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People who “drink to cope” can make their symptoms worse: study

digest.bps.org.uk

64 points by ChrisHardman29 4 years ago · 67 comments

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whilestanding 4 years ago

I've been able to quit all the substances I used to cope; cigarettes, marijuana, alcohol, after a rather depressing realization that in fact none of them made me feel better in the long run. Short term gains at the cost of long term financial physical and mental health. The model I use to think of it is that drugs steal life energy from your future and give it to you in the present. That's the devil's deal you're given.

  • Darmody 4 years ago

        The model I use to think of it is that drugs steal life energy from your future and give it to you in the present.
    
    I've never seen it this way but it makes a lot of sense. It's just the opposite of making sacrifices today for a better tomorrow (like studying, practising sports, etc).
    • nitrogen 4 years ago

      Sometimes borrowing from the future is desirable, if done carefully. In my case, with naturally delayed sleep cycles even without artificial lighting, caffeine lets me take some of that night-time energy and shift it to the day. It's a wasteful conversion, but necessary in the modern world.

      • meowkit 4 years ago

        Agreed is can be desirable. An example for readers: This is the fundamental basis of financial credit. Pull from the future to improve the present.

  • ornornor 4 years ago

    > The model I use to think of it is that drugs steal life energy from your future and give it to you in the present.

    I know this might sound naive but I don’t have firsthand experience: is that also valid for marijuana? What are the long term effects in that case?

    • 1_player 4 years ago

      Hazy memories that are lost forever and causing my now lifelong general anxiety was the result of 10+ years of smoking marijuana.

      YMMV, my 20s are lost to time, and I guess I needed to get to the stage where inhaling it was playing a panic attack russian roulette to finally get serious about quitting that awful herb. It definitely was fun the first few years.

      But sure, there's someone bound to tell me there was something wrong with me, and that for them marijuana was a panacea. To be fair, I did not respect it, but neither do the stoners nowadays who think THC and CBD are a miracle cure for any problem and that it's perfectly, 100% safe.

      • pennaMan 4 years ago

        n=1 but I thought myself computer science while skipping high school and smoking copious amounts of said "awful herb" and I'm convinced I would of never chased that dream sober. I also have fond and clear memories of said period.

  • stadium 4 years ago

    Did you replace the substances with other more positive habits?

    • whilestanding 4 years ago

      Mostly yes. I found I had more time and energy to take care of all the things in life that need constant maintenance like cars and motorcycles, housework, lawncare and my body. Basically everything in my life got objectively better, but subjectively I had to face my demons and issues soberly, and that is not easy. This is the abyss that I think people avoid staring into that makes them take the substances. And it very real and very dark I will say. The grass isn't necessarily greener on the sober side, but it is certainly healthier. I do still waste my time when I don't have energy or will to do something productive on things like videogames or zoning out watching twitch or youtube.

iamthepieman 4 years ago

Part of drinking to cope is dulling the internal self critical monologue. For someone who drinks to cope this includes blocking out the very thought that they ARE drinking to cope. If you are then asked to explicitly think about the choice to drink and how that makes you feel then I would expect exactly the results that the researchers in this study got.

    "Whenever a participant reported having had an alcoholic drink....At various points over the following three hours, they then rated the extent to which they felt the drink had “relieved unpleasant feelings or symptoms”, and also provided updated ratings of their levels of those various negative feelings."
I'd be interested in a study which analyzed participants focus on negative thoughts without explicitly asking them to be self aware about them.

I also wonder if this is applicable to procrastination and self deceptive actions in general. If I'm reading some "candy" novel when I should be sleeping but know that I've got to check in 15 minutes from now about how I feel about bedtime procrastination then I'm not going to enjoy the book. The whole point is to immerse myself in something that distracts me from my depression, anxiety and shame at the very process of distraction.

  • lambdaba 4 years ago

    > For someone who drinks to cope this includes blocking out the very thought that they ARE drinking to cope

    From Saint-Exupery's Little Prince:

    “Why are you drinking? - the little prince asked.

    - In order to forget - replied the drunkard.

    - To forget what? - inquired the little prince, who was already feeling sorry for him.

    - To forget that I am ashamed - the drunkard confessed, hanging his head.

    - Ashamed of what? - asked the little prince who wanted to help him.

    - Ashamed of drinking! - concluded the drunkard, withdrawing into total silence.

