Being depressed may not be an ‘illness’

A fantastic video on the Guardian today about how women are being over-prescribed anti-depressants, when fluctuations in mood and anxiety levels are quite natural, and can sometimes be explained by your circumstances.

How to stop worrying

reduce anxietyWorry is a normal human activity – we all do it from time to time. But for some people, it dominates their life. So how can you stop worrying? The initial answer is that it’s unlikely you’ll be able to stop completely, but you might be able to reduce it. Before we proceed, lets define what worry is.

Worry is a mental activity where we speculate about potential negative outcomes in our future; those outcomes feel threatening, which produces anxiety. This speculation often arises from uncertain or unpredictable situations in the present day, anything we might feel is out of our control.

That lack of control or predictability is very uncomfortable for some people, so they attempt to reduce the uncertainty (and increase control) by speculating about what might happen.

If you speculate about what positive things might happen, then you’re lucky, because most people are drawn to speculate about the negative possibilities, the threatening or unpleasant outcomes which they would rather avoid. If your thoughts often begin with “What if…(something negative) happens?” then you’re probably a worrier. The common themes for worrying are almost universal – family, relationships, work, health, or finances for instance.

Some forms of worry are about planning strategies to avoid these potential negative outcomes, or how to deal with them if they’re unavoidable. But quite often people are so anxious about the imagined outcome that they don’t even get to the planning stage, they just turn away from the unpleasantness, and try to avoid thinking about it. This is where alcohol comes into the picture for a lot of people – it is very effective at silencing worries (in the short term at least).

Now we’ve got a working definition of what it is, so how do you stop worrying?

People who worry excessively tend to make threatening interpretations of ambiguous circumstances – and unfortunately life is full of ambiguity, uncertainty and unpredictability. Additionally, worriers often lack confidence in their decision-making or problem-solving abilities, which can lead to doubt about their own ability to cope. As such, an objective evaluation of your coping ability might be helpful – if you think back to a few crises you’ve experienced in your life, ask yourself how you managed to cope with them, did you work out a solution to the crisis, did you get through it eventually? You might be able to recall a few situations where you didn’t handle things so well, but it’s probable that overall, you’ve managed to deal with everything in your life thus far. This suggests you’ll be able to handle everything else that might happen too, doesn’t it? That’s not to say that you can avoid all unpleasant situations in your life, but that you’ll be able to deal with them when they occur, you will cope. This could mean that speculating about hypothetical outcomes is unnecessary.

How could you learn to tolerate uncertainty better? How could you reduce the need to control your life so rigidly? Is it possible to accept that the future is unknowable, unpredictable, and be ok with that? In fact, is uncertainty unavoidable in life? Ask yourself if there are certain scenarios you never worry about. For instance, some people worry about paying for their children’s education, yet they don’t worry about war breaking out. Why is that? Why don’t you worry about nuclear war? The answer to that question might provide useful insights about the issues you do worry about.

We need to look at what processes maintain your worry, what beliefs you hold which give your worries strength. What purpose do you think your worrying serves? Why do you do it? What might potentially go wrong if you didn’t worry? Does worrying help you in any way at all? Does being a worrier say something good about who you are even? These are important questions to consider, because these beliefs may be unhelpful for you, and may need some adjustment if you want to stop worrying.

If you’re someone who avoids thinking about solutions for imagined negative outcomes, then those outcomes remain threatening, and continue to pop into your mind to make you anxious. A way to deal with this is to actively imagine the unpleasant scenarios occurring, and then consider how you would react, how you would deal with the situation, what support you would call on, and what options you might have available. It’s not a pleasant exercise to engage in, for sure, but the idea is to expose yourself to the imagined threat, and then imagine yourself solving the problem, coping with the situation somehow.

Again, you probably won’t be able to stop worrying completely, but it might be possible to reduce the amount you worry to a more tolerable level.

