Friday, March 20, 2009

Alcohol and Alcoholism

Alcoholism is a chronic, progressive and potentially fatal disease characterized by significant impairment that is directly associated with persistent and excessive use of alcohol.

There is disagreement about how to define alcoholism. Basically, it is defined by:
Length, amount and pattern of drinking
Social problems because of drinking
Psychological dependence
Physiological dependence
Medical diseases caused by alcohol such as liver damage

Dependence on alcohol is defined by tolerance and withdraw symptoms. There are two types of dependence: Psychological and Physical.

Psychological dependence is based on the degree of psychological discomfort experienced when alcohol is unavailable.

Physical dependence is based on the presence of physical symptoms in the absence of alcohol after prolonged heavy drinking. Some of those physical symptoms are:
o Increased heart rate
o Sweating
o Elevated blood pressure
o Tremors

Withdraw symptoms are generally the opposite of the drug’s direct effects lasting a few hours to a few days

What are the signs of Addiction?
Signs of alcohol addiction are:
• Tolerance and withdraw
o 50% more needed for high
o withdraw symptoms when stopping
o take more to avoid withdraw
• Loss of control
o larger amounts
o persistent desire or effort to cut down
• Time involvement
o a great deal of time spent thinking about, obtaining & using
• Social dysfunction
o avoiding work from hangovers, going to work high, driving
o avoid social events because of use
• Knowledge of adverse effects
o continues use despite family dysfunctions and arguments

An alcohol addiction begins with an individual experiencing short term gratification from drinking alcohol much as it does for most people. It causes us to feel that the substance can be good for us. This first experience is usually a positive one. As a result, we gain a sense of comfort with it when we are out socially.

The individual that runs the risk of having a problem with alcohol takes a turn from the general population at this point. This individual begins to use alcohol as a form of self-medication. They begin to use it to ease anxiety and stress. They begin to increase their use of alcohol and as a result, their tolerance to alcohol begins to increase resulting in even more alcohol use.

Problems such as memory loss, sneaking extra drinks, guilt about drinking behavior all begin to appear. In the process, they do not recognize that there is a problem beginning. Denial is freely used by the individual who becomes lost in the world of alcoholism. At this point, they feel they can stop anytime they want to… they just don’t want to.

Now, the blackouts begin. The alcoholic rationalizes it’s use and blames others for the problems it is creating in their life. More and more alcohol becomes the center of the alcoholic’s life. As it progresses, the alcoholic experiences reverse tolerance where instead of taking four drinks to become drunk, it only takes half a drink.

The tolerance drops and intoxication may be day long. They have physical effects such as tremors and not attending work more frequently. Usually they feel they have hit bottom and become willing to accept suggestions for treatment. Marked by physical and moral deterioration, they will drink poison if alcohol is not available.

Many times job performance is the last thing to be affected by the illness because of the need to maintain economic support and to continue the illusion that everything is fine.

The alcoholic personality exhibits:
• Exaggerated self-importance
• Charming & Charismatic
• Grandiose behavior
• “I” as opposed to “we” thinking
• Denial
• A rigid, judgmental outlook
• Lack of solid logic in thinking
• Black and white thinking
• All or nothing thinking
• Obsessive thinking and thought patterns
• Impatience
• Childish behavior
• Irresponsible behavior
• Irrational rationalization
• Projection
• Overreaction

There are some predictors for possible problems with alcohol. Those are:
• Solitary drinking
• over-permissive norms of drinking
• lack of specific drinking norms
• tolerance of drunkenness
• adverse social behavior tolerated when drinking
• alcohol used to reduce tension and anxiety
• alcohol used apart from social affiliate functions
• alcohol use separated from overall eating patterns
• drinking with strangers, which increases violence

Here is a self-evaluation questionnaire developed by the National Institute of Alcohol Abuse and Alcoholism.
• Do you drink alone when you feel angry or sad?
• Dose your drinking ever make you late for work?
• Dose your drinking worry your family?
• Do you drink after telling yourself you won’t?
• Do you ever forget what you did while you were drinking?
• Do you have headaches or have a hangover after you have been drinking?

If you can answer yes to any of those questions, then you may have a problem with alcohol. Understand that chronic alcohol use can lead to dementia and organic brain disease.

What is safe & Moderate Drinking?
The USDA defines moderate drinking as no more than one or two drinks per day for men, and no more than one drink per day for women. One drink is considered to be 12 oz of beer, 5 oz of wine, or 1.5 oz of liquor.

