Mental Health Care

The mind-bending effects of alcohcl begin soon after it hits the bloodstream. Within minutes alcohol enters the brain, numbing brain cells. By depressing both inhibitory and excitatory cells, alcohol can produce different effects in different settings and in different people. It can kick up a newfound vivacity in some making them the life of the party, turn quite a few into morose uncommunicative souls, or rake up in still others a fighter’s instinct leading to a brawl or worse. The effect largely depends on the amount of alcohol in the bloodstream. The initial reaction may be stimulation, but as drinking continues, sedating or calming effects occur. By depressing the control centres of the brain, it relaxes a person and reduces his or her inhibitions. Initially, it affects areas of thought, emotion and judgment. Small amounts of alcohol thus may relieve tension or fatigue, increase appetite, or produce an anaesthetic affect that numbs pain. The more a person drinks, the more the higher thought processes get out of control, bolstering self-confidence and reducing inhibition, anxiety and guilt. Then, as a person becomes intoxicated, painful or embarrassing situations appear less threatening and speech may become loud and slurred. Impaired judgment may lead to incautious behaviour, and physical reflexes and muscular coordination may become noticeably affected. Taken in large enough quantities, alcohol is a lethal poison-it can cause life-threatening coma by severely depressing the vital centres of the brain.

An evening on a binge of drinking can also end up in an alcoholic blackout. The person forgets all or part of what happened during drinking. This is a common problem and affects 30 to 40 per cent people who take alcohol.

Alcohol also affects the sleep pattern. Even a few drinks can lull a person to sleep, but it also depresses the rapid eye movement (dream sleep) early in the night. The consequence is generally a fragmented sleep laden with bad dreams. The person does not feel refreshed when he or she rises after a night’s repose.

Excessive use of alcohol can produce several harmful effects on the brain and nervous system. A habitual drinker may develop Korsakoff’s syndrome; there is thiamine deficiency, the person suffers a memory loss and loses the ability to learn new things, and may begin to replace fact with fantasy unconsciously in his or her memory. Up to 15 per cent chronic drinkers develop peripheral neuropathy and suffer from limb numbness, tingling, and funny sensations. Some develop cerebellar degeneration and suffer from an unsteady stance and gait. While many of these changes are reversible, and a year or more of abstinence may allow much improvement, the damage becomes permanent if a person does not stop drinking. Some people may suffer irreparable loss of brain function, and develop a condition called alcoholic dementia.

Psychiatric disturbances. Alcohol is certainly a great mimicker. It can lead to a variety of psychiatric disturbances during heavy drinking or subsequent withdrawal. These include intense sadness lasting for days to weeks during a phase of heavy drinking; severe anxiety during alcohol withdrawal; psychoses during the severe form of the alcohol abstinence syndrome; and alcoholic paranoia marked by auditory hallucinations and paranoid delusions.

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