The festive season has come to an end, with the 31st night sure to have been a hazy blur for the majority of the adult population of the island. The festivities, while being the perfect time to unwind from an unfortunate second year plagued by a global pandemic with no real end in sight, also highlighted the ever persistent issue that Sri Lankans experience regularly but often goes unnoticed – the widespread prevalence of functional alcoholism.
There’s no better time than the holidays to witness the majority of the, hopefully adult population getting blackout drunk. While the season makes it obvious, and may at times feel like it’s really just for this exclusive period of time, if you look a little more carefully you will see that many of those who binge drink during the festivities don’t really limit their activities of consumption to the holidays. For many of them, this is a more common indulgence, maybe weekly, and for some it may even be a daily practice.
Before we get into the discussion, we’d like to present a clear disclaimer that we are not in any way preaching abstinence. If you are an adult human capable of exercising reason then by all means do as you like. We are not here to rain on your parade. However, it is important to recognise whether you do in fact have a problem.
It is even more important to have this conversation considering Sri Lanka’s extreme lack of attention to mental health concerns. Especially issues like addiction or elements that lead to addiction like depression or anxiety, which we consider to be shameful or in some cases, are believed to simply not exist, completely disregarding the science which clearly states that addiction is very much an illness that requires treatment.
Identifying addiction
Alcohol use disorder (AUD), which includes a level that’s sometimes called alcoholism, is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease consumption or stop drinking.
Speaking with us, National Institute of Mental Health (NIMH) Senior Consultant Psychiatrist Dr. Pushpa Ranasinghe said that there are certain symptoms of alcohol addiction. According to her, unhealthy alcohol use includes any alcohol use that puts your health or safety at risk and includes binge drinking.
She stated that you may have to look out for patterns of drinking that result in repeated significant distress and problems affecting the functioning in your daily life, adding that while it can range from mild to severe, treatment is important since a mild disorder can escalate.
While the aforementioned concerns AUD, the issue of functional alcoholism is slightly more nuanced, in that it may be harder to identify.
A “functional alcoholic” isn’t a formal medical diagnosis, it is rather colloquially used to describe a person who is dependent upon alcohol but can still function in society. Their “functionality” is likely to be indefinite. It could be someone who is able to manage areas of life including jobs, home, and families, often appearing to be physically and mentally healthy. However, they are likely struggling with uncontrollable cravings, unsuccessful attempts at quitting, and obsessive thoughts about their next drink – hallmarks of an AUD.
Learned behaviour and social phobia
Dr. Ranasinghe shared that there is a genetic component to addiction, as there are those with the genetic composition that makes them more prone to developing an addiction. However, for the most part, the abuse of alcohol is “learned behaviour” she said, adding: “Often when you are exposed to society, you see your parents’ or your relatives’ or your communities’ reliance on alcohol.”
She noted that reliance on alcohol is often a result of mental health issues, or a form of self-medication. One may have certain social phobias, or hope to reduce one’s anxiety, feelings of depression, to relieve stress or pain etc. “There are so many who are incredibly stressed out at work, or are deeply depressed. These people discover alcohol and begin to rely on its effects to numb or alleviate some of their distress and they steadily grow to depend on it,” she explained.
She said that this is why it is important to undergo a proper assessment to identify your problem, in order to treat it and determine which of these root causes you are attempting to drown out. She noted that if you do in fact have a dependency, then it will require a great deal of determination on your part to overcome it. However, medicine is available to help. She added that in case of withdrawal, during the detox period, there’s medication to help you through it. However, you must take the first step in seeking help.
Dr. Ranasinghe provided that there are many persons with undiagnosed AUD in our country, noting that this is mostly due to society and how there is a certain level of glorification of alcohol consumption. The media is a key instigator in this regard, promoting the use of alcohol. While acknowledging that the Government has taken measures to stop the commercialisation of alcohol in the media, she noted that this monitoring cannot be applied to individuals who seek out media that glorifies alcohol on their own.
