The love affair of our species with alcohol has been documented over millennia.
The Romans were heavy users of wine and even had their god Bacchus overseeing wine, fertility and ritual madness (sounds a lot like a diagnostic) Before this, in Ancient Greece, Bacchus was known as Dionysus. His worship by the Greeks included animal sacrifices!
Humans it seems, require very little prompting to use and overuse alcohol and this is the general population.
So, what’s the big deal with Asperger’s and Bipolar? Aren’t we just doing the same as everyone else?
The answer is yes and no but the central thesis here is to examine the causality and intersectionality of these 2 mental health groups with alcohol use.
Asperger’s and alcohol
The Actually Autistic population might seem an unlikely recruitment pool for alcohol abuse. The primary reason that Aspies take to drinking alcohol, sometimes to excess, is to soothe their anxiety, social or generalized. We are (at least initially) using alcohol as an anesthetic.
Aspies (who aren’t bipolar) tend to stick with alcohol and don’t progress to the ranks of full blown substance abuse of hard drugs.
Aspies tend to have a very concrete, black and white view of the social world. Alcohol can be purchased at the local store and is a socially accepted form of drug which is legal and there’s no ‘stigma’ in being seen buying a fifth of Vodka.
This and other aspects of Asperger’s and Alcohol was elaborated in fine detail in the book ‘Asperger Syndrome & Alcohol’ by Matthew Tinsley.
In my case, another reason to remain ‘safely’ within the confines of alcohol was the cost. Half a gallon of liqor costs far less than illicit drugs and of course who knows what ‘the score’ has been cut with. This is an example of employing my logical and reasoning faculties that are the hallmark of an Aspie.
There was a time when I would have 2 or 3 drinks ‘at home’ to soothe my anxiety before going out to a social event that I loathed but had to attend for ‘political reasons’
The alcoholic threshold
Matthew Tinsley also introduces the contrasting idea of Psychological addition and Physical addiction.
Matthew clearly describes his physical addiction to alcohol at the end of his drinking days, when he was putting away 3 quarts of Gin per day (some people don’t even drink that much water!) His drinking began as a self-medication tool, to manage the stress of his job. He also describes the horrific effects of being physically dependent on alcohol.
He was in his words ‘drinking all day and every day’
I never got anywhere close to this and I can’t imagine being in that place; Gin for breakfast, straight from the bottle!
That said I have, until recently, drunk alcohol steadily and throughout my life, sometimes heavily, often/usually at home and I really don’t know what prevented me from becoming an alcoholic. I have certainly made the quantitative investment, but it never happened.
At one point, during a lengthy work assignment thousands of miles from home, I was purchasing 2 and sometimes 3 bottles of Vodka a week from a local store and for such an extended period that store owner started discounting my bill!
Each time I stopped drinking for an extensive period, typically 3 months to 2 years, I would just stop cold turkey, on a dime. No more effort than taking out the garbage (with all the empty bottles inside)
My alcohol abuse was firmly contained within the Psychological addiction state. But I have been told by a Doctor that if left unchecked this will often progress to Physical addiction and full on alcoholism.
In her book Touched with Fire, Dr. Kay Redfield Jamison PhD addresses substance abuse noting that bipolar patients quite typically use alcohol when depressed or when anxious to take the edge off.
But the kicker for me was what she explained regarding the drug of choice for those with Bipolar disorder in the hypomanic or manic phase. This was often/usually the domain of cocaine and amphetamines, to enhance or prolong the feeling.
This puzzled me, as a card-carrying user of prescription Lithium, as I used alcohol (when I was drinking) regardless of my mood state. It could be the most wonderful anesthetic, drinking myself into oblivion but if I was ‘out for the night’ during a hypomanic episode, booze stokes my fire and makes for a very animated soiree.
I believe this to be an example of Autistic override. Reason and logic tell me that if I get on the bus I should stay on the bus because I didn’t want to end up with my entire paycheck going up nose on payday, or just generally destroying me faster than alcohol ever could.
There is also the autistic tendency to follow routines. I drank alcohol, I’d always done alcohol, so that’s what I did and never sought out anything else (fortunately) and of course alcohol is legal…
My drinking phases and the always inevitable progression to heavier drinking, always began with an anxiety trigger, regardless of mood and to use a favorite phrase of @RichardDreyfuss my drinking and behavior would get ‘louder and faster, louder and faster’
I would progress from drinking at home to ‘going out’ and drinking in ‘colorful’ bars, where I could again, get ‘louder and faster’ – at this point my bipolar Illness has trumped my Autistic faculties of reason and logic and this would continue, for weeks or months, heavy drinking at home or ‘on the darkside’ and other reckless behavior.
Make no mistake, in highly elevated mood states I take on the full bipolar persona; wild, reckless, unpredictable out of sight and out of mind from my responsible and measured autistic self, who is in shackles in some dark and distant dungeon.
It is only when my bipolar mood returns to stable and the manic fog clears, that my Autistic abilities of reason and logic can again be accessed and my behavior reined in and I believe that I have probably, always been in this stable state when quitting booze.
Alcohol aside I tick all the diagnostic boxes for bipolar disorder, spending sprees, purchasing a car with almost all of the money I had at the time and then borrowing my rent money from my brother, falling over drunk and getting injured and even blacking out after overconsuming alcohol.
So, for those of us with bipolar with any history of substance abuse, the drugs can be incidental (Psychologically addictive), it’s really about what is your objective?
Quenching the anxiety or exorcising the depression (for a few hours) then it’s probably booze, or whatever medication/drugs the person happens to prefer.
If they are up and wanting to go higher, hypomanic/manic, then the drug is whatever works for them. I could get the job done with alcohol, as can many others but many can’t.
Now I get the job done with a Pescatarian diet, swimming a mile 3 or 4 times a week and…….nearly forgot…….Lithium.
With alcoholics I would go so far as to say that with some, maybe many, it wasn’t initially about the booze, unless they had a genetic predisposition to alcoholism.
They can begin their journey mired in stress, an Aspie struggling with social or work related anxiety, someone with bipolar looking for that high speed elevator, that person in a miserable marriage and on and on.
These people eventually (or, maybe quickly) develop a psychological addiction and the unlucky ones and this seems to be a lottery, go on to develop a full blown physical addiction, to alcohol or some other substance.
Bipolar seems to hardwire us to seek out substances that can manage our moods; this is affecting 40% + of us at some time in our lives.
Asperger’s seems to act as a safety net, when it gets a look in.
At the time of writing I am just over 100 days sober.
I am doing it alone but many/most seem to/need to travel this road within some kind of structure and support system.
I wish you a healthy life, whether or not you consume alcohol.