Depresivul anonim

SURSA-THE SOURCE

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This leaflet is written for:

• anyone who feels depressed and suspects they may be drinking too much.
• anyone who suspects they may be drinking too much and is feeling depressed.
• friends, family or colleagues of anyone who is both depressed and drinking.

 

It contains some basic facts about alcohol and depression, how to help yourself, how to get further help, and where to find more information.

Alcohol and us

More than 9 out of 10 people in the United Kingdom drink alcohol. It is part of our culture and we feel comfortable with it. Moderate drinking doesn’t cause many problems. However, over the last 30 years, society has become wealthier and alcohol has become cheaper. We are starting to drink at a younger age and we are drinking more. More than 1 in 4 men, and about 1 in 7 women are drinking more than is medically safe for them. According to the Department of Health, around 1 in 8 men is physically addicted to alcohol.

How does alcohol affect the brain?

Tolerance

Alcohol is like many other drugs that act on the brain, such as tranquillisers. If we drink it regularly, we find that it has less effect on us. We need to drink more and more to get the effect we want. This is called ‘tolerance’ and is a powerful part of becoming addicted to alcohol.

 

Alcohol can also lead to:

• Dementia - memory loss, rather like Alzheimer’s dementia.
• Psychosis - long- term drinkers can start to hear voices.
• Dependence - if you stop drinking, you get withdrawal symptoms such as shaking, nervousness and (sometimes) seeing things that aren’t there.
• Suicide - 40% of men who try to kill themselves have had a long- standing alcohol problem. - 70% of those who succeed in killing themselves have drunk alcohol before doing so.

What is the connection between depression and alcohol?

We know that there is a connection - self-harm and suicide are much more common in people with alcohol problems. It seems that it can work in two ways.

 

• If we drink too much, too regularly, we are more likely to become depressed.

 

Regular drinking can leave us tired and depressed. There is evidence that alcohol changes the chemistry of the brain itself and that this increases the risk of depression.

 

Hangovers create a cycle of waking up feeling ill, anxious, jittery and guilty.

 

Regular drinking can make life depressing - family arguments, poor work, unreliable memory and sexual problems.

 

• If we drink alcohol to relieve anxiety or depression, we will become more depressed

 

Alcohol helps us to forget our problems for a while. It can help us to relax and overcome any shyness. It can make talking easier and more fun, whether in the pub, a club or at a party. It is a very effective way of feeling better for a few hours.

 

If you are depressed and lacking in energy, it can be tempting to use alcohol to help you keep going and cope with life. The problem is that it is easy to slip into drinking regularly, using it like a medication.The benefits soon wear off, the drinking becomes part of a routine, and you have to keep drinking more to get the same effect.

How much alcohol is too much?

Some drinks are stronger than others. The easiest way to work out how much we are drinking is to count “units” of alcohol. 1 unit is 10 grammes of alcohol - the amount in a standard pub measure of spirits, a half pint of normal strength beer or lager, or a small glass of wine.

 

If a man and woman of the same weight drink the same amount of alcohol, the woman will have a much higher amount in her bodily organs than the man. So, unfair as it may seem, the safe limit is lower for women (14 units per week) than for men (21 units per week).

“Binge” drinking

How much you drink at one time is also important. These “safe limits” assume that our drinking is spread out through the week.

 

In any one day, it is best for a man to drink no more than 4 units and for a woman to drink no more than 3 units. Drinking over 8 units in a day for men, or 6 units for women is known as ‘binge drinking’.

 

You can drink above the safe limit on one night, but still remain within your “safe” limit for the week. There is some evidence that, even a couple of days of binge drinking, may start to kill off brain cells. This was previously thought only to happen with people who drank continuously for long periods of time. Binge drinking also seems to be connected with an increased risk of early death in middle aged men.

Guide to units of alcohol

This table below gives a rough guide to the amount of alcohol found in standard measures of different drinks.

 

These guidelines are approximate and may vary depending on the brand chosen and the size of measure. All alcohol sold in the UK above 1.2% ABV (Alcohol By Volume) should state how strong it is in percentages (%).

 

The higher the percentage, the more alcohol it has in it. Pub measures are generally rather smaller than the amount we pour ourselves at home.

