Scotch Double, Please.

I drank normally for most of my adult life.  Really.

Two beers was a typical limit.  And even that was occasional.  My typical pattern was to have beer in the refrigerator during the summer months and into the fall during football season, but often there would be no alcohol at all in the house, not by any intentional choice, but simply because I didn't bother to pick any up.  I mean really, 30 below zero, with a thirty mile an hour wind does not stimulate a desire to have a cold one.  I might have a glass of wine when we went out for dinner.  Pizza and beer was a good combination.  And when I would go to the pastor's convocation, I would sit with colleagues till closing, sharing a few pitcher's of beer.  This was the only time I would regularly become intoxicated, and that was only once a year.

When I was first diagnosed with depression, my psychiatrist told me I'd have to refrain from alcohol or else the treatments he could offer would be ineffective.  Alcohol is a depressant.  Taking both anti-depressant medications and drinking alcohol simultaneously simple doesn't work.  They counteract each other.  So I didn't drink.  No big deal.

What ended  up being a big deal was that the psychiatrist put me on an anti-anxiety drug called Ativan, or lorazapam, both for anxiety and to aid my sleep.  It is highly addictive.  A number of years later, feeling better, I decided it was time to go off my medications.  This was before I was diagnosed as being bipolar.  I was being treated for dysthymia at the time, a long term moderate depression, and so it was not untypical to come to a point where discontinuing medication was an option.  When I went off the Ativan, my doctor weaned me by putting me on half a dose for a few weeks, and then off.  I think he may have warned me about alcohol use, but I'm not sure about that.

What happened was that I immediately, as in overnight, began having a couple of scotch doubles per night to ease the anxiety and help with sleep.  Prior to this time, I had resumed drinking once a week, or so, rarely more.  A friend would come over on Wednesday nights, and we'd share a couple of drinks of scotch.  That's it.  Once a week.  Then, I stopped the Ativan and it was every night.

Having a couple of drinks per night is generally, socially acceptable.  And in the beginning it was not much of a problem.  At least I didn't think it was a problem.  In the beginning I didn't realize the extent to which I was dependent.  What I discovered later was that I had become chemically dependent on the Ativan, and then when I went off the Ativan, I experienced a "cross addiction" to alcohol.

I realized at one point that if I didn't drink, I couldn't sleep.  So I went to my physician an shared that I felt that I had become dependent on alcohol for sleep.  He put me on Ambien, which produced horrific nightmares.  Then Lunesta. When I went to fill the Lunesta prescription, my pharmacist informed me that Lunesta should not be taken nightly, because it is potentially addictive, habituating, and in the end, could cause significant liver damage.  "I wouldn't recommend using it anymore than once every three nights."  My solution was to alternate between the scotch and the Lunesta.  I preferred the scotch.

The thing was, it worked.  It did what I wanted it to do.  When my wife would raise concerns about my drinking, I would defend it by pointing out that whether it was scotch or Lunesta, the fact was that without help I could not sleep.  It was simply a matter of choice which drug I would use.

The problem is that alcohol is not only addictive, but habituating.  As time went on I needed more to achieve the desired effect.  My two scotch doubles (specifically 6 to 7 fluid ounces per night) became 3, (over 10 fluid  ounces) per night.  And that was the average.  I know this because I have a record of all my purchases of scotch.  I did my finances on Quicken and could look back and itemize every purchase at the Idaho Liquor Store.

What I now realize is that when I would cycle between hypomanic highs, and depression, my consumption would increase at both ends of the spectrum.  As my drinking increased, my tolerance level did as well.  I used to joke that it took two doubles just to feel sober.  It actually did.  There were three phases in my drinking.  First I drank because I liked the taste.  Then I drank for the effect, I liked the buzz.  And finally, I drank to feel normal -- that is to alleviate the symptoms of withdrawal.

Toward the end of my drinking this became quite pronounced.  I had decided I would not drink on Saturday nights because I didn't want my congregation to smell alcohol on me Sunday mornings.  On Sunday mornings I would shake to the point that I could not pour the wine from the pouring chalice anymore.  I thought it was stress.  Turns out that to avoid smelling of alcohol, I was actually detoxing in front of  my congregation each Sunday.

I reentered psychiatric care in 2012 and the psychiatrist put me back on Ativan, hoping I wouldn't need to drink as much.  It didn't work.  On my last night drinking, I was in a rage over some issues at work, trying to 'drink it away', and I decided I'd need the Ativan as well.  Not a good choice.  It nearly killed me.

Alcohol worked until it didn't.  Now it never will again.