The best defense is a strong offense: preventing alcohol abstinence-induced depression

The march toward alcoholism is a multifaceted and dynamic process. It is characterized by an ever-progressing cycle of anticipation of use, positive reinforcement during intoxication, and a withdrawal-induced negative affective state that, fueled by stress, drives relapse and, ultimately, excessive alcohol consumption. How does one untie this Gordian knot? A good place to start might be targeting a brain region involved in relapse that is stress-sensitive, bi-directionally modulates motivated behavior, and interfaces multiple circuits encoding affect. Thanks to early work, the bed nucleus of the stria terminalis (BNST), which is part of the extended amygdala, fits the bill.