Month: May 2018

Binge Drinking in Midlife

“He didn’t show up for any of the meetings yesterday or today. I saw him at the beginning of the party day before and he seemed fine. He has not called in sick or returned any of our calls.” This is not the beginning of a murder mystery. This is a conversation about a middle aged binge drinker.

Social drinking has caught on in India. Friday night is synonymous with ‘getting drunk’ for many young, urban Indians. As the years go by, some people who binge drank in their youth may change their ways. Others, unfortunately, continue binge drinking into midlife. A 2009 multi-country study (GENACIS) reported as much. The study confirmed what we all know: Men in India drink much more and drink often compared to women. But the study also found that middle aged binge drinkers in India include both men and women. And both genders’ tendency towards heavy drinking only worsens with advancing age.

The binge drinkers I am talking about here may have once been the up all night partying types. But most people who binge drink into midlife stop being social drinkers. They don’t drink in the company of others. They mostly drink alone. Or, they may have a drink or two at a social gathering. And, they don’t stop at that. They come back home to continue solitary drinking for the next 24-48 hours, skipping work and other obligations.

The consequences of binge drinking

Most people know about the physical health consequences of drinking too much, too often. It can destroy the liver, create memory problems, cause alcohol poisoning and death. But there are equally devastating social and economic consequences to binge drinking, as well.

Binge drinking creates inconsistency at work. There are some very intelligent individuals in the corporate world who have a binge drinking problem. These folks may get to positions of seniority and authority in midlife. However, they find it difficult to stay in a job for long because of this problem. The organisation may be able to overlook their unpredictable, complete disappearances for some time. Eventually, despite their brilliance, the employer’s patience runs out. The resulting job loss and career disruptions have an economic impact on the family.

Binge drinking also creates uncertainty and chaos in the lives of the family members. The family members never know when and in what condition the binge drinker will turn up. Or, not turn up. Binge drinkers are unpredictable around their drinking. Hence, family outings, occasions, formal events or informal events are all frought with anxiety for the family.

Kids often suffer the most. Society looks down upon those who get drunk frequently. Kids pick up this attitude and feel ashamed because of their parent. They avoid bringing friends home because they do not know what condition their binge drinking parent will be in.They also end up covering up for their parents or tend to ‘over-achieve’ to compensate. Kids also worry about their parent’s wellbeing. More long term, kids who have grown up with parents who are alcohol dependent have a greater likelihood of becoming alcohol dependent themselves.

And, we have not even considered the impact of living with the typical alcoholic that movies portray. The binge drinker who may be a wife beating, child beating, raging alcoholic. Or, the one who, inebriated, gambled away her life savings and is on the streets. Or, the one who got into a serious fight or a fatal car accident, drunk. Or, some other such drastic situation. All because alcohol messed up their ability to control impulses or think rationally.

But why do people get addicted?

Binge drinking in midlife can usually be traced to binge drinking in youth. When young people drink, it is mostly a group activity. Youth drink because they are curious, they enjoy the disinhibition it brings, it makes them a part of their peer group, or they drink under pressure from their peer group. Increasingly in midlife, though, binge drinking serves to fill some kind of a vacuum or helps avoid painful emotions. Boredom and stress are two justifications.

The question this brings up is: Do other people not go through painful emotions or stress? Everyone does not resort to binge drinking. There is judgment in that statement. Somewhere we believe the binge drinker lacks will power. The implication is that he/she is a weak person. Or, a lazy person. A defective human being.

It is true that most people who are addicted to alcohol hide their addiction. They fear the judgment we talked about. Drinking may be their only coping mechanism. Or, they have tried giving up but failed. They feel guilty about that. They may also feel that they have no control over it. It all makes them feel bad. Hence, they do not like talking about it. Most of the times, there is outright denial of the addiction. This makes it doubly difficult for well-wishers to point out the obvious.

Research so far tells us that it is a combination in various parts of genetics, learned behaviour, and mental health disorders that are to blame. If you have a family history of alcohol addiction and/or you are suffering from an anxiety disorder, clinical depression or bipolar disorder, you may more easily get addicted to alcohol. And then there is the physiology and psychology of addiction that keeps a person hooked. Physiological addiction basically means that a person needs to consume more and more alcohol to get the desired effect. However, the increasing levels of alcohol are toxic for the various organs of the body. Psychological addiction means that a person relies on alcohol rather than anything or anyone else to make them feel better or avoid painful emotions.

