Ask the expert: Dr Bobby Smyth
Welcome to ReachOut.com’s Ask the Expert service
Through this service the ReachOut.com team will be working with a group of professionals and experts with detailed and specialist knowledge of youth mental health issues such as anxiety and depression to answer your questions and address your concerns.
Each month we will concentrate on one particular mental health area and work, mainly, with one specific collaborator. Dr Bobby Smyth was our featured expert taking your questions if concerned about your, or someone else’s, use of alcohol, drugs or use of something that has become problematic.
hi my son is 20 years old his mother passed away in march 2010 he started going off the rails before this but since then has gone severly downhill to the extent that i had to get a protection order against him to protect his younger brothers and sister,most of behavior is due to drug and alcohol abuse at this stage i really fear for his life, i am open to any advice or suggestions you may have,
It sounds like your family has endured a very challenging situation. While you say that your son’s behaviour was becoming problematic before his mother’s death, at which stage he would have been 16 or 17 years old, you noticed that this behaviour deteriorated dramatically following this bereavement. You don’t provide information on his mother’s illness before her death, but it is likely that life at home was difficult for months if not years beforehand, unless she died very suddenly. We all cope differently with the serious illness and death of a loved one. It seems very possible that your son has coped very poorly with his mother’s death.
I assume that his behaviour was becoming aggressive and/or dangerous, and this caused you to pursue a protection order against him. This must add to everyone’s sense of loss, your younger children now losing their brother from the family, in addition to the loss of their mum. You mention that drug and alcohol abuse appear central to his difficult behaviour. Alcohol is certainly a very common contributor to domestic violence in Ireland. While the protection order reduces the likelihood of direct exposure to violence, it does nothing to reduce the factors driving the violence. When you say that ‘you fear for his life’, I assume that you are concerned that he will kill himself, or may have some fatal accident while intoxicated.
While your relationship with your son has probably been damaged by the difficulties of recent years, it is this relationship with him that has real potential to bring about positive change for him. It is important to make sure that your son realises that you love him, while certainly not loving all of the things he does. It will help him to know that you have not given up on the relationship. Make efforts to spend time with him, and use your knowledge of him to pick the times when he is least likely to be drunk, stoned or hungover. Persist with this even if he says he is uninterested. In my experience of angry teenage boys, parents tend to give up on the relationship long before the teenager does, even though the teenage boy will never admit that they cling to a desire to get things better again. They can get trapped into a self-destructive spiral of “I’m going to reject you before you reject me”.
When you do catch him during the OK times, even if they are only fleeting, tell him the specific things about those occasions that you enjoy. If the drunken, hung-over or aggressive behaviour starts again, try to assertively and calmly step back, choosing not to engage in another pointless row. Again at the calmer times, let him know how worried you are about his alcohol and drug use. Let him know that there are options where he can access help. Do some research on the potential treatment services in your area. Check out the service finder on www.drugs.ie There are likely to be counselling options available for him. There are residential treatment options which may be considered for someone of his age, including The Aislinn Centre in Ballyragget, Co Kilkenny. While he may turn down these suggestions, it is still worthwhile presenting them to him. Let him know that you don’t have all the answers. You could tell him that you are just a really worried dad who is desperately concerned that he is going to lose a son.
I do not know if he has talked about his upset at his mother’s death. It is possible he uses substances to ‘blank out’ feelings of loss and sadness. If he is not inclined to verbalise feelings of loss, it may help him to see you talk about your own feelings of grief and sadness following her death. If he does name the loss of his mother as the major issue, then you could actively assist him to locate a counselling service to address grief. If he did engage in that, his substance use and anger would inevitably crop up as issues to be addressed.
It is also important to look after yourself. You have been through a lot also. Make time for yourself. I realise that there is a lot to juggle as a single dad, but make time for each of your younger children also. Seek out and accept support from family and friends.
