Substance Abuse: ED’s Cousin

I’ve broken one barrier by discussing bingeing, so I’m here to break another by revealing my problems with alcohol. Let’s not relegate conversations about substance abuse to meeting groups, and instead bring them further into the public conversation, especially among the EDcommunity. 

Folks who have eating disorders more often have problems with substance abuse than non-ED folks. It’s a well-documented link. Read more from NEDA. A psychologist would say that Substance Use Disorder (which includes alcoholism and abuse of narcotics) is highly “comorbid” with eating disorders.

Neurobiologists propose that the same mechanisms which predispose people to eating disorders also predispose the same folks to substance abuse. Psychologists point out that substance abuse and eating disorders carry similar coping mechanisms (i.e. numbing feelings and ignoring unpleasant emotions). No matter how you explain it, the connection is clear.

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Going in to college I was reluctant to drink. Several family members, including both immediate grandfathers, have drinking problems, and my dad is a heavy drinker. I knew that alcoholism has genetic components, and I was afraid that I would also abuse alcohol.

So, I started slowly. A shot or two at a party, rarely. Sophomore year of college I revenge-drank when my friend told me I was “faking it” and downed 6 shots in rapid succession. I drunk-broke my foot and was in a boot all summer. An experience like that might suggest that I never drank heavily again– on the contrary, the experience of being wildly drunk thrilled me. For a few hours that summer night, I felt free and totally unencumbered by feeling depressed, feeling fat, or social anxiety.

Ten months ago I took a semester off from school to work. I lived with my parents and held down two part-time jobs and an internship. My parents are big wine drinkers, so there’s always a couple bottles in the house. After a day of double-shifts I would come home and “relax” with a glass of wine. It was benign. I mean, the French drink wine every day.

A few months later, I realized that I was drinking more than a glass every night of the week, and was concerned about how many calories I was consuming in alcohol, so I tried to cut back. I couldn’t. Every night I would swear to myself that I wouldn’t drink, and I swear, the problem worsened. I would cave and instead of having one glass of wine, I’d have three. I drank moderately on the weekdays, feeling terribly guilty that I couldn’t stop, and binge drank from Thursday-Sunday. I showed up late to my morning shifts at the dog shelter because I had had 6 drinks the night before. Every morning, I promised myself, that was the last time.

I went six weeks without one day alcohol-free and was panicking. No matter what I tried (I hid the alcohol, drank buckets of tea, brushed my teeth early in the night) I couldn’t stop. I googled the symptoms of alcohol abuse and thought that’s not me. I don’t have a problem, really. I mentioned to my nutritionist that I had been drinking often and she asked whether I thought of going to an Alcoholics Anonymous (AA) meeting. My face burned with embarrassment. I wasn’t an alcoholic. Alcoholics were middle-aged men that couldn’t hold a job (believe me, I know my perceptions of alcoholism were misguided and stereotyped).

I started drinking earlier in the day. 5pm, 3pm, 1pm. When I drank into the night, which was nearly every night, I would pass out in bed without brushing my teeth, taking my pills, responding to emails. In no time at all I was slipping into a pattern of poor hygiene which made me feel ashamed. I still couldn’t stop.

It became difficult to convince myself that I didn’t have a problem when I started taking covert shots around my friends and when friends and family started making jokes about how I was an “alcoholic” and needed “AA.” (Bad jokes, by the way.) It was hard to kid myself when I was going through a bottle per night and hiding the remnants from family.

I returned to school in August and the drinking slowed. We don’t keep alcohol in our apartment,  and the temptation to drink was lowered. I thought I had begun to conquer the problem. On the weekends, though, I had more access to alcohol and would binge drink. Sure, I was no longer consuming 20+ drinks weekly, but the drinking still felt out of control. It felt embarrassing.

I’ve made a few appointments with a therapist to talk about the issues (I keep canceling) and have sought out AA meetings locally (I never go.) It’s easy to convince myself that this time is the last time.

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Sound familiar?

Having binge eating disorder (which, by the way, I don’t really separate from anorexia, bulimia, EDNOS, etc.– but you get the point) works the same way for me. It took me a year and a half to see a nutritionist, even though I binged daily and gained 20 pounds, miserable. It was too easy to tell myself I had control over the problem. Besides, I was ashamed. Binge eating disorder is stigmatized, like alcoholism. I didn’t want the label. Binge-drinking and binge-eating make me feel the same way. Numb, dissociative– it’s magical, terrifying, and dangerous. Alcohol abuse especially. No matter how much I binge eat, I know that nothing really terrible will happen (although my eating disordered brain would insist that weight gain is really terrible). But binge drinking is different. There have been times I sincerely thought I could drink myself into a coma. The only real stop factor has been feeling so nauseous that I couldn’t take another sip and passing out in  bed before it got that far.

Eating disorders have been described as an addiction. An addiction to food, to thinking about weight loss, to starvation. Anyone who has starved knows the elated, obsessed, addictive feeling of waking up with a hollow stomach. Anyone who has binged knows the addictive feeling of fixating on food and finally caving into a wild food-fest.

For this reason, many have proposed treating eating disorders and substance abuse disorders similarly. Providers wonder whether the AA format could work well for eating disorders (it’s been well documented that eating disorder support groups, like AA meetings, can lead to significant reductions in feeling guilty about one’s disorder and resultant symptom reduction). There’s hope in the comparison.

The point of sharing my brief story of alcohol dependence/abuse and its similarities to my eating disorder(s) is to help others make the connection. For me, learning that others have co-occurring problems like this made me feel less alone. Instead of thinking, “What the hell, two major problems?!” I began to think, “This makes sense– a lot of people have eating disorders that happen alongside alcohol or substance abuse, which means others have my experience and have conquered it somehow.” I suppose the deficit in my narrative is that I haven’t actually found a solution to my problem with alcohol, nor have I necessarily found a long-term fix for the disordered eating. Still, my hope is that chronicling my own journey with eating and alcohol problems will help similar others feel less alienated and like they can voice their difficulties. I’ve broken one barrier by discussing bingeing, so I’m here to break another by revealing my problems with alcohol. Let’s not relegate conversations about substance abuse to meeting groups, and instead bring them further into the public conversation, especially among the EDcommunity.

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