Treatment of Depression

Depression-treatmentTreating depression takes a long time, as it requires various long-standing patterns to be changed.

Lets begin at the level of your moment-to-moment thoughts; a vicious circle often develops, where as a result of low mood your style of thinking will automatically tend towards negativity and over-generalisation. These thoughts will maintain or exacerbate your already low mood. So you need to learn how to identify your negative automatic thoughts, and practice challenging them when they occur. Lets look at an example:

Imagine something goes wrong during your day, and you think to yourself “I always make mistakes, I’ll never be successful”, which obviously makes you feel low. Those two words, ‘always’ and ‘never’, are examples of over-generalisation, so those thoughts would be more helpful if they were more specific, like this – “I’m making a few mistakes at the moment, I wonder what needs to change so I can solve this?” – such a re-framing might help you feel a bit better about your situation. You may have picked up certain unhelpful styles of thinking which are holding you back, which you could benefit by altering; or some of your beliefs about yourself may need adjusting to be more adaptive.

Here are some other unhelpful thinking styles to watch out for in your thoughts

Moving on to the level of behaviour, depressed people often find the pleasure they feel from their normal activities becomes diminished, and so you end up doing less and less, getting less pleasure and less sense of achievement. Part of the treatment thus involves increasing the number of activities you are doing, building up a range of things which might be rewarding or pleasurable. Depressed people often become accustomed to procrastinating however, you may find ways to delay or avoid activity. So you might need to evaluate some of the things you’re saying to yourself whenever you put-off doing things.

Depression itself causes some problematic ideas about the likelihood of successful change – two very common thinking styles are helplessness –  e.g. – “I can’t do anything to solve these problems” and
hopelessness – e.g. – “what’s the point in trying, nothing will change?”

Next time we will continue with more issues in the treatment of depression.

Increased death rates from alcohol in women

A study published last week in the Journal of Epidemiology and Community Health found a concerning increase in the number of women in their 30’s and 40’s dying from alcohol-related conditions (in UK cities at least).

This is contrary to the general trend, which has shown no increase in deaths from alcohol for the population as a whole in the period studied (from 1980 to 2011).

Explanations vary for this unusual result for younger women, but many are blaming cultural factors for the acceptability of heavy drinking amongst women recently. Whatever the explanation, policy-makers should perhaps take note that action needs to be taken.

What causes depression?

There is often some misunderstanding of what it really is, so we should perhaps briefly describe what the medically agreed symptoms of depression are:

  • symptoms-depressionlow mood most days (feeling sad or empty)
  • lack of pleasure in activities
  • low motivation
  • irritability
  • inability to concentrate & poor memory
  • lack of activity and energy generally
  • feelings of guilt & worthlessness
  • appetite changes
  • sleep disturbance

The causes of depression are different for each person, of course, but certain similarities occur:

Early life events:
Some people are more predisposed to depression than others, as a result of their life experience – certain events may cause the development of low self-esteem, poor problem-solving skills or hopelessness.

Depending on what messages people have been given in life (by peers or parents for example), they may develop a range of dysfunctional, rigid beliefs about themselves, other people, or life generally, for example –

  • “I’m weak”,
  • “I’m unloveable”,
  • “if other people don’t approve of me then I’m worthless”, or
  • “if I need people they won’t help me”, or
  • “I’m not strong enough to cope if unpredictable things happen”.

Thinking styles:
How we make sense of our life has a big influence on how we feel. An example of this is ‘attributional style’. For instance:

  • If a negative event occurs, perhaps a mistake with significant consequences, and you attribute it to an internal, enduring cause (e.g. considering yourself useless), then of course it would tend to make you feel low.
  • If you attribute the same event to an internal but transient cause (“I wasn’t paying attention right then”), then you might feel less depressed about it.
  • Were you to attribute the event to external factors beyond your control (“anyone would make mistakes under this sort of work stress”), then you might barely feel down about it at all.

