actually having diminished exercise tolerance, so you don't have the same aerobic capacity that you did before, feeling irritable.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Those are all symptoms of hangover that people have probably experienced. There's an older school of thought that actually it was mild alcohol withdrawal. So withdrawal is when you are drinking so much that when you stop drinking, you actually get symptoms. Seems like that is likely not the case. The constellation of symptoms is quite different.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so the thinking is that it's a combination of really two things. One is dehydration. So we already talked about how alcohol make you, you know, make you pee more. And so you get dehydrated.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And then the other is actually byproducts from the drink that you're drinking itself, either the sort of breakdown products of alcohol, or there are certain types of liquors and drinks that have other types of molecules, cogeners that can build up and make you feel even crummier. So for example, clear alcohol tends to cause less of a hangover than dark alcohol.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And that's probably because of the other substances that are in it. But it's really sort of toxic byproducts and dehydration, if I were to sum it up, of what's causing a hangover. Why is anxiety one of the biggest kind of symptoms of a hangover and alcohol withdrawal?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, it's probably the effect of these byproducts that then, you know, are still impacting the way your body functions, your brain, and it takes a long time for your body to excrete them. And so we can see just feeling that really anxious, restless, kind of gross feeling afterwards.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, it does, especially over time. And so what we see when people have been drinking over a long time is actually your body starts to adjust. because our bodies are very adaptable. So if your body's used to having three or four drinks every night, your body's going to start to accommodate to that. And so what we see is actually changes in the brain.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So you see changes in the amount of receptors you have, the amount of hormones you have, your dopamine levels, your stress hormone levels. Your brain is actually adapting to the effects of alcohol. So one thing you may see is that you actually don't get the same effect. So it used to be that two glasses of wine made you feel a certain way, and now you need three or four to feel
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
the same way that's a concept called tolerance that your body is adapting to having that alcohol around all the time and your brain's actually changing the reverse of that is if all of a sudden you stop drinking you're going to feel all out of sorts you're going to feel shaky you may have a headache you may feel anxious you may feel nauseous and that's because your body's gotten so adapted to always having alcohol on board that it takes time actually for those changes to reset
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, there's a couple of really important things to know. First, alcohol itself can cause depression and anxiety. Even though you feel like in the moment it's helping relieve symptoms, there's actually something called a substance-induced mood disorder where you can look all the world like you have depression and it's actually caused by using alcohol heavily over time.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So you may, if you're drinking heavily, you may actually be running, you know, working again at cross purposes with your efforts to try to manage your depression or anxiety. The other thing is there are some types of medications that are really dangerous when they mix with alcohol and anxiety medications in particular, especially any medication that also has sort of a slowing down effect.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So some people take medicines in a class called benzodiazepines, so things like Xanax or Klonopin or Ativan. Those when mixed with alcohol have sort of a combination effect that can actually slow down your breathing, could cause an overdose, could make you very sick, could make you more sort of impaired sooner. So really important to not mix those medications with alcohol.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
How does alcohol compromise your memory? So alcohol affects all parts of the brain, including the amygdala, which is an area that lays down memory. And it has complicated actions in the brain. So it increases sort of more slowing down hormones. So we think of it as a depressant because it sort of slows you down and relaxes you. And it decreases more excitatory neurotransmitters.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
In the short term, because your consciousness is being affected, you won't be making new memories. Over the long term, heavy alcohol use can actually cause dementia. It can cause severe memory problems.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
There's actually a unique condition that we only see with alcohol generally, where the part of your brain that lays down new memories gets damaged and people get basically an amnesia syndrome where they can't make new memories. So they can only remember things from the past, but they're unable to make any new memories anymore.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And that's a very extreme example, but we see it in the hospital and it's really scary when it happens.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
