Almost Alcoholic

It is very possible to have a drinking problem that is not defined or described as “Alcoholic.” Many people use alcohol to deal with stress but do not realize that it exacerbates the problems in their lives. There are techniques and therapies available to help you to lessen your dependence on alcohol and rediscover balance in your life.
Are you Almost Alcoholic?

Some people believe there are only two kinds of people in the world: alcoholics and non-alcoholics. Many also believe that we are either born alcoholics or we are not. This has been a prevailing view for a long time, and though this statement may seem dramatic to some, it does have some basis in reality. Those who hold these beliefs tend to be people who have experienced or witnessed the most severe symptoms and/or the most severe consequences of drinking, such as:

Being unable to stop drinking, beginning from the first time he or she had a drink
Repeatedly having blackouts (i.e. can’t remember the next day what happened) after having only a few drinks
Being arrested multiple times for driving while intoxicated
Becoming violent on more than one occasion when drinking
We know from our own clinical experience that there are people who develop severe alcohol drinking patterns and behaviors such as the ones just described. These are true alcoholics. However, there are also a large number of people who don’t meet the accepted criteria for diagnosing alcoholism, but fall into a grey area of problem drinking. These are the almost alcoholic.

True alcoholics vs. almost alcoholics

Anyone who drinks heavily is at risk for adverse health consequences, but some people appear to face a heightened risk for developing alcohol-related health problems. The reason appears to be largely biological, though environmental factors also likely play a role in this difference. Researchers have found, for example, that people differ in how their bodies metabolize alcohol. Since our biological make up is determined at birth, there is some truth in the idea that we have certain traits that make us more (or less) vulnerable to the effects of alcohol.

Our discovery of the almost alcoholic came through our many years of working not only with people who had the kinds of drinking problems just described, but also with a much larger group of people with a variety of drinking patterns that didn’t meet the criteria for alcoholism. As noted earlier, the majority of this larger group came to us not because they were concerned (or because others had expressed concern) about their drinking but for help with some other problem. The connection between the problems they sought help for and their drinking emerged later. Let’s look at a couple of examples:

Jennifer’s story

Jennifer, 41, was married with two children, an eleven-year-old son and a nine-year old daughter. Jennifer’s was a typical, two-income contemporary family. She had a middle management job in a large real estate development and management company, while her husband, Dan, worked in the information technology department of a large university. As was true for most of the couples they knew, they struggled with balancing the demands of work with those of parenting, not to mention housekeeping. They enjoyed their life in a comfortable suburban community with good schools and access to recreation; at the same time, both Jennifer and Dan sometimes expressed that they found life on a “treadmill” difficult.

Dan and Jen had met in college during their junior years and married a year after graduating. As college students, they’d enjoyed partying as much as most of their friends, but had never gone “over the top” with it. They’d each known the occasional hangover, especially as freshman, and both enjoyed meeting friends for tailgating parties at football games after graduation.

Jen did not drink at all during her pregnancies. However, after her second child was born, and after she returned to work following a six-week maternity leave, she joined Dan in his routine of sipping a glass of wine while they “decompressed” after work. That meant unloading the kids, making dinner, supervising homework, getting ready for the next day, and so on. Then, after the kids were in bed, Jen would have a second glass of wine, and sometimes a third. She told us that for a number of years this was an effective way for her to release the stress that built up over the course of the day. She also felt that the third glass of wine helped her sleep better.

When Jen sought therapy, it was not because of her drinking—which she still regarded as normal, and indeed helpful, given her high-pressure lifestyle. Jen was referred by her primary care physician, with whom she had shared her concerns about not sleeping well. Not sleeping well left her feeling “wired” the next day. That pattern then led her to feel increasingly depressed, which was reflected in a shortened temper (especially with the children), chronic feelings of fatigue, and a complaint from Dan that their sex life was “evaporating.” She’d asked her doctor about sleeping medications, or perhaps an antidepressant. The doctor said she would consider that, but first she wanted Jen to talk with a counselor.

Jen is a good example of this large group of people whom we have come to know well in our offices, people whose drinking emerges as a factor in their presenting problems. She did not make an appointment with a counselor because she was worried about her drinking.

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