This is a simple example of the many attributions we make for what happens in our lives, all of which are just opinions, subjective views, not facts. Depressed people might counter “yes, but I AM useless”, but again this is only an opinion, not a fact.

Current events:
If, on top of these predisposing vulnerabilities, current life events occur which deplete emotional energy or make coping difficult, then depression can develop. Some examples of such events might be:

  • A loss of some sort (not just of a loved one, but perhaps a loss of some important aspect of life such as status or health for instance).
  • Prolonged stress – the perception that the demands being made of you exceed your available resources; if this is chronic then a state of helplessness (“I’ll never escape”) or hopelessness (“what’s the point”) can develop.
  • Periods of anxiety can also precipitate depression, as the feelings of vulnerability, unpredictability and lack of control can create pessimistic beliefs about the future.

Once depression develops, what maintains it?

depression symptoms

Another aspect of our selves is our moment-to-moment stream of consciousness; the linguistic content of our thoughts. These have an immediate effect on our mood, so depression can be maintained by ‘Negative Automatic Thoughts’ which take the form of unhelpful styles of thinking.

There are three main themes: –

  • the self (eg. – I’m defective or inadequate)
  • the future (eg. – it’s hopeless and pointless)
  • the world/life (eg. – it’s difficult, uncaring, cruel)

Some common unhelpful thinking styles include:

  • Over-generalisation (using words like: always, never, everyone, no-one, everything, nothing)
  • All or nothing, categorical thinking (if you’re not perfect then you’re a failure)
  • Negative filter (only seeing negative evidence about yourself, ignoring any positives)
  • Mind reading (“I know they don’t like me”)
  • Catastrophising (“that’s it, I’ll never succeed at this now”)
  • Labeling yourself based upon your behaviour (“I did something stupid, therefore I am stupid”)

Self blame:
Lack of compassion for yourself is often a factor in maintaining low mood – even if we are capable of being compassionate and caring towards others, we believe that we don’t merit the same compassion or forgiveness for ourselves. Thus guilt and self-recrimination can become entrenched.

Lack of activity:
Once low mood sets in, energy levels and motivation drop, and as a result people do less. Their opportunities for having fun, for feeling a sense of achievement, for sharing experiences with friends, all diminish. Thus a feedback loop is established, potentially leading to further drops in mood.

And finally of course, alcohol is a well-known depressant, a substance which many people turn to in times of difficulty, thus compounding the problem.

In the next article, we’ll look at the treatment of depression based upon the causes we’ve identified here.

Social Anxiety

social-anxietyThere are several factors which contribute to social anxiety, and each of them needs to be addressed for the whole problem to be dealt with.

Lets look at them in turn – firstly there is your belief that other people are highly likely to reject you or judge you negatively, when in fact this is probably an overestimation on your part. People are more forgiving than you think.

So you need to test out how likely this is with some experiments. Start with a situation that’s fairly non-threatening (you’ve probably got some scarier situations you could imagine, but we don’t need to jump in at the deep end). When you’ve thought of a slightly anxiety-provoking social scenario, predict how exactly you think others will judge you, and how will they demonstrate their judgment? What evidence can you gather that they have judged you? Then conduct the experiment (expose yourself to the situation) and compare the results with what you predicted would happen. What can you conclude from this? Most likely it will be that other people aren’t quite as judgmental as you believed them to be, and that in fact it’s almost impossible to tell if they are or not – because you are not a mind-reader.

So this brings us to another aspect of social anxiety disorder – that you accept the judgments you imagine other people are making of you, and you predict that this situation will be intolerable, so much so that you want to avoid it at all costs, which is where the fear and anxiety arise. The truth of the matter is that occasionally people are judgmental, but when they are, although it’s unpleasant, it is tolerable and need not be avoided, hence some of the fear and anxiety associated with it can reduce. However, you will only fully accept this once you’ve experienced it several times without avoiding the situation.

