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Welcome to the Carers’ Hearts blog. This week I am exploring how having the odd glass wine or beer to ‘relax’ in the evening or with your meal, can sometimes creep into multiple glasses or more, to try and suppress or numb the strong and negative emotions that can accompany being a carer.
I am not talking about addition, which is different and is also experienced by many carers, so, I will do another post with an expert in the new year looking at this separately. In this post I want to reflect on how, often without even noticing it, alcohol can become the ‘crutch’ we turn to when we feel emotionally and physically drained from the constant demands of the caring role.
Even if your life before you became a caregiver didn’t involve late nights of wild abandonment and partying, most of us had ‘lives’ that would mean we would drink alcohol to a lesser or greater extent, mostly in a social context. One of the differences and often ‘danger areas’ when your life changes as a carer, even if you are a working carer, is that having the social element of drinking alcohol removed, means that the focus is on the alcohol itself and its effects. Like the feelings it can give you; being relaxed, having fun, forgetting about what has happened in the day. But now, you are drinking alone, and it can feel like a means to an end; so, you have to feel anything for a while or to have to think or make yet another decision, just to disappear into the oblivion.
At this point, you might be thinking “so what if I have a couple of drinks, I deserve it, I have to have something for me, it doesn’t harm anyone!” and I get it. This post is not about me lecturing you or anyone else about what you should or should not do. It’s about me sharing my own experience to firstly say, that it is something that is more common than you might think. YOU are not alone; WE are not alone. Self-medicating with alcohol is something that has become increasingly known about and researched by the medical profession over the last decade, as the consequences of the unpaid caring role become more widely acknowledged and understood.
There are many studies that explore the burden of being a family or informal carer, with the increase in either substance abuse or carers over medicating with prescribed drugs. There are, of course, lots of reasons why using substances as a coping mechanism can occur, too many to go into in this post. However, some of them can include being overwhelmed by the emotional and physical nature of the caring role; suffering grief at the loss of a loved one, even they may be still living but slipping away from you a little more each day; pre-existing mental health issue or social isolation and loneliness.
Enjoying an occasional drink, as a conscious choice, and savouring the experience, can be all the things you want it to be. However, the key word here is being ‘conscious’, and aware of the action you are taking, as well as being mindful of the consequences, because, of course, as with anything in life that is a pleasure, sometimes pain will follow.
There can be many reasons why carers develop negative behaviours such as self-medicating with alcohol or prescribed medication, some of them can be:
- Anxiety and fear about how well they are managing caregiving duties
- Stress from juggling so many responsibilities
- Sadness and even clinical depression that results from watching a loved one’s decline
- Physical pain arising from the demands of caregiving (i.e. back or neck pain)
- Isolation that is the result of a care recipient who isn’t safe staying alone
- Resentment towards siblings or other family members who don’t help with caregiving
- Anger at being placed in such a difficult position
- Long-standing, unhealthy family dynamics
In many cases, this will be a temporary reaction to circumstances and behaviours will return to normal, with no significant harm done. However, it is when those negative behaviours become the ‘norm’, that they can seriously impact on your psychological and physical health.
Thinking about the increased and consistent consumption of alcohol, it can be easy to underestimate the number of units of alcohol you are consuming, because, let’s face it, we don’t often write this down or keep a mental track of it. The UK Government recommended weekly number of units for men and women is 14, spreading those units over 3 days or more. But when you think about a bottle of a popular white wine, Sauvignon Blanc, is 10 units, it doesn’t take much to take you over the 14-unit limit, if you are regularly consuming a couple of bottles a week.
Wherever you live in the world, it is likely that risks of alcohol abuse have been discussed regularly in the media, so I am not going to go into huge detail about them, save to mention a few that hit home with me and helped me to think differently about how I was consuming wine and make the changes I needed to make.
In addition to the increase risks from many cancers linked with excessive alcohol consumption, the ‘biggies’ for me are it’s negative impact on:
- Nervous system
- Immune system
Firstly, there is a hereditary risk of dementia in the women in my family, so doing anything that is going to increase the risk of that developing as I get older, is clearly not wise! Secondly, with the advent of COVID, actively suppressing my own immune system doesn’t make sense either! But then combine this with the increased risk of death or suffering long terms effects from catching COVID when you are overweight, is it a double whammy. As most alcoholic drinks, like wine, are ‘empty calories’ and are loaded with sugar, so, if you are consuming more alcohol, then suddenly your daily calorific intake goes through the roof and you put on weight, putting you at increased risk!
From a physical and mental health perspective, being in control of when and how much alcohol you are consuming, and being aware of the reasons why it may have become a negative behaviour, is actually very important, not just for you, but also for the loved one or friend you are caring for.
So, what can you do to start to recognise any potential negative behaviours and take positive steps to take control, and either live more healthily with alcohol or perhaps, remove it from your life completely, even if just temporarily?
