What are we dealing with here?

December 30, 2008 9:28 AM

I need some help analyzing a situation with a possibly depressed family member.

My uncle had a successful business in an extremely competitive industry for thirty years. Seven years ago he decided to retire and help his wife with her business. That lasted a year or so until she requested that he stop interfering. She found him very negative and fairly condescending of several aspects of her business and staff.
He's also suffered through several back operations and was on painkillers for three years or so.

The bit that has really got us worried is that for the last three years he has been drinking fairly heavily at night. He sits on the porch and drinks from 5pm until he goes to bed. Occasionally you can hear him talking loudly to himself or having an imaginary argument with someone. He is also permanently negative about everything, a real "half empty glass" perspective of everything.

So what are we dealing with here? Is this going to get worse and what should we be doing about it? I doubt he would respond well to suggestions of therapy.

posted by Umhlangan to human relations (8 comments total)

One possibility is for everyone to completely ignore him until he becomes lonely and begins to ask why he isn't being included. Keep a serious eye on the drinking... is it every single day, does he gradually move it back to 4PM, then 2PM, then noon, does it become his primary focus for being?

Don't know your uncle's drinking history prior to the past three years, but I can share some personal experience with late stage alcoholism. I was dependable, successful professionally, and managed to stay out of trouble... mostly. I had not reached any kind of "bottom." But alcoholism is a progressive disease. Here is what I became:

I must have hated myself. Night after night I sat alone in my room. The television or a good book was all I needed. This was before the Web, so I hadn't yet discovered the joy that can bring. Oh, and I drank.

That's what I did. That was my life. I drank from the moment I got home from work until I passed out. And I did it in my room with the door closed. I didn't have to face other family members who would hassle me. I didn't drive somewhere to endanger others. I just sat in my room and drank. It's all I knew.

I never bought myself any new clothes or neat gadgets to play with. I gave all my money to my wife so she would leave me alone. I stopped at the public library every week to get some new books to read, but that was about all I did for myself. I rarely ate. See why I must have hated me?

And I hated who I was. When you've been a drunk for nearly 25 years though, you know no other life. As much as I wanted not to, I could not not drink. I didn't know how. I didn't know how to handle day to day crisis without drinking. When that is your crutch, everything is a crisis. I drank when I felt good, I drank to forget.

I have been in recovery now for 15 years. For every recovering alcoholic there comes a turning point. For me it was discovering the right place to ask for help. Surprising as it might sound, that right place is in the midst of other recovering alcoholics. I came to the conclusion that I wanted sobriety more than I wanted to drink.

My life is wonderful. My hands don't shake when I eat soup. I am not sick every morning. I have learned to handle situations that used to baffle me; with my mind and not a bottle. My family and friends value my presence, and I theirs. I love and am loved.

I've been presented the gift of a second life. Not everyone gets that chance and I know not to blow it. How could I? Simple, just take another drink. I don't have to do that today because I finally know how to live life on life's terms. For that I am eternally grateful.

Umhlangan, I am sorry your family is having to go through this with your uncle. Unfortunately, it is very difficult to change someone who doesn't want to be changed. He somehow needs to face that turning point that I described. Often it just takes time. Be prepared to be there for him when he is ready. Feel free to email me any time if you have questions or concerns.
posted by netbros at 9:52 AM on December 30, 2008 [14 favorites]

I'm wondering if anyone has had a direct conversation with him about all this. By that I mean - has your aunt (who should probably be the one to lead the way on this) chosen a calm moment to have a focused, clear conversation with your uncle, where she says "this is what I'm observing - you seem very sorrowful and even angry most of the time. I notice that you are drinking habitually and sometimes talking to yourself. By sitting on the porch drinking all evening you are withdrawing from your friends and family. Your behavior is hurting people who love you. Do you think there might be a problem? What do you think it is?"

It seems to me that until someone important to your uncle has this conversation with him, there's not going to be any change or progress. Just observing the behavior from a distance doesn't do anything but enable the behavior to continue. It could be that he's really in pain and has no other ideas about how to deal with it besides drinking to numb himself -- but no one can know for sure what's going on inside him until they ask. I suggest that you work with your aunt to figure out how to lead this conversation. Your uncle needs to know that she cares and is worried, and she needs to tell him that she's noticed this behavior and doesn't want to continue it and wants to move toward improved quality of life for both of them. The initial conversation is the opening move.

From that conversation many things may emerge, and it's impossible to say exactly what those will be, or what the next steps should be, until you have a better sense of what your uncle has to say and how he sees his situation at the moment.

If he's unforthcoming - just rejects the approach and leaves or refuses to discuss it - then you have one kind of problem: that he's got a problem he's not choosing to deal with. So in that case, the other family members, and your aunt especially, need to make choices about how they will respond. In this case, because there's drinking involved, I suggest that your aunt might want to explore the resources of Al-Anon, which is an organization for people who are affected by the drinking of other people, usually relatives or spouses. Al-Anon focuses not on the drinker, who after all needs to take care of him or herself, but on the person who is affected - helping that person to get perspective on the problem, establish boundaries and limits, to make changes if they need to, and to find happiness regardless of what is going on with others in their lives. I wouldn't even worry that your uncle may (and probably does) have other problems besides the drinking behavior; alcoholism is often part of a complex of problems, and a whole lot of people who are problem drinkers also have depression, disabilities, negative beliefs, etc. It doesn't matter much which is the chicken and which is the egg -- it sounds like the drinking behavior, and the associated mood, is a problem for the family, so Al-Anon for people who are affected is a good way to get started on a solution.

