What makes a person an alcoholic?

There are several definitions of alcohol addiction that have changed over the years. Alcohol addiction can present itself in many different ways; it depends on the amount and how often you are drinking and the type of alcoholic drink you consume regularly. While some people drink heavily all day long, others binge drink and then stay sober for a while. Dr Lars Davidsson, a consultant psychiatrist at the Anglo European Clinic, gives us an overview of what an alcohol addiction exactly is and what the first steps in treating this condition involve.

What exactly is alcohol addiction?

Alcohol addiction can be hard to identify as drinking is a part of life for many people and is so widely accepted in our society. However, if you find you are drinking alcohol and it results in medical or social problems, then it’s likely you have an alcohol problem. If you find people are complaining about your drinking habits, such as your friends, family or partner, and you find yourself in difficult situations frequently due to your drinking habits, then it might be the early signs of alcohol addiction. It is generally agreed that someone is addicted to alcohol when they frequently rely on it and can’t remain sober for long periods.

In the UK, the new advice suggests that men and women who drink regularly should not consume more than 14 units a week, which is the equivalent of seven glasses of wine or six pints of beer.

What are the symptoms of alcohol addiction?

Like any addiction, this problem can slowly get worse, so it’s important to spot the signs early. Some symptoms of alcohol addiction are:

• Drinking alcohol at inappropriate times
• Changing plans to be where alcohol is and avoiding situations where there’s no alcohol
• Feeling dependent on alcohol to function
• Having a high tolerance for alcohol and not experiencing hangover symptoms
• Hiding alcohol or hiding that you are drinking it
• Finding your work and social life is becoming negatively affected because of your drinking habits
• Losing friendships because of your behaviour when you’re drinking
• Feeling remorseful about your drinking
• Your family or friends are complaining that you are drinking too much

Why do some people become alcoholics?

It comes down to a complex combination of genetics, culture and social standards.

Alcohol addiction is known to run in families and you may find that each generation gives the same justification for drinking. While genetics plays an important role, there is also the social influence to take into account. Across western cultures, alcohol is readily available and binge drinking is widely accepted. The act of being drunk is associated with celebrations and we use it to relax and enjoy ourselves – even if we can’t remember it the next morning! You’ll often notice that we all look for reasons to drink, whether to celebrate or because we are sad, we find an excuse to have a drink.

It’s impossible to pinpoint one reason why people turn to excessive alcohol use, but the rewarding effects of drinking can be largely responsible. It’s well known that alcohol boosts someone’s mood when they are feeling down and relaxes someone when they are feeling anxious. It is for this reason that people with high stress, anxiety or depression are more vulnerable to developing alcohol addiction. It’s important to note that alcohol addiction is a real disease and a person with this addiction may not be able to control themselves and stop drinking.

Can chronic alcohol use lead to other psychological conditions?

Yes, it can. While drinking can temporarily reduce anxiety, in the long term, excessive alcohol consumption can make you more anxious and feel more depressed. Many people who suffer from psychological conditions such as insomnia and paranoia are also more likely to self-medicate with alcohol in order to relieve themselves of their symptoms.

Although it is rare, excessive alcohol consumption can cause alcohol-induced psychotic disorder (AIPD), which manifests as hallucinations, delusions and paranoia.

What are the first steps in treating alcohol addiction?

The first step in overcoming alcohol addiction is to accept that it’s a problem. It’s similar to any other kind of addition or psychiatric problem and is nothing to be ashamed of. The problem is very common and seeking specialist help is very important for your mental and physical health.

As a psychiatrist, the first thing I would do is assess how much you are drinking and if there’s anything in particular that triggers this habit. I would then look at your physical health, take blood tests and check if you are lacking vital vitamins. In patients who consume large amounts of alcohol, there is a risk of them developing Wernicke-Korsakoff syndrome (WKS) which is a certain type of brain disorder caused by a lack of vitamin B6. Patients who have developed this condition present a variety of issues related to memory loss and hallucinations. Treatment of this usually involves replenishing the lack of vitamin B6 and reducing alcohol intake. Then depending on the patient’s situation, I might send them off to see an addiction counsellor if I believe they would benefit from this.

Detoxing from alcohol is the next step in the rehabilitation process. A lot of patients worry about the effects of an alcohol detox as the withdrawal symptoms can be quite difficult and, if not managed correctly, quite dangerous. You shouldn’t be worried about going through an alcohol detox though; the correct care from a medical specialist will guide you through the withdrawal symptoms so you can focus on your recovery.

Individuals who have been drinking heavily for years are more likely to suffer more serious alcohol detox withdrawal symptoms, such as insomnia, delirium, tremors and hallucinations, than those who have recently developed the addiction. These patients are more likely to suffer minor symptoms such as nausea, headaches and anxiety.

Support from family and friends is always helpful, but there are many cases when it is an issue. Alcoholism is known to cause distress to family members, and if this is the case, then it might be a good idea to seek support from your partners or friends – you can even bring them to the appointment if you feel it would help. Encouragement throughout the process of stopping drinking is extremely helpful in your road to recovery.

Which specialist would you see for this?

Seeing your GP is usually a good start, however, some people prefer to go directly to a psychiatrist. There are also many support services around to help such as the AA, you might want to consider a rehabilitation clinic or an alcohol counsellor. More so than anything else, it’s important you see someone and seek help.

If you are suffering from an addiction and would like to see a psychiatrist, visit Dr Lars Davidsson’s profile and check his availability.