Month: February 2021

When I first stepped off this wine oiled hamster wheel, others were surprised or even a bit sceptical — but over time, many friends and strangers (mostly women) quietly started to reach out, letting me know they were inspired and had followed suit, or asked me how it was done.

How? For me, it started with a genuine desire for change. Then a very intricate search for a method that made sense to me. I did not want group therapy, I didn’t want to share intially my habit with others, but I did want to find someone who was on the same page, except without the daily intake of alcohol, and a skilled one to one approach that was suitable for my lifestyle, the only name that seemed to keep coming up trumps was Harrogate Sanctuary.  After the ice breaker meeting online with Sarah, I was convinced that her very personal, understanding and empathetic nature was a good fit. Over six weeks, she taught me how to rewire and reboot. There were no scripts or rules, the programme was tailored to me. We worked together for over six months in the end, and still have a light maintenance programme going on, she keeps me on track, but has allowed me to see that I am not damaged or a slave to wine or what others may think of me for being alcohol free.

She taught me about making commitments to myself rather than trying to please people, which I had done for over 45 years. This was made stronger by telling others rather than allowing them to assume, or making up stories about health kicks and so on. Then persistence, dredging up a belief I could do it, staying focused on the positives.

Sarah also feels it is critical to maintain being busy, even through these awful last few months.  I needed forms of joy and abandon in my life to stave off becoming bored and resentful.

Sarah’s programme is goal driven, that suited me as well.

She reminded me that change was a long process and to do it properly you need to have both a reason and the ability.

I had both, she told me — others who wanted to stop drinking weren’t nearly so lucky or priviledged. I had choices — so what kind of life did I want to choose?

Her advice to consider how drinking fits into life goals, along with being aware of alcohol’s relationship to stress.

I found like so many others,  that alcohol is an ingrained coping mechanism and so can feel very necessary in order to deal with stress or help wind down after a challenging day. Swapping that for writing daily to Sarah, became my new coping mechanism, and always journal for my own wellbeing these days.

Writing down why I drank, why I no longer wanted to and what it was like dealing with stress and anxiety without an artificial crutch became extraordinarily useful.

I cannot recommend this wonderful, logical, and no nonsense approach enough.

This is one of the best blogs I have read, to describe the lack of care for one of the biggest triggers of mental illness, alcohol. As someone replied to a tweet of mine recently, ‘I think it’s largely because almost everyone uses it and society doesn’t want to acknowledge that it’s a problem for many, many people… it’s hidden in plain sight.’

We know that people’s mental health is suffering during the pandemic and is likely to worsen during this second winter lockdown, and also that many of us are consuming more alcohol than usual.

The trouble is that alcohol presents itself as an immediate (but short-term) solution to feeling anxious, low mood, winding down from a stressful day, difficulty falling asleep, and moving on time when it hang heavily on our hands. Lockdown may add relationship and financial stresses, and significantly reduces our access to other options for destressing.

However, the short-term fix that alcohol provides starts to become the problem as tolerance develops and we need to drink more to have the same effect. Once that happens alcohol starts to cause or add to the problems we were trying to solve (feeling anxious, low mood, poor sleep etc).

So, the same symptom may be either a cause or a consequence. For instance, symptoms of depression or anxiety may increase our alcohol use, which then is likely to worsen our mental state, worsening anxiety and depression symptoms, and fuelling further alcohol use which people may regard as treating their anxiety or depression.

Similar vulnerability factors (genetics, adverse childhood experience, social inequalities, stress, life events and personality traits) may be common to both mental ill-health and alcohol use disorders. For example, higher levels of impulsivity are seen both in alcohol use disorder and bipolar disorder and likely contribute to their high co-occurrence.

But while stigma around mental ill-health is thankfully starting to reduce, the same cannot be said for people with alcohol use disorders, where it remains frequently dismissed as a ‘lifestyle choice’, a ‘lack of willpower’ or a form of ‘moral weakness’.

People who become physically or psychologically dependent on alcohol often feel a huge sense of shame, and self-stigma, which adds to their already low mood, and sense of hopelessness, and is a significant barrier to seeking appropriate help.

Sadly, most health professionals are not trained in what should be the simple act of assessing levels of alcohol consumption or offering brief interventions, which have a strong evidence base for effectiveness.  