We actually see brain damage on people who've had chronic heavy alcohol use over many years. So if you take a picture of the brain, like with a CAT scan or with an MRI, what we describe it as is volume loss. So normally you want to see a big, healthy, robust brain. And as you age and with types of dementia, One thing that we see is the brain starts to shrink.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So like the actual functional parts of the brain are smaller. We see that process accelerated with heavy alcohol use. So often take someone who's in their 50s who really shouldn't have volume loss in their brain at that age. But if they've been using alcohol at a very heavy amount for a long time, we'll often see their brain looks like a much older brain because of that shrinking.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And then there are very extreme examples like this rare memory condition where we literally see that part of the brain almost die. Like you can see it light up that it's been severely impacted. That's scary. Yeah. It is really scary.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, I think these are such important questions. And one of the greatest tragedies to me around substance use disorder is often family members and the general public have been fed the wrong thing to do. And so I think it's a great thing to talk about. First, it's important to define sort of what is an alcohol use disorder, because that's sort of what we're getting at.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You know, there's there's heavy drinking where we're worried about the long term health effects. And then there is where alcohol has become a problem in your life. And really, the definition of an alcohol use disorder is losing control over your drinking, compulsive use of alcohol and using despite consequences.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So if you are continuing to drink despite the fact that your partner has shared that they're really worried about you or you've started to have problems at work because you're calling out sick or you're You're continuing to drink despite health problems related to it. So your doctor says, you know what, your liver tests are elevated.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You really need to cut back on drinking and you continue to drink. Those are all signs that alcohol started to play a different role in your life. About 15% of the population will have an alcohol use disorder in their life. So this is a very common health condition, more common than many other conditions we see. The great news is that it's entirely treatable. Most people will get well.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I think we often have in our minds that this is like a terrible stigmatizing recalcitrant condition that no one ever gets better from. That is not true. And that notion that this, you know, something to feel hopeless about, I think drives a lot of the stigma and shame. There is good treatment out there. People will get well, but they do need care and they need support.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I think the first thing you can do if you're a loved one is just share your worries, not in a way that blames the person, not in a way that's judgmental, but in a loving way, just like you would about anything else with someone's health, that this is what you've observed. This is why you're worried. Explore what the person thinks.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And that becomes really important because when it comes to addiction, it really doesn't matter at all why I think someone should make changes to their alcohol use. The only thing that matters is they think their life will get better in some way. And so really starting to sort of untangle what are this person's goals and how is alcohol getting in the way of them reaching it? That becomes the work.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And a partner can be a wonderful mirror for that. You know, I know you're working towards a promotion at work and you mentioned that you had to call it sick twice this week and your boss is frustrated at you. What do you think about that? So really exploring it.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And ultimately, you're sort of empowering the person to feel like they can make a change and that you're supporting them, but you're not forcing it on them, which is often what people feel caught up in having to do.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I think people have heard these notions of like tough love, enabling, hitting bottom. Those are probably the biggest fallacies. So for people who aren't familiar with those concepts, the idea that tough love is that like you really should make things hard on a person that if sort of consequences pile up, the person will ultimately get better.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Enabling is the idea that you're kind or caring to someone that you're actually hurting them in some way. And hitting bottom is this idea that people have to just fall so far and suffer some terrible consequence before they make a change. Those are all really problematic concepts for a couple of reasons.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So first of all, the definition of alcohol use disorder is not being able to stop despite bad things happening to you. And many people are drinking because it's a powerful coping mechanism. And some of the things that put you at risk for an alcohol use disorder are traumatic life experiences, untreated anxiety and depression, not feeling good about yourself.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So having the only people that you sort of love and trust in your life try to cut you down to size and tell you that you're doing something terrible and set some ultimatum is actually not going to help you get well. None of us make hard changes when we feel threatened or sort of punished or not supported. We do it when we feel loved and safe and have hope that our life could be better.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so as a loved one, that's probably the greatest gift you can give to the person. Now, it's complicated because you're impacted by their behavior. So it's very easy as a provider.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
One of the things I love about doing this work, because I've been on the other side and had family members and it's a different experience as a doctor, like whether or not my patient continues to drink doesn't impact me personally. I can just be their partner, their champion, work with them.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
For families, there are times where the behavior becomes so unsafe that people have to keep themselves safe and set boundaries. And that's OK. I think the distinction there is that it's not doing it for the person's benefit. So if you kick someone out of your house, it's not going to necessarily help them get better.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