If your uncle can admit that he's angry, unhappy, depressed, or whatever, that is a positive step for him and a window to beginning the discussing of solutions. One result of the conversation might be that he agree to get some professional attention. If you think he'd rebel at the thought of therapy, then make the suggestion that he begin with seeing his normal doctor, along with your aunt, so they can talk about the symptoms and potential causes. It may be that the doctor sees a need for antidepressants or other medications, can recommend moderation in the drinking, or even will refer your uncle to a psychiatrist or therapy practitioner. It's hard to say without knowing what the problem exactly is. However, a regular GP can often be of real help here.

One option might be for your aunt to call and make an appointment with his doctor, even telling the doctor ahead of time what's going on. Then when she has the initial conversation she can say "I've taken the liberty of making an appointment with Dr. Smith for you on Thursday. Will you go?" However, that kind of move really depends on the situation and I leave it to your judgement. Some people would rebel at feeling controlled like that - but for others, it might be a welcome relief to know that someone in their family has taken the initiative to make a plan.

In any case, I would recommend a doctor even before exploring the idea of therapy - because with chronic pain, a medication history, self-medication and its side effects, and likely depression, a medical approach is really warranted right off the bat, I would think.

It sounds like you're at the beginning of a process here. Good luck in being a support to your family.
posted by Miko at 10:20 AM on December 30, 2008

He was on painkillers for 3 years?? I can't offer advice how to handle it like the other posters have, but I'm guessing that he became addicted to the high he got off the painkillers and is trying to recreate it the only way he (legally) can.
posted by texas_blissful at 11:42 AM on December 30, 2008 [2 favorites]

Has he seen a physician recently? Most people don't talk to themselves, and this could be a sign of some kind of cognitive impairment. You don't mention whether he has always been so negative. People with traumatic brain injury or other cognitive impairment can become incredibly hostile (see Phinneas Gage as an example), and a doctor can let him know if something physical is causing his distress. Better yet, they may be able to help him. Either way, if you let your uncle know you are concerned for his well being, you are one step closer to getting him the help he needs.
posted by abirae at 4:11 PM on December 30, 2008

Chronic pain is a big deal. People on painkillers are not always addicts trying to avoid life. I had a friend who had a back accident. She hated the drugs so much that she quit cold turkey just on principle at least twice. She tried everything from acupuncture to physical therapy to yoga, but until she got back surgery, the only way for her to function (to have a job, to do anything besides try not to scream) was painkillers. She worked with doctors to minimize addiction and side effects, but even still, she sometimes seemed drugged out. It was a really tough situation for about three years.

Chronic pain is no joke. A friend of mine can pick people out as people with chronic pain. It starts to affect your whole personality and outlook. Imagine being constantly hurting. Imagine feeling like you're "old," particularly if you're someone who made your life around being strong and your physical capabilities. It's not easy, that's all I'm saying.
posted by salvia at 4:34 PM on December 30, 2008 [1 favorite]

Chronic pain is nothing to take lightly. I have had it for over 4 years now from a motorcycle accident and I will have it the rest of my life. If your uncle has back problems then he may very well have chronic pain too. Chronic pain can and will take over your whole life. It will literally slowly drive you insane. I was scared to death of becoming addicted to pain meds so I wouldn't take mine for a week or more at a time. In that time I became impossible to be around. I was hateful, said hurtful thing, cried, and yes, even talked to myself. I have now learned that there is a huge difference between being dependent on the pain meds and being addicted to them. I don't "have" to have them all the time but when I do have pain I need them and take them as such. Having said all that, I really think your aunt might want to get your uncle to a qualified pain clinic and have his back pain evaluated. It might be just what he needs.
posted by Jules22871 at 4:55 PM on December 30, 2008 [1 favorite]

All of the above is the worst case(s) scenario(s). He might just need something to do with his life? People idolize retirement, but ironically, the people who are the most effective at being able to retire early are the ones who may not be able to handle not having anything to do any more.

Nonetheless, if you've witnessed these things and it's not the family gossip machine blowing things out of proportion, he does indeed need to do something.
posted by gjc at 5:47 PM on December 30, 2008

Thank you all for your comments. Netbros, your comment was a huge eye-opener for me and has given us a clearer picture of what we are dealing with. He is drinking every day and fairly large glasses of scotch at that. I just hope that the turning point comes sooner than later. At a recent, outside family function I found him outside on the porch drinking away by himself so it's no longer happening just in the home.
Your honest account also inspired me to pick up the phone and call a heavy drinker who used to be a very close friend but, you can probably guess why we haven't been in touch much over the last ten years. It was a very open conversation and we'll be getting together for coffee soon. So something good has already come of this thread.
posted by Umhlangan at 4:19 PM on January 1