Alcohol - Self-Medication

[Richard-Allen]

This is a tricky question to ask, but I’m hoping some of you will be able to understand where I’m coming from.

For many years now I have been helping and offering support to those with liver disease here on HealthUnlocked site. My experience is one of Alcohol-related Liver Disease (ArLD), of which I ended up having a liver transplant back in 2016. I was one of the lucky ones.

Since then, I have been using my experience to help in liver research.

Many people sadly end up going down the alcohol road due to primarily the use of alcohol as a form of self-medication, a coping mechanism/mental crutch to help live with mental health disorders including bipolar.

I have always maintained the importance of doctors treating the person and not just their physical condition. So, for a person to develop an alcohol condition, it’s important to understand the reason behind their need to drink.

What many people may not realise, is that 84% of those people who drink alcohol and go on to develop a serious liver condition do so because they choose to. This includes those whose drinking is a form of self-medication. The remaining 16% are the people who are now drinking because they have to. These people now have an addiction problem.

I’m trying to find out just how many people with a mental health disorder like bipolar use alcohol as a form of self-medication, I also believe that these drinking bouts can occur at certain times of the month and last from a few days and then repeat a few weeks later.

I’d be interested to hear from anyone who can relate to this. I should point out that I am not a doctor, nor am I medically trained in any way. I’m just trying to find out just how common this can be, as this could very well be important for future ArLD studies.

Many Thanks

Richard

[Sunrisetabby]

My apologies for the hackneyed trope, but based on my own experience, alcohol, and I am not talking one or two drinks, but binging into darkness, is an outstanding social lubricant. Although undiagnosed, I likely am autistic, and I thought the book Asperger Syndrome and Alcohol: Drinking to Cope? by Tinsley and Hendrickx had some interesting information on a topic that is sadly understudied.

Two authors I enjoy, Leslie Jamison and Jack London, both very likely suffer/suffered from mental health afflictions, possibly bipolar, and this New Yorker article on the pair is quite good:

newyorker.com/magazine/2018...

The above article by Gary Greenberg begins: "Jack London started drinking at age five, plunging his face into a bucket of beer he was carrying to his father and lapping it up; he spent the afternoon lying sick under a tree. As a teen-ager, he drank prodigiously, got into fights, and suffered epic hangovers. At least once, he combined all three activities, downing whiskey “like so much medicine” somewhere south of Oakland (“I think the place was Haywards. It may have been San Leandro or Niles”), brawling on the train back to the city, and ending up . . . well, it’s not entirely clear, but he came to, the next night, in a strange boarding house, after seventeen hours in a “comatose condition.”

By the time London wrote down these recollections, in “John Barleycorn,” published in 1913, he was both a famous writer and an every-day drinker, although he generally held off from booze until he’d met his thousand-word daily quota."

[Sunrisetabby in reply to Sunrisetabby]

Richard, I also wanted to respectfully but strongly disagree with your judgmental characterization that "What many people may not realise, is that 84% of those people who drink alcohol and go on to develop a serious liver condition do so because they choose to." Yes, addiction, like most things, exists on a spectrum, but I am strongly against victim blaming, especially when, I don't think they really have a choice." I still don't know how much free will I think that we actually have, and we certainly seem to have at least some control, but my understanding is that our free will is much less than we actually believe. I have considered, and found somewhat persuasive, Sam Harris's arguments on the issue, including on his book free will. If you are going to use statistics or percentages, I recommend that you cite where those numbers came from. As you are likely aware, one of the most important parts of scientific research is including and attempting to accurately describe the uncertainty or potential error range likely based on the limited research that lead to the findings. That 84% of people choosing to drink to the extent that it causes a liver problem could perhaps be more accurately written as 42% +- 42%.

[gettingsomewhere]

Hi RichardI enjoy the odd tipple but know others who cannot get through the day without a drink, and others who binge drink.

I think one can't really consider the problem of alcohol self medicating without considering our wider society. I see you're from the UK so you'll know the woeful lack of NHS supprt services. My sons friend (in his twenties) tried to get help but there was none available. I know of others too so would agree with the above reply that the 84% you quote needs to be questioned in this context.

Where did you get this figure from?

[Millie09]

Hi Richard, hope your keeping well! So as you know I have cirrhosis, 16yrs since diagnosis of end stage liver disease.