But there may come a time and a place where people need to do that for their own emotional safety or well-being. But for that human being to help someone get well, and this is where earlier conversations are so important, is to really sort of love and support them and work together on it and make sure they find access to good treatment, which is out there and available.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, so many important pieces in there. I think there's so much stigma in our society about alcohol use disorder and substance use disorder. And people rightfully so feel really ashamed and secretive. And sometimes long after they've started to worry about themselves, They're scared to tell anyone else because they think someone will judge them or treat them poorly.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And that stigma and fear of bad treatment or judgment actually keeps people from seeking help for a long time. I think the other really important piece is that when you're removing something that has played a powerful role in someone's life, you need to fill up those spaces with other things. I think our sort of Puritan roots as a society is we have this idea that like you're doing something bad.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You need to just pull yourself up by your bootstraps and knock it off and white knuckle it. And in fact, like it should be hard. You know, that's often our sort of these ideas of tough love and hitting bottom is like, well, you're you're like have done something bad and you, you know, you don't have willpower. So we're going to make it tough on you.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
When in fact, like the broader concept is why would someone make changes and how is their life going to get better? And how do we make it easy to make a change? And so if you think about any change you made in your life, if you set yourself up for success, you're going to be far more likely to be able to make that change.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So if you're suffering from trauma, depression, anxiety, you're not going to be able to just stop drinking without help. You need help treating the anxiety, depression, trauma and also treatment for the alcohol use disorder. That's not because you're weak. That's not a failing. And if you're not able to sort of
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
meet your goals with whatever intervention and support you're getting, that's a sign that that support is not enough for you. So really shifting from this idea that the person is failing to thinking like the system, the treatment, the resources are failing. And how do we adjust that instead of blaming the human being who's suffering? I just want to thank you.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, I think ideally it starts young. Like ideally you're having these conversations very early on with kids in a pragmatic, not in a scare tactic way. So we know that things like dare, you know, this like I'm going to scare you into this is what alcohol and drugs do to your brain. Actually, kids use more drugs after seeing that sort of stuff. It's not helpful.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Kids see right through adults when they're sort of all or nothing about things. So having these nuanced conversations like you're going to be around friends who are drinking really heavy. What do you think about that? What's been your experience? What are some of the worries you might have about that?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And talking about the very practical risks that are not necessarily like liver failure addiction, which are not going to be resonant for a 19-year-old. But, you know, getting into a situation that doesn't feel safe, you know, getting into a sexually vulnerable position with someone, doing something that you don't want to do, missing class the next day.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So talking about sort of relevant, personalized issues that may come up for that kid. And then importantly, that your child feels safe talking to you. You know, you want them to feel comfortable coming to you about small things so that they'll come to you about big things.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so you can share all of this in a way that doesn't feel judgmental, doesn't feel accusatory, really opens the door to ongoing conversations instead of making someone feel sort of, you know, like they're being blamed or judged by their parent. So for somebody that's never even broached this and
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Well, first of all, it is not too late. You have not failed. None of us are perfect in this. These are hard conversations and we haven't learned how to do it. So it is never too late. It doesn't matter how many times you've ignored it or had an unproductive conversation. I think in that moment, probably the most important things you can communicate are, I love you. I'm worried about you.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
I'm here for you. I know that treatment works. This is how I can support you. So like many things, you're sort of talking about yourself. You're talking about your care and concern. You're rooting everything and how much you love this person. And you're offering to be a partner and helping them find support and treatment. And it may not happen that day. It usually doesn't.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So often the journey to recovery is the circuitous journey of a thousand small steps. It's very rarely that dramatic leap we see on TV. And so to not give up hope and to know that those small moments of kindness and support actually are progress and are part of the person's journey to ultimately getting well. If you're the one that really just wants to cut back,
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So if you're listening and you want to cut back on alcohol use, I think first figure out your why.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, I think understanding first how alcohol fits in your life. And so people can do this at home by just keeping a drinking diary. So even just jotting down on your phone or in a notebook when you want to have a drink, sort of what activities you associate with drinking, what, you know, when you do have a drink, how many drinks you have over what time periods.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
It's sort of like keeping a food journal where it actually just makes you more mindful. Like, oh, I'm like triggered to want to snack on this thing because I'm feeling really upset about this fight I just had. You can identify that with alcohol, too. Like you mentioned this earlier, I'm really stressed out at the end of the day. And so I come home and want to reach for a glass of wine.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Understanding sort of how alcohol fits in your life is an important first step. And then figuring out what are the goals you're working on right now. And that could change over time.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