 

Beer, Cider & Alcopops	Strength ABV	Half Pint	Pint	Bottle/ Can 330ml	Bottle/ Can 500ml	Bottle 1 Litre
Ordinary strength beer, lager or cider eg. Draught beer, Woodpecker	3-4%	1	2	1.5	1.9	-
“Export” strength beer, lager or cider eg. Stella, Budweiser, Heinekin, Kronenbourg, Strongbow	5%	1.25	2.5	2	2.5	-
Extra strong beer, lager or cider eg. Special Brew, Diamond White, Tennants Extra	8-9%	2.5	4.5	3	4.5	9
Alcopops eg. Bacardi Breezer, Smirnoff Ice, Reef, Archers, Hooch	5%	-	-	1.7	-	-

 

Wines & Spirits	Strength ABV	Small glass/ pub measure	Wine glass	Bottle 750 ml
Table Wine	12-14%	-	1.5 - 2.5	10
Fortified wine (sherry, martini, port)	15-20%	0.8	2-3	14
Spirits (whisky, vodka, gin)	40%	1	-	30

How much am I drinking?

Most of us under-estimate the amount we drink. One way to check on this is to keep a diary of how much we drink over the course of a week. This can give us a clearer idea of whether we are drinking too much. It can also help to highlight any risky situations - regular times, places and people when we seem to drink more.

Diary Table

DAY	HOW MUCH?	WHEN?	WHERE?	WHO WITH?	UNITS	TOTAL
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Total for week

Warning signs

• You regularly use alcohol as a way of coping with feelings of anger, frustration, anxiety or depression.
• You regularly use alcohol to feel confident.
• You get hangovers regularly.
• Your drinking affects your relationships with other people.
• Your drinking makes you feel disgusted, angry or suicidal.
• Other people tell you that when you drink you become gloomy, embittered or aggressive.
• You need to drink more and more to feel good.
• You stop doing other things to spend more time drinking.
• You start to feel shaky and anxious the morning after drinking the night before.
• You drink to stop these feelings.
• You start drinking earlier in the day.

What if I am drinking too much?

• Set yourself a target to reduce the amount of alcohol you drink.
• Avoid any high-risk drinking situations(check out your diary).
• Work out other things you can do instead of drinking.
• Involve your partner or a friend. They can help to agree a goal and keep track of your progress.

 

We know that many people are able to cut down their drinking after discussing it with their GP. Some people can stop suddenly without any problems. Others may have withdrawal symptoms - craving, shakiness and restlessness. If this happens, your GP can help.

Depression and stopping drinking

There is evidence that, although many heavy drinkers feel depressed when they are drinking, most will feel better within a few weeks of stopping. So, it is usually best to tackle the alcohol first, and then consider dealing with the depression if it has not lifted after a few weeks.

 

After a few alcohol-free weeks, you will probably feel fitter and less depressed. Friends and family may find you easier to get on with. If your feelings of depression lift, this strongly suggests that they were caused by the drinking.

 

If the depression is still with you after four weeks of not drinking, talk to your GP or about further help. It may be useful to talk about your feelings, particularly if your depression seems linked to relationship problems, unemployment, divorce, bereavement or some other loss. Counselling may be helpful.

 

If the depression does not lift and is particularly severe, your general practitioner may recommend a talking treatment called ‘cognitive psychotherapy’ or suggest anti-depressant medication. In either case, you will need to stay away from alcohol and go on with the treatment for several months. There are some medications used to reduce the craving for alcohol, but these are usually only prescribed by a specialist.

 

Treatment for both alcohol problems and depression can be very successful. It helps to regularly see someone you can trust, either your own doctor, counsellor or a specialist psychiatrist. Changing our habits and style of life is always a challenge and takes time to achieve.

Dos and Don’ts of Drinking safely

• Do sip your drink slowly - don’t gulp it down.
• Do space your drinks with a non-alcoholic drink in between.
• Don’t drink on an empty stomach. Have something to eat first.
• Don’t drink every day. Have two or three alcohol-free days in the week.
• Do provide non-alcoholic drinks as well as alcohol on social occasions.
• Do ask your doctor or chemist if it is safe to drink with any medicine that you have been prescribed.
• Do keep to the target (amount of alcohol per week) you have set yourself.
• Do check your drinking every few weeks with your drinking diary.

 

Finding Help

If you just can’t stop drinking, or can’t keep it to a safe level, you can get help from:

 

• Your general practitioner
• Self help groups, such as Alcoholics Anonymous or AlAnon
• Voluntary alcohol agencies
• Specialist treatment in the NHS - your general practitioner who will also know how to contact specialist services.

