Most people associate alcohol with fun, with being sociable and with celebrations. We may also use it to help us feel better when we are tense or unhappy, or to feel more confident.

Social drinking can be extremely pleasurable and, in moderation, may even have health benefits.  One snag is that, although alcohol initially acts as a ‘pick-you-up’ and mood – enhancer, it is ultimately a depressant so a heavy night drinking is likely to leave you feeling worse rather than better.  Also, the more you drink, and the more often you drink, the more of it you need to feel the same effects.  Over a period of time habitual over-consumption can have a wide range of consequences – social, psychological and physical.  Individuals often are not aware how much they are drinking or its impact on those around them.

It has been estimated that on a typical day 10,000 people in the UK seek help for their own, or a friend or relative’s alcohol difficulties.

Measuring your intake

If you are concerned about your drinking or that of a friend, there are simple things that you might want to bear in mind.  Consumption is normally measured in ‘units’. A unit is the equivalent of half a pint of 3.5% alcohol by volume (ABV) of beer, lager or cider. It is also equivalent to a 25ml shot of spirits of 40% ABV, or a small glass of wine at 9% ABV.

Provided that you have no liver damage, it will take about an hour for your body to break down and metabolize one unit. However, the concentration of alcohol in the bloodstream at any one time is dependent on many factors in addition to the amount you drink, such as body size, weight, stomach content, and rate of drinking. Women have consistently higher blood alcohol levels for the same amount ingested because of their lower body water component.

Safe Limits

It is generally believed that alcohol is safe to drink at levels of up to 2-3 units per day if you are a woman, 3-4 if you are a man (i.e. up to 2 pints a day). There is an increasing risk to your health if you are consistently consuming over these levels. After a period of intoxication, it is strongly advised that you avoid alcohol completely for at least 48 hours to allow time for liver damage to recover.

Binge drinking, i.e. drinking a great deal in one evening or over a short period such as a weekend is regarded as particularly hazardous to health.

Problems with Drink

Most people who drink at all will have experienced at least one episode of alcohol self-harm – a hangover! If you consistently drink fairly heavily, your tolerance to alcohol’s effects will increase and you run the risk of developing dependency. This may be physical, psychological, or (most commonly) both.

If you recognize the presence of two or more of the following, it is time to do something about it:

• Your drinking is occasionally out of control and becoming more so
• You are regularly drinking beyond safe limits
• You may be drinking more to achieve the same effect, or in the mornings, or on your own
• Your work may be suffering with difficulties in concentration, mood swings and having to contend with feelings of guilt
• Relationships with others may be dwindling, and your outlook and lifestyle restricted by a need to consume alcohol
• When you try to reduce intake you recognize sweating, tremors and anxiety.
• Most drinkers stop well short of dependency.

Attitudes to alcohol

Much of your drinking behaviour is dependent on context and environment.  Alcohol can readily become associated with some of the issues and transitions that you are trying to deal with at the time. Its ability to help you to relax, to reduce tension and to dis-inhibit, lends itself to being used to avoid or manage some difficult situations. Some of the issues involved may be loss, separation, sex, relationships, and responsibility. Drinking in the pub may give you a relaxed sense of community, but habit may make it hard to relax without it.

If you grew up in a family where alcohol was regularly misused, you will have experienced at first hand many of its ill effects. You may now find yourself experiencing feelings of alienation, dissatisfaction, or apathy. These may be related to the way you survived a possibly chaotic situation at home, and these feelings may resurface in an environment in which drink is so freely available.

Reducing or limiting intake

Here are some ideas that may help you to cut down your intake:

• Keep a diary of intake in units to clarify your pattern of use and quantities. Cutting down works best if you set limits for yourself that you feel you might reasonably stick to.
• Identify those occasions, times of day, companions, or moods when you are prone to excessive use.
• Rather than just focusing on reducing your alcohol intake, think about increasing some other activity. There are lots of different and novel opportunities to do something different whilst you are at university – use them; you may uncover an unknown aspect to your personality.
• The influence of others can be powerful, so use it to support yourself; friends may well have been concerned about you for some time.
• It can be helpful to write up a balance sheet of the pros and cons of drink, in order to clarify whether you are really determined to cut down.
• Drinking with food rather than instead of it can be important.
• It might also help to try to cut down your intake with the support of a group.

Helping Others

It can be extremely distressing if someone you care about is drinking at levels that give rise to problems for themselves or others. Although you can encourage and support them to make changes, it is they themselves who must ultimately decide (and be prepared) to do the changing. If you are particularly sensitive about alcohol (e.g. because of related problems in your family) it may be helpful to bear this in mind.  Some suggestions to help are:

• Allow space for them to talk about anything that may be bothering them
• Rather than labeling them, focus on the effects drink is having on others, as well as on themselves
• Make clear what behaviour is unacceptable to you and avoid arguments
• Do not cover up for them
• Ensure that the burden of support does not rest only on you, and that you have time for yourself too.