Giving up alcohol

Because alcohol provides some kind of immediate relief, it is difficult to stop alcohol use. There needs to be a strong reason to want to give up alcohol. Sometimes, that motivation gets created when one is confronted with a serious negative consequence.

For many women, their responsibilities as a parent or realising that their drinking is affecting their child spurs them to take corrective action. For men though, it is often the women in their life who nudge them or push them to seek help. The problem is that most of the time the binge drinker is not convinced that there is a problem.

Even when realisation finally strikes that alcohol is doing more harm than good, leaving it is difficult. Once the body gets used to a certain amount of alcohol, reducing the amount or stopping altogether is problematic. It is that horrible hangover amplified that makes many turn back to the bottle.

Support is, therefore, one of the biggest factors that usually helps those who want to leave alcohol. Support to keep one motivated. And, it is a daily battle to be fought. Family can play a big role in supporting the binge drinker leave alcohol. But it is a long journey. And sometimes family members are unable to show understanding and support on a consistent basis. At the first slip or second slip the family is ready to give up. And, one then gives up faith in one’s ability to get back on the sobriety track. This is where organisations or support groups like the AA (Alcoholics Anonymous) come in. AA membership is free and they hold meetings in most cities and towns in India. You are not judged, you are encouraged, and each milestone of sobriety is celebrated.

In addition to seeking help from a support group, you may also need to see a psychiatrist and/or psychologist/therapist. They would be especially helpful if your alcohol dependence is a result of a mental health condition, such as depression. Residential treatment programs are not a requirement. But if you are experiencing serious withdrawal symptoms, you should consider getting admitted to one. This is because your body can no longer function as normal without alcohol. Hence, you would need to detoxify under a medical professional’s care and supervision.

Binge drinking is a reality across all sections of society. And it takes a terrible toll. If you are a binge drinker, seek help. Achieving sobriety may take effort and time, but it is possible. If you are a family member or friend, talk to the binge drinker. Not with judgment, but with concern. And be there to support them on the long road to sobriety.

9 Reasons marriages end up in divorce in midlife

“Did you not know? They got divorced a couple of months ago. The kids are now in boarding school.” This piece of news may have come as a shock because you did not realize your friends were headed in separate directions.

Your friends are not an exception. Divorce is on the rise in India. Not just the big metros, even smaller towns in India are witnessing marital discord leading to separation. Often the affected couples are in their midlife. Many of them have kids. Separation at any stage of life is traumatic for one or both partners. However, when couples with children decide to separate, it affects many more lives.

As a spouse in midlife, this information can be quite unsettling. You may worry for your marriage. But, we can try to make sense of this phenomenon. Let’s begin by talking about expectations. No marriage is perfect. The only time couples walk into the sunset holding hands is in the movies. Most couples in real life go through ups and downs. Almost all have to work towards creating and sustaining a strong bond.

Couples also face different issues at different stages of life. Most marriages go through teething troubles in the early years. Some marriages do not survive the initial challenges. Others that do sometimes run into trouble during midlife.

Midlife is a time when one goes through many changes. The body changes, aspirations change, interests change, responsibilities change. The stresses that midlife brings affects relationships in big and small ways. And, a midlife marriage has to be strong enough to survive these changes.

From my clinical practice, I have noticed the following common reasons for a midlife breakup:

Boredom, feeling disconnected or alienated

Marriages are about choice. Even most arranged marriages have an element of choice. You chose to get married to your spouse because you found them special or different from the others in some way. Or, you felt special with them.

Now, age can erode that sense of ‘specialness’ as you become more familiar with your spouse’s failings (No one is perfect, remember?). Some spouses, in fact, become experts at criticising. They systematically disregard or negate all positive aspects of their spouse’s personality or behaviour. It is the “Yes, but…” on an unending loop. When either spouse is so critical, the “special” feeling gets killed. You don’t feel special and you don’t see your spouse as special, either.

The result is emotional withdrawal and distance. Over time a feeling of alienation, disconnect or boredom dominates the relationship.

Over-involvement in work/career pursuits

Often midlife brings career satisfaction. People may find themselves in positions of authority at this age. With authority and seniority comes a sense of achievement or accomplishment. But with that creeps in greater responsibility.

Most senior professionals find themselves still putting in long hours at work. Work related travel adds to time away from spouse and family. This can make couples feel disconnected. Or, one spouse feels that the burden of house-hold/family responsibilities is disproportionately falling on their shoulders. For couples who are already facing relationship issues, this can add to the list of resentments.