Studies show that the most effective way to reduce the susceptibility to developing an alcohol dependency is by “delaying your first alcohol intake”, she said, adding: “If you take your first drink after you are 24 or 25, then you are less likely to get addicted than if you were to have tried it at ages 16-17.” Dr. Ranasinghe added that this was because the growing brain has a tendency to establish certain pathways, and when you introduce it to alcohol during this development stage, then it is likely to affect the development of those brain mechanisms. In comparison, as an adult your brain is developed and you are able to exercise reason since those pathways have already been established.
Are you a functional alcoholic?
It may be fun to go day-drinking with your friends, and it may feel great to unwind at the bar after a stressful week. However, it is important to keep in mind how much you rely on liquid courage to get by, or to be your companion through life.
Speaking to us, Clinical Psychologist Kanthi Hettigoda said that even though you continue to function well in society, it is possible that your drinking will slowly increase to the point that you become alcohol dependent without even knowing it.
She noted that often when drinking what you experience is your id taking over while your super ego, which is responsible for your civilised behaviour, takes a backseat. According to Hettigoda, what people fail to realise is that the constant exposure of the id can be damaging to your personality. “You may feel it is cool to drink, but you are exposing an unflattering picture of yourself,” she said.
We can note here some red flags that signal you may need to reevaluate your practices:
There are questions you could ask yourself, for example – “Do you pour yourself a drink or seek out a drink the moment you get off work?”, “Do you get agitated, irritable, or nervous if some event or occurrence prevents you from having a drink?”, “Do you tend to joke about alcoholism, referring to yourself as a drunk or an alcoholic?”, “Do you constantly talk about drinking, or brag about stockpiling liquor so there’s ‘enough’ alcohol available?”, “Do you ‘drink’ your meals or use mealtimes as an excuse to start drinking?”, and “Have you ever hidden your alcohol consumption?”.
Then there are other more obvious instances like whether you have engaged in any high-risk behaviours including binge drinking and driving under the influence. Has a loved one ever confronted you about drinking and did that interaction make you feel angry or irritated? Have you ever experienced an alcohol-related blackout, and do you experience symptoms of withdrawal when you’re not able to drink alcohol?
If the answer is yes to the majority of these questions, then perhaps you may have to take a closer look at your alcohol consumption patterns and decide if you could maybe benefit from some professional help.
Before we get into the discussion, we’d like to present a clear disclaimer that we are not in any way preaching abstinence. If you are an adult human capable of exercising reason then by all means do as you like. We are not here to rain on your parade. However, it is important to recognise whether you do in fact have a problem.
It is even more important to have this conversation considering Sri Lanka’s extreme lack of attention to mental health concerns. Especially issues like addiction or elements that lead to addiction like depression or anxiety, which we consider to be shameful or in some cases, are believed to simply not exist, completely disregarding the science which clearly states that addiction is very much an illness that requires treatment.
Identifying addiction
Alcohol use disorder (AUD), which includes a level that’s sometimes called alcoholism, is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease consumption or stop drinking.
Speaking with us, National Institute of Mental Health (NIMH) Senior Consultant Psychiatrist Dr. Pushpa Ranasinghe said that there are certain symptoms of alcohol addiction. According to her, unhealthy alcohol use includes any alcohol use that puts your health or safety at risk and includes binge drinking.
She stated that you may have to look out for patterns of drinking that result in repeated significant distress and problems affecting the functioning in your daily life, adding that while it can range from mild to severe, treatment is important since a mild disorder can escalate.
While the aforementioned concerns AUD, the issue of functional alcoholism is slightly more nuanced, in that it may be harder to identify.
A “functional alcoholic” isn’t a formal medical diagnosis, it is rather colloquially used to describe a person who is dependent upon alcohol but can still function in society. Their “functionality” is likely to be indefinite. It could be someone who is able to manage areas of life including jobs, home, and families, often appearing to be physically and mentally healthy. However, they are likely struggling with uncontrollable cravings, unsuccessful attempts at quitting, and obsessive thoughts about their next drink – hallmarks of an AUD.
