Who Are These Alcoholics?

Google “alcoholic pictures” and you will find that an alcoholic tends to be an unhappy adult white male who sits in the dark with his head in his hands. He is alone and depressed with only a bottle for company.




An alcoholic, defined clinically, is someone physically dependent on (addicted to) alcohol and unable to control how much they drink; alcoholic also has cravings and increased tolerance, and goes through withdrawal symptoms when alcohol leaves their system. Comparatively, a problem drinker, or an alcohol abuser, is someone psychologically dependent on alcohol but without the physical dependence (although a hang over is a collection of moderate withdrawal symptoms). For the problem drinker, the issue isn’t alcohol (because they can go without) but the reasons why they drink and what happens after they drink.

National Institute of Health and National Institute of Alcohol and Alcohol Abuse classified U.S. alcoholics into five subtypes. These results are from a 2007 national survey, and it is estimated 14 million Americans qualify as alcoholics.

Young Adult subtype: largest group in the U.S. with 31.5 percent of alcoholics. Low rate of mental illness, drug abuse and history alcoholism in their families. Least likely to seek out help.

Young Antisocial subtype: In their mind-twenties, 21 percent of U.S. alcoholics. Early onset of alcohol use and problems related to alcohol abuse. More than half from families with alcoholics. About half are diagnosed with Antisocial Personality Disorder. Many suffer from the trinity of mental illness (depression, bipolar disorder and anxiety problems). More than 75 percent smoke cigarettes and marijuana, and many have problems with cocaine and opiates. More than a third seek help.

Functional subtype: 19.5 percent of alcoholics. They are mostly middle-aged, well-educated, with stable jobs and families. Third have alcoholism in their family histories, a quarter had major depression at some point in their lives, and nearly half were smokers of tobacco.

Intermediate Familial subtype: 19 percent of American alcoholics, they are middle-aged and half withs familial history of alcoholism. Most smoked, half of them had clinical depression, and 20% have had bipolar disorder. Nearly 20% had problems with cocaine and marijuana. In this group only a quarter get treated.

Chronic subtype: 9 percent of U.S. alcoholics. Middle-aged; began drinking heavily at an early age. High rates of Antisocial Personality Disorder and criminality. Highest rate of mental illness (depression, bipolar disorder, anxiety disorder). High rates of smoking, marijuana, cocaine, and opioid dependence. 2/3 of the group get help (many of them to mandated to treatment making them the most prevalent type found in treatment.


Information, which I summarized here, comes from:

http://www.news-medical.net/news/2007/06/29/27074.aspx?page=2

http://www.alcoholic.org/research/alcoholism-statistics-and-information/

Are you an alcoholic? Find out here. 

In my practice I work to help problem drinkers with their emotional health, in addition to learning how to become a more mindful, moderate drinker.

Suicides in Spring

I found this article titled “Clues in the Cycle of Suicides” in the New York Times. It dispels a popular belief about suicides: it is during spring and early summer when suicides peak, not winter, which I thought would be the period with the highest number of suicides. Winter’s long stretches of darkness and cold, along with the holidays that tend to intensify loneliness and isolation contribute to increased symptoms of depression. In contrast, spring brings warmth and a promise of hope with another cycle of natural life.

To explain the connection between spring and suicides, article summarizes very interesting recent research concerning the relationship between inflammation and depression, and the decreased production of melatonin to the spike of symptoms of agitation and mania for those diagnosed with bipolar disorder and depression, raising the point that genetics (nature) contributes to development and symptoms of mental illness.

What I found most fascinating was the concept of the “broken promise” syndrome, which I interpret as the feeling of being let down because spring did not eliminate their despair. Maybe the bright cheeriness of spring made despair seem even darker – hopelessness worsened because spring’s promise of hope and renewal did not apply to them, unlike rest of the natural world. Not feeling better in spring became yet another indicator of their emotional and spiritual alienation.

When thinking about it this way, I realize I am only beginning to grasp the enormity of human despair and suffering and the interplay between nature and nurture. But rather than feeling overwhelmed by it I feel emboldened to meeting the challenge of helping people reconnect to themselves and to help them understand that nature does indifferently work against them. In my experience working with clients, understanding the genetics component can help ease the stigma that often comes with a diagnosis and help them take steps toward self-acceptance.