Annika AngeloAlcohol negatively impacts most mental health conditions in the long-run. We see it being associated with increasing anxiety, depression, and even PMS/PMDD symptom severity! But how does alcohol impact ADHD? Let’s investigate the research.
Alcohol’s impact on the dopaminergic system
If you struggle with chronic overdrinking of alcohol, know that you’re not alone. Having ADHD puts you at a significant risk for the development of alcohol use disorder (read here for an article on the specifics). In fact, despite only making up 4% of the population, people with ADHD make up 20% of people with AUD. But why is this?
Let’s start at the basics. ADHD is, at its core (beyond the additional complexities), dysregulation in the dopaminergic system in the brain. Dopamine is that neurotransmitter we associate with memory, movement, motivation, mood, attention, and reward. Regarding alcohol, when we already have dysregulation in our dopamine system, it both can further dysregulate the system (I’ll get to this in a bit) AND make us more susceptible to using due to alterations in the reward pathways.
Basically, this topic is two-fold: how alcohol impacts the dopamine system in general, and how it impacts the dopamine system over time.
How alcohol immediately impacts dopamine
When we drink alcohol, we see an increase of dopamine release in the brain – mainly in the nucleus accumbens region, the one more associated with reward/pleasure. It also impacts dopamine receptors. The one it most affects is the D2 receptor, which again is the one more associated with reward. This is why a lot of people end up reporting feeling happier, less inhibited, and more likely to do things they otherwise wouldn’t.
How alcohol impacts the dopamine system over time
Here is where it gets a little complicated. While yes, alcohol can increase dopamine/increase signaling in the brain, over time it can actually not just deplete our sensitivity to dopamine, but also lead to lower levels of dopamine overall. The theory behind this is that repeated exposure of high doses of dopamine trains the brain to reduce its sensitivity to dopamine and decrease its overall levels, since our body works to achieve a state of homeostasis and adapts to its environment. In essence, the brain evolves its dopaminergic system because it expects you to drink. At the end of the day, it’s a vicious feedback loop:
Now obviously, this affects ADHD. That being said, it isn’t ethical to conduct a high-quality causal study to uncover how exactly long-term alcohol use affects ADHD symptoms. Even so, here’s some associational studies I think you’ll enjoy looking at!
| METHOD | OUTCOMES | STUDY |
| Compared symptoms of ADHD with symptoms of alcohol use disorder | They found the higher scores a person had regarding AUD, the higher scores the person had on ADHD (tldr: more drinking is associated with more severe ADHD symptoms, and vice versa) | https://journals.sagepub.com/doi/abs/10.1177/1087054715626511 |
| Had people with and without ADHD complete surveys on insomnia, alcohol use, and ADHD symptoms | They found that the people who had the worst ADHD symptoms drank the most and suffered from insomnia – which makes sense since alcohol is notoriously bad for sleep, and people with ADHD experience worse symptoms with worse sleep. | https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2020.01150/full?las=1&%3Flas=1&%3Flas=1 |
| Had people with ADHD, AUD, and ADHD + AUD take surveys on executive function, ADHD core symptoms, mind-wandering, and quality of life. | Hyperactivity was increased in the group with both ADHD and AUD compared to just ADHD | https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1112843/full |
So, what should we do?
First off, release any shame.
If you’re in the alcohol crowd with ADHD, just know that it’s already harder for you. I hope that learning more about the brain rewiring gives you a little peace. It’s not just a matter of willpower – it’s a fundamental neurological change that will take a lot of time and a lot of compassion to undo (if that’s your path).
Second, as with everything, I encourage you to think about your life and be honest about where you’re actually at so that you can take actionable steps that set you up for success instead of failure (which will mean that shame cycle never ends).
For example, we see the worst effects with binge-drinking. Drinking 5+ drinks in one sitting (one bottle of wine) is worse for us physiologically than drinking 1 drink over the course of five days. If you find yourself drinking a bottle of wine every few days, make a smaller goal of drinking only half the bottle instead of the full one or drinking that wine bottle over the course of a week. That already will make a significant impact on your mental health.
And of course, alcohol is an independent journey. Successive reduction isn’t possible for some people. Being sober-ish instead of being fully sober isn’t an option for some people. And maybe you don’t even think it’s a problem for you. Even so, I encourage anyone who wants to work on improving their ADHD to do a 30-day alcohol-free challenge. I think you’ll be surprised on how it’s been impacting you 🙂
Thanks for reading!
Don’t forget to tune into this week’s episode of my podcast: How Alcohol Impacts your Brain and Nutrition – Basically, exactly what the title says! I interview registered dietitian Chelsea Clarke from @Soberishnutrition, and we talk all about the neurobiological impacts of alcohol, from the brain to the digestive system. We also talk about what to expect nutritionally as you work to reduce your alcohol intake!