But again, if your goal is something related to fitness or wellness or health, you may find after learning more about alcohol and the role it plays in your life that actually you want to change how much you're drinking. And so then you have your why. My why is I'm training for a marathon and I found that when I drink, I have a hard time waking up and going for my long runs.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so I'm only going to drink on this day and I'm going to keep it to this amount. So it's very specific and that's important for behavior change. If you make this broad sort of general goal of I'm never going to drink again because alcohol is bad, you're probably not going to do it because that's hard and it doesn't really relate to you as a human.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So as much as you can make it specific, measurable, time bound. So it's like the next three weeks, I'm going to try this and then I'm going to reassess. That makes it much easier to actually make change and stick to it over time.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Exactly. And there's lots of tips out there, but you want to make it as easy as possible for yourself. So if your goal is to cut back on drinking, you don't want to have a week where you're packed with going out to happy hour with people. You want to really set yourself up for success. So organize your social activities around non-drinking activities.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Come up with a plan if you're going to be in a situation where you would normally drink, that you're going to have a glass of club soda in your hand the minute you walk in the door. You're going to have a friend who knows that you're working on this who's going to be your partner.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Setting those intentions and those ideas and tools and tricks ahead of time will make it way easier for you to ultimately reach that goal of cutting back.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Great question. I think first letting people know about your intentions. So sharing what your goal is, is really important because people can't support you if they don't know. And if you've always drank a certain way with your partner or friends and all of a sudden you're not, they're not going to be like, what's going on?
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Whereas if you say to them, hey, guys, I know you love me and support Eat Me. I want to share with you that my new goal is to not drink more than one drink a day or only drink on Friday and no more than two drinks or not drink at all. And this is my why. I'm doing this because I'm worried about myself or I'm doing this because it feels counterproductive to my health.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And I really want your support. And this is how you can support me. So then you're really framing it as they get to be a partner with you. You're not criticizing their drinking because often people feel then like, oh, I'm a little self-conscious. This person's going to be judging me or they think I'm bad. You're just asking for their help.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so maybe that looks like instead of meeting for drinks, you meet to go to yoga class or you meet to go for a run or you let the person know why you're going to be ordering a soda water instead of a drink. And so you can be really concrete both for yourself and what those tools look like, but also for the people in your life to signal to them how they can help support you.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And sometimes people can't do that. And that happens whenever we make any big change. People may have experienced that if they decided to have a weight loss journey or change their life in some way, that there are people that really fit in our lives for a certain point that can't journey with you through that transformation. And that's sad.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
But if you find that despite those conversations, someone is actually destructive to the change that you want to make and not supportive, then that may be a broader question about sort of the role of that relationship in your life.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah, I think I'd like to just talk for a moment about alcohol use disorder. I think we've been covering sort of the health harms of alcohol use, either at a low risk level or moderate level or high level. For anyone who is struggling with alcohol use disorder is worried they may be struggling with alcohol use disorder. Treatment works. You will get well.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Finding sort of a trusted health care provider that you can partner with is a part of that journey. But to really have hope, this is not a hopeless condition. It will not be with you forever. You will be in a place where you're free from this.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And there are treatments that are out there and just getting those much like you would for depression or diabetes or high blood pressure is the most important thing. And this is not an issue of shame or willpower or being bad. And I hope that people will feel like they can come in and get the help that they need.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
It can be really hard to hear this, especially in a society that still stigmatizes alcohol use and alcohol use disorder. I think take this as a message of love. Someone loves you. They care about you. They're sharing their worries and they're there to support you. And they want to be a part of this journey to help you live the best life you can possibly live in whatever way that means.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And hopefully it will be a moment to pause and thank and get the support you need to make some changes.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Thank you, Mel, for having me. This is a true pleasure. And hopefully these words will reach people who are working to better their lives or worried about someone they love.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Sure. So alcohol is a molecule. It's a water-soluble molecule that is readily absorbed in your body through your stomach and your small intestine when you drink it. And it affects all different parts of your body and body systems, in particular your brain, which is why we feel the effects of alcohol pretty soon after you start drinking.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And we can talk through what those effects are, but it impacts our behavior, our sleep, our mood, and many other parts of our body system. Okay. You talked about alcohol as a molecule.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yes. I mean, the way alcohol that we drink... happens is through a process called fermentation. So something that has sugar like grape juice or you think about beer, barley or potatoes or other often starches are fermented. And in that transformation process, they form an alcohol molecule that then has a different effect on our body. Alcohol's found in all sorts of different things.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So obviously it's intentionally made through fermentation to ingest, but we also use it in cleaning products or like rubbing alcohol or mouthwash, hand sanitizer. So there are alcohols all around us and used for many different things. Huh.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