During social interactions, you’ve probably developed several ways in which you try to reduce your anxiety, or make yourself feel safe. These range from the obvious ones (like alcohol), to the more subtle (like rehearsing what you’re going to say beforehand), or more common ones (such as pretending to look at something on your phone). These ‘safety behaviours’ are counter-productive, because they reduce the opportunities for you to learn that social situations aren’t really so threatening. What things make you feel calmer in a social situation? You believe these things ensure your safety, when in fact you’re safe without them.

social anxiety disorderWhere you focus your attention is another important factor in reducing social anxiety. You probably pay close attention to the bodily symptoms of your anxiety when you experience it – you become self-conscious, and this acts as a feedback loop because you judge your own anxiety symptoms, making them seem more alarming to you, and so they get worse.

All the while, you are not focusing on the social situation, not engaging fully in the conversation, thus it becomes harder to read the cues other people are showing you, which can lead you to make further mistakes (stuttering, not understanding what someone said, forgetting their name etc.) It’s important therefore to remind yourself to focus your attention outwards, not on your body.

Evaluate the negative thoughts you’re having at the time which might contribute to your fears. Such thoughts may view the situation as catastrophic, or in ‘black or white’ terms (ignoring the grey areas), and may tend to overgeneralise – for example:

“If I get anxious — then I’m a failure”

“If I blush — people will think I’m weak”

“If I stumble over a word — I’m a loser”

“If I act differently to other people — I must be weird”

“If I lose my train of thought — it shows I’m stupid”

Such thoughts need to be challenged and replaced with more helpful, rational alternatives. This takes practice though, as these thoughts are quite automatic and habitual. Taking the examples above;

“If I get anxious — that’s acceptable

“If I blush — people will feel compassion

“If I stumble over a word — I’m normal

“If I act differently to other people — I’m not one of the herd

Essentially you need to learn that social situations are not as threatening as you imagine them to be, social mistakes you might make are not as catastrophic as you believe they are.

The goal is not to eradicate anxiety altogether, as that would be abnormal, but to reduce it to tolerable levels. Because actually you can learn to tolerate the discomfort that these situations create for you, and such tolerance can be improved with practice.

Anxiety is not a helpful measure of your social performance. You can feel anxious, and other people will still accept you. Imagine for a moment that you encounter someone who is obviously anxious when they are speaking to you – would you reject them and judge them negatively? No, of course not, and neither would most of the people who meet you.

Other people are not as critical towards you as you are yourself. Hence what you believe people will think about you is more likely to be a reflection of your own self-critical beliefs. And changing that is the subject of another article.

Is Social Anxiety making you drink?

shyness-social-anxietySocial anxiety is a common problem, characterised by being apprehensive and nervous about potential rejection or humiliation by other people.

If you find yourself getting worried about upcoming social events, and imagining how uncomfortable they’re going to be, or how other people will notice your anxiety, then you might well get into the habit of drinking alcohol in order to calm your nerves.

You might believe that you will behave in an unacceptable way, which will result in other people making an unfavourable evaluation of you, and this feels very threatening. You might believe that people will think you are weak, crazy, stupid or boring, and as such you might find it very difficult to engage in conversation or eat a meal.

Sometimes social anxiety escalates to include a panic attack, which can then fuel further anxiety, as you become worried that another panic will occur next time you socialise.

As such you might often find yourself preoccupied with thoughts about your visible symptoms of anxiety (sweating, blushing etc.), and how other people might be viewing them. You really want to make a good impression, but you’re worried that you’re just not able to. Social phobia like this can simply be described as a fear of being embarrassed.

As such, the consumption of alcohol can become an easy solution for people finding themselves in this position – drinking quickly and easily reduces the anxious feelings, boosts confidence and aids conversation. However, many people find that they end up binge drinking, and thus embarrassing themselves in exactly the way they were hoping to avoid.

Next week, we’ll look at how this problem can be overcome.