Learned behaviour and social phobia
Dr. Ranasinghe shared that there is a genetic component to addiction, as there are those with the genetic composition that makes them more prone to developing an addiction. However, for the most part, the abuse of alcohol is “learned behaviour” she said, adding: “Often when you are exposed to society, you see your parents’ or your relatives’ or your communities’ reliance on alcohol.”
She noted that reliance on alcohol is often a result of mental health issues, or a form of self-medication. One may have certain social phobias, or hope to reduce one’s anxiety, feelings of depression, to relieve stress or pain etc. “There are so many who are incredibly stressed out at work, or are deeply depressed. These people discover alcohol and begin to rely on its effects to numb or alleviate some of their distress and they steadily grow to depend on it,” she explained.
She said that this is why it is important to undergo a proper assessment to identify your problem, in order to treat it and determine which of these root causes you are attempting to drown out. She noted that if you do in fact have a dependency, then it will require a great deal of determination on your part to overcome it. However, medicine is available to help. She added that in case of withdrawal, during the detox period, there’s medication to help you through it. However, you must take the first step in seeking help.
Dr. Ranasinghe provided that there are many persons with undiagnosed AUD in our country, noting that this is mostly due to society and how there is a certain level of glorification of alcohol consumption. The media is a key instigator in this regard, promoting the use of alcohol. While acknowledging that the Government has taken measures to stop the commercialisation of alcohol in the media, she noted that this monitoring cannot be applied to individuals who seek out media that glorifies alcohol on their own.
Studies show that the most effective way to reduce the susceptibility to developing an alcohol dependency is by “delaying your first alcohol intake”, she said, adding: “If you take your first drink after you are 24 or 25, then you are less likely to get addicted than if you were to have tried it at ages 16-17.” Dr. Ranasinghe added that this was because the growing brain has a tendency to establish certain pathways, and when you introduce it to alcohol during this development stage, then it is likely to affect the development of those brain mechanisms. In comparison, as an adult your brain is developed and you are able to exercise reason since those pathways have already been established.
Are you a functional alcoholic?
It may be fun to go day-drinking with your friends, and it may feel great to unwind at the bar after a stressful week. However, it is important to keep in mind how much you rely on liquid courage to get by, or to be your companion through life.
Speaking to us, Clinical Psychologist Kanthi Hettigoda said that even though you continue to function well in society, it is possible that your drinking will slowly increase to the point that you become alcohol dependent without even knowing it.
She noted that often when drinking what you experience is your id taking over while your super ego, which is responsible for your civilised behaviour, takes a backseat. According to Hettigoda, what people fail to realise is that the constant exposure of the id can be damaging to your personality. “You may feel it is cool to drink, but you are exposing an unflattering picture of yourself,” she said.
We can note here some red flags that signal you may need to reevaluate your practices:
There are questions you could ask yourself, for example – “Do you pour yourself a drink or seek out a drink the moment you get off work?”, “Do you get agitated, irritable, or nervous if some event or occurrence prevents you from having a drink?”, “Do you tend to joke about alcoholism, referring to yourself as a drunk or an alcoholic?”, “Do you constantly talk about drinking, or brag about stockpiling liquor so there’s ‘enough’ alcohol available?”, “Do you ‘drink’ your meals or use mealtimes as an excuse to start drinking?”, and “Have you ever hidden your alcohol consumption?”.
Then there are other more obvious instances like whether you have engaged in any high-risk behaviours including binge drinking and driving under the influence. Has a loved one ever confronted you about drinking and did that interaction make you feel angry or irritated? Have you ever experienced an alcohol-related blackout, and do you experience symptoms of withdrawal when you’re not able to drink alcohol?
If the answer is yes to the majority of these questions, then perhaps you may have to take a closer look at your alcohol consumption patterns and decide if you could maybe benefit from some professional help.