Other factors also have an impact: confusion over alcohol units; the increase in alcohol strength and portion size in recent years; the alcohol industry’s sub-standard labelling; and advertising which implies that no event is complete without alcohol (have you tried finding a birthday card without an alcohol reference of late?). All this results in a potent cocktail of social norms of high alcohol consumption combined with ignorance of its harms, which can drive people further down the road to mental ill-health and risk of suicide.

The health and social care act changes of 2012, resulted in addiction services taken out of NHS commissioning, and subject to frequent re-tendering and budget cuts. This has disproportionally affected people with co-occurring alcohol dependence and a mental health disorder.

Many addiction services no longer have competencies in-house to deal with co-morbid mental ill-health, and mental health services frequently refuse to work with people who have a comorbid alcohol use disorder, such that patients wanting help with the depression that they see as causing them to use alcohol, are often told they can’t be helped until they are alcohol-free. People in truly desperate states are bounced between addiction and mental health services, with many often falling through the gap.

 So what can be done?

1. We all need to be more aware of what we drink, and why, and at a population level increase our alcohol health literacy
2. We need to be aware and challenge the alcohol and advertising industries’ attempts to encourage alcohol as the only narrative in our social world
3. We need to encourage conversations about alcohol use as we now seem better able to do about mental ill-health
4. We need health professionals to recognise alcohol as a modifiable risk factor for so many mental (and physical) health disorders and have the competence to manage it
5. We need mental health services to reclaim alcohol use disorders as primarily a disease of the mind, and genuinely embrace person centred care
6. We need government to commit to the resources required to redress the balance of 10 years of funding cuts

This may seem like a lot that needs to be done, which it is, but the most effective thing we can all do is make small but sustained changes to our own alcohol awareness and behaviours.

Written by Julia Sinclair

It has taken me too long to write this blog, for the relevance and importance of the connection between wine time and depression is so key.

More and more I hear from clients of how they are treated by GPs with regard to their mental health, and primarily, their drug of choice, alcohol, which is a gateway to so much more, is broken before the conversation can begin.  I am very fortunate in having a great general practitioner, caring and compassionate, and most importantly, a good listener. However I am in the minority. Before anyone starts about how much pressure GPs are under, we all are, which is why so many seek solace in a bottle or two. It is not to have fun with, it is to self medicate, having drawn a complete blank with their professional health expert, their first port of call, their hope.

There is a script that seems to be followed to the letter. It goes something like this. ‘Doctor I am very anxious and depressed, probably drinking a bit too much’, nervously giggling which translates into shameful embarrassment. Asked how much is imbibed, the lie is told, and that is just above safe guidelines, with the odd binge now and again. Then asked if they are depressed, there is an immediate admission of that, often ‘Yes, deeply, and so anxious, work, family, you know….’ Three options are offered, the go to anti depressants, which will take apparently weeks to take effect, and you can potentially suffer awful side effects, including more anxiety and depression, beta blockers, along with ADs these won’t work effectively either given the drinking that’s going on, and possibly CBT, with a therapist who is up to their eyes in it, months of waiting, and when you get to see them, few specialise in alcohol or other drugs, another script. GPs also have alcohol problems, some of them, and I have seen many. So they do leave judgement at the door, although often my clients tell me they have had a sniffy sort of look followed by, ‘cut down, you know it makes sense’. Doh, we are not stupid, we are at the end of a very long tether, wanting some sort of clear and kind plan to help.

So that has taken the ten minutes, off you go, with your new prescription, and get on the merry-go-round of most likely anti depressants, which could be another lifetime of despair. 

Hoping for the best, because most people that I see do have that attitude, they don’t feel like victims, they start the course, along with celebrating that they at last may have an answer to the low mood, with a bottle of white.

Now it becomes extremely dark. Anxiety ramps up, tiredness, worse than before sets in, and the drinking increases. There is an awful pattern of guilt and frustration because we have always been taught that doctors know better than we do. Well, newsflash, they don’t with this. They haven’t got a clue what to do with us, they are not trained and they have no empathy unless they have been in the same place as we once were.

