Saturday, May 24, 2008

Alcohol & Depression

What's different about alcohol for older people? As we get older, our bodies change. On the outside we notice lines, wrinkles, extra weight. Our skin is perhaps not quite as strong or flexible as it used to be. On the inside we:
  • lose muscle
  • gain fat
  • break down alcohol more slowly.
How much is it safe to drink? The more you drink, the more likely it is that alcohol will harm your health; BUT there are “sensible” levels of drinking which, for most people, are unlikely to be harmful. These are roughly:
  • 14 units of alcohol a week for women
  • 21 units for men
How many people drink too much? Older people tend to drink less alcohol than younger people, but even so 1 in 6 older men and 1 in 15 older women are drinking enough to harm themselves.

Are there any risks to “sensible” drinking? Just because we drink within the limits does not mean that it is safe. Very little research has been done on older people so we may be mistaken in thinking that these limits apply to everyone. There are also some particular problems:
  • health problems can make us more susceptible to alcohol
  • balance gets worse with age - even a small amount of alcohol can make you more unsteady and more likely to fall.
Alcohol can:
  • add to the effect of some medications, e.g. painkillers or sleeping tablets
  • reduce the effect of others, e.g. medication to thin the blood (warfarin) – alcohol can increase the risk of bleeding or developing a clot or blockage in your bloodstream.
What are the risks of drinking too much? Alcohol can damage nearly every part of the body:
  • the stomach lining → ulcers or bleeding
  • the liver → cirrhosis and liver failure
  • heart muscle → heart failure produces a build-up of fluid in the lungs which makes you breathless
  • cancer → of the mouth, stomach and liver
  • malnutrition→ alcohol has lots of calories for energy, but none of the protein, fats or vitamins you need to keep your body in good repair
  • sense of balance → falls and accidents
  • blackouts or fits
  • stroke

Isn't drinking good for the heart? If you drink about 1 unit a day, you are slightly less likely to have a heart attack. This finding came from studies in men in their 40s and 50s - so it may not apply to everyone. It makes more difference to control your weight, take exercise and make sure that you get proper treatment for any high blood pressure, high cholesterol or diabetes.

How can alcohol affect mental health?Too much alcohol can cause:
  • Anxiety: This may be because you start to feel anxious as the alcohol wears off – like a mild withdrawal symptom. So you have a drink to feel better – but as the effect of that wears off, you start feeling anxious again.
  • Depression: You feel less hungry, have difficulty sleeping and get tired more easily. You start to feel that you have lost interest in things you used to enjoy, are slower to take things in when reading or watching television and feel less positive about the future - or even feel that life is not worth living.
  • Hearing voices: This is less common but can happen if you have been drinking heavily for a long time. It starts with vague noises, like leaves rustling, and gradually becomes distinct voices. These can be unpleasant and are usually distracting.
  • Confusion: If you have been drinking but not eating, the lack of Thiamine, an important vitamin, can make you confused and unsteady on your feet. If this is not treated urgently, you can get permanent damage to your short-term memory – this is called Korsakoff’s syndrome.
  • Dementia: You can lose your short-term and, as time goes on, your long-term memory.
How might an older person develop an alcohol problem? About a third of older people with drinking problems develop them for the first time in later life. Bereavement, physical ill-health, difficulty getting around and social isolation can lead to boredom and depression. Physical illness may be painful. It can be tempting to use alcohol to make these difficulties more bearable. It may then become part of our everyday routine and difficult to give up. Unlike younger people, there may be less pressure to give up drinking - there may be less family responsibilities, or no pressure to go to work each day.It is possible that health professionals don't spot heavy drinking in older people as often as they should, because:-
  • Older people tend not to talk about their drinking, perhaps because of embarrassment.
  • They mistake the effects of alcohol for a physical or mental health problem.
  • They forget that older people may have drink problems so they don’t look so hard for it.
What help is available? It is often easier to treat drink problems in older people than it is in their younger counterparts.

Treatments include: Detoxification or ‘detox’, Support groups, Psychological or ‘talking treatments’,Acamprosate, Helping the problem

What do I do now? If you think that you have an alcohol problem, talk to your doctor. If necessary they can arrange for you to have tests, see a counsellor, or refer you to a specialist. There are also a number of organizations offering free advice for alcohol problems.



source: http://www.rcpsych.ac.uk
Posted by Tom at 05:27:54 | Permanent Link | Comments (0) |