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Dr. Michael
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience:  Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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I drink almost 1 litre of wine a day, over about 4-6 hours,

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I drink almost 1 litre of wine a day, over about 4-6 hours, from about 5-10 or 11pm. I don't get drunk--I might fall asleep for 20 minutes and then wake up while watching TV, but never black-out. I drink daily but go to work w/o problems, don't drink when I baby-sit my grandbabies b/c of a promise to my daughters and don't drink and drive. Do you think I am an alcoholic?  Also, I scored "5" on the MAST test but I wasn't sure about some of my answers---such as the relationship between my drinking and mental health problems.  I am bi-polar but have been stable and working part-time for 5 1/2 years b/c I take my medications, see my psychiatrist q 3 months for med checks and my therapist about q 2-4 weeks, as needed.  Before my stabilization, I had multiple in-patient hosp. due to depression and suicide attempts and I drank to self-medicate b/c prescription RX's didn't work and I had ECT about 17 years ago and it just screwed-up my short-term memory and memories 17 years ago that never came back. (ie my son's HS graduation).  Drinking while on my meds doesn't seem to interfere w/ their effectiveness (my psychiatrist knows I drink).  I take Seroquel,Lamictal& Effexor and Straterra for ADHD.
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. Michael replied 3 years ago.
Hello. I believe I can be of help to you with this issue.

No. Based on your reports of your use, your psychological functioning and your ability to carry out daily responsibilities, you do not meet criteria for alcohol dependence or "alcoholism". In fact you do likely do not meet diagnostic criteria for alcohol abuse. You are obviously drinking to help regulate your emotions or mood state, in the same way you are taking medication. Your daily intake levels of wine may be pressing the upper end or 'limit' of what is considered adaptive or healthy; however, many people in Europe drink as much wine as you do everyday, with full cultural support and no ill personal effects.

You might want to attempt to slowly, gently moderate your wine drinking just a bit and at the same time, begin meeting with a clinical or counseling psychologist or social worker who has expertise in mood disorders. You may find that you can hit upon some new coping strategies for managing problems with your mood which would actually help you reduce your overall levels of medication use, and your 'need' to help regulate how you think and feel through wine consumption. I don't hear you describing an ongoing, skill-building aspect of your treatment. Having someone to talk to, someone to bounce your concerns off of who is objective, dispassionate, etc., and has expertise to teach you meaningful mood regulation skills (cognitive behavioral therapy, dialectical behavior therapy, ACT therapy), can do people some long term good.

What do you think?

What do you think?
Customer: replied 3 years ago.

I have been with my therapist, a psychologist, for almost 11 years.

She specializes in mood disorders. She has been with me thru the very worst times and now during good times. I know that she doesn't approve of my alcohol consumption b/c I went a week w/o drinking b/c I wanted to lose a little weight and she said that she was very happy about it. My wine glass is 10 oz and I always fill it full and drink 3-4 glasses in the evening. She says that 4 oz is the normal size of a wine glass and that I am exceeding the limit. My father died of cirhossis of the liver and my sister is an alcoholic (not drinking now)but on a lifetime of methodone b/c of her percocet addiction and she has no plans to d/c the methodone. She says it's the only "anti-depressant" that really works for her.

Because my therapist knows all of this, I don't think she is objective about my drinking. This is why I am asking a stranger for his opinion.

I am confused and not sure that your advice is good for me. I am not French or Italian where they learn to drink responsibly at meal times from the time they are children.

I am not drinking to regulate my mood state as you seem to think from what you have said. My mood is fine b/c of the meds I take. I drink b/c I like the taste and it is relaxing. I don't like to exercise or do meditation, so pls. don't suggest that as an option.

I took about 3 different alcohol assessment tests online, including the MAST and all 3 said that I had a high probability of alcohol abuse or dependency, and that does scare me!! I've gone to AA in the past but never really felt that "I fit in" b/c I have a long list of

"NOT YETS" such as no DUI's, lost job or family. jail time, black outs, etc. It's been almost 2 years since my last AA mttg. and I am now wondering if I should go back.

Are you familiar with the book "UNDER THE INFLUENCE"? I fit the criteria for an early alcoholic b/c of my increased tolerance level and craving for alcohol.

