Primary Care in Rochester and Kasson

Alcohol Awareness: Addressing stress in a healthy way

5/14/2020 by Marcia Johnson, LICSW, and Kileen Smyth, LICSW


In our daily lives, we may be used to our “normal stresses “, and have developed adequate coping skills. Prior to this pandemic, you may have had a regular dining routine, planned ahead for meals, exercised regularly, and drove your car to your job every day. You enjoyed weekly meetings with colleagues, lunches out with friends, and several days a week you worked out at the group classes at the gym. You had friends with whom you dined out, had a glass of wine, and occasionally attended religious services. You may have had a daily meditation practice, and didn’t worry much about what was coming tomorrow.

Everyone reacts differently to stressful situations such as this most recent infectious disease pandemic that requires social distancing, quarantine, or isolation. People feel anxious and worried about their own health, health of others who may have been exposed, resentments related to quarantine, and time off of work and potential loss of income or job security. Now it seems for many, that previous coping skills may not be adequate to deal with current stress and emotions. But what happens when the coping skills we traditionally utilize are limited by social restrictions? What happens if our anxiety from the pandemic is not easily so easily managed? 

Many people have turned to the coping mechanism of using alcohol to deal with the emotions and stressors during the pandemic. People may be drinking more because they are bored, they are lonely, or they do not recognize other ways to manage feelings. Alcohol relaxes many of those underlying “fight-or-flight” symptoms, which are so prevalent during times such as these, and extremely uncomfortable to feel. The drinking is not problematic in itself, but what can follow, is what may create problems for the future.

Having a cocktail at the end of stressful day is relaxing and alcohol is a central nervous system depressant which calms heightened emotions and anxiety. Withdrawal happens when alcohol leaves the body, and increases muscle tension, decreases blood flow, and increases heart rate, much like anxiety (think hangover). So what appeared to be a good coping skill to deal with the daily stress, the next day tends to create more anxiety and difficulty coping. Over time this may evolve into problematic, ongoing alcohol consumption. 

Brain science indicates that when a person drinks alcohol, “happy chemicals” such as dopamine and serotonin flood the brain with positive and comfortable feelings. Alcohol use becomes problematic over time when repeated usage brings those chemicals so frequently to the brain that the brain decreases production of its own natural “happy” chemicals. Repeated regular alcohol use causes the brain to deplete itself of serotonin and dopamine, thus requiring increased alcohol for a person to feel “normal”.

Now take into account, COVID-19, and increased stressors of losing jobs, educating children from home, shelter in place orders, increased technology demands, social isolation, and increased fears about the future. Many people have started using alcohol as a coping skill, instead of the usual social connections. There are biological reasons such as genetics, psychological reasons like not having learned coping skills, and social or environmental influences, such as hearing or seeing others around you imbibing – that may be indicators for alcohol use to become an addiction, and thus, a problem. We also know that alcohol is a disease all by itself, and can be caused just by repeated heavy drinking.

Some of the most common misconceptions about drinking include the idea that “drinking is only a problem if I drink every day,” or “I am not drinking at home alone so it is not a problem”, or “I do not drink to intoxication”. Alcohol consumption becomes problematic, when it starts to negatively affect social interactions, work responsibility, and interpersonal relationships. This could mean that you are only drinking once a week, but to excess, and it is affecting whether you come in to work in the morning, or it is affecting relationships around you. And let’s face it, if you are drinking, you are drinking at home these days! 

The cardinal symptom of alcohol dependence is intermittent dyscontrol, also known as not being able to predict what is going to happen once a person starts drinking. Other symptoms of problematic alcohol use are increased tolerance, and symptoms of withdrawal such as regular hang-overs and needing more drinks to achieve the desired effect.

The good news is that you can make a conscious decision to stop drinking, then change your attitude and your actions to support that decision to stop drinking. Utilizing cognitive behavioral therapy (CBT) skills, we can understand that thoughts influence emotions, which then influences our behavior. This teaches us that we can make a decision to take a break from the alcohol, and put into motion other behavioral goals/coping skills to cope with ongoing stress. 

Some of the important facts to understand about alcohol use disorder:

  • If a person wants to stop drinking, so that it does not become more of a problem, there are Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) meetings for people every day in Rochester, most are currently virtual, due to the shelter in place orders, but they are still active. A closed meeting means that the only requirement for attendance is someone wants to stop drinking.
  • If alcohol use really has become an immediate problem, there are a number of different chemical dependence treatment programs currently admitting in the community, and you can find them through
  • If you want to know if it is a problem you can schedule a chemical dependency (CD) evaluation through Mayo Department of Addictions, with orders for CD Consultation.

Denial can become more complicated in addiction because of the mind-altering nature of alcohol. Denial impairs judgment, distorts truth, and grows in strength as addiction progresses.

Significant characteristics of alcohol dependence identify it is a primary disorder, progressive in that it gets worse over time, chronic in that it does not go away, and “fatal” in that it destroys relationships, self-esteem, and can cause death.

Alcohol dependence is often called a “feeling disease" because individuals become numb to actual feelings. The nature of alcohol use is that often feelings are distorted, and may seem over inflated or disconnected.

Recovery from alcohol to some is a one-day-at-a-time adventure. Being sober is not the same thing as living sober.

Social connection is one of the key components of recovery, due to the importance of ongoing support in making a decision and remaining abstinent.

Why wait until drinking alcohol every day has a physiological addictive effect on your brain, and you have to work harder to remain abstinent? Why not identify healthy coping skills now, and make the decision to schedule these activities in your day, instead of having that drink? Why not take a walk outside with your family? Go for a bike ride, or practice yoga. Call someone who needs to hear your voice, or play some music and dance in the living room. Connect with an app that promotes mindful meditation such as “Headspace” for a few minutes.   

Wouldn’t it be much better to come out the other side of this whole COVID-19 pandemic, healthier, and not burdened by having to deal with an additional alcohol problem that got started during a difficult time?

Marcia Johnson, LICSW, is a social worker/therapist in Integrated Behavioral Health (IBH) and has worked over 20 years in psychiatry and behavioral health at Mayo Clinic in Rochester. She runs groups for senior vitality, as well as cognitive behavior therapy (CBT) for depression and anxiety. Marcia also volunteers as a mental health supervisor at the Compassion Counseling Center

Kileen Smyth, LICSW, is a clinical social worker/therapist for IBH. She provides individual and group therapy for patients dealing with anxiety, panic, obsessive-compulsive disorder, depression, insomnia and an array of other family and life transition challenges. Kileen also facilitates group supervision, helps educate colleagues and enjoys the opportunity to network with mental health colleagues throughout the Rochester community.