    • rektide 4 years ago

      nice quote. it's funny & appropriate. at the same time though i think the surface level tale hides the likelier realer truth.

      the drunk isnt just ashamed of his drunkenness, he's ashamed he's not something else entirely, ashamed for all the wishes & dreams he's not. a realler life has past the drunkard by.

      to borrow a random quote found a couple comments away, from a german band Die Toten Hosen, "no alcohol is no solution either".

  • sjg007 4 years ago

    Procrastination is about managing your emotions effectively.

    I imagine anxiety is somewhat related when you get outside of fight or flight.

coldtea 4 years ago

Speak for yourself.

Especially if your research setup is as good as useless ("The team concedes various limitations to the study, mostly to do with factors affecting generalisability. The over-representation of women among the participants (as well as the fact that a large proportion were diagnosed with BPD) certainly means that the results are not necessarily applicable to the general population"), not to mention the methodology is self reporting questionaires.

  • badrabbit 4 years ago

    My only beef with drinking is it makes you so fat so fast! I wish I knew it was worse than eating bars of butter and buckets of cooking oil.

    It doesn't solve problems but stops the pain. Frees you temporarily from thinking and deciding things under the influence of pain.

    I don't get modern medicine. Grief, loss, loneliness (long term), stress and more mental/emotional ailments are found to be detrimental to human health, even causing most non-cancer chronic diseases. I would really like to see a study that somehow shows people surviving long term who were about so self-medicate with tobacco or alcohol, instead of survival rate that only takes into account the substance's harm.

    Alcohol and cigarettes harmed me but they also helped me survive. It's not a black and white clear cut thing.

    • beardedman 4 years ago

      > makes you so fat so fast

      I would consider myself a high functioning heavy drinker (but not an alcoholic). I'm also physically fit without weight issues, so I think this is probably more a personal statement.

      • mjbeswick 4 years ago

        Ethanol is metabolised in the primarily liver into acetaldehyde which slowly damages the liver, if you drink enough to process more your live can handle it will damage the live. It also leads to fatty liver disease which cause metabolic problems. Being fit and a healthy weight doesn't make much difference.

        It's the same reason why a diet high in sugar cause the same problems; as sugar is 50% fructose which is metabolised by the live in the same way as ethanol.

      • maccard 4 years ago

        A pint of Heineken (very popular lager in the UK) is 225 calories. For a small person, 6 pints might be the equivalent of their daily food intake. Anecdotally speaking, drinking doesn' fill me, and I end up either snacking on nuts (which are also super high calorie), eating chips, or just eating a meal anyway.

        Of course you can drink heavily and not have weight problems, in the same way you can eat cake and frozen pizza exclusively and not have weight problems, but you would be lying to say they don't make you fat reeeeeal quick.

        • beardedman 4 years ago

          No I wouldn't. My DCI is around 3k due to me running around 9 - 11km every day. Which would mean 4 pints every day would only be a 3rd (not even) - and I eat a balanced / high protein diet. I'm not saying I drink 4 pints every day - but I am saying it's personal.

    • oblak 4 years ago

      How does alcohol make you fat? I don't think I've met a fat alcoholic. Must be something else

      • austincheney 4 years ago

        Alcohol temporarily halts sugar metabolism as the body views it as a digestible poison and grants alcohol digestive priority. Sugars not metabolized by the liver must either be pissed out or stored as fat, but passing excess sugars to the kidneys takes time all the while the priority for the kidneys is passing alcohol not metabolized by the liver using as much stored water as it takes.

      • badrabbit 4 years ago

        The same way pizza and bread make you fat. I tried anything from wine to vodka, if I drink enough to get drunk, unless I compensate with a really good food diet and a ton of workout, I will gain weight. What makes you gain weight is not just the raw calories but relative to food, it is very efficient in delivering most of those calories to your blood.

        "Don't drink your calories"

      • almost_usual 4 years ago

        Beer alcoholics can be fat, hard liquor not gonna happen.

        • badrabbit 4 years ago

          Depends on how many calories you burn.

          If calorie intake is 1 and calorie burn is also 1, you have 0 surplus calories. Let's say you have 1 extra calorie (keeping it simple) , the source is important. Alcohol > sugar > oil > bread/carb foods > veggies/fiber,etc... in terms of how much of that 1 cal your body can extract and convert to fat for long term storage.

          I wish there was diet alcohol lol.