 

Other useful leaflets produced by the Royal College of Psychiatrists include: Depression

Depression in Older Adults

Manic Depression

Men and Depression

Physical Illness and Mental Health

We also have factsheets on Antidepressants and Cognitive Behavioural Therapy.

 

References

Davidson K.M. (1995) Diagnosis of depression in alcohol dependence: changes in prevalence with drinking status. British Journal of Psychiatry 166: 199-204

Department of Health (1999) Statistics on alcohol: 1976 onwards. Department of Health : London

Mcintosh C. & Ritson B. (2001) Treating depression in substance misuse. Advances in Psychiatric Treatment vol 7, 357-364

Raistrick D. (1996) Management of alcohol misuse within the context of general psychiatry, Advances in Psychiatric Treatment 2:125-132.

 

 

Helpful Organisations/ Websites

Depression Alliance Information, support and understanding for people who suffer with depression and for relatives who want to help. Self help groups, information, and awareness raising for depression. Tel: 0845 123 23 20

 

Alcoholics Anonymous Contact details for all English AA meetings. There is a quiz to determine whether AA is the right type of organisation for an individual, and a frequently asked question section about AA and alcoholism. Tel: 0845 769 7555. email: aanewcomer@runbox.com

 

Alcohol Concern This site provides information and articles on a range of topics surrounding alcoholism. Includes 18 excellent factsheets crammed with information that would be very useful for professionals such as Alcohol and the Law and Drink-drive accidents, a search engine, and a good list of alcohol related links. Tel: 0I71 928 7377 email: contact@alcoholconcern.org.uk

 

Al-Anon Family Group Support group for friends and families of alcoholics. Includes a frequently asked questions section, pamphlets and other literature, and information on group meetings in the UK. Tel: 020 7403 0888

Institute of Alcohol Studies The IAS is a charity aimed at improving education about alcohol in the UK. The site provides publications on alcohol, as well as news. There are a large number of factsheets dealing with all aspects of alcohol in society, complete with facts and figures. Tel: 0207 222 4001. info@ias.org.uk

Recommended Reading

Alcoholism: The Facts. DW Goodwin. Oxford University Press (2000)

Tackling Alcohol Together. Duncan Raistrick. Free Association Books(1999)

Alcohol: The Ambiguous Molecule. G. Edwards, London: Penguin (2000)

 

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This leaflet was produced by the Royal College of Psychiatrists’ Public Education Editorial Board.

Series editor: Dr Philip Timms.

Last update: July 2006

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Fara nicio urma de zambet , pentru cei ce nu stiu sa rada , fara nicio intrezarire de lumina, pentru cei ce nu stiu sa vada , fara niciun fel de cuvant, pentru cei ce nu stiu sa vorbeasca , fara solutii , pentru nimeni! Sunt inundata de pulsul ciudat al inimii stranse in batista de abis, astept de mult , de cand credeam ca stelele stralucesc numai pentru cei privilegiati , nu reusesc sa ma trezesc din confortul de a fi mereu trista … ceasurile sticloase nu ofera nicio rezolvare, sa fie oare recompensa pe care o merit , ca mi-am strans axionii si dendritele in menghina nepasarii , ca mi-am ranit chipul cu o reflexie tarzie , ca n-am mai indraznit sa ies de aici? Undeva, destinul e ciobit ….s-a pierdut contactul cu exteriorul .. si atunci ce rost mai are sa strig dupa ajutor, din moment ce nu reusesc sa exprim nimic? Am transpirat , insa n-am creat nimic durabil, am ascultata de prea multe momai , incapabila de a constientiza ce-i mai important ! Multe as mai putea pretinde, daca as avea libertate totala sau daca as fi in stare sa traiesc cu adevarat!

Interesting and original:

AICI

Lori, the pert and pretty nurse, took her troubles to a resident psychiatrist in the hospital where she worked.

“Doctor, you must help me,” she pleaded. “It has gotten so that every time I date one of the young doctors here, I end up in bed with him. And then afterward, I feel guilty and depressed for a week.”

“I see,” nodded the psychiatrist. “And you, no doubt, want me to strengthen your willpower and resolve in this matter.”

