The Anatomy of a Blackout

Me on my 23rd birthday blacked out

If you haven't heard of the book, Blackout: Remembering the Things I Drank To Forget by Sarah Hepola yet, you've most likely been living under a rock. She has been on all of my favorite recovery podcasts, blog sites, and news sites, (even CNN and NPR!) and I'm not surprised because her book is just as good as all the hype it got.

Not only is her storytelling ability and candidness refreshing and captivating, her story is one I can 100% relate to. I found myself thinking at several points in the book, wow, it's like she is taking thoughts out of my brain and writing them in this book. I literally couldn't put the book down. I kept thinking she is me, I am her, we are the same person.

Our most notable similarity is the way we used to drink: full-on, time losing, lights out blackouts. Her precise accuracy in describing the feelings of a blackout touched so close to home that it brought up a lot of painful flashbacks for me. I'm glad Sarah has brought the discussion of blackouts to the forefront.

When I was drinking I thought everyone blacked out. I thought it was normal, until my friends started telling me they never blacked out like I did. When I was so often left piecing together the night before, my friends were the first people I would ask, "What happened last night? We went where?" They would say, "You really don't remember ANYTHING?" They thought it was impossible that I could have lost hours of my life without so much as a flash of what occurred. Let me tell you, coming out of a blackout or waking up the next morning has got to be the worst feeling in the world.

Blackout Defined

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines a blackout as a period of amnesia during which a person actively engages in behaviors but does not create memories for these events as they transpire. All blackouts are not created equal and they are generally distinguished according to the amount of amnesia experienced. The most common form of blackouts are the spotty nights where you can remember some parts, but not all events that occurred. These are known as "brownouts." Your night may seem a little foggy and then someone says something about your night that may trigger some of your memories. This works for some people, but not all.

The type of blackouts Sarah Hepola and I experienced are known as en bloc blackouts - full and complete amnesia often spanning hours or more. Trying to recall memories from these types of blackouts is futile.

When and Why Blackouts Occur

The reason memories from an en bloc blackout cannot be recalled, no matter how hard we try, is because the memories were never formed in the first place, so no amount of digging will make them appear. Blackouts occur when alcohol turns off brain circuits that involve the part of the brain known as the hippocampus. One of the responsibilities of the hippocampus is to consolidate memories from our day-to-day lives. Information enters our brain and is processed in many different areas, then funneled into the hippocampus, which organizes the information into a constantly updated record of facts and events in our lives. Alcohol interferes with this system and thus, a void in the record-keeping is created.

So, why are people who are blacked out able to talk, walk, have sex, or do anything else like a normal person? During a blackout, the ability to remember things from before the blackout is possible, therefore a person can carry on a conversation or tell a story from years before or even from the night of their blackout while they were intoxicated but not yet blacked out. This is why it's hard for outsiders to tell if someone is in a blackout or not. Typically there are no definite signs. Depending on the chemical makeup of a person, how much they drank, and how impaired their brain functions are, a person who is in a blackout can appear visibly intoxicated or not intoxicated at all. Anything a person does during everyday life, a person can do while blacked out, they just won't remember it the next day, or whenever they come to.

What Puts You at a Greater Risk For a Blackout

The NIAAA says research points to several factors that increase a person's tendency to blackout while drinking.

• Drinking in ways that would cause your blood alcohol level to rise quickly and reach a high level. This can be achieved by drinking a large quantity very fast.
• Being female.
• Genetic sensitivity to blackouts.
• If you've blacked out before, there's a good chance you'll black out again.

Blackouts - The Scariest Part About Drinking

To this day, it still gives me a sick feeling in my stomach that there are so many hours of my life that are unaccounted for. Situations where I took part in sexual acts  I would not have given consent to had I been alert and sober, drugs I took without knowing what I was doing, and times where I still have no idea what happened, and I never will. To this day, it has been one of the hardest parts about my sobriety - coming to terms with these facts, accepting them, and letting them go. Scary, that I experienced these blackout periods and continued to drink for so long. Scary that people around the world may think that blackouts are normal. They aren't. They are the scariest part about drinking.