Expert:  Dr. Michael replied 3 years ago.
You are probably drinking up to 40 oz of alcohol per day with is somewhat more than I presumed initially. Also, your disclosure that addictions e.g., opiate addiction, alcoholism seem to run in your family, changes the pictue a bit. You also not that you have alcohol cravings; and a good indicator of abuse/dependence is one's emotional reaction when they are not allowed to drink e.g., mild to severe withdrawal symptoms. Given this new information, you are indeed, probably in the excessive drinking/abuse realm of consumption; the alcoholism 'risk' profile you present is worrisome---and I'm glad you realize that it is. Now, in my last post, I suggested that you gently curtail your drinking--cut back, gradually. I'm thinking that achieving a goal of consuming only one-third to one-half of what you are drinking could be achievable; it might provide you with whatever psychological benefits you derive from the 32-40oz you are now consuming. If you find that you are having grave difficulty doing this, after attempting it for a couple of weeks, then I do think you should perhaps get into an outpatient program and seek cessation of your drinking. You may be in the high risk, genetically-predisposed subgroup of drinkers who can more easily become alcoholics in later life, as they continue to drink. This would certainly be indicated if, over the past 4-5 years, the amount you have consumed everyday has gradually increased to its current level. This would suggest a very slow and gradual escalation of drinking into alcohol abuse and then, possibly dependence. What do you think?
Customer: replied 3 years ago.

I have to go to work but will respond later this afternoon or evening.

Thankyou!

Expert:  Dr. Michael replied 3 years ago.
Very well. I'll look for your response. I will then answer tonight or tomorrow a.m.
Customer: replied 3 years ago.

Hi!

I will try and see if I can cut back on my alcohol consumption. I am not sure what you mean by "withdrawal." I always try and make sure that I am not out of wine (my favorite) but if I am, I will drink a Rum and Coke, Bloody Mary or other alcoholic beverage. I don't get physically sick when I don't drink--if that is what you mean by withdrawal. If I am going to someone's house where alcohol is not served (like my daughter's house) I might have a glass or two of wine before going, unless it is too early in the day---like before 12 Noon.

I did try and cut back drinking for a short while when I was trying to lose weight (and I did lose a few pounds) but I returned to my wine.

I am trying to be as honest as I can with you and want your professional opinion, even if its not what I want to hear.

Thanks!

PS Some of the alcohol quizzes as about trouble sleeping. What does that mean and how does it relate to alcoholism? I have started having trouble sleeping about 3 weeks ago and even if I take a 0.5mg of xanax (which used to knock me out w/in 2-3 minutes!) it doesn't always work. I also have a restless sleep where I dream a lot about stuff going on in my life.

Expert:  Dr. Michael replied 3 years ago.
When people cease alcohol consumption they will experience emotional distress; interrupting any habit e.g., drinking wine, running, having a diet coke every afternoon, causes this; but with alcohol, people experience physical distress because their body has adapted to the alcohol. They become agitated, can't sleep. Withdrawal symptoms is what you would be experiencing if you stopped drinking all alcohol for several days. This would be a sign of alcoholism. If you were merely emotionally upset a bit, because drinking alcohol helped you calm down or feel a bit better, and this source of 'calming' was removed from your life, this would be more along the lines of psychological withdrawal.

So the question is, if you know that you are at risk for developing alcoholism and you don't get physically ill when you stop drinking, then you could probably easily adapt to cutting back on your alcohol consumption. You could do this by premeasuring how much you will drink today, an then making sure you drink it extra-slowly, making the drink last longer than usual, even though you have poured out fewer ounces.

Alcohol contains lots of calories so you might find that when you cut back, you will lose weight, which might be a good thing. Also, drinking alcohol tends to disrupt the normal sleep cycles of people. Withdrawal symptoms will cause some fairly significant or dramatic withdrawal symptoms if the person is addicted and has developed a high level of tolerance to alcohol. In your case however, the problems sleeping during the last few weeks could easily be caused by the stress and worries you experience, especially if you have trouble falling asleep; and, when you can't fall asleep, you have many thoughts or problems running through your mind.

I hope this information is helpful to you. Please let me know if I have overlooked any aspect of your original question. Please hit the green Accept button at the bottom of the screen. Thanks.
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience: Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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