“For God’s sake, NO!” exclaimed the Nurse. “I want you to fix it so I won’t feel guilty and depressed afterward.”

 sursa

Depression always goes hand-in-hand with an eating disorder. Together the two rob a person of their happiness and self-worth, and easily wreak havoc on innocent lives. Unfortunately, we are living in a “pill society” and, more often than not, therapists tend to treat depression alone with drugs instead of with a more psychological basis and along with the eating disorder. It’s amazing to look at the statistics and discover the multitudes of people who suffer from depression while this, just as with eating disorders, still appears to be an enigma to understanding. Hopefully the information contained here will help clear some of the fogginess of sadness away…

overview

Depression is not biased - it affects anyone at any race and age and economical standing. It can strike at any moment; it doesn’t need a tragic incident to trigger onset. Over 19 million over age 18 are considered to be clinically depressed, or 1 out of 5 people in general society. Depression is so common that it is second only to heart disease in causing lost work days. More frighteningly so, untreated, depression is the number ONE cause of suicide (appx. 13,000 people died from suicide in ‘96 alone).

the.many.forms.of.depression

There are indeed three different kinds of depression - normal, mild, and then severe. I have found personally that those with eating disorders tend to range between having mild and severe depression.

normal.depression - This is a natural reaction to the loss of a loved one, one which has caused sadness, lethargy, and in serious cases, grief to the point of loss of appetite, insomnia, anger, obsessive thoughts about the lost person, and never ending guilt. What is different about normal depression from mild and severe cases is that most people eventually recover and return to their typical moods after encountering normal depression. When the moods of a person do not lift and instead continue, then mild depression is setting in.

mild.depression - When a person is chronically depressed, possesses low self-esteem, and has some symptoms of severe depression, then they are considered to have mild depression. With mild depression the person can still function through their daily life, but it is very hard for them and they are known as having “the blues.” Many times the mildly depressed person has nothing to hold accountable for their change of moods. Doctors and therapists should carefully watch over a person with mild depression because often times the mild depression will start out this way, but eventually progress into severe depression.

1.  
   I am the voice inside your head and I control you
   I am the hate you try to hide and I control you
   I am denial guilt and fear and I control you
   I am the lie that you believe and I control you
   I am the high you can’t sustain and I control you
   I am the truth from which you run and I control you
   I take you where you want to go
   I give you all you need to know
   I drag you down, I use you up
   Mr. Self Destruct-NIN

severe.depression - The person with this feels utterly hopeless and feels such great despair that they lose all interest in life, causing the person to be incapable of feeling pleasure. Sometimes the person will be unable to eat for days or be incapable to get out of bed. Trying to do these activities when severely depressed, the person feels anxious, irritable, agitated, and chronic indecisiveness. Sleep disturbances such as insomnia are not uncommon. Just as with mild depression, severe depression often does not set in after a traumatic incident or the loss of a loved one. However, the intense feelings of grief, guilt, and unworthiness are experienced just the same. Untreated, an estimated 25% of sufferers try to kill themselves after suffering for 5 years with this horrible mood disorder.

why.does.this.happen?

Often trying to figure out which triggered what (Did the eating disorder trigger the depression, or the other way around?) ends up being a game of whether the chicken or the egg came first, so I don’t even bother. What’s more important to me is finding the main trigger to the depression currently. Obviously the helplessness and hopelessness that comes from anorexia and bulimia is plenty enough to aggravate someone’s moods. The person with the eating disorder feels helpless - they feel out of control, while desperately searching for control by starvation and/or purging. At the same time, they feel like failures for not losing enough weight and not doing it fast enough (making a twisted accomplishment). The current state of the medical community also doesn’t host many rays of light, as it isn’t uncommon for a severe case to be called “hopeless” and “incurable,” or for a mis-understanding and mis-educated doctor to call someone with an eating disorder “selfish” and “manipulative.” It’s extremely hard to “think positively” and to “just read a few self-help books” and then magically, POOF, be ok. Depression doesn’t work that way, and inevitably it is aggravated and made worse. The person may occasionally able to have a once in a blue moon GENUINE happy moment, but for the majority, they are down in the dumps (often believing they deserve to be there).