Seeking help

Reading this, you may begin to recognize aspects that are relevant to your present situation or to a situation into which you fear you may be slipping. Sometimes it helps to talk things over with someone else such as a counsellor, family member, friend or your doctor in order to disentangle your thoughts, feelings and actions.
Counselling – This can provide you with time and space away from normal day-to-day demands to explore what is going on for you and what could be the best way forward.  This can also help you to understand your own grieving process and look at ways to help you to cope and manage.

Useful organizations:

Alcoholics Anonymous
http://www.alcoholics-anonymous.org/

Al-Anon
http://www.al-anonuk.org.uk/
Offers support to relatives and friends of problem drinkers.

What is anxiety?

We have all experienced anxiety where we fear that something unpleasant is about to happen.  People often become anxious when they face difficult situations such as illness, unemployment, moving house, or job interviews.  Mild anxiety prior to an examination, for example, can be useful as it can make you feel more alert and enhance your performance.  Mild, short-term anxiety is extremely common, however, for some people anxiety can become so extreme that it affects day-to-day functioning.  A doctor may make a diagnosis of generalized anxiety disorder if a person has been experiencing a high level of tension and anxiety for several months for no clear reason.
Causes of anxiety

Anxiety can occur in people from all backgrounds, any occupation, and at any time of life.  There is no one cause for anxiety for some people anxiety begins after a long period of stress that has gradually built up. Other people may feel they are not in control of certain aspects of their life, and may develop a general anxiety about the future.  Some people may have experienced stressful life events in the past and become anxious about encountering similar experiences in the future.  Some people appear to have a genetic predisposition towards anxiety; certainly there is an increased risk of developing anxiety problems if there is a family history of anxiety.  There is also evidence that anxiety problems can be caused by physical factors such as over-activity of the thyroid gland and can also be caused as a side effect of certain drugs including commonly prescribed antidepressants.  Anxiety is also a common symptom of withdrawal effects such as benzodiazepine and some recreational drugs.

Symptoms of anxiety

Anxiety can affect you both physically and mentally.

Psychological symptoms
Anxiety can cause a change in your behaviour, and the way that you think and feel about things.  Some psychological symptoms are:

Restlessness, Feeling ‘on edge’, Difficulty concentrating, Irritability, Easily distracted.

Physical symptoms
Anxiety can also affect you physically these can include:

Dizziness, Lethargy, Palpitations, Muscle aches, Dry mouth, Sweating, Shortness of breath, Stomach ache, Diarrhoea, Headache, Excessive thirst, Difficulty in falling, or staying, asleep.

What sort of help is available to me?

Most people diagnosed with anxiety are treated by their doctor, although a small minority of people may be referred to a psychiatrist, or a member of the local Community Mental health Team for more specialized help. Depending on your symptoms, the severity of the anxiety, and your circumstances, the doctor may suggest some form of talking treatment or medication or a combination of these treatments.

Anxiety treatment options

Medication – A variety of medications, including antidepressants and anxiolytic drugs, also known as minor tranquillizers, can be used to ease the symptoms of anxiety.  For some people medication is all that would be needed for others a better outcome is reached through a combination of medication and therapy.

Talking treatments – Talking treatments alone can be effective in treating anxiety for some people, for others a combination of talking treatments and drug treatment may be the most effective treatment. Talking treatments aim to help people recognize the stress factors in their lives, and work out coping strategies in order to be able to deal with these. A wide variety of talking treatments are available, ranging from counselling and psychotherapy to cognitive behaviour therapy.

Relaxation techniques – When practiced regularly, relaxation techniques such as meditation, muscle relaxation, controlled breathing, and visualization can reduce anxiety and increase feelings of relaxation and emotional well-being.   See my self-help guide for a Daily Relaxation Technique

Distraction Techniques – Anything that focuses your thoughts from feeling anxious can be a wonderful relief.  For example:  puzzles, crafts, gardening (even just pulling weeds), video/P.C games, light reading, TV, exercise and even housework.

Physical Activity – Many of the physical symptoms of anxiety can be attributed to an excess of hormones, such as adrenalin, in your system. Although it may be difficult finding the motivation to exercise, it can be very therapeutic to take part in physical activities. Jogging, swimming, sports; even brisk walking can help to use up any excess adrenalin.

Care for yourself – You will feel better if you are able to eat properly, if you don’t over do alcohol or drugs.  Keep in touch with family and friends.

Complementary therapies – The following are non-medical treatments that some people find helpful.  Massage can help to alleviate stress and anxiety making make you feel better.  Some people benefit from meditation, yoga, homeopathy and acupuncture.

Useful Organizations

SANEline
www.sane.org.uk
SANEline offers emotional support and information to those experiencing mental health problems, their families and carers.

British Association for Counselling and Psychotherapy (BACP)
web: www.bacp.co.uk
Directory of Counsellors and Psychotherapists.

British Association for Behavioural and Cognitive Psychotherapies (BABCP)
web: www.babcp.com
Directory of psychotherapists.

No Panic
web: www.nopanic.org.uk
Information and support line for people experiencing anxiety problems.

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