Alcoholism and Anxiety

Counselor: Dr. James Haden

Patient: Gary Owen

Age: 34

Occupation: Mill Worker

Symptoms of Condition: Sever anxiety attacks, social phobia, and alcohol dependence.

Gary had been working for the mill for over seven years. It was a good job that kept him and many others busy in this reservation community. Gary would have a lot of spare time on his hands when there were stretches of time when business was not going so good, and the workers would get laid off. A lot of idle time contributed to Gary’s drinking problems. There were times when Gary would wake up and feel just fine, but many days out of the week Gary felt a sense of impending doom that would not go away during the day, into the night, or even into the week. Drinking would help this bad feeling go away, and drinking was one of the only ways that Gary could go out and meet people. If there was a local sporting event going on in town, Gary would slam more than a couple shots of whiskey, so that he would have no fear of seeing other people there and no fear of even talking to them.

Gary knew that his drinking problem was getting bad, very bad. His drinking was getting to the point where he had to drink before every situation to calm his nerves. Going out of the house sober was a situation that was not a comforting thought. Gary needed help, and he knew that the best way to get this help was to find someone who knew about such problems, a place where some of his family members had gone looking for help, the Yellow Creek Treatment Center.

Gary sat in the waiting room. His hands were sweating, and he could feel his heart beating rapidly in his chest. The questionnaire that he had filled out the day before was nothing to really worry about, but talking with other people about his drinking problems was going to be another story. He was here for help, but he was still worried about what the receptionist and counselor would think about him. This feeling was not something new to Gary. He had felt this feeling many times, and he thought of how nice it would be if he only had a couple drinks to calm him down, because right now he felt like getting up and leaving. He kept nervously looking at the clock, and it seemed that 11:00am would never get here. He calmed himself down a little. He knew that these thoughts were irrational, that everything would be all right, that he wasn’t threatened, but he had always felt this way….

*********

Dr. Haden was in his office examining the files in front of him, preparing himself for his next patient Gary Owen. Dr. Haden had recognized Gary’s last name, and curiosity kept Dr. Haden looking through these files all morning. One file was a questionnaire that Gary had filled out before being admitted to the treatment center, and the other documents were case files on some of Gary’s close family members that had been to the center for help in the past. There were striking similarities between these documents and the questionnaire that Gary had filled out the day before.

Dr. Haden looked up from the files on his desk as the receptionist led Gary into his office. The look on Gary’s face was calm, but the quickness at which his eyes darted around the room gave him away. Gary sat down in the chair in front of Dr. Haden’s desk.

Counselor Haden: (Extending his hand) Hi Gary, my name is James Haden.

Gary: (Shaking hand quickly) Gary Owen.

Counselor Haden: (Raising an eyebrow) Any relation to Alice Owen?

Gary: Yeah, my cousin Alice is the person who recommended I should seek treatment. She told me that talking to someone really helps.

Counselor Haden: So what is it that you need help with?

Gary: I guess that I need help with a couple things. (Looks at his hands) My nerves are really bad right now. I have always been nervous around other people. When I was younger I could kind of handle these fears, but these days I have to have a lot to drink even when I am going to see my relatives. Some of my family has said that I have a problem, but I don’t know what to do about it because if I am not drunk, what are my other options? Stay at home and hide away from everyone and even my family? I feel pretty pathetic, but I can’t even stand to be around people in public places unless I am drunk. (Shakes his head frustratingly) I just need to know what is going on with me, and why it is getting worse.

Counselor Haden: How is your relationship with your parents? What are they like?

Gary: I get along with them all right. My dad can sometimes disappear for weeks at a time with his jug of whiskey, and no one knows where he is. He really needs help, but I don’t know if he will ever get it. But enough about him, I need to take care of myself first…

Counselor Haden: Gary, there is no shame is coming here looking for help. You are here because you know what you need to do to become a better person. And I wanted to tell you that much of your alcohol problems and everything that you have been describing to me indicates that you have a unique kind of anxiety called social phobia. To understand social phobia you have to know what anxiety is.