Who can drink?
Those who already drink in moderation and do not have a history of substance abuse or psychiatric disorder or have a direct relative with a drinking problem

Who Can’t Drink?
• Children & adolescents
• alcoholics
• Those with family members with alcohol problems
• Women pregnant or trying to get pregnant
• on medications
• planning on driving or requiring full attention

Frequently, families will deny the problem and try to hide the problem from public view. When one or both parents are alcoholic, the family becomes chaotic and then organizes roles to leave out the alcoholic. Eventually, they will attempt to leave the alcoholic or have the alcoholic leave the family.

If someone you love has a problem with alcohol, concern, sympathy, cajoling, threatening, and other natural responses will have little effect on their behavior. The best way to intervene between an alcoholic and the bottle is to do an intervention that confronts the addict. An intervention organized by a trained professional is probably the best way to go.

The intervention presents the reality to the addict in a way they can hear it. An intervention is two or more persons who are close to the addict and have witnessed his behavior under the influence. It is made up of two or more of the following: spouse, employer, parents, siblings, children, close friends, co-workers, clergy, therapist, drug/alcohol counselor or other significant persons.

The goal is to break down the addict’s defenses so that reality can be seen long enough for the addict to accept it. Present facts about the addict’s behavior and consequences of that behavior in an objective, nonjudgmental and caring way. Pile up the episodes of the effects of the addict’s behavior describing them in explicit detail. Have those they love/respect express the anguish his/her actions have caused them. This should shock them into facing the truth about their condition.

At the end of the intervention, they are then presented with several treatment options that have been worked out in advance with a qualified drug/alcohol counselor, therapist or physician.

Good resources for more information on alcohol and drug addiction/treatment can be found at:
•AA – mutual support to stay sober found at
•Al-Anon – for individuals affected by an alcoholic found at
•Alateen – ages 12 to 20 found at
•ACA – Help for growing up with alcoholic parents found at
•Cocaine Anonymous found at
•Narcotics Anonymous found at

For more information log onto For free clips and self-help audios, log onto the Dr. Walton Series at

Wednesday, March 4, 2009

Overcoming Depression

Everybody experiences moments or even a few days of being down in the dumps and/or sad from time to time. This is a very normal experience we all have occasionally. People often refer to getting the blues as being in a depression.

However, clinical depression is a distinct experience from getting the blues. There is a difference between getting the blues and clinical depression. Anyone can get the blues.
It's a temporary, and normal, reaction to stress or difficult situations and times.

The blues come and go they usually don't affect our sense of self-worth or cause us to experience physical symptoms such as weight loss or gain or have suicidal thoughts.

As opposed to the blues, clinical depression is much longer lasting and is more intense affecting not only our mood, but our thinking, our bodies, our abilities to perform our jobs and our social interaction.

Clinical depression brings on feelings of inadequacy, generalized loss of interest of pleasure, social withdrawal, feelings of guilt or brooding about the past, irritability, excessive anger, decreased activity, effectiveness or productivity.

In children, it is observed in impaired school performance
and social interaction. They are usually irritable and cranky as well as depressed. They can also suffer from low self-esteem and poor social skills and are pessimistic.

Many people often don't recognize that clinical depression is a serious illness. They will frequently see it as character flaw in the individual, or something that you just need to buck up and get over.

It's not uncommon to hear someone tell them to just snap out of it. It's no easier for someone with clinical depression to just snap out of it than it is for someone with a broken leg to just get over it and walk. Clinical depression is a condition that needs to be treated professionally for the best recovery results.

Some depressions are a result of chemical imbalances in the brain and can be treated with anti-depressant medication.
Others respond to treatment in a one-on-one situation in psychotherapy along with improved nutrition and exercise.
And others could benefit from a combination of all of them.

In any case, clinical depression does not generally go away on its own and it requires some from of treatment for the best results.

Statistically, women are two to three times more likely to develop clinical depression than men. Over the course of a lifetime, approximately 6% of the general population will develop clinical depression.

It generally has an early onset beginning sometime in childhood, adolescence or early adulthood. There is a strong correlation that it is more common among first-degree biological relatives of people clinical depression than among the general population.

Men have a difficult time admitting that they are experiencing depression. They have been taught to hold onto their feelings through the culture of the society. They also generally have a biological disadvantage to identifying their feelings and putting them into words.

Their brains are designed to think linearly in order to triage easily and come to fast solutions. Therefore their brains somewhat sacrifice the ability to observe extended connections and draw connections to their feelings. The result is that men have a more difficult time placing words to their feelings.

