Treatment of Depression

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

You may have picked up certain unhelpful styles of thinking, which need to be re-learnt, or some of your beliefs may need adjusting to be more adaptive, and perhaps new behaviours modified or adopted.

Lets begin at the level of your moment-to-moment thoughts; a vicious circle often develops, 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 clearly makes you feel low. Those two words, ‘always’ and ‘never’ are examples of over-generalisation, so they would be more helpful if they were more specific, like this – “I’m making a lot of mistakes at the moment, I wonder what needs to change so I can succeed with this?” – such a re-framing might help you feel a bit better about your situation.

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

At 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. Part of the treatment thus involves increasing the number of activities you are doing, building up a range of activities which might be rewarding or pleasurable, or have a sense of achievement involved. Depressed people often become accustomed to procrastinating however, you 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 something.

Depression itself causes some problematic ideas about the likelihood of successful treatment – two very common thinking styles are helplessness – “I can’t do anything to solve these problems” and
hopelessness – “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.

Beliefs:
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.

Alcohol:
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 Disorder

social phobia treatmentThere 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 phobia treatmentWhere 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?

social phobia alcoholSocial 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?

self control over alcohol

“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

psychotherapy counsellingA 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 Guardian.co.uk

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

alcohol consumptionA 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

low self esteemWe 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.

negative thoughtsSimilarly, 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

drinking health effectsAs 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

psychological counsellingA recent research study published in the Lancet has demonstrated the effectiveness of online psychological counselling for mental health problems. The study followed a group receiving therapy over typed internet chat (or instant messaging), and found it more than doubled their chance of successful recovery from depression when compared to a control group just taking anti-depressants.

The study director Dr David Kessler said these results are comparable with those seen in face to face therapies. Clearly, some people find it useful to write down their thoughts as a way of talking through them.

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

disturbed sleepMany 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

alcohol helpAn 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.

group supportLuckily 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

alcoholic 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?

habitual drinking problemAlthough 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

cutting down alcoholDo 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?

different types of alcoholicThe 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.

Stages of Change in an Alcohol Problem

change your drinking habitsAs you’re reading this website, then you might be thinking that you need to change your habits around alcohol. This means you’re in a stage called ‘contemplation’.

The Stages of Change model is a well established and useful way of considering different people’s levels of motivation to change their behaviour. This is how it applies to alcoholism:

Stage 1: Pre-contemplation -

Someone who drinks alcohol but doesn’t consider that they have a problem with it, or that they need to do anything about it. Other people around them might disagree however. Occasionally they might regret drinking too much, have an accident perhaps, but they still don’t feel their drinking needs to change.

Stage 2: Contemplation -

Possibly where you are now – you might have realised that your drinking is causing more problems than it’s worth, and that you’re probably drinking too much. You’ve noticed your health is suffering, or your closest relationships have been affected. Maybe your work is not up to scratch because you’re always hungover. But then on occasion you switch back to thinking it’s not such a problem after all, and you get drunk again.

Stage 3: Decision -

You realise that you do need to do something about this, so you decide to seek help, or talk to someone professionally, join a support group, maybe check out AA, or start looking online for some possible tips to cut down your drinking.

Stage 4: Action -

You start to reduce your alcohol consumption, you set yourself limits and you achieve them. You start talking about the problems in your life that might be causing your drinking, maybe to a counsellor or another mental health professional. You might well announce your decision to cut down or quit drinking to your partner or family members.

Stage 5: Maintenance or Relapse -

Your new pattern of drinking is becoming a habit, your alcohol consumption is back to acceptable, healthy levels again. Or maybe you haven’t had a drink for a couple of months, and you’re feeling comfortable with your sobriety. You can feel the benefits of not drinking so much – you’re healthier, happier and functioning better.

There is always a possibility that future circumstances might take a turn for the worse, and you end up drinking again. Maybe you go right back to stage 1, or one of the other stages instead. The important thing is to learn from this process, not to blame yourself for it. If you see this set-back as a ‘failure’, then you’ll just feel more depressed about it. You’ve made a mistake and had a relapse, that’s all, but you can get back to where you were again.

If you think you’re ready to take action about your drink problems, contact us to arrange an online live chat with a professional alcohol counsellor.

How to Cure a Hangover

cure for hangoverEveryone has their own little hangover cure don’t they. There must be thousands of them out there, but how many actually work? The truth is different people probably need different things to help them, depending on their individual constitution.

However there are a few reliable cures that seem to work for everyone. One of the main causes of a hangover is dehydration (largely responsible for your headache), so clearly the best thing to prevent or cure them is rehydration – plenty of water or fruit juice (as that often contains anti-oxidants too).

Sugar filled soft drinks like cola are NOT a good idea, because although they’ll make you feel good temporarily by boosting your blood sugar, you’ll very quickly feel even worse again as you suffer from the insulin crash afterwards.

Having said that, caffeine can often help with a headache and get you feeling sharper again, it depends on your preference. Unfortunately most caffeinated drinks are also diuretic, meaning they will dehydrate you even more. Part of your rehydration might perhaps include essential electrolytes too (Calcium, Potassium, Sodium, Magnesium etc).

Another cause of hangover is acetaldehyde, the toxic chemical produced when alcohol dehydrogenase breaks down alcohol in the liver. This is what causes the ‘poisoned’ feeling. There are a couple of things which work quite well to mop this up – the first is an amino acid called cysteine, which is found in large quantities in eggs. So that’s breakfast sorted out. You can also buy N-acetyl cysteine as a supplement in health food shops. The second thing which mops up acetaldehyde quite well is probiotics – the healthy bacteria found in yoghurt. However perhaps the best way to take this is in capsule form where it’s far more concentrated. A few of these before bedtime can really help you.

Most alcoholic drinks will leave you with low blood sugar (hypoglycaemia) by morning, so its important to get that back up again in a slow, stable way. Which means complex carbohydrates as opposed to simple ones. What I mean is whole grains, like wholemeal bread or muesli, vegetables and fruit (particularly bananas to boost your potassium levels again). Carbs like simple sugars, white pasta or potatoes will not help.

The nausea can be eased very effectively with ginger or peppermint tea, and again with those rehydration salts (or electrolytes).

Painkillers are obviously quite tempting, but paracetamol causes further toxic strain on the liver and kidneys, and ibuprofen can irritate the stomach. So aspirin is probably the safest analgesic for a hangover.

Finally you might well benefit from some B vitamin supplements – to calm your central nervous system (responsible for the tremors, sweats and anxiety), but these will tend to have a more long term effect rather than being a short term cure.

No doubt you’ve got plenty of suggestions for your own hangover cures too, so lets hear what works for you in the comments…