Staff Perspective: Chasing the High - Hedonic Dysregulation as a Pathway to Alcohol Abuse
When we think about alcohol or substance abuse in the military, most of us jump to familiar explanations: PTSD, deployment trauma, combat stress. These are the headline drivers we expect to see on intake forms and clinical assessments. But lurking quietly, often unnoticed and unspoken, is another powerful risk factor, one that rarely makes it onto the paperwork or into clinical interviews: boredom.
Recently, as I was combing through some service member podcasts, a moment caught my ear. A US Marine Corps veteran was asked: “What do frogmen do when there is no war?” He answered plainly: “Well, we drink.” Another vet chimed in, saying, “They pay us to run into gunfire.” He was implying that when the high-stakes action fades, the lingering question becomes: what else is there to do to pass the downtime and dullness of everyday life? That exchange got me thinking deeply about the role boredom and under-stimulation play in hazardous alcohol use among service members.
Military service is inherently intense, whether you’re training for or engaging in combat, your days are structured around high stakes, constant readiness, and high adrenaline. Your hedonic set point, the baseline level of stimulation required to feel engaged, can shift upward in these environments. Living in a near-constant cycle of adrenaline and dopamine recalibrates what “normal” feels like. When the intensity fades, when missions end, deployments slow, or daily life becomes routine, that elevated set point doesn’t immediately reset. The everyday quiet can feel intolerable. From a clinical lens, this is where sensation-seeking and boredom converge: service members may chase stimulation to fill the gap, and alcohol often becomes the most accessible outlet.
This isn’t just a post-deployment issue. Cycles of high intensity followed by prolonged downtime are built into military life. Reserve and Guard members swing between operational tempo and stretches of civilian routine. Veterans transitioning out of service often find their hedonic set points misaligned with the slower pace of civilian life. At each of these junctures, boredom and under-stimulation create vulnerabilities. Without structured, meaningful outlets, the risk of unhealthy substance use rises, not only as a way to cope with stress, but as a way to re-establish a felt sense of aliveness.
If boredom, sensation-seeking, and hedonic adaptation are part of the risk equation, our assessments and interventions need to reflect that. Instead of only asking, “What trauma are you coping with?” we might also ask, “How do you manage periods of low stimulation?” or “What role does boredom play in your drinking or substance use?” or “When do you find yourself seeking intensity, and how do you channel it?” Because sometimes, the clinical task isn’t just treating symptoms of trauma or stress, it’s helping service members discover healthier, sustainable ways to engage when the mission quiets down.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of War.
Kathryn E. Monsey, LCSW, LCDC, is a Military Behavioral Health Social Worker for the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. She assists in the implementation and expansion of the Star Behavioral Health Providers Program (SBHP). SBHP trains civilian behavioral health providers to work with service members, veterans, and their families.
When we think about alcohol or substance abuse in the military, most of us jump to familiar explanations: PTSD, deployment trauma, combat stress. These are the headline drivers we expect to see on intake forms and clinical assessments. But lurking quietly, often unnoticed and unspoken, is another powerful risk factor, one that rarely makes it onto the paperwork or into clinical interviews: boredom.
Recently, as I was combing through some service member podcasts, a moment caught my ear. A US Marine Corps veteran was asked: “What do frogmen do when there is no war?” He answered plainly: “Well, we drink.” Another vet chimed in, saying, “They pay us to run into gunfire.” He was implying that when the high-stakes action fades, the lingering question becomes: what else is there to do to pass the downtime and dullness of everyday life? That exchange got me thinking deeply about the role boredom and under-stimulation play in hazardous alcohol use among service members.
Military service is inherently intense, whether you’re training for or engaging in combat, your days are structured around high stakes, constant readiness, and high adrenaline. Your hedonic set point, the baseline level of stimulation required to feel engaged, can shift upward in these environments. Living in a near-constant cycle of adrenaline and dopamine recalibrates what “normal” feels like. When the intensity fades, when missions end, deployments slow, or daily life becomes routine, that elevated set point doesn’t immediately reset. The everyday quiet can feel intolerable. From a clinical lens, this is where sensation-seeking and boredom converge: service members may chase stimulation to fill the gap, and alcohol often becomes the most accessible outlet.
This isn’t just a post-deployment issue. Cycles of high intensity followed by prolonged downtime are built into military life. Reserve and Guard members swing between operational tempo and stretches of civilian routine. Veterans transitioning out of service often find their hedonic set points misaligned with the slower pace of civilian life. At each of these junctures, boredom and under-stimulation create vulnerabilities. Without structured, meaningful outlets, the risk of unhealthy substance use rises, not only as a way to cope with stress, but as a way to re-establish a felt sense of aliveness.
If boredom, sensation-seeking, and hedonic adaptation are part of the risk equation, our assessments and interventions need to reflect that. Instead of only asking, “What trauma are you coping with?” we might also ask, “How do you manage periods of low stimulation?” or “What role does boredom play in your drinking or substance use?” or “When do you find yourself seeking intensity, and how do you channel it?” Because sometimes, the clinical task isn’t just treating symptoms of trauma or stress, it’s helping service members discover healthier, sustainable ways to engage when the mission quiets down.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of War.
Kathryn E. Monsey, LCSW, LCDC, is a Military Behavioral Health Social Worker for the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. She assists in the implementation and expansion of the Star Behavioral Health Providers Program (SBHP). SBHP trains civilian behavioral health providers to work with service members, veterans, and their families.