The Siren’s Call: The 4 stages of drinking in PTSD and how to break this cycle

The four stages of the drinking cycle

You don’t drink because you’re weak.

You drink because—it works.

For now.

Alcohol whispers gently when the world is loud.

She calms your nerves, lightens your chest, lets you exhale for the first time all day.

But she’s not your saviour.

She’s a siren.

She sings to you when you’re tired. When you’re raw.

She calls you toward comfort—but what she delivers is wreckage.

The Four-Step Alcohol Spiral

Stage One: Relief

It starts in discomfort.

You’re wired, touchy, emotionally brittle. There’s no pleasure in the evening, just pressure.

So you reach for the drink—not to feel good, but to feel less bad.

Two, maybe three, go down, quickly. And like magic, the world softens.

That tightness in your chest releases.

You finally feel okay.

But it doesn’t last.

And over time, it takes more to get there.

The beginning of tolerance creeps in.

Tactics to address Stage 1:

Discharge the static.

Exercise after work resets your nervous system.

Nothing heroic—just enough to break the tension.

Salt, water, protein and fat help stabilise mood.

Otherwise, you walk through the door primed to hear the Siren’s call.

Stage Two: Reward. Antireward. Sip. Repeat.

This is where she starts to sing the most seductively.

Each sip brings a flicker of pleasure—a tiny tickle of reward. Not euphoria. But nice.

Then comes the rebound: anti reward.

A subtle drop. A downward nudge.

And the only thing that alleviates that? Another sip.

Reward. Antireward. Sip. Repeat.

That’s the loop. That’s the spell.

You know where it leads. You know how you’ll feel in the morning.

But in that moment, you don’t care. That’s Future You’s problem.

As Homer Simpson said while mixing a cocktail of vodka and mayonnaise:

“Future Homer? I’d sure hate to be that guy.”

Risk fades. Disinhibition rises. You pour more. You text someone you shouldn’t.

The Siren’s melody is louder now, and you’re not steering the ship safely anymore.

Tactic to address Stage 2:

Naltrexone can help for some—blunting the flicker, breaking the loop.

Otherwise, build friction:

• Brush your teeth.

• Pour a non-alcoholic stand-in.

• Phone someone.

• Break the trance before it deepens.

Stage Three – Withdrawal and Toxicity

Eventually, you crash into bed.

And for a few hours, you're unconscious. The Siren has knocked you out.

But then, around 3am, the Siren’s voice is gone— the wreckage sets in.

Your heart’s pounding. You’re sweating. You’re anxious and wired. Restless.

This is rebound withdrawal, and it hijacks your sleep and your nervous system.

Meanwhile, deep in your cells, the real damage is underway.

Your liver converts alcohol into acetaldehyde, a mitochondrial toxin that wrecks energy production, ramps up oxidative stress, and leaves your biology limping.

The hangover isn’t just unpleasant.

It’s cellular energy collapse.

Tactic to address stage 3:

• Clonidine can suppress the sympathetic surge, damage control.
• NAC (a supplement) can help neutralise the toxic load, damage control.
• Skip the paracetamol—it just piles onto your liver.
• If you’ve got taurine or magnesium, use them. This isn’t just “feeling off.” It’s metabolic injury.
• The less you drink the less rebound effect.
• A big binge where you wake up in the morning still drunk is not a solution!

Stage Four – Rebound Vulnerability

By the next afternoon, the acetaldehyde is mostly gone.

But your energy system is still broken.

You’re tired. Edgy. Unmotivated.

And the world feels too much again.

You tell yourself you’re just stressed. Or busy. Or burned out.

But really—you’re back at Stage One.

The Siren’s voice returns, soft and familiar:

“Just one to take the edge off.”

And the spiral begins again.

Tactic to address Stage 4:

Sunlight. Exercise. Salt. Sleep. Meat. Address the chaos in your life. Rebuild here or repeat.

Campral can lessen craving by stabilising your brain after the alochol wears off.

Thiamine (vitamin B1) can help limit brain damage from alcohol

They sound basic—but they’re the inputs for resilience.

Go low-carb for a few days to restore fat-based energy metabolism.

Too depleted to start cleanly? Try MCT C8 oil (1 tsp to start) to kickstart ketone production and brain fuel.

Deliberate rest is essential. You’re not lazy. You’re repairing.

The Siren

She doesn’t kick down your door.

She whispers.

She soothes.

She sings to you when you’re tired and raw.

She offers comfort—then quietly poisons your nights and hollows out your days.

Alcohol feels like your lover.

Your relief.

Your friend.

But make no mistake—she is a Siren.

She sings while you sink.

She takes your sleep, your energy, your clarity, your joy.

And when you’re too tired to resist, she curls her melody around your spine and says:

“Just one more.”

You reach for relief—but what she brings is wreckage.

She doesn’t just whisper.

She drags you under.

You don’t drink because you’re weak.

You drink because—for a while—it works.

But if you’re stuck in this cycle, don’t ask whether you deserve to get out.

Ask whether you want your life back.

What Now?

If you see yourself in this cycle, don’t wait until the next crash to act.

Start small.

Break the trance.

Try one tactic today—before the Siren starts to sing.

Add more and more tactics to block out her intoxicating sound.

And if you need help, get the kind that respects your strength and your struggle.

This isn’t about shame. It’s about getting your life back—deliberately, one step at a time.

Chat with your doctor about the stages, they probably won't know them by name, but will understand that clondine, naltrexone or campral might be helpful tactics for you.

The other tactics you can do yourself to stop hearing the Sirens song. 

Best regards,

Dr Al Griskaitis, Psychiatrist