Do you need willpower to quit drinking?


will power“I wish I could quit drinking so much, but I just don’t have enough willpower”.

As a therapist, I hear this quite often, but perhaps we need to explore what willpower really means in order to find a solution to the problem.

The capacity to resist the urge to drink arises initially from various motivations – like the desire to avoid a hangover, or the need to be able to concentrate at work the next day, or the preservation of a close relationship perhaps. If sufficient motivations can be brought to mind, and they feel more compelling than the potential pleasure of alcohol, then a person can exercise self-control and not drink despite wanting one at the time. This is a reasonable definition of willpower.

Some people seem to have more willpower than others regarding their drinking, but perhaps only because alcohol has not taken on so many important functions for them (like stress-relief, confidence boosting, avoiding boredom etc.), or they have found other ways of achieving those results.

People with alcoholism are unable to resist the urge to have a drink, despite knowing that in balance it’s not doing them any good. Partly this is because short term consequences are often more effective at influencing behaviour than long term consequences, and in the short term the pleasure/relaxation of a drink outweighs the negative effects tomorrow or at some indeterminate time in the future (or so it seems to them). A strategy to deal with this tendency of course is to concentrate on the negative effects of alcohol in the short term, rather than the vague long term ones.

People can learn to have more control over their urges to drink, to predict when they are likely to occur so they don’t come as a surprise, to learn to bring to mind all the ‘pros and cons’ rationally, or to address those needs that alcohol has filled some other way – and so they increase their willpower.

Therapy becoming less stigmatised

counselling-therapyA survey by the British Association for Counselling and Psychotherapy (BACP) has found that talking therapies are becoming more acceptable in UK culture, people are less embarrassed to admit they have had therapy, and more would consider it as an option than they used to.

Thankfully it seems our society is changing into one which acknowledges the difficulties we all face with our mental health, and as such does not stigmatise those who decide to seek help in the form of counselling or therapy.

All we need now is sufficient access to these therapies, because at present (and with cuts in public spending under way) there is just not enough capacity to meet demand. The cheaper option of medication is often suggested by GPs with limited funds, which though effective at dealing with symptoms, does not address the underlying issues.

Further coverage in the

What happens in an AA meeting

A good article on the BBC today about what happens in an AA meeting – well worth reading.

Alcohol Consumption as Stress Management

stress-managementA lot of people consume alcohol as a way to manage stress. How often this is effective as a coping strategy probably decreases as the amount you drink increases. But although alcohol doesn’t really work as a long-term way of handling stressful situations, it does provide relief in the short term. And this is where the problem starts.

Our tendency to consider short-term effects in preference to longer term ones is visible in many areas of our lives. But why can we not more easily use the negative consequences of alcohol in helping us decide how much to drink?

People use the word “stress” quite a lot, but what does it really mean? Do we all use the word to mean the same thing? Everyone perceives different things to be stressful, but a few aspects of our experience are probably universal.

The first aspect is that a feeling of stress arises when we believe situations in our lives require more of us than we are able to give in terms of emotional or mental energy. We become depleted, and our decision-making abilities seem to lessen along with this.

Another aspect of stress is that we encounter events which trigger the ‘fight or flight’ reaction inherited from our ancestors. When we sense threat, or the possibility of emotional pain ahead, or any outcome that might make us anxious at some level, adrenaline is produced to prime our bodies to take action and our blood pressure goes up.

Of course not many stressful situations require physical responses these days, we have to deal with most events through more subtle behaviours than running away or fighting. And yet consumption of alcohol does seem to allow us to effectively ‘run away’ doesn’t it? Maybe this explains it’s popularity.

How is it then that some people seem to manage stress better than others? Is it just their resilience? More likely it depends on our beliefs about ourselves, our estimation of our ability to handle the events in our lives, which is a self-fulfilling prophecy. If we can effectively deal with events, there may be less urge to run away from them, and hence perhaps less urge to drink. If you are drinking less, then undoubtedly your capacity to respond to stress is improved.