Anxiety is closely related to stress. Stress is a reaction that is essential for human survival. When danger is present, stress kicks in so that you can react by either running or fighting. Another form of useful stress is when you have something important goal to accomplish. Stress helps in these ways.

Anxiety, on the other hand, is stress that is not useful but is inappropriate. Feelings of uncertainty and fear are common forms of anxiety. You have most likely felt many of the symptoms of anxiety. Here is a pamphlet that provides a good description of anxiety and its symptoms. (Symptoms Link)

Gary: Looking over this pamphlet, I see many of the symptoms that I experience on a daily basis. Even when I was sitting in the waiting room my heart was beating pretty fast and my palms were sweating, and it was for no reason.

Counselor Haden: (Looking straight at Gary) I had noticed that you were pretty nervous. Pay special attention to the section on social phobia disorder. Phobias are specialized forms of anxiety. Phobias are irrational fears that force the person to avoid the situation or painfully endure it.

Gary, you may have fears of being publicly humiliated and extreme discomfort in social situations, and could be borderline for a panic attack. Social anxiety includes such fears as stage fright and fear of urinating in a public restroom. Social anxiety can greatly impact any situation where others are around. You don’t need to live with these fears, and understanding them is a big first step.

Gary: So what do my problems with alcohol have to do with all of this?

Counselor Haden: These problems with anxiety tie directly into your problems with alcohol. Anxiety and alcohol problems are closely related, but are not well understood. Many studies have been done on how these two problems are related. An indication of this problem can be seen in our children. If a child shows signs of anxiety then this is an early warning sign this child will experience alcohol problems later in life.

Anxiety can lead to alcohol dependence, and likewise, alcohol dependence can lead to anxiety. These two problems fuel each other in a vicious cycle that won’t let the person out of its clutches. Alcohol dependence is also closely related to antisocial tendencies; very similar to the problems you have been experiencing.

Another sad fact is that studies have shown that alcohol problems and anxiety disorders run in families, and with relatives. So there very well could be others in your family suffering from the same problems.

Gary: How is it that these problems stay with the same family?

Counselor Haden: There are two major contributors to why this could stay within a certain family. A person’s biochemistry is at the core of the problem, but another major contributor is the area where you live. Where you live has an undeniable impact on the problems people have.

Gary: I am having a difficult time understanding what you just said. Could you explain a little further?

Counselor Haden: (Reaches into a file cabinet while talking) The biochemical part of the problem is an in-depth subject (hands Gary a pamphlet), but here is another pamphlet that will help you understand how the brain chemicals dopamine and serotonin impact anxiety and contribute to the problems with alcohol dependence. (Link to Neurotransmitters)

High unemployment rates and a lower standard of living on the reservations cause anxiety problems for the people that live there. Unemployment allows a person more idle time to contemplate negative aspects of their lives. These thoughts of depression are directly related to thoughts of anxiety, alcohol, and suicide. You and many other people on the reservation are drinking to medicate yourselves from anxiety and depression, but it is only adding to the problem.

Unhappiness in daily life can lead to thoughts of not being a useful member to the community, which is related to higher divorce rates and more people living alone. This all leads to a decline in trust between people.

Gary: What you have told me is a lot to think about. But what can I do to get rid of these feelings, to cure my anxiety and problems with drinking?

Counselor Haden: There are some very effective forms of medication out there available to people with anxiety (Link to Anxiety Medications), and some alternative methods of alcohol treatment (Link to Traditional Treatment-Rae). There are ways of changing your lifestyle that will also help with reducing anxiety.

Remember, you are responsible for your own actions. Anxiety is something that will not go away without help. You are on the path to taking control of your life, but much more needs to be done. Anxiety and alcoholism are both devastating diseases of the mind that can only get better with treatment and a hopeful frame of mind.