The Self-Inflicting Torment of Nightlife Events

The Pre-Game

Imagine a Friday night where you and your friends decide to celebrate the end of a long, intense week with a party. With every second of preparation, the excitement builds as everyone is scrambling around to look their absolute best. After getting ready in your most stylish outfit, your friends suggest everyone drinks some alcohol before heading out for a fun night. As you hear the bottles opening and drinks being poured out into shot glasses, you slowly start to lose in a fight against temptation. It does not take long for you and your friends to consume hearty doses of liquor before heading out for the night.

Many people forget to consider how the brain and body respond to alcohol and the effects that come with consuming it. Within hours after consumption, your body’s central and peripheral nervous systems experience many changes to the cellular and molecular processes that power them. The stressful and harmful effects of alcohol disrupt vital connections between the neurons that maintain systemic relationships between the brain and the rest of the body, ultimately leading to consequences that can be life-threatening if left untreated.

The Party

When you arrive at the party, the front door opens and you are greeted by crowds of people socializing, flashing strobe lights, and the sounds of blasting music. As you and your friends make your way through the hallways, the host encounters your group, offers an additional round of alcoholic beverages, and insists on making a toast to a fun night. Seconds later, you start to feel the alcohol run down your body and hit your empty stomach knowing that you forgot to eat food beforehand. With no food to rely on for nourishment, you begin to experience the symptoms of the alcohol going directly into your bloodstream. Soon enough, the exhaustion hits your body and forces you to sit down on the living room couch stained with vomit. 

Some of these symptoms are due to an increase in oxidative stress, or the imbalance caused by a lack of oxygen-reactive species and antioxidants. A prolonged episode of oxidative stress elicits more severe hangovers, especially right after drinking [1]. Alcohol-induced oxidative stress is linked to the metabolism of ethanol, which is involved with the production of oxygen-reactive species [2]. For example, the rate of metabolism is a direct indicator of hangover severity; a faster rate makes symptoms less severe, while a slower rate has the opposite effect [1]. Not only does oxidative stress affect metabolic processes, but it also causes significant changes to one’s neurotransmitter levels that can be harmful to the body [3]. Likewise, the effects of prolonged oxidative stress may lead to the development of osteoporosis (bone disease) and other diseases caused by an immense lack of vitamin, mineral, and antioxidant intake [4]. 

The hours continue to pass as you have already lost sight of your friends amidst a wave of intoxication. Your energy has sufficiently depleted, and your levels of dopamine, the neurotransmitter that handles one’s pleasure and satisfaction, have hit an all-time low due to a combination of variables including excessive amounts of stress and malnourishment. A decrease in dopamine levels and receptor function is associated with reduced regional activity in the orbitofrontal cortex, dorsolateral prefrontal cortex, and cingulate gyrus [5]. These parts of the brain are involved with consciousness and decision-making; negative changes in dopamine and other related neurotransmitters, such as glutamate, increase the likelihood of impulsive behaviors and actions. You have reached a point where irritable symptoms from episodes of prolonged overstimulation become increasingly prevalent with every breath you take. Your ability to keep focus drastically declines as signs of dehydration and exhaustion hit your body with full force. Soon enough, your body starts to give in and the world around you spins faster and faster until it eventually comes to a complete stop; your eyes close shut.

The Recovery

The next morning, you wake up in a daze. You open your eyes to a living room trashed with decorations, plastic cups, and all kinds of spills. With the primary function of protecting the brain from toxic substances and other harmful compounds, the blood-brain barrier (BBB) worked hard all night to supply your brain with as many nutrients as physically possible. However, the BBB’s role to protect the brain prevents most drugs from entering as well, making things difficult for the overall development of therapeutic strategies for those suffering from severe brain damage [6]. 

The effects of an alcohol hangover start to set in, referring to the negative mental and physical symptoms experienced after alcohol consumption as the concentration of alcohol in the blood approaches a value of zero [1]. Looking at your phone, you realize you fell asleep for too long and are severely late to work. In fear of facing a penalty, your body jolts up from the couch as the adrenaline from stress and anxiety kicks in.

Reaching down to your pockets, you search for your wallet and keys to head out. However, they are nowhere to be found. Trying to remember where you had placed them, nothing seems to click in your head. Studies relating to the effects of alcohol and sleep deprivation show negative impacts on specific neurocognitive domains such as selective attention, working memory, and motor function [7, 8].  Additionally, prolonged exertion leads to a significant decrease in cognitive performance and ultimately leads to the symptoms exhibited by “brain fog,” a particular feeling of mental fatigue [9].

With a sense of defeat, you slowly sit down on the ground surrounded by remnants of what seemed to be a night to remember. In addition to your serotonin levels being affected by continuous oxidative stress, emotions of sadness and depression fill your body as you lose yourself in the midst of your thoughts. There is nothing left to do but ask yourself, “was it all worth it?” Moments later, your phone buzzes with a notification. You open it and realize it’s a text from your good friend that reads, “there’s a party tonight down the street from my place, we should go!” Putting your phone back down beside you, you stare out the window, take a deep breath, and the world slowly comes to a standstill. A deafening silence fills the room.

References

1. Mackus, M., Loo, A. J. V., Garssen, J., Kraneveld, A. D., Scholey, A., & Verster, J. C. (2020). The Role of Alcohol Metabolism in the Pathology of Alcohol Hangover. Journal of clinical medicine, 9(11), 3421. https://doi.org/10.3390/jcm9113421

2. Das, S. K., & Vasudevan, D. M. (2007). Alcohol-induced oxidative stress. Life sciences, 81(3), 177–187. https://doi.org/10.1016/j.lfs.2007.05.005

3. Salim S. (2017). Oxidative Stress and the Central Nervous System. The Journal of pharmacology and experimental therapeutics, 360(1), 201–205. https://doi.org/10.1124/jpet.116.237503

4. Kimball, J. S., Johnson, J. P., & Carlson, D. A. (2021). Oxidative Stress and Osteoporosis. The Journal of bone and joint surgery. American volume, 103(15), 1451–1461. https://doi.org/10.2106/JBJS.20.00989

5. Volkow, N. D., Fowler, J. S., Wang, G. J., Baler, R., & Telang, F. (2009). Imaging dopamine's role in drug abuse and addiction. Neuropharmacology, 56 Suppl 1(Suppl 1), 3–8. https://doi.org/10.1016/j.neuropharm.2008.05.022

6. Michinaga, S., & Koyama, Y. (2017). Protection of the Blood-Brain Barrier as a Therapeutic Strategy for Brain Damage. Biological & pharmaceutical bulletin, 40(5), 569–575. https://doi.org/10.1248/bpb.b16-00991

7. Durmer, J. S., & Dinges, D. F. (2005). Neurocognitive consequences of sleep deprivation. Seminars in neurology, 25(1), 117–129. https://doi.org/10.1055/s-2005-867080

8. Spinola, S., De Vita, M. J., Gilmour, C. E., & Maisto, S. A. (2022). Effects of acute alcohol administration on working memory: a systematic review and meta-analysis. Psychopharmacology, 239(3), 695–708. https://doi.org/10.1007/s00213-022-06060-5

9. Meeusen, R., Van Cutsem, J., & Roelands, B. (2021). Endurance exercise-induced and mental fatigue and the brain. Experimental physiology, 106(12), 2294–2298. https://doi.org/10.1113/EP088186