Brief Answer:
As below.

Detailed Answer:
Hi,

Welcome to Healthcare Magic!

You sister has already won half the battle by accepting that she has a problem and deciding to do something about it. Kudos to her! The issues she and her family are facing are common and can be overcome. Here are some pointers that will help her.

1) Her family should sit with her and help her set realistic goals. These goals should be over short term and relatively easy to achieve. For example, rather than deciding to quit totally on a certain date a few weeks from now, she should be encouraged to cut down her daily intake by ten percent today and continue the same intake for next week. She will find this easier to manage than quitting completely. However, her family will need to keep an eye on her and keep on motivating her. Once she can do one week of slightly reduced intake, she would have gained in confidence and can then be asked to reduce ten percent more and continue for the next week. The process can be hastened up if she is willing and feels confident enough.

2) In spite of her (and everybody else's) best efforts, there are going to be days when she will fail to keep her target. These are inevitable and must be handled with tact. Your sister lies on these occasions because she is ashamed of her failures and feels that she has let down her family. She needs to be told clearly that her family is proud of her for whatever she has achieved and these instances should be taken as just transient events that do not deserve much importance. These lapses do not mean that she cannot succeed. She just needs to give a thought to what may have caused the event and how to deal with the situation next time. From the next day onward, she should again try to stick to her target, as if the lapse never occurred. Her family should take care not to express a single word of criticism when lapses occur as this can demoralize her completely.

3) She will benefit from medical help. There are medicines which can manage withdrawal, reduce craving and make quitting easier for her. If she knows this, she will realize that all is not lost if she cannot do it herself and there are other choices open to her.

I hope this helps her. Please feel free to ask in case you need any clarifications.

Best wishes.

Dr Preeti Parakh
MD Psychiatry

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Brief Answer:
As below

Detailed Answer:
Hi,

Whether a break from responsibilities would help her in quitting alcohol or not would depend on the factors that make her drink. For example, many times lapses occur because people use alcohol as a means of coping with stress, either at home or at workplace. For such people, a reduction in stress helps but of course, it can never be a lasting solution. The best thing that they can do is to find healthier means of coping with stress. Then are some others who have lapses when they are free in the evenings, having finished all their chores. They drink to avoid boredom and because they have "nothing better to do". For them, the solution is to give them added responsibilities and keep them busy. Other common triggers for lapses are strong emotions like anger, XXXXXXX frustration, or just being with other people who are drinking.

Applying this to Linda's case, I would suggest that her family should look at the issues that make her drink and try to give her a respite from them. For example, if the children are a handful and caring from them makes her feel angry and frustrated, then taking the children away from her for a few days may help. However, if looking at her children makes her think that she has their future to worry about and she should quit for them, then it will help to have them around. XXXXXXX should have a say in deciding what will help her. I also feel that a partial break is better than a complete break from all responsibilities.

Regarding gastric bypass surgery, I do not feel it could have been responsible for her alcohol dependence. But the stress of her own ill health along with her son's condition, and the responsibility of caring for him would certainly have driven her towards alcohol.

Best wishes.

Dr Preeti Parakh
MD Psychiatry

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