For some couples, over-involvement in work is also a way to avoid confronting relationship issues. It is the elephant in the room that grows bigger with time and eventually stomps all over.

Spouse’s involvement in other pursuits

Midlife is a time when many adults decide to take a break from what they have been doing so far. Or, they may decide to re-prioritise life.

After years of focusing on work and family they may decide to pursue or explore activities that they enjoy. Indian cities now offer a range of recreational activities from ultra-marathons to bird watching. These activities provide the opportunity to meet like-minded people and socialize.

In some cases, the time devoted to such activities is at the expense of the time and attention one can devote to family. When one spouse becomes deeply involved in any such individual interest, the other spouse can become deeply resentful.

Spouse’s worsened addiction

Addiction or dependence on alcohol, drugs of any kind, gambling or sex can become worse in midlife. If a person had got into these addictions earlier in life, they tend to persist unless treated. Some individuals can also fall into addictions as a way to deal with midlife stress. Many a times the addiction is a symptom of an underlying mental health condition, such as depression or bipolar disorder. In such cases, appropriate treatment of the mental health condition is required.

Most of the time addictions affect relationships. Living with a spouse who has an addiction causes great emotional and/or financial stress. At some point, the non-addicted spouse may decide that he/she can no longer endure such stress. Marriages that have survived into midlife can then fall apart.

Unresolved issues around intimacy

Sex in India is shrouded with much mystery and misconceptions. And most Indians do not seek appropriate help for problems with intimacy.

Many couples struggle with sex from the time they get married. Most such couples do not have any physiological or biological problems. The issues arise either from a lack of information and exploration or from psychological issues. By the time couples reach midlife, they have often given up trying to solve the sex mystery. But a feeling of dissatisfaction lingers. If intimacy is an issue and the feeling of ‘specialness’ is also missing, then the marriage is likely to run into trouble.

Infidelity

Not getting into morals and values, the fact is that individuals tend to vary in their commitment to a relationship. Many Indians get into marriage stating reasons other than wanting to spend their entire lives with that one person. In addition, some individuals thrive in the attention they get from the opposite sex. Looks and appearance may matter greatly. Hence, they are open to entering into sexual encounters outside of marriage.

One or both partners may also get into affair if there are long term, unresolved relationship issues. No marriage is perfect and all couples need to work through various differences. However, when one or both partners have created an emotional distance from the other or there is constant fighting and animosity, “specialness” disappears and space for an affair is created.

Empty nest

Children leaving home for college or work causes a big change in the lives of family members.

For couples whose lives have revolved around their children, adjusting to this change is challenging. But it is most difficult for couples who have been avoiding facing relationship issues. Some couples are unable to resolve issues, have long standing resentments and fail to create a mutually supportive relationship. Spouses in such a marriage begin to then rely on their children for emotional support. They connect more with their kids than with each other. The kids may even become the go between the parents. The only reason such couples cite for being together is the kids. When the kids leave, there is no glue to hold the marriage together.

Financial issues

When two people get married they often hold different views on money. Growing up experiences, personalities and family values around money determine how much importance individuals give to wealth and possessions. When two people have similar perspectives on money, it is easier. However, problems can arise if these thoughts diverge greatly. Most couples over time figure out a common policy on money. Any initial differences over whether separate accounts should be maintained or joint ones are usually resolved by midlife.

Midlife tends to bring up different concerns around money. Savings, investments, planning for retirement become more important issues. Financial responsibilities can also be significant if kids’ college education and health issues of family members are added to the mix. Job loss and career breaks can cause significant stress. One or both partners may feel unhappy with their financial situation and resent past or present decisions. Some are nagged by the thought that one’s earning years are limited. Resentments around financial issues can cause big rifts.

Social contagion – hanging out with friends who are divorced

Friends are a great source of support. They also play a big role in defining what is socially acceptable behaviour. This is not only true during one’s teenage years but throughout life.

Divorce is gaining social acceptability in India, and more so in the big cities. Knowing people who have gone through a divorce helps one view divorce as a feasible option. It also helps create social support if one decides to separate. Instead of struggling through issues with one’s spouse, it seems easier to call it quits.

 

Whatever be the reasons for marital dissatisfaction, divorce is rarely an easy decision. Life after divorce can also be difficult for one or both spouses and the kids. But, it is possible to save and build back marriages, even in midlife. Hopefully, knowing what leads midlife marriages to the divorce courts may help you course correct before it is too late.

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The above article is based on Dr. Dubey’s work with Indian couples.

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