Self criticism causes depression

self-criticismWe all make mistakes from time to time, it’s inevitable. But how you react to them can make a big difference to your self esteem.

What do you tend to say to yourself when you make a mistake? If you have a judgemental inner voice that says something like “I’m so stupid, I always make a mess of things” or, “why did you do that again, you’re so useless”, then of course you’ll feel bad about yourself as a result.

If you have many of these self-criticisms happening regularly, it tends to lower your opinion of yourself, and can lead to depression, and from there to drinking more.

depressionSimilarly, how you respond to your alcohol consumption has an impact on how you feel about yourself. If you drink more than you intended one night, you might judge yourself for it, saying something like “you’re such a loser, you got drunk again”. The consequences of such a thought are probably feelings of hopelessness and low self esteem. Contrast that with a different reaction to getting drunk, like “I wish I hadn’t done that again, I really need to work out what’s going wrong” – there’s no judgement or self-criticism in that, and you’re more likely to feel hope that you can change.

This is just one small example, but the important point is to listen out for the content of your inner voice, and notice when it’s being harsh or critical, then stop to consider what you could say to yourself instead that would be more understanding and caring.

And before you reject this idea, saying “but that’s just how I am”, these self-statements are not a fixed part of your personality, they are just habitual, so they can be changed.

You can start by making yourself more aware of what you habitually tend to say to yourself. Write it down when you notice you’re being self-critical, then you can begin to challenge such thoughts when they pop up next time, maybe something like “hang on a second, I’m not useless, I just made a mistake, that’s all”. No judgement, no labelling yourself as faulty, just an acknowledgement of human error, and maybe some forgiveness too.

Alcohol makes your heart healthier

alcohol-heart-healthAs if you needed another excuse to have a drink. Now researchers in Spain have conducted a study of 40 000 people and found that those who drank alcohol regularly tended to have a lower risk of a heart attack than those who were teetotal (particularly for men over the age of 40). And the more you drink, the greater the protective effect.

Don’t forget of course that all the other health risks still apply – so you might not have a heart attack, you’ll just get liver cirrhosis instead, or pancreatitis, a stroke perhaps, or you could develop diabetes, or stomach cancer. So don’t take this as an excuse to have a drink after all.

The Independent

Online Psychological Therapy Proven Effective

online-therapyA recent research study published in the Journal of Technology in Human Services has demonstrated the effectiveness of online psychotherapy for mental health problems.

The meta-study reviewed 92 different studies of online counselling or therapy (a total of 9,764 clients), and found no difference in effectiveness from usual face to face therapy.

The studies involved clients with a wide range of mental health problems, including addiction, anxiety and depression.

If you think you might want to give it a try to help with your alcohol problems, get in touch with us here.

Effects of Alcohol on Sleep

effects-alcoholMany of you will say that you need a drink in order to sleep, that alcohol actually helps you sleep better. While it may be true that drinking will get you off to sleep quicker, unfortunately the quality of your sleep will be much worse overall.

Alcohol inhibits the brain from entering REM stage sleep, which is when we do most of our dreaming, and prolongs the initial stage of deeper sleep. So when you wake up, you will probably not have dreamt enough – and dreaming is an essential component of sleeping. That or you wake up early once the alcohol has worn off.

Alcohol also inhibits your kidneys from absorbing water, so you tend to urinate more, and end up dehydrated. This further disrupts the quality of your sleep, and often produces a headache by morning. As such you end up feeling tired and unable to concentrate for the rest of the day. If you drink every evening, then you may be chronically sleep deprived, even though you might sleep all night, the quality of your sleep is not what it should be.

Making the transition to drinking less is often marked by a difficulty in falling asleep however, so you’ll have to readjust to dropping off naturally again. Getting regular, strenuous exercise is a good idea then – if you’re physically tired you’re much more likely to be able to sleep without needing your usual ‘knock-out drops’.