There is a major epidemic now, more than ever before of stigma and taboo. There are more and more suicides and lost families because of the non joining up of dots with drinking too much and mental health. No amount of shiny leaflets and platitudes can replace some honest and quality care.  What is potentially a fixable mental health issue, then becomes something so much darker, more dangerous and potentially life threatening, when what was needed was some truly empathetic care and general non stigmatised attitudes. 

More and more in the media we hear of tragic loss because of complex mental health crisises, many of which could have been nipped in the bud if they had been handled appropriately in the first place.

It makes me incredibly angry, and more and more fired up in my desire to break this last taboo, and most especially for women. 64% of my clients this year were on anti depressants, having stopped drinking, only 12% remain on them.  We just want an open and honest approach to this without all the fear, and a simple change of attitude will do that.

Every other potentially life-threatening illness receives specialist care. As each patient will present with a unique set of diagnostic problems, the treatment will be altered for their best outcome.

For the most part, there is blanket coverage with alcohol misuse, dependence or fully blown alcoholism. Every client I have seen has their own story about attempting to get to grips with their own problem. Most have already tried mainstream agencies, and some have gone to AA. The results have been not only poor, but incredibly demoralising for them. A professional client also pointed out that she not only felt at ease with our modern approach, but I had also been thoroughly vetted, CRB check along with my reputation, could that be said for anyone she spoke to at a meeting of strangers at an AA meeting in such a vulnerable state?

The first admission of needing help is a huge deal. It can take weeks, months even, to pluck up the courage to stop sailing down the river of denial and decide to do something about it. So, they brace themselves to confess. The next step, from a GP is to get them some help. From where?  Often mainstream agencies who naturally are doing their best with the script they have. As a leading light in the GP circles told me on twitter, there is simply nowhere that is ‘Specialist’ to help. Then they have another soul searching, heart wrenching decision to make, exposure to a room full of strangers to admit they have a problem with alcohol and that they are powerless. When women are in an anxious state does anyone really consider that lowering their self-esteem more is helpful? They probably have never felt so shameful in their lives. AA for example, may be a huge organization but how effective is it? So antiquated, founded for men, have we not got a duty of care to the modern woman who can actually think for herself? How can anyone seriously commit currently to a life time of meetings to stay sober? Given the rise of the problem during the last year, if AA was able to address this epidemic, then the numbers would be falling, right?

We really do need a new approach. As much as I have been asked to use my expertise in other age groups and demographics, I have refused simply because the best skill that I have above all others, is that I totally empathise with my clients, and vice versa. Which means that their outcomes are incredibly successful.

A man talking about his fall from grace with booze has different ramifications than those of women. A 22-year-old co-dependent, with other drugs along with the gateway one generally, alcohol, has little in common with a Mother of 3 who drinks wine.

The cost will be far too high I hear the cry! The costs involved in the treatment I offer are very effective. I give my clients the opportunity to stay well, and my fee is less than the amount that they would have spent on booze in the first place. Win win, they spend on their wellness, and I can continue to help.

I have no idea why anyone would really need to spend 6-8 weeks incarcerated in a Rehab, using either private or public money, vast amounts of it. Being cut off from the real world is surely going to be a problem when they go back to it. I have a client who tried it three times, her words, ‘It was like being on an 18-30s holiday’. She was 57 at the time. Coupled with the fact that as soon as they are released, alcohol is everywhere, no one must score it on a street corner.

Then there are the box tickers. Whilst a client is trying to bear their soul, with a very intimate subject, forms are filled in and if they don’t match then, tough. Generic, and often very patronizing, my women are often highly skilled and incredibly articulate. Nor do we throw people away just because they might have the odd blip. It happens.

The powers that be, who seem to be so opposed to change need to start to join up some dots. I now have established an 86% recovery rate, which is both rewarding for the client first and foremost, and importantly very cost effective. The best part is that is it so very simple. Or perhaps that is the problem, that there are no vast swathes of trustees, directors, committees and think tanks involved to see what is glaringly obvious to me and my clients.

If you are a middle aged or mature woman, and have run out of options for appropriate care, finding it more and more difficult to avoid self medication during lockdown, Harrogate Sanctuary has solutions, we talk, we have ice breaker meetings, we communicate rapidly and empathetically. It is a very personal service, and you have nothing to lose by picking up the phone.