        • oblak 4 years ago

          I didn't even consider beer alcoholism. It would still have to be just bad eating habits, though. I know skinny people who drink several litters beer a day and the fatsos whole like this stuff have always been somewhat big. It's not the alcohol, no

        • friedman23 4 years ago

          whiskey has 70 calories in an ounce, you can absolutely get fat from hard liquor, the only liquor that wont get you fat is the disgusting kind

          • almost_usual 4 years ago

            They’re probably not an alcoholic. Hard liquor alcoholics throw up, have diarrhea, and struggle to eat.

            Chances of getting fat increase if you’re drinking 15-20 beers a day.

            • convolvatron 4 years ago

              real alcoholics don't throw up. they do struggle to eat. in fact its pretty usual to to forget, or just not.

              when I quit drinking I was _appalled_ at how much I had to eat. probably twice what I had been. and I lost quite a bit of weight.

          • rajin444 4 years ago

            Can your body fully process those calories? I know nuts are calorie dense but you don’t get the full caloric value.

      • nickthemagicman 4 years ago

        Each beer is like 300 to 400 calories. And then you eat bar food when you're drunk which is not known as the worlds healthiest.

  • nickthemagicman 4 years ago

    >> mostly to do with factors affecting generalisability

    Ha. Its Science-ish!

asdffdsa 4 years ago

When I used to drink regularly (6x a week or so, light on the weekdays but binge drinking on the weekends), I'd have anxiety on the weekday nights. My habit would be to quell it with a drink because alcohol "reduces anxiety".

However, after reading up on how one of the symptoms of alcohol withdrawal is increased anxiety, and hypothesizing that the weekday drinks actually made my anxiety worse overall I stopped drinking on weekdays and limited drinking on weekdays a bit. My anxiety improved after that.

  • mjbeswick 4 years ago

    It's more the fact that alcohol is a depressant, so if you drink regularly enough you will feel when it's effects wear off. Benzodiazepine and GHB produce a similar kind of withdrawal.

friedman23 4 years ago

Ignoring whether the actual study this article is based on is good or not, there are reasons why chronic drinking of alcohol could worsen symptoms for someone with anxiety and depression.

Alcohol will cause you to urinate a lot of magnesium and other electrolytes and can cause deficiencies. Magnesium deficiency is strongly associated with mental health disorders. It will also impair your sleep. This is a double whammy if you are already suffering from symptoms of depression or anxiety, alcohol will likely drive you further in the hole.

  • sjg007 4 years ago

    Alcohol and not eating properly caused my deepest darkest depressions.

  • lambdaba 4 years ago

    Yep, also affects GABA (anxiolytic companion of the excitatory glutamate), depletes thiamine (vitamin B1, important for glucose metabolism), etc.

  • mynameishere 4 years ago

    I always enjoy my occasional sightings of the single-theory-to-explain-everything maniac.

    https://imgur.com/a/47ivFZK

    • friedman23 4 years ago

      I don't think there is a single theory to explain everything, for example, if I needed comics to explain everything I read or see I would probably feel extreme depression and self loathing too.

aerojoe23 4 years ago

What about the whole correlation does not equal causation thing?

Given: They're saying they drink to deal with their symptoms. The symptoms get worse when they drink.

The study concludes: Drinking makes it worse.

But the other option is: Their symptoms would have been even worse without the drinking.

I'm not saying hypothesis is correct, just that the article didn't mention the study addressing it. Unless I missed it.

  • ksaj 4 years ago

    It could be that drinking delays eventually handling the problem. Many problems grow when ignored, which is to say that delay is the actual problem. In this case, it is perhaps encouraged and even exacerbated by chronic drunkenness, versus something else like ADHD or cognitive decline.

    Debt is a good example of that, because of interest and potential fines that increase the longer payments get delayed.

treeman79 4 years ago

Drinking has been a major problem in my family history. So I almost never did. I did notice this weird trend where when I did drink (lightly) my brain fog would clear up.

Many years later I discover that I have a genetic clotting disorder. Blood thinners will quickly fix my severe brain fog.

I use a mix of prescription ones or even just aspirin now.

But I think a lot of my family drink to clear there heads.

My pet theory anyway.

Pigalowda 4 years ago

The headline and article attempts to generalizes findings from a cohort with Borderline personality disorder - which they admit is a big limitation. I’m not sure what made the researchers think sloppy GABA activation (etoh) would help with a personality disorder because I didn’t read their manuscript.

I can’t see how this got past IRB or how they were able to ethically enroll patients. BPD has many psychological manifestations all rolled into one disorder including rage and emotional lability. It’s a mystery to me why alcohol would be a responsible choice here.