Along with an eating disorder triggering and aggravating depression, biological problems also affect mood disorders such as this. Studies on seratonin, also known as the “feel good” neurotransmitter, have caused some interesting findings to come up - some showing that you can be born with messed up levels and that alone can cause a 4 year old to be diagnosed as clinically depressed. The basics of seratonin are if it falls too low, depression and other complications occur, and starving and/or purging always messes up this chemical. Usually when someone with anorexia is in what is known as “starvation mode” (occurs generally when the weight has fallen below 98 pounds and the body just goes completely bonkers and manic), depression is almost solely biological. Some therapists even require that a patient’s weight be raised up past 98 pounds before they will treat them for the eating disorder and/or depression because it is too hard to have the person think clearly at such a weight and condition that the body is in.

depression treatment

Just as with any additional disorder, depression MUST be treated along with the eating disorder. Often depression treatment includes Cognitive Behavioral Therapy (CBT) which identifies the ten forms of distorted thinking found in depression (see below). Besides CBT, there are many anti-depressants that are used. These include the famous Prozac, Zoloft, and Paxil. It is true that generally after a person is taken away cold turkey from their anti-depressant that they relapse back into old thinking patterns and the depression re-surfaces, however, when treated along with Cognitive Behavioral Therapy, most are able to be “weened” off of the anti-depressants without many problems. The key is to learn better rationalization techniques along with using the drug as just a little “booster,” so that in the end you have learned how to rationalize and use logic for your problems well enough that you no longer need anti-depressants.

the.nine.forms.of.distorted.thinking

1. All-or-Nothing Thinking :
   This is the black or white thinking pattern. If the person is not perfect they are nothing and a total failure. If the victim gets an A- on a test it’s the end of the world
2. Labeling :
   The person makes a mistake and instead of thinking that hey they made a mistake no big deal they label themselves names such as a failure or pathetic. Another example of this is having a parent yell at you for forgetting to do a chore. Instead of thinking that you’ll remember next time you may label yourself totally worthless and because of that your parents don’t love you now.
3. Over-generalization :
   This is when a person makes a slight blunder and believes they will never get it right. (”I relapsed again; I wont ever be able to recover.”)
4. Mental Filtering :
   ED victims tend to do this quite a lot. Say a friend commented on a piece of art work but then added that one of the colors was a little off. Instead of remembering that 99% of the art work is great looking the person dwells on the negative part of what the friend said and filters out any positive remarks. Many times the ED victim will say that they are good for nothing and that no one gives them any positive remarks but they do not realize that any positive remarks that they have been given they have immediately dismissed.
5. Discounting the Positive :
   This thinking is when you do something well such as cooking a good meal and then when given positive remarks on it you immediately think things like “Well, anyone could have done it,” or, “It wasn’t that great…”
6. Jumping to Conclusions :
   You assume the worst based on no evidence. You decide that another person is reacting negatively to you. (”I know she didn’t really mean it when she said I wasn’t fat; she’s lying just to be nice.”)
7. Magnification:
   This is the exaggeration of importance of problems and minor annoyances. An example of this would be an eating disorder victim not exercising for a full hour and thinking that what he did before was worth nothing.
8. Emotional Reasoning :
   Ever confuse your emotions for reality? This is when the thoughts of ‘I feel fat so therefore I am fat’ come up. The self-demanding tip-off’s include ‘must’, ‘ought to’, and ‘have to’.
9. Personalizing the Blame :
   These thoughts are another very common trait among eating disorder victims. The person believes that things beyond his or her control are the victim’s fault. (”I ate yesterday and that’s why the plane crashed,” or, “If I had gotten an A+ instead of an A then my mom wouldn’t have a migraine today.”)

Personally, I have found that a major key in helping rid depression is realizing that we all have limits and faults, but that that is OK, and that there are better ways of dealing with things than self-destruction. One particular quote has been especially helpful, and it goes a lil’ something like this: Most depression or anxiety-producing events are not inherently awful. What makes them feel distressing is the way we react to them.

AICI

Major scale

words& music, balauru

I see the World
With the same eyes
I “smell” the Magic
With the same nose
I go outside
My soul is cold
Look in the mirror
The child is old

And I cry may pain
With flowers
I look at my years
With regret
I just want
To be happy
A few more hours
Yes I want
To be young again

I feel love
With the same heart
I whisper poems
With the same lips
I go outside
My soul is cold
Look in the mirror
The child is old

And I cry may pain
With flowers
I look at my years
With regret
I just want
To be happy
A few more hours
Yes I want
To be young again
Again
Again
Again

Dedicat ideilor si personalitatii unui psihoterapeut de geniu [ + ]