Group Support for Alcohol Problems

support-groupAn important factor in solving your problems with alcohol is talking to other people who understand what you’re going through, who won’t judge you for it, and who will genuinely share their experience without just trotting out the old clichés about drinking.

I’m sure you’ve heard these many times from friends or family, like – “oh you don’t need to worry about it, you don’t have a drink first thing in the morning, do you”, or “I don’t understand why you can’t just have a couple like I do” etc.

Of course most people immediately think of Alcoholics Anonymous meetings when they consider getting support from a group of people with drink problems. But again, many people are intimidated by the doctrine of AA, as the 12-step model it follows has certain expectations for you to fit into (though not all AA meetings strictly adhere to these principles). Similarly, some people are so uncomfortable and embarrassed about their drinking that they don’t want to admit it face to face with others, even if they are strangers.

alcoholic-helpLuckily there is now the option of communicating online, where the computer screen can grant you that cloak of anonymity (much like a catholic confessional, but without the “forgive me Father…”). As such you can exchange comments with others on any of the posts on this site, or more effectively you can join our alcohol support forum – day or night there will always be a wide range of people logged on who can give you feedback, support or advice about your drinking and an idea of how to make some changes. Check it out and if you like what you see, register for an account (free of course).

Dangerous Levels of Drinking

hazardous-drinkingAccording to figures released today by the NHS:

  • 1 in 4 adults are drinking at hazardous levels,
  • 1 in 10 men are on the verge of alcoholism,
  • 1 in 6 women drink at levels sufficient to damage their liver or lead to depression,
  • 1 in 10 men and 1 in 25 women are approaching alcohol dependence (admittedly rather vague terminology).

We have to ask ourselves why people in the UK seem to be developing more problems with alcohol, and what can be done about it. The cost to the health service alone is staggering – presently some £2.7 billion. That’s before we even consider the personal and social costs involved.

Is Your Drinking Just a Habit?

alcohol-habitAlthough it may seem like ‘just a habit’, you are making a choice to have a drink each and every time. That choice involves many components – your beliefs about alcohol and yourself, your thoughts (your inner dialogue), your feelings and your behaviour.

Your wish to not drink so much (because you can recognize the negative consequences) will translate into action depending on your motivations. Partly you are motivated to have a drink because its pleasurable, it helps you relax etc, and at the same time you’re motivated not to drink because you know about all those negative consequences. So you’re in a dilemma. The strength of your different motivations will determine how easy you find it to choose not to have a drink.

Lets take an example to illustrate this – there is something happening at work which you find very stressful, so you get home feeling frustrated and edgy. You believe the stress at work is not going away soon, and perhaps you also blame yourself for some aspect of the situation. You have a belief that you can’t handle this stress well naturally, and you believe that alcohol removes it very effectively. So you want a drink. But of course you know you shouldn’t, because you’ll be hungover again tomorrow, and that will leave you feeling worse. So your inner dialogue, your thoughts, might be something like – “well I haven’t had a drink for a couple of days, so I deserve it.” or – “I just don’t want to feel stressed like this, I want this feeling to stop NOW”.

However, emotional pain and difficult feelings are a part of life, there’s no escaping them, but alcohol deals with them so effectively, that its easy to develop a reliance on it to take away all your painful feelings. In order to cut down or stop drinking therefore, you have to accept that painful feelings must be dealt with sober, just as you are. You can deal with life, but you are choosing not to experience discomfort, because it can so easily be tranquillised with alcohol.

Its a common thing to drink because you feel “I can’t cope” – but what does that actually mean? Whatever is happening in our lives, however painful it is – we get through it, we survive, and that is coping. So the belief that we can’t cope makes us give up trying, give up hope. And again, alcohol is there to take away that hopeless feeling, to take us to that dream-world where things are fluffy and safe.

