Pills Are So Hip!

If AA isn't hip, pill-taking is, apparently.
The fashion designer Betsey Johnson for her upcoming fall fashion show in New York has designed invitations to look like prescription bottles filled with breath mints. 

Photo By George Chinsee

I am not sure how I feel about this. 
On the one hand, psycho-pharmacotherapy has helped countless people manage symptoms of mental illness. 
On the other hand, abuse and overprescribing have created unnecessary suffering
and deaths. 

Does it promote irresponsible drug taking? 
Or, should we accept that everyone is medicated and move on?

It seems this is yet another example of what some people do for fun (recreationally using anti-anxiety and narcotic drugs; taking Adderall or Ritalin to enhance mental functioning or just to stay awake to drink more) has the potential to be very harmful.

I hope there is a label on that "funny" invitation to warn people that medications need to be treated with caution.

More to come on psychostimulant abuse...

How to Drink Moderately

These are some suggestions that I use with my clients.
By no means is the list complete. 

• Eat something before getting to the bar or party.

• Have a plan for the evening: How long will you stay?
Who are you going to be with?
Know when you will be home.
Goal is to avoid open-ended nights.

• Limit yourself to only one drink within a 30-minute period.

• Limit yourself to 4 drinks for men and 3 for women and the weekly maximum of 14 for men and 9 for women as recommended by the National Institute of Health for moderate-risk drinking.

• Know what a “drink” is. Remember, a pint is 16 ounces.
Drinks you have with dinner also count. 

• 12 fluid ounces of beer (about 5% alcohol)
• 8 to 9 fluid ounces of malt liquor (about 7% alcohol)
• 5 fluid ounces of table wine (about 12% alcohol)
• 1.5 fluid ounces of hard liquor (about 40% alcohol)

• Keep in mind BAC (BloodAlcohol Content) and think about why it’s important. Maintaining a BAC lower than .06%* is crucial to moderate drinking because our ability to reason becomes impaired at this point. It is the point of no return for problem drinkers. Even if the intention is to limit alcohol intake, if the BAC is higher than .06% you are more likely to continue drinking. Binge drinking is defined as having a BAC of .08% or higher.
*Disclaimer: these recommendations are for people who don't plan on driving a car. Remember, riding a bike under the influence is dangerous and against the law.
Drivers, please consult regulations for your state.

• Alternate between alcoholic and non-alcoholic drinks.

• Drink water in between drinks.

• Nosh on snacks while drinking. 

• Tell others, friends and acquaintances, of your intention to drink moderately, if you feel they would be supportive.

• Ask yourself what is the primary goal of the event? Is it social
or just for alcohol consumption? If it’s the latter, rethink who you are hanging out with. 

• Plan activities that don’t automatically involve alcohol.
Be creative.

• If you always drank at a certain time, for example after work, have a plan in place for those off nights. Go to the gym, go for a run or plan an outdoor activity. Go to the movies. 

• Remind yourself of the reasons why you want to drink moderately. For example, the hangover next day; money spent on drinks, cabs and food; the pride in knowing that you can practice self control.

• Practice mindfulness with alcohol. Is your goal to enjoy the taste of that IPA or red wine? How does it taste? What is its texture? Describe what you observe about your experience of drinking
and the people around you.

• Notice how alcohol affects people differently. How do you think alcohol affects you?

• Write in your journal about the experience. 

• Remind yourself that it gets easier the more you practice it.

• List the benefits of moderate drinking in the same journal.

• Know how alcohol interacts with the medications (over the counter or prescription) you take. Often, medications amplify the effects of alcohol, so let that be the guide in what moderate drinking looks like for you.

If you have other ideas, add them below.

Addiction, Depression and Antidepressants

I read with great interest this piece on The Fix called The Dumbest Article You'll See About Addiction, and that's about right. The writer, Maia Szalavitz, is responding to a criticism of her original piece, in which she shares how Zoloft had saved her from a deep depression after kicking a serious heroin and cocaine habit she picked up during college. Twenty years later, while still prescribed Zoloft, she describes how it dramatically improved her mood and the way she responded to the world (depressed people, she says, tend to misread other people's facial expressions), that she has had a successful writing career and a very satisfying life. 

The second writer, critiquing on Slate, says that Szalvitz merely replaced one addiction with another, and asks the astoundingly naive question why we are easier on pill poppers than alcoholics. It's difficult to believe that her editor or anyone else on staff, let slide her ignorance and insensitivity to issues of mental health. While it’s true Big Pharma has integrity issues, the fact is anti-depressant medications and other psychopharmaceuticals dramatically improve, if not save, the lives of many, many people.

Be sure to read the many comments on both pages. It's a serious subject matter that affects many people.