Mild/moderate alcohol consumption does often temporarily alleviate anxiety. But it also pushes the concerns to the next day - and that is the positive feedback loop for increasing daily consumption. This leads to worsening health and worsening/chronic psychological issues that are perpetually pushed back by daily consumption.

Darmody 4 years ago

If you ever need the urge to drink to cope with your problems, try doing something physical instead.

It doesn't have to be any sport. Things like cleaning your house works as well. Do something repetitive, something that your autopilot is able handle easily. It will eventually clear your mind.

Not only you won't have to deal the with bad effects of drinking but you'll get something good out of it.

almost_usual 4 years ago

Really depends on how much alcohol and if it progresses. If you’re day drinking, binging, and kindling your brain you’re kinda fucked.

Annoying hangovers turn into getting withdrawals for days after having 2 drinks. That’s when the real alcoholism starts.

LatteLazy 4 years ago

The UK had basically no mental health services. It's self medicate or nothing.

stopnamingnuts 4 years ago

Anybody who finds this interesting and is interested in an entire community dedicated to this perspective may also take a look at reddit.com/r/stopdrinking.

Its non-opinionated, decentralized but moderated (pun unintended) discussion was a huge help when I quit drinking five years ago.

I'll just add that my path lined up with others who have commented here. Once it dawned on me that it was a crutch, and not just for fun, it felt like time to put it aside and do some work on myself.

However a series of steps or exploring a higher power wasn't what I felt worked for me. /r/StopDrinking turned out to be that sweet spot.

ape4 4 years ago

“Ah beer. The cause of and the solution to all of life’s problems.” -Homer Simpson

  • RGamma 4 years ago

    "No alcohol is not a solution either" - translated from Kein Alkohol ist auch keine Lösung, Die Toten Hosen (referring to the proverb "alcohol is no solution")

    P.S. automatic translation of the song lyrics is quite adequate

p1mrx 4 years ago

I think it would benefit society if we could s/alcohol/cannabis/g in the public consciousness. Vaporized flower or edibles seem ideal, because combustion creates a variety of questionable chemicals and local pollution.

A subset of the population will always be looking for some way to escape reality, but the top 2 (alcohol and tobacco) have relatively disastrous health effects.

Granted, anyone who's fine with reality as-is should be encouraged to stay the course.

beardedman 4 years ago

I'm not sure why the UK has been on the drink-bashing train over the last few years, but why not address the "eating junk food to cope" issue first. IMO it's much more prolific in the western world (increasingly in the developing world) & is a much much much newer ailment than drinking. "drink to cope" - yes we've been doing this for the last 4k years.

  • mettamage 4 years ago

    From my personal experience in my social circle, I agree. It's a tougher problem too than drinking, because food is everywhere.

    • elseweather 4 years ago

      You have to eat something, but you don't have to drink. I've seen it described as: Imagine telling alcoholics to keep it under control, while still making them have 2-3 drinks a day!

      • mettamage 4 years ago

        That's a good depiction of how diabolical this addiction is. I'm happy I don't have it, but I recognize this in others.

        I wish I could help them. I've tried. And while I studied psychology, I'm not a psychotherapist.

sAbakumoff 4 years ago

drinking to cope with a problem is pretty much the same as pouring gasoline on the fire

arbitrage 4 years ago

> The study involved 110 participants; 58 were from the general community and 52 had a diagnosis of Borderline Personality Disorder.

Be wary with this headline ... this study does NOT reflect the general population, at all.

  • consp 4 years ago

    They should definitely lead with this instead of the actual title. But is doesn't sound as interesting of course.

  • dang 4 years ago

    We've replaced the headline with a more modest sentence from the article body and added the ": study" qualifier, which is always a good idea.

Ginden 4 years ago

Maybe I'm biased, but I have lower trust for studies with results like that.

Alcohol obviously reduces anxiety short-term, because of its effect on GABA signalling.

Alcohol can excarbate anxiety in long-term.

But there is catch - there are therapeutic drugs that have similar effect, benzodiazepines. Benzodiazepines can be misused (and make recovery from anxiety harder) and can be used for therapeutic purposes to improve patient's quality of life.

Obviously, benzodiazepines are more selective (ethanol affects nearly every system in brain), but I would expect that moderate and rare drinking to cope with single stressful event can be moderately beneficial, but drinking to deal with "stressful live" would be heavily detrimental.

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