Do I have a drinking problem?

I'm young, and I can handle it, but the craving is starting to scare me.

Published November 5, 2007 11:00AM (EST)

Dear Cary,

My history in a nutshell: I'm 32 and I've had four major depressive episodes. I've been on medication for this for 12 years. I've done years of personal and group therapy. It is partly genetic -- my mother and brother have similar problems (although my mother refuses to admit it). It is also partly environmental. My parents divorced when I was 10. My dad married and divorced several women in the next 15 years. He was financially responsible for us but rarely around for visits. My mother ended up with an abusive alcoholic, and I both watched her be abused (emotionally, verbally, physically and sexually) and was abused myself (emotionally, verbally and sexually, although he never actually touched me -- he just said creepy things and did inappropriate stuff). After I left home, I spent years in relationships that were bad for me, was promiscuous and miserable, didn't take care of myself, and had a lot of problems. I ended up in my very own three-year-long abusive relationship, in which my partner regularly coerced me into sex.

Four and a half years ago, I began to understand what happened to me. I had a great therapist who helped me in so many ways. I left my abusive partner. I had wonderful friends, an amazing brother, and my father became a much bigger part of my life. I met a wonderful man who became my partner (three years now), who is respectful and kind and loving and works around my issues. My mother and I have recently reconciled after years of no contact. I feel like I've mostly worked through things. I still have issues here and there, but people keep remarking on how honest and open and "wise" I am. I figured I had this mostly licked.

Eighteen months ago, I moved to England and started a Ph.D. I'm far away from my family, my friends and my partner. It was hard at first, but it got better as I adjusted. After 15 months, and for no apparent reason, I entered another depressive phase. I didn't realize for a while and got pretty bad before I went to my doctor and got my medication increased. I had started drinking more and more, but figured that it was a coping mechanism. The medication kicked in six weeks ago. I'm still drinking a bottle of wine almost every night, sometimes more.

I'm tipsy-drunk almost every night. I panic. I often crave the release of alcohol. If I start drinking, I don't stop until I run out or pass out. Thinking about giving up drinking makes me feel a bit panicky. I have, on several occasions in the past year, gotten very drunk at department functions -- probably not the best idea when professors/supervisors are around. So far, it hasn't affected my Ph.D. or my life. I'm young, in school, and living in a culture that glorifies drinking. I'm not hiding my drinking, and I haven't done anything bad. I'm not cheating on my partner, or failing, or even pissing off my flatmates. I've never had a drinking problem before, despite years of depression, anxiety and PTSD. But I'm beginning to worry.

Cary, what do you think? Do I have a problem? If I have a problem, what actions should I take? I really need an objective opinion on this, but I don't have anyone here that I can really ask about this.

Thanks.

Suddenly Drinking

Dear Suddenly Drinking,

Thank you for your concise and beautifully detailed letter. I sense that it took some courage and focus to put things so clearly. Your letter is a reminder why many people who do not particularly care for my own writing style read the column anyway: They read it for the letters! I sometimes wonder, in fact, if more people would take the time to write such letters of their own, quietly and carefully summing up their struggles and challenges and how they have responded to those challenges and what they did well and what they did poorly and what is worrying them now, I wonder if they themselves might get some relief that way. I wonder this because many people who write to me will say, Well, whether you respond or not, it has helped me to put this down, to write it out.

It does help to write it out. I hope it has helped you.

So do you have a problem? I can hardly give you an objective opinion, I myself having been an obsessive, out-of-control drinker, physically, psychically, spiritually, romantically in love with drinking, which was my savior, my saint, my refuge! But at least I can give you an opinion from someone who shares your experience. And my opinion is that your drinking sounds dangerous indeed, like it could soon slip out of control. The things you mention -- the panic at the thought of giving it up, the craving of that release, the fact that once you start you don't stop -- these are all phenomena I recognize vividly from personal experience. The getting drunk at functions, too, and keeping it together but just barely, this I remember with painful clarity. I too, near the end, had begun to wonder: Do I have a problem?

It turns out that yes, I did have a problem.

I must say, without intending to butter you up, I admire how aware you are of what is going on. I could not bring myself, at that point, to do what you have done. I would sometimes blurt out, in vague, coded fashion, while under the influence, that I thought I needed help. But this was always said in a jocular way. I was too afraid, until the end, to say that I honestly thought I needed help. I was kidding myself to the end. So what I admire about your letter is that you are certainly not kidding yourself.

And I must say, the way I got through that was just finally doing what you have done: looking at it and being alarmed (well, more than alarmed; that's putting it rather politely) and seeing where it was leading and being honest with somebody else who had been through the same thing. So it seems to me that in writing this letter, you have intuitively taken that first step you need to take to examine your behavior and reach out to others.

So what would I suggest you do? First, because you are on medication for depression, I would strongly urge you to confide in your psychiatrist about your drinking, as the alcohol may be interacting with your meds in dangerous and unpredictable ways. But then, about the drinking itself, I suggest you make some discreet inquiries. The U.K. does seem to be a harder-drinking culture than the American culture. But look around you in the bar, or at the party. You may notice, if you look carefully, that not everyone is drinking. A few are nursing mineral water and soft drinks. I used to see such people and think they were obviously on the mend from an awful bender and would soon be at it again. But it turns out that there are always a few people in any crowd who do not drink, and while some of them just never did, others have, to prodigious excess in some cases, and have now stopped. These are the people you want to talk to. If you see one, and get into a conversation, you might ask: Did you never drink, or did you used to drink and stop, and if you stopped, did you do so on your own, or did you get help, and if so, what kind of help? How did you do it?

That is what I suggest. Your doctor can help with your medications and your PTSD, but there is nothing like another former drinker when it comes to stopping drinking. Whether you are at the point where you can definitively say, Yes, I have a drinking problem and I must now stop, there is benefit in simply sharing your experiences with others who are willing to listen. And I think you will find that those who are willing to listen are, in many cases, those who have been through what you and I have been through. We're the ones who grasp each other eagerly, thirstily, saying, Did this happen to you? And this? And that? Me too!

We can be found in bars and drawing rooms and faculty parties all over the world. Anywhere you can find a bar, you can find people who have drunk too much and quit and lived to tell. Those are the ones to talk to about how to stop.


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