Alcoholic Drinks and Brain Injury: A Very Bad Combination

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OK. You like alcoholic drinks. But after a stroke or traumatic brain injury (TBI), you most likely will do yourself harm. What counts as “bad”?

Stroke:
- Alcohol can interrupt blood flow regulation. Even small amounts may increase ischemic damage risk.
- Aphasia or speech issues may worsen due to brain fog from drinking.
TBI:
- Chronic drinking post-TBI is linked to poorer long-term outcomes like 30% worse cognitive recovery in heavy drinkers, one study showed.
- Sensitivity to alcohol is higher post-TBI. Even one drink can cause worse effects like severe mood swings and increased fatigue.

With post-stroke or TBI, there’s no “safe” alcohol level because of the brain’s delicate nature. Guidelines recommend no alcohol for at least 6 to 12 months post-injury, and longer if possible for you.

Heavy drinking or binge drinking–4 drinks for women, 5 for men in one sitting–or chronic use which equals more than 1 drink per day is especially damaging, doubling risks such as seizures or recurrent stroke.
Even occasional use can disrupt sleep, mood, or meds, leading to poor recovery.

Let me show you why.

Interferes with brain healing:

After a stroke, the brain attempts to rewire, called neuroplasticity, to recover lost synapses. Alcohol disrupts this process by reducing neuron growth and impairing synaptic connections. Studies show even moderate drinking can slow recovery of motor and cognitive skills.
TBI causes inflammation and oxidative stress, and alcohol intensifies both those conditions, delaying healing and increasing risk of secondary brain damage, leading to poor progress like in speech, movement, or memory.
Alcohol shrinks brain cells and damages brain tissue, making it harder for the brain to recover.
Drink water, herbal tea, or coconut water to keep the brain hydrated and support recovery.

Worsen depression and mood:

Alcohol is a depressant, lowering serotonin and dopamine levels, which are already disorganized post-stroke or TBI.
For TBI, alcohol can intensify mood swings or irritability because of frontal lobe damage as well as increased anxiety or emotional upheaval.

Increase the risk of seizures:

Post-stroke seizures occur in 5-10 percent of survivors.
Alcohol increases the seizure possibility, especially if you’re on anti-seizure meds like Keppra, because alcohol reduces the effect of Keppra.
TBI survivors have a higher seizure risk. Alcohol can trigger seizures by disrupting brain electrical activity, causing further brain damage and setbacks.

Impairs cognitive function:

Stroke and TBI often cause memory, focus, or problem-solving issues.
For TBI, it can worsen brain fog or processing speed, already suffered through injury.
Difficulty with daily tasks, learning rehab exercises, or managing depression is harder.
Alcohol interferes with short-term memory, making it harder to remember names, faces, or recent events.

Increases chance for another TBI:

Alcohol leads to non-self-awareness of surroundings.
Alcohol impairs judgment and coordination, increasing risk of falls or accidents.
For TBI survivors, another head injury can be disastrous, called the second-impact syndrome.
Potential for worsening brain damage or new injuries often present.

Interacts with medications:

Common post-stroke or TBI meds like antidepressants like SSRIs, blood thinners for stroke, or anti-seizure drugs interact negatively with alcohol. For example:
- - Alcohol reduces SSRI effectiveness, worsening depression.
  - With blood thinners like warfarin, it may increase bleeding risk.
  - It can magnify side effects like drowsiness or dizziness.

Exacerbates physical symptoms:

Alcohol worsens balance and coordination, already affected by motor problems is stroke survivors. Alcohol also raises blood pressure, increasing risk of recurrent stroke, 2-4 higher in heavy drinkers.
For TBI, it can intensify headaches, dizziness, or light sensitivity, common in TBI, making daily tasks even harder.
Increased fall risk are apparent, especially with stroke-related weakness.

Disrupts sleep:

Stroke and TBI require quality sleep for recovery.
Alcohol interrupts sleep, reducing REM and deep sleep stages, most important for a damaged brain.
Poor sleep worsens depression, fatigue, and cognitive issues.
Slower recovery and amplified emotional and physical challenges .

Practical steps to avoid alcohol:

Replace alcohol for non-alcoholic drinks, like sparkling water with lemon to give the feeling the drinking without harm.
If depression moves you to drink, try a distraction like 5-minute breathing exercises or some other relaxing activity.
Unite with a stroke or TBI support group to listen to other people’s tales about alcohol.
If quitting alcohol feels hard, ask about counseling or meds to reduce cravings, custom-fit to your brain injury.
Seek help from your doctor, especially if you drink constantly because you can encourage seizures.

Avoiding alcohol gives your brain the best chance at healing and improves your ability to manage your mood. You’re navigating a tough road. Good luck, but remember: It’s all up to you!