I never asked or wanted to consume as much alcohol aa I did over the years ,

But I did, it became my crutch , as you know I worked full time as travel agent manager, also looked after my two sons ,cared for the home BUT I had to live with an abusive wife beater not just physically but mental torture,

This over time made me develop anxiety , major panic attacks and after my separation I became agoraphobic border line ,

I had 2 years of CBT from my therapist also back then it was Aquarius that helped me along my way to sobriety .

So yes .. totally agree with you

I know many on forum Richard ( British liver trust ) that also used alcohol whilst suffering major anxiety etc..

I could Go on forever about how I used alcohol to cope with my mental health

Best wishes

Linda

[Willow2022]

Depression and Anxiety here.

I have an addictive personality: cigarettes? Yes please! Cloves? Sound great! Weed? The more the merrier. Ecstasy? Love it. Painkillers? Sign me up! Alcohol? The best!

I was able to quit all of it. Though alcohol was the worst. I have always drank since my teens but when I was drinking a bottle of wine per night during a severe bout of depression I did so for a few reasons:

- the taste

- the numbing effect

- the sleep aid

My emotions were (and are) too much for me to FEEL so I had to dull it all down to a loud roar. During counseling I decided to never drink again, not even socially as enables my mind wanting to be numb.

[cashew78]

Your question is vexing to me. First, to parrot and applaud what was stated previously, your comment, " What many people may not realise, is that 84% of those people who drink alcohol and go on to develop a serious liver condition do so because they choose to. ", is overly simple and doesn't adequately address the real issue. People don't choose to have liver disease or become alcoholics; they're engaging in a behavior to address and numb-out serious physical or mental anguish and pain. Yes you absolutely have free will to not drink and getting your life in order will necessitate you taking responsibility for things, but just like having chemotherapy to fight a serious health condition, you do it to fight a serious health condition, not because you want to make yourself sicker and loose all your hair. You're sneaking in a qualifier into your question that blames someone who may be a victim of serious trauma whose only means, for whatever reason, may be the bottle.

To answer your question, "trying to find out just how many people with a mental health disorder like bipolar use alcohol as a form of self-medication, I also believe that these drinking bouts can occur at certain times of the month and last from a few days and then repeat a few weeks later." the scope and definitions implied seem off. Replace 'alcohol' with 'addictive and/or compulsive behaviours', and you have an answer of 100%. I dare say anyone and everyone with a mental health disorder I've met, including myself, has engaged in an addictive behaviour to address the pain we're treating through self medication. It's just some of those behaviours stick around longer than others and, in a society where alcohol is very freely available, some are going to manifest more noticeably than others. Alcoholism, drug abuse, promiscuous behaviours, thrill seeking behaviours, and basically anything at least a little hedonistic is going to crop up because they offer, at least for a short time, an outlet and comfort. So if you're scope is the western world and western societies, I dare say probably 99% of people with any level of mental health challenge have had a drink over it. If you're referring to consistent bing-drinking behaviour then I suspect you might need to get into the medical journals and academic works published and ongoing for the answers you seek.

[Cb1963]

I think it's a difficult subject to put exact figures on, my own journey involved alcohol from witnessing two tragic events in my life and getting down to the nitty-gritty of different events that others might not have experienced. But both things that happened caused my life to spiral out of control, and all those years ago there wasn't as much help for my circumstances, and drinking was a "crutch " to lean upon , in the beginning it was moderate I suppose, but I'd still go on benders, and drinking more to either blank out my thoughts or trying to get that euphoric moment, but as the years passed I became addicted, and turned into a chronic alcoholic, which caused my depression to become more disconcerting and I only wanted to drink, there's many layers to each person regarding alcohol, and without the various support I received over 12 years ago I doubt I'd be here.

I think it's also down to personalities, and perhaps there's some type of addiction in all of us, it could be food, gambling, smoking, recreational drugs, even over the counter medications, or wanting numerous partners, there's so much more to my downfall with drinking, however I'm happy to say that I'm 12+ years sober, and lead a quiet life these days, and grateful for staying this way, but I don't know how id feel if I wanted to turn to drinking again how this would make me feel, could I manage or would I fall back into my old ways, that's the frightening part about drinking, it leaves me feeling unsure, because I never wanted to become an alcoholic, and I don't know if my run in with alcohol made me who I am today.