Expert: Rebos - 5/27/2006

Question
Hello Rebos,
I have a 32 year old brother with some serious issues. He began drinking in his teens and has been an alcoholic since 18. He is currently separated from his wife and two young children. He also suffers from severe depression and bi polar disorder. He recently hit rock bottom when his wife left. He came to live in my small town to get a fresh start. He is having a hard time leaving his apartment and frequently talks of suicide. He has tried out patient programs and always returns to drinking. He would like to try an in patient program but has no money or insurance.He is too depressed or drunk to hold a job. He has a hard time with having successful happy siblings. My brother has a big heart and is a tremenedous person. He is adored by his children and misses them deeply. I fear that if he does not find a long term live in facility he will be dead in less then 3 years. He has so much to give. What can I do to help him? Thanks for your time.
                     Sincerely, Nicole

Answer
Good afternoon Nicole:

Thank you for your question. I will do my best to give you some information that will help you.

Please be advised that I am not a doctor or a pharmacologist, and can not tell you what the side effects of drinking alcohol are when a person is on meds for a bi-polar condition. However, I can share with you the experience I have had with others relative to your question. I feel certain that his bi-polar problem can be controlled by your brother staying sober, and in doing so he will remain alert to taking his medicine as required.

Alcohol has the same chemical formula as ether, except that ether does not have any H2O (water) in it. As with ether, alcohol is a serious depressant…and indeed can have a profound effect on the depressive part of being bi-polar. Of one thing I am sure, alcohol will diminish the effectiveness of the meds that he takes to control the depressive part of his condition. Likewise…any drink that has caffeine in it will result in having a negative  effect on the manic side of his illness. I would expect (in the past) that his doctor has advised him of a number of products that he should avoid for his continued well being. Alcohol is serious stuff to a person with a bi-polar problem whether or not taking medication.

It is very easy for those who are close to an alcoholic to become “enablers”. An enabler is a person who allows an alcoholic to continue drinking, primarily by not holding them accountable for their unacceptable behavior. If an enabler has no special knowledge or training in the field of alcoholism and they try to help… an alcoholic can sense the ineptness and weakness of an enabler and they continue on drinking because they know that they will be forgiven and rescued time and time again. In a backhanded way an enabler is giving an alcoholic “permission” to drink by their continued acceptance of an alcoholic’s unacceptable behavior. Because alcoholism is a progressive disease it only gets worse it never gets better on its own. Every time you overlook your brother’s problem, get him out of a jam, lend him money, lie for him, or in any way allow him to get away with being irresponsible, you are in reality buying your brother his next drink. Alcoholics are users. They are too self-centered to think about any thing other than their next drink. They don’t have mothers, fathers, family, lovers, wives, children or friends they have “victims” and take “hostages” as long as they can get away with their drinking.
His suffering of guilt and remorse after every bout with drinking is just the “Poor Me’s”. There is an old saying when it comes to alcoholics…poor me…poor me…pour me a drink”

The best advice that I can give you and your family is to attend Alanon meetings. When you do go you will find that your problem is not quite as unique as you may think. At Alanon you will learn how to live with having an alcoholic in your life, and about the disease of alcoholism. You will learn how to say what you mean, mean what you say and not be mean when you say it. They will show you how to detach from the alcoholic with love. You will also learn to never threaten an alcoholic and not follow through with your threats. You will learn how to be strong enough to resist the influence that your brother has over your family’s life. Alanon is intended to help you, and not your brother directly. However, in order for you to be able to help him, you must first learn to help yourself. At Alanon you will meet others who have an alcoholic in their lives, and that their lives have become unmanageable also. Alcoholism is a disease that affects everyone who comes into contact with an alcoholic. Your brother is not a bad person…he is a sick person that somehow has lost his way to be able to help himself. Your brother must be held responsible for his actions! You may not be able to do anything about your brother’s drinking but you can do something about the problem that has developed in your life by having an alcoholic in it. Until you are armed with the right kind of information, and understand the disease, your efforts to help will be for nothing. Alcoholism is deadly and it destroys everything and everyone who comes into contact with it. For meeting locations, you can call your local Al-Anon chapter (check your local phone book under "Alcoholism") or call the following toll-free numbers: 1-800-344-2666 (United States) or 1-800-443-4525 (Canada).

Remember, as it presently stands your life is being controlled by a very sick person. If you don’t go to Alanon the least you can do is to try and get your self out of the picture completely, (which is a very difficult thing to do because, after all he is your blood and not a complete stranger that we are talking about) and simply tell those who try to drag you back into it that you want no part of it until your brother does some thing positive about stopping drinking…such as turning himself into a halfway house, going to AA or some other support program, (if he is a veteran) going into a VA program, or even turning himself into a mental institution where they have an alcoholic ward and recovery program. If he is serious about getting well and just not conning you and your family there is a place for him to seek help. Let’s face it, if he is in such a mental condition that he may want to hurt himself there is a place for him to get all the help he needs.

There is no one method used in the recovery of alcoholism that works for everyone, and there is no cure for the disease of alcoholism. If you take a cucumber and turn it into a pickle, you can never change it back to a cucumber again. Once an alcoholic, always an alcoholic. There are recovering alcoholics and there are active alcoholics. That being said alcoholism is not a moral issue. It is considered a disease by the American Medical Assoc. There is no shame in being an alcoholic the shame is in doing nothing about it!

Unfortunately, AA or any other method that an active alcoholic may try to use to recover does not always work for those who need it, but will always work for those who want it. Your brother may need a detox, some in house counseling, and enter a halfway house.  If he is healthy and does not yet have convulsions or seizures during his sober periods he probably can do without being detoxified. However if his health has deteriorated it would be wise for him not try to stop “cold turkey”. He will fail at it and have another excuse to drink.

From its earliest days, AA has enjoyed the friendship and support of doctors who are familiar with its program of recovery from alcoholism. Doctors, better than any other group, are in a position to appreciate how unreliable other approaches to the problem of alcoholism have been in the past. AA has never been advanced as the only answer to the problem of alcoholism, but the AA recovery program has worked so often, after other methods have failed, that doctors today are frequently the most outspoken boosters of the AA program. The AMA has stated that AA membership is still the most effective means of treating alcoholism. In AA’s words they say, “Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with them selves. There are such unfortunates. They are not at fault; they have seemed to have been born that way. They are naturally incapable of grasping and developing a manner of living that demands rigorous honesty”.

As long as your brother thinks that he has no problem if people would only leave him alone there is very little that you can do for him other than what I wrote earlier. No alcoholic can get sober and stay sober for the long haul on his own. He is destined to get worse and will most likely end up doing things that he once thought that he would never do. Believe me I am not trying to scare you but there are lots of “yets” that your brother has yet to face if he continues to drink. You and your family should not have to deal with him unless he wants to get well.

I hope that in some way I have helped you with your situation. There are no easy ways out. There is no “good fairy” that’s going to come down and tap your brother on the shoulder and make him all better. It will take a lot of hard work and effort on his behalf. I hope that you do go to Alanon for your well being. Please feel free to contact me again. Thank you rebos