It is. And in fact, some of my patients with the most severe forms of alcohol use disorder will drink hand sanitizer or rubbing alcohol or mouthwash if they can't get regular alcohol, which tells you really the power of addiction once someone gets to that level of severity. But it's the same molecule with the same effect.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Exactly. The actual alcohol molecule that we think of in a fancy cosmopolitan is not different from what's in rubbing alcohol, let's say. I never knew that.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Absolutely. I mean, that it is so socialized and a part of culture and a part of celebrations and events that I think it just feels like a part of life.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah. So this is probably the most fascinating area of research where things have changed and gone back and forth over many decades of science. And it's actually a somewhat tricky question to answer, which is why I think there have been very confusing sometimes and conflicting studies about this.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So if you want to try to understand what is the impact of low risk drinking, moderate drinking, higher risk drinking, you have to figure out how do you study that. So you need to follow population over time to see what happens. And then you need to figure out how do we isolate the effect of alcohol.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so early on, there were lots of studies showing that low risk drinking or moderate drinking were actually healthy. I think I remember something about like a glass of red wine is really good for you, the antioxidants. I don't know if that's the red wine lobby telling us that.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
One criticism of those studies showing that low risk drinking is healthy is that the group that is often used as sort of the comparison group are people that don't drink at all. But it turns out that many people who don't drink at all may not be drinking because they have chronic health problems or because they actually used to have an alcohol use disorder and they're now in remission or recovery.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And they may have health consequences that are leading to higher mortality compared to people who are drinking at a low risk or infrequent level. So a lot of the newer studies have actually used infrequent drinkers as the sort of control group or the comparison group. And I think that's really helpful to understand the data that way.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
There was a really big study actually this year that looked at hundreds of thousands of people that had been surveyed since the 1990s all the way through the mid-2010s and did a really elegant job of trying to answer this question. And the things they did differently than other studies is first they controlled for other healthy behaviors, lifestyle behaviors, chronic conditions.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Because one question is a person who's drinking a glass of wine a day, maybe they're also running every day and, you know, doing other sort of health promoting behaviors. And maybe that person who's chosen not to drink at all has lung cancer. And that's the reason they're not drinking. And so they actually controlled for all of that.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And they did see that in the low risk category, there seemed to be a slight decrease in mortality. And it was not true for cancer. So any amount of alcohol is associated with an increased cancer risk. And that's a really important thing to know, especially if someone has a personal family history of cancer. Breast cancer is one that's strongly associated with alcohol use.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
And so factoring that in as you're making your decisions about alcohol is really important.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
You know, it's different for every type of cancer. And I think we're just starting to understand this. If you take breast cancer, there are things that seem to increase hormone levels are often associated with a risk of cancer. So that's an area of active research to understand why alcohol and breast cancer in particular are so closely linked. Other types of cancer, it's a little more clear.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
They tend to be cancers of the liver or the gut that are strongly associated with alcohol. And that makes sense if you think of alcohol as a potential poison going into your gut, being metabolized by your liver, causing changes there. That's an area that we do see a lot of cancer risk. Can you talk about what you're seeing as it relates to...
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
Yeah. So one of the main health harms from alcohol, especially heavy alcohol use, is liver damage. And so what we see happen is this progression where the first thing that happens is inflammation of the liver. And when your liver gets inflamed, you start getting fat deposit in the liver. So the first kind of step is what we sometimes call fatty liver. So it's fat deposition in your liver.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
That actually can totally reverse if you stop drinking or you make changes. And that's the amazing thing with the liver. It's a really regenerative organ. So you could cut 80% of someone's liver out and they would be okay. But there is a point where you cross the threshold where you can no longer repair the damage. And that's when you get to a stage called cirrhosis.
The Mel Robbins Podcast
What Happens to Your Body and Mind When You Stop Drinking Alcohol
So from fat deposition, then you start getting scarring. Your body lays down all this scar tissue because of the chronic inflammation in your liver. And when your liver becomes so scarred that it's really stiff and starts not functioning well, that's cirrhosis. And we often used to think of cirrhosis as something that happened to people like decades down the road.