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Dr. Olsen
Dr. Olsen, Psychologist
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Experience:  PsyD Psychologist
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My brother (age 47) is drinking and smoking himself to death

Customer Question

My brother (age 47) is drinking and smoking himself to death and I can't convince him to stop. He has been a heavy drinker for years, but he controlled his drinking during the week because of his job. He lost his job three months ago and now he drinks vodka all day, every day. He recently had an alcoholic seizure (two months ago) when he tried to stop drinking cold turkey, and now he is afraid to stop. He has elevated liver enzymes, is malnourished, and is cutting himself off from his family. He has few friends, no interests, and sits alone in his apartment all day and night, sipping drinks. I'm worried that he is going to have a serious health issue soon. I have offered to help him stop drinking (or taper off) but he can't seem to convince himself to do either. Any suggestions?
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. Olsen replied 3 years ago.
Hi there,
Thank you for writing in here.
I am so sorry to hear about your brother's situation.
It sounds like he is addicted to alcohol.
He may be depressed as he lost his job. It's common for people with alcohol abuse and dependence problems to suffer from depression.
His excess use of alcohol may aggravate his health and depression over time.
Perhaps, he may be afraid of quitting alcohol or he may be at a loss of what to do without drinking.
I would advise him to see his primary care physician for a physical check-up and safe alcohol detoxification.
Then he may need to start working with a psychotherapist for alcohol addiction and depression WEEKLY in his area.

A combination of psychotherapy and pharmacotherapy are considered to be effective to treat Depression.
Cognitive-behvaior therapy (CBT) will work for depression.

He may ask his doctor for a psychologist/psychotherapist that he can work with WEEKLY. Or he may call his insurance company and get a list of providers in his area.

Or, you can search a licensed psychologist on internet- such as the PSYCHOLOGY TODAY website. Go to (http://therapists.psychologytoday.com/ppc/prof_search.php?iorb=4764) and enter your zip code and optional category of specialty such as Depression. Read psychotherapists’ profile to see if he or she specializes in Cognitive-behavior therapy. You may also want to create your mental image of psychotherapist that he wants to work with – Male or female? To note, many therapists offer initial consultation for free. So he can see it as an informational meeting. He can ask any question and negotiate psychotherapy fee.

If he has no health insurance or seek a low fee counseling, he may call The United Way toll free # 211 (Dial 2-1-1)to find the community mental health centers in his area in which he can get counseling even without health insurance.

In addition, stress reduction and relaxation techniques such as yoga, swimming, biofeedback, acupuncture, meditation and massage therapy may be helpful for him to reduce the severity of depression. Also, eating a healthy diet rich in Omega-3s – Cold water fish, walnuts, flaxseeds, salmon, halibut, shrimp and tofu etc. may be helpful to his brain health and affective regulation.

I hope your brother gets well with all available help and support.

Please let me know if you have more questions or I have overlooked any. Warm regards,

P.S. Please remember to click the green ACCEPT button. You do not get charged twice; I will continue to answer your question whenever I am back online; my goal is to get you the best answers possible. If I can be of further help with any issue, just put "for Dr. Olsen" in the front of your new question. All the best, Dr. Olsen

Customer: replied 3 years ago.

Thanks for your suggestions. I agree with your assessment, and with your recommendations. The problem, however, is to get him to go to a doctor, and that's what I really need help with. I believe you were correct when you said "he may be afraid of quitting alcohol or he may be at a loss of what to do without drinking," and because of that fear he does not want to go to a doctor, a psychotherapist, or any other type of professional treatment.

 

I have shared a great deal of information with my brother about alcoholism and drinking, and I've made it very clear to him what his life will be like if he continues to drink as heavily as he does now. I've also told him what I think his life would look like if he quit drinking, and I defined three treatment options for him (go see a physician and follow his/her advice, go to a hospital detox unit, or taper off) and told him I would help him with whatever treatment option (one of those or another that he devises) he chooses.

 

He has read the information and we have verbally discusses it and the treatment options. But he cannot reach a decision to do something -- I believe because he's afraid of quitting and of what his life would be like after he quits drinking. When I have pushed him to make a decision, he has told me to back off, that I'm increasing his stress, and then he stops talking to me.

 

At this point, I'm not pushing him to stop drinking. I am staying in contact with him several times per week, and encouraging him to eat better, get exercise, and look for work (he is doing none of those). He is now cutting himself off from his family and says he has no intention of seeing our family for Thanksgiving or Christmas, and that he will instead stay home and drink.

 

I'm worried that my brother is going to have a very bad incident soon that will involve a hospital or the police and I'm trying to find some way to get him to treatment before that happens. He will NOT voluntarily go see a doctor at this point, so that suggestion (as reasonable as it was) will not work in this case.

 

Any other ideas? Even offbeat suggestions are welcome.

 

Thank you!

Expert:  Dr. Olsen replied 3 years ago.
Hi there,
Thank you for your reply. I got your message now as I was away from the computer all day.
Can I get back to you tomorrow?

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