The first activity I did to unhook myself from an increasingly downward spiral of negative behaviour was to think about the reason ‘why’ I was motivated to take actions, that I knew were harmful, not just to me, but inadvertently also to my loved one. Below are some of the questions I asked myself, in a non-judgemental way, which you might want to take some time, perhaps alone, when you can think clearly and ask yourself these, or any questions that pop into your mind. If you want to, you can record your answers in this worksheet or on your phone or tablet, it does help to make notes of your thoughts, perhaps to review later, but please don’t feel that you have to.
- At the point of getting a drink, what am I thinking?
- Am I present or conscious of making that choice?
- Or is it a behaviour that is now automatic, rather than making a choice?
- When I am at my best, I am feeling XXXXXXX. Fill in this part with how you feel when you are at your very best, for example “…I am feeling fit, well rested and healthy’.
- Can I use a pause button when I am reaching for the bottle or glass to give myself time to be sure this is what I want to do?
- How can I be more aware of what I am drinking? Does it taste good? Can I even taste it anymore?
- How does it make me feel? relaxed? less aware of emotions?
- Is it about wanting the drink or the numbing effect it brings?
- How will I feel later or tomorrow, if I continue to have this drink?
I found asking myself these questions and answering honestly, with an open heart of wanting to change what I felt was becoming a negative behaviour, challenging but insightful. I wasn’t proud of some of the answers but recognised and accepted that this needed to be the first step to making positive change.
The next activity was to stop judging myself and start to show the kind of compassion I show every day to my loved one, family and friends, to myself. It’s hard, I know, the whole carer ‘thing’ is so emotionally draining and spending time to be compassionate with yourself probably isn’t that high on your enormous list of things to do, but it should be!
Self-compassion is a way to relate to our struggles in a way that helps us to grow. These can be very small actions that we think about and then make small changes; it is important not to judge yourself; not to fall into the drama of something and catastrophise it and it is about having awareness of yourself in that moment. Acknowledging that something is hard and perhaps at times, overwhelming but it’s also about acknowledging it’s not just you who might be struggling; other caregivers around the world will be experiencing those same feelings and emotions. Recognising it is a shared experience that will help you to draw strength from what is a very difficult role.
There are three main elements to self-compassion and all three need to be present for it to be a useful and stable mindset. In the ‘COVID & Caring’ blog and podcast on June 17th, I go into more detail about each of the elements and have posted Kristin Neff’s exercises to help you explore the power of self-compassion. But in brief, the three elements are:
1. Start to develop a self-compassion routine. You need to be aware that you are struggling but in a balanced way, not getting wrapped up in the emotions.
2. Cultivate a sense of common humanity. The challenge of caring is a difficult one, however, it is a role shared by millions of people around the world, so you are not alone, even though it may feel like it at times. The power comes from accepting that life can be cruel and unfair sometimes and empowering each other to work through the difficult times.
3. The last element of self-compassion is kindness.
The last activity I did was to listen to the Loving Kindness meditation. It is only short but is so smoothing and empowering, that I now listen to it anytime I start to feel that I am being harsh on myself or judging myself. I can feel the physical effects of listening to this meditation almost immediately now, noticing my shoulders dropping, unclenching my jaw and breathing more smoothly and evenly.
Here is the written version of the Loving Kindness meditation and here is the audio version. So, please take some time for yourself to read or listen and while you show self-compassion to yourself, without judgement, reflect on if you would like to stop or reduce a negative behaviour around alcohol, that you are an amazing person and you have the strength and courage do to what you know is right for you.
For me, I chose to stop drinking completely during the first lockdown. Although I did start to have some wine over the Summer, I have changed how I view the reasons why I was drinking and have not returned to the same levels prior to March this year.
I have made the choice to have a year off alcohol completely in 2021. I want to explore how my life as me and as a carer, changes without having a ‘crutch’ there as the easy option to numbing those strong feelings, by taking more time to continue to build my emotional resilience. While, also focusing on improving my physical health and I hope to have a nutrition coach to share with us some positive, but practical ways we can take care of our physical wellbeing, while we also take care of others!
So, if you would like to join me on my 2021, “Give up the booze for a year challenge”, please let me know and we can travel this particular journey together!
In the resources section below, you will find references and links to useful information and organisations to help you to make informed choices about your situation and way forward.
The next episode, “Feeling lonely or isolated during festive holidays” will be published on the 2nd December when I will be reflecting at particular times of the year, such as a Christmas, Ramadan or Hanukkah, being a carer can mean that you might feel even more isolated or lonely, if you are unable to join others to celebrate these special times. I will explore more deeply some activities and exercises to help reduce the sense of loneliness or isolation during national and cultural holidays.
Thank you so much for listening to this episode, I know this topic is difficult and emotional to talk about, but that is why it is so important to explore them together and I hope you found them useful. I hope you can join me next time and remember, what a special thing it is that you do.
References and Resources
Rospenda, K. M., Minich, L. M., Milner, L.A., & Richman, J. A. (2010). Caregiver Burden and Alcohol Use in a Community Sample, Journal of Addictive Diseases, 29(3), 314- 324.
Music Composed by Michael Coltham – Black Lab Music
Black Lab Music