Last Updated on November 6, 2020
The term “dry drunk” may sound contradictory—and perhaps even a bit harsh. But the phenomenon it references is one that many people face in recovery. What happens when a person stops drinking, but still struggles with the behaviors, perspectives, and feelings associated with alcoholism?
For many, quitting alcohol is only one step in a long process. Below, we’ll look at how problem drinking changes the brain, and why psychological and emotional support is so important in overcoming alcohol dependence long-term. How can you, or someone you love, establish lasting change and live a happier, more fulfilling life after alcohol addiction?
What Does “Dry Drunk” Mean, and Where Does It Come From?
The 12-step program Alcoholics Anonymous is often credited with popularizing the term “dry drunk.” In this context, the term generally describes someone who no longer drinks, but continues to behave in the negative or destructive ways associated with alcoholism.
The term also appears in the pamphlet The Dry Drunk Syndrome by R.J. Solberg. According to this pamphlet, a dry drunk is an “alcoholic who doesn’t drink but is still plagued with self-defeating thoughts and behavior.”
Alcohol use disorder is complex. There is often a link between addiction and childhood trauma, difficult emotions, mental health disorders, or issues with self-worth and self-awareness. Chronic alcohol abuse also changes the brain, which can cause or worsen some of these problems. What the term “dry drunk” essentially refers to is that these underlying causes generally need treatment for a person to attain full recovery.
Despite its use in some recovery communities, however, the term can sound insulting and derogatory. Alternative terms now include untreated alcoholism or Post-Acute Withdrawal Syndrome (PAWS). These phrases more accurately depict alcohol use disorder and mental health issues as medical conditions, not moral failings.
What Is Post-Acute Withdrawal Syndrome (PAWS)?
As the symptoms of physical withdrawal subside, many people face emotional, psychological, and behavioral challenges in adapting to life without alcohol. This is often referred to as Post-Acute Withdrawal Syndrome (PAWS). Some of these issues may be due to changes in the brain from long-term alcohol abuse. Others may be rooted in underlying issues that preceded problem drinking.
Common symptoms of PAWS include:
- Replacing alcohol with other ways to cope (food, shopping, sex, video games, internet use, etc.)
- Struggles with depression or anxiety
- Impatience or poor impulse control
- Constant fear of relapse
- Isolating from friends and family
- Feeling nostalgic for drinking days, or resentful about the recovery process
- Frequently expressing anger or negativity about recovery, or toward friends and family
- Feeling or expressing jealousy of people who do not struggle with addiction
- Being self-obsessed: displaying either superiority or low self-esteem
- Continued sense of restlessness or uneasiness with life
PAWS is especially common among people who stop drinking on their own. These individuals don’t always receive professional support in uncovering and treating the mental or emotional causes of their drinking.
Some people with PAWS also have difficulty acknowledging that a problem remains. After all, they’re not struggling with alcohol, and that seems good enough. But no one wants to go through life feeling miserable, overwhelmed, or like they are white knuckling it without their substance of choice.
Choosing to treat these underlying causes and consequences of addiction can make it easier to repair relationships, sustain recovery, and move forward towards a healthier, happier life.
Effects of Long-Term Drinking on the Brain
Part of what “dry drunk” references is lasting changes in a person’s brain chemistry from chronic alcohol abuse. Like many addictive substances, alcohol disrupts neurotransmitters like dopamine, serotonin, and endorphins. Short-term, this can create a temporary rush of euphoria. As the alcohol leaves your system, however, the reverse can happen—you can feel depressed, or experience what is popularly called “hangxiety.”
Long-term, heavy drinking can also cause your brain to rebalance itself—reducing or increasing the production of some neurotransmitters to compensate for the effects of alcohol. This can raise your tolerance, meaning you’ll need to drink more to achieve the same euphoric effect. It can also mean that if you remove alcohol from the equation, your brain chemistry will be thrown off balance.
Common mental health issues caused or influenced by alcohol include:
- Chronic stress
People in recovery may struggle with these problems for months, or even years, as their internal chemistry readjusts. This can be frustrating, leaving them feeling as if they are making little progress. It can also cause them to continue behaving in some of the negative ways they did while drinking.
Since many people also begin drinking as a way to cope with difficult emotions, or underlying mental health problems, some form of support is often necessary to help them move forward.
Beyond Quitting: Treating Behavioral Health
Within Alcoholics Anonymous (AA), the label “dry drunk” is often applied to people who aren’t “working the program,” i.e. following the 12 steps. Since there are many effective ways to recover from alcoholism that don’t involve AA, this can be very unfair. Buried within this, however, is the belief that recovery is about personal transformation. And it’s true that, for many, quitting or cutting back on alcohol means a larger change.
Behavioral health support is about giving people the tools they need to build a healthy, fulfilling life without depending on alcohol. This can mean support groups like AA, but it can also mean evidence-based tools such as therapy, coaching, or even medication to reduce symptoms.
Cognitive behavioral therapy, for example, can help people identify self-defeating thought patterns, and work to replace them with more positive ones. Seeing a therapist can allow you to work through difficult emotions that drive you to self-medicate. Recovery coaches can give you strategies for managing cravings, and building healthier daily habits. And medication can help with the chemical imbalances generated by long-term alcohol abuse, making it easier to move on.
In summary, overcoming PAWS, or “dry drunk,” is about recognizing the part of one’s addiction that extends beyond the bottle. It’s about finding holistic care to help heal difficult behaviors, habits, emotions, thought patterns, trauma, and other underlying issues related to one’s drinking.
There Are Many Paths To Recovery
With all of that said, it’s important to state that recovery looks different for everyone. Within the term “dry drunk” is an implied judgement—that someone isn’t recovering the way another person thinks they should. For some, overcoming physical addiction may actually be the biggest priority. And for others, they may need to work out challenging behavior patterns on their own time, at their own pace.
There’s no need to compare your recovery to others. What’s important is that you are getting the care and support you need to reach your goals, and stay there. If you find that the psychological, emotional, and behavioral aspects of recovery remain tough long after the booze is out of your system, you aren’t alone. And there are many new ways to access help, including solutions you may not have thought of.
Ria Health provides comprehensive care for alcohol addiction, including behavioral health support, from an app on your smartphone. Members get access to expert medical advice, weekly coaching meetings, anti-craving medications, digital tools, virtual support groups, and more. You don’t even need to quit completely—we support moderation as an option and tailor treatment to each person’s unique goals.