They feel feelings as strongly as women, they just don't know how to identify them as easily. Hence, when men go into depression they tend to isolate more than women. They also tend to experience anger more when depressed than women. Men have been socialized in a way that anger is considered one of the few acceptable expressions of emotion. Therefore, it is not uncommon for men to appear grumpy or angry when they are depressed. They also are more action oriented than women, so they go into action by isolating, or throwing themselves into their work.

Men are taught to go it alone and tough it out. To seek out help is to appear weak. They are least likely to reach out for help when they most need it and could most benefit from it.

The suppression of these feelings and their internalization of them by men can lead to host of physical symptoms that can be made worse by their reluctance to care for themselves during these times due to a lowered sense of self esteem.

Women, on the other hand, have more access to their feelings as a result of their brain structure as well as the benefit of a culture that supports their expression of feelings. Women more easily recognize when they are feeling depressed and are more likely to reach out to other women or therapy for help over men.

However, women have a tendency to internalize and blame themselves, which may impede them to reach out for help. They have also been taught to sacrifice themselves for others and may then ignore their own feelings and not reach out for help.
There is also a tendency for women in depression to focus on the negative, which makes the symptoms of their depression worse and cuts them off from reaching out for help as a hopeless endeavor.

To help move yourself away from depression:

Check automatic thoughts. What is the evidence its true, what's the evidence its not true. Make a more reasonable statement by combining the two.
Volunteer and take the focus off yourself, get out of being internally focused.
Buy self flowers. Scents such as vanilla and baked bread have an uplifting effect.
How would you treat yourself if you were a friend?
Schedule pleasant events
Sometimes, it is anger turned inward to protect others around them from their feelings so they attack their mood with depression.
Meditation, exercise and proper nutrition are very helpful
Separate out facts from feelings, just because you feel something doesn't make it a fact. Sometimes our thoughts and feelings can lie to us about what is real.
Learn how to communicate with others better by reading books or going to therapy.
Get a therapist who you feel comfortable talking with.
Seek medical attention for your depression

I generally recommend seeing a psychiatrist for treating the medical aspect of depression. They are specifically trained to help you choose the best medication available for your condition if you choose to use medication. Milder forms of depression can be treated with psychotherapy alone, but more sever forms generally require a combination of both medication and psychotherapy for maximum benefit and recovery.

If you know of someone suffering from depression and you want them to seek help:

Be straight forward to tell them about the behaviors you are observing.

Do not stigmatize them by calling them crazy, or defective in some way.

Tell them that they are not alone and that many other people who have sought treatment for depression have been helped.

Do not judge them rather emphasize the benefits they might gain from receiving help, such as an improvement in their mood and feelings, improvement in their thoughts and greater success in their relationships and at work.

Give them hope.

From time to time, bring up the options and benefits for help.
Pass along articles that you find. Do this at a very measured pace. If you bring it up too often or are too forceful about it, it will only lead the person who is experience depression to isolate more or become more resistant to any form of treatment or help.
Show interest in their entire life, not just in whether or not they get treatment.

To help a resistant partner get help for depression, it is important for them to see the benefits of such help for themselves as well as for their family. It is important for the individual's family and or partner to have empathy for them and their experience.

Try to view their experience through their eyes without blaming them or telling them to snap out of it. It may be helpful to set a therapy appointment or doctor's appointment together. Don't blame them as the problem or refer to them as the sick one. This would only lead them to avoid receiving any kind of help in a bid to prove that they are OK on their own.

However, if someone staunchly refuses treatment, there is only so much you can do as long as they are not a danger to themselves or others. You can only do what you can do.

Talk therapy, usually referred to as psychotherapy, can be very helpful for all forms of depression. Marriage and Family Therapists, Clinical Social Workers, Psychologists and Psychiatrists are all qualified to treat depression through talk therapy.

The goals of therapy are to:
Improve mood and stability
Decrease irritability
Increase motivation and interest in life
Improve memory
Improve sleep in quality and pattern
Improve outlook on life
Improve energy
Improve clarity of thought and cognition
Improve sexual desire
Eliminate suicidal thoughts
Improve functioning at work, school and home

Psychiatrists are the only ones who are licensed to dispense medication and they generally limit their practices to handling the medical side of depression leaving the talk therapy side to MFTs, Social Workers and Psychologists.

For more information on depression log onto For free samples and self-help audios, log onto the Dr. Walton Series at