For further information, I suggest that you look at some websites including www.smartrecovery.org/resources/family.htm There is also a book by Robert Meyers called “Get Your Loved One Sober: Alternatives to Nagging, Pleading and Threatening” from which you should get some clear and constructive ideas. You can listen to a podcast by Robert Meyers talking about the approaches outlined in that book at the following link http://behaviortherapist.podbean.com/2010/03/10/get-your-loved-one-sober-with-craft/
Colm says: I think my friend drinks too much. He always wants to go drinking, its all he cares about and he’s stopped playing football with us. I dn’t know what to say to him and if I did say somthin would he think iv lost it
People tend to drift into drink problems quite slowly. Consequently, they may not notice the changes in themselves or in their behaviour. As your friend’s drinking has increased, you have noticed that he seems less interested in spending non-drinking time with you and he has dropped out of football. This is a common symptom of dependence to alcohol or indeed any other drug. It is called ‘salience’. It is just one of six potential symptoms of dependence, so I am not saying that he is alcohol dependent based upon that information alone.
You are wondering what to say, and also wondering how he might react to anything that you do say to him. Firstly I would encourage you to talk to him about the change you have noticed in him. As I said above, he may not really be aware that drink has become such a big part of his life.
In terms of what you say to him, the challenge you face is to say things that are less likely to provoke defensiveness. You could start by letting him know how much you value his friendship and how much you enjoyed playing football together in the past. You could let him know that you think drink has taken over your friendship. You could tell him that you have read some stuff about alcohol and depression and you are worried that he may be overdoing it.
In terms of when to talk to him, I suggest that you try to pick a calm time when he is neither drunk nor hung-over. Stereotypically, Irish men are not great at having this type of serious chat with their mates. We would probably be better off if more of us were willing to do so. Our friends can often be one of the first people to notice negative changes in us. Having this conversation with him sounds like a good thing to do. It may be just the prompt he needs to review his relationship with alcohol.
You cannot control how he reacts to anything you say, if you do chose to talk to him. However, he is unlikely to react angrily or dismissively if you approach the conversation from a position of concern, reminding him of the good things which you think have been lost from your friendship as a result of his decision to give high priority to alcohol.
How do you know if your addicted to drink?
There are lots of different expressions used to describe someone who has developed a serious drink problem. They used to be called “alcoholic”, an expression still used by the self help group Alcoholics Anonymous. Some doctors prefer the word “dependent”. You used the word “addicted” in your question. All these words basically describe the same thing.
People who are addicted to alcohol can look very different from each other. There is no single characteristic which confirms that a person is addicted. When screening someone for a potential alcohol addiction or dependence, there are six main symptoms or problems which will be asked about:-
- Cravings. You experience a very strong desire to drink, which seems like it may overpower your rationale thinking. You wish you didn’t want to drink, but you experience a powerful urge to do so.
- Difficulty stopping. You notice that you often end up drinking more than you planned. For example, you may go out with the intention of “only having two pints tonight” and of avoiding spirits, but end up having six pints before then doing a few shots. This symptom is called “loss of control”.
- Salience. You begin spending increasing amounts of time planning your drinking, doing your drinking and then recovering from hang-over. In tandem with this, you notice you gradually decrease your participation in other hobbies or activities, and start losing contact with other people who aren’t into drinking.
- Ongoing use despite harm. You notice that your drinking is affecting your physical health (e.g. falls, injuries, gastritis, liver problems), your psychological health (causing depression or anger for example) or your social well being (e.g. damage to relationships, destruction of property while drink, missed days at work or school). Despite noticing these problems, you decide to continue drinking.
- Tolerance. It takes more alcohol to get you intoxicated. (While Irish people have historically tended to admire people who can hold their drink, being able to do so simply means that your liver and body have become so used to high levels of alcohol use, that they have adapted to accommodate this.)
- Withdrawals. You notice a range of symptoms such as sweating, tremor, palpitations, restlessness and anxiety occurring a day or two after you stop drinking.
In order to be deemed “addicted to” alcohol, you only need to have three of these six problems. While everyone knows about withdrawal symptoms, most people in Ireland who are addicted to alcohol do not have withdrawals. You do not need to drink every day to be deemed addicted. Many people addicted to alcohol continue to function OK on a number of fronts, possibly holding down a good job for example.
If you are still wondering about your own drinking, or that of someone close to you, you could consider talking to a health professional or checking out the websites below.