To get through life being generally sober, we have to accept that painful feelings can be handled naturally. Not rubbed out, but acknowledged, truly felt. You’re stressed? So see how it feels for it to just subside naturally with time. You feel bored? So just sit with that and examine what it really means to you. What could you actually do to remedy that feeling? Again, explore it and see what needs or thoughts are associated with the feeling. Then you might realise a different solution or two, whatever they might be.

Or perhaps you just don’t think you’re a particularly valuable person? Any mistake, any difficult situation can be attributed to your own failure or lack of some quality. Again, alcohol makes you feel good about yourself, temporarily anyway. And then it bites back with a vengeance. So to an extent, the solution might also be about healing that relationship with yourself. Your beliefs about yourself can often be a sort of self-constructed fiction. That constant inner commentator is so detached from the world, in many ways. So you may believe yourself to be inadequate because that’s how you’ve been affected by life, but of course its a subjective opinion, its not a fact, just a viewpoint.

The point here is to make yourself aware of the various elements that make up your drinking habits, then you can try to solve each part, rather than just relying on will power to not drink, which as you’ve probably discovered by now, isn’t that effective.

Cutting Down or Giving Up Drinking

giving-up-drinkingDo you need to give up drinking completely if you have a problem with alcohol? There are conflicting opinions on this. The AA approach says that abstinence is the only way that works for sure.

But being abstinent is no guarantee against a relapse, and some would say that it is just avoiding the problem, not dealing with it. So how about learning some new habits around alcohol instead – because you have learnt how you behave towards alcohol already, so surely those habits can be changed?

Giving up for a while could be a useful exercise though – it doesn’t have to be forever. In fact the thought of it being a lifetime commitment prevents some people from even contemplating a period of sobriety. Why not try a month of no drinking at all, just to see how it feels? Then if you can manage that ok, you can decide whether to keep going with it, or not, the choice is yours.

The difficulty with cutting down of course is that all your best intentions tend to dissolve after the first few drinks – so a self-imposed limit is easily ignored with a slightly inebriated justification (‘oh I’ll do it tomorrow instead’, ‘I had a really hard day today, I deserve another one’, ‘oh he’s opened another bottle, it would be rude of me to refuse’ etc.)

Delaying the time you allow yourself to start drinking is one way to make cutting down easier. If you have less time for drinking, then perhaps you’ll drink less quantity (that’s the theory). A drinking diary can also help you keep track of how much you’ve actually had over the week.

How much you drink also tends to be a product of how much alcohol you purchase. So one obvious step is to not buy quite so much. Make sure you don’t keep any drink in the house – just buy it as you need it. That way the choice to drink has to be a conscious decision. Don’t forget, for this to really work you’ll need your partner to agree on the plan, so they don’t buy any either, unless you both decide to.

There’s a third option too – a combination of cutting down and giving up – just staying sober for a day or two at a time every week. It’s better than nothing, and you’re getting used to dealing with life without drinking. Try and plan which days you’re going to do it in advance, and plan to do something else incompatible with drinking perhaps. But be careful of the trap of rewarding yourself for your two days of sobriety with, you guessed it, a binge!

What type of Drinker are you?

types-drinkerThe Department of Health has released research where they have identified nine different types of person who drinks alcohol to excess (their definition of excess being double the recommended weekly amount or more).

It might be useful to see if you can recognise which type you are. The types they defined are –

  • Depressed drinker
  • De-stress drinker
  • Re-bonding drinker
  • Conformist drinker
  • Community drinker
  • Boredom drinker
  • Macho drinker
  • Hedonistic drinker
  • Borderline dependent

It’s a fairly comprehensive list, but if you’re not sure which category you might fit into, have a look at the list of criteria for each type of drinker on the BBC

Of course it would seem to suggest that people who drink fall into one type or another, whereas experience would suggest that the same person could be defined under many of the categories, depending on what is going on for them that day.