I use drinking to manage social anxiety.

August 13, 2007 5:25 AM

I use drinking to manage social anxiety. Suggestions?

I have a tendency to binge drink. I feel that I do this because I am a shy, inhibited person, and I just love that it helps me interact freely with others without feeling self conscious or thinking too much (I'm a huge overanalyzer—it’s exhausting!). Being single exacerbates this because I get so nervous when I go on dates…it’s very tempting to share a bottle of wine at dinner and then go to a bar afterwards.

My drinking is completely related to social events. If I'm getting invited out a lot, I'm drinking more; if I'm not going out, drinking plays almost no role in my life. Also, many of my friends are heavy drinkers, and invariably all events are centered around alcohol.

I am beginning to realize that alcohol is a social crutch that I might do better without (or with less). Most of all, I am concerned about the health effects of binge drinking. My diet is great, I exercise, etc...will binge drinking 3 times a month really damage my liver?

So, my questions are …
How bad for one’s health/liver is binge drinking (~3 times/month)?
How can I cut back/quit and just learn to deal with my social phobias?
How to manage dating nerves without alcohol?

I would consider getting help from a professional, but I really don’t feel that a 12-step program would suit me or the specifics of my problem. I truly don’t feel that alcohol is THE problem…I feel that shyness is the true issue and that alcohol is just the quickest, easiest way I’ve found to deal with debilitating shyness. However, I want to protect my health and realize that alcohol in excess is not healthful.

I’m a women, fyi.

posted by anonymous to health & fitness (24 comments total)

How can I cut back/quit and just learn to deal with my social phobias?

Might not be much help to you, but when I start finding myself drinking more quickly because I'm nervous, I move onto pints of soda water instead of lager. Its still a crutch, of course, but it's cheaper, doesn't get you smashed and rehydrates you. Of course, this only really helps if you like soda water, so YMMV
posted by Jofus at 6:02 AM on August 13, 2007

3 times a month? Please. That's junior varsity.

Relax, you are going to be fine. Go have a drink.
posted by nineRED at 6:10 AM on August 13, 2007 [3 favorites]

There is some evidence that alcohol has more debilitating effects on women, in far smaller amounts, than it does on men. Moreover, in many situations, the effects on women in terms of impaired judgement, coordination, and social communication can have greater repercussions than for men, and at lower volumes of alcohol. In many cultures, it's also still more stigmatizing for women to be self-described as alcoholics, so it is harder for women to find and successfully participate in treatment, when their drinking does become uncontrollable.

You might not have developed a physical dependence on alcohol at this point, and perhaps all you really need are better strategies to manage your use of alcohol. Here are some I've seen work:

1) Postpone the start of your drinking until later in the evening. Don't have a cocktail before dinner, have a mineral water, or a V8 instead. Don't have wine with dinner. The later you start, the easier it is to drink less in the remaining hours of an evening, without seeming to be avoiding drinking entirely.

2) Only drink after you've eaten substantial solid food. This avoids or at least mitigates the hypoglycemic blood sugar crash that drinking on an empty stomach sometimes causes. You'll drink less, because your blood sugar isn't crashing, and you'll absorb the alcohol you do drink a little more slowly, for having it dispersed in the greater volume of stomach contents you'll have after a meal. If you go to a cocktail party or reception where there are only light snacks, nuts, or nothing but drinks, don't drink alcohol there.

3) Have a "limit," and announce it to people you're drinking with, when you start drinking. If your "limit" is two drinks, stick to it. In bars, keep your swizzle sticks, straws, toothpicks, napkins, or whatever "per drink" marker comes with your rounds, as a reminder how many you've had. Don't drink with people who don't respect your "limit," or try to get you to go over it, regularly.

4) Beer and wine are just as "serious" in terms of alcohol abuse as shots or mixed drinks. Don't think that by "switching" to beer or wine that you're not going to be drinking as much. In fact, there's some evidence that beer is the preferred drink of many alcoholics.

5) Don't smoke when you drink.

6) Drink water or other non-alcoholic beverages in the middle of any social drinking. You can sometimes get a drink of water when going to the restroom in restaurants. It helps to dilute the alcohol in your system, and prevents you from being thirsty due to alcohol's dehydrating effects.
posted by paulsc at 6:13 AM on August 13, 2007 [1 favorite]

I second nineRED... no doctor is going to inherently tag you alcoholic due to excessive drinking three times a month. When you start poping one in the morning to cure the hangover -- perhaps.. but not yet.

And if your drinking is concerning you, I strongly second Paulsc's guidelines. Well put.
posted by SirStan at 6:24 AM on August 13, 2007

It's difficult to know whether you are just getting a little tipsy 3 times a month, or are truly binge drinking. Binge drinking has no agreed on definition, but a useful guideline is that 25+ units for men or 18+ units for women in a single session constitutes binge drinking. A small glass of wine, single of spirits, or half a pint of beer is one unit... are you really drinking the equivalent of 9 pints of beer per session, three times a month? If you are someone who only drinks during those times, I doubt it, that amount would put a woman of average size and tolerance on the floor. I'm smaller than average but have the alcohol tolerance of a herd of cattle, and I very rarely drink more than 18 units in a single night unless it's Burns Night. S'all I'm sayin'.

But, that's not your question. So, if you want to manage social awkwardness, I would meet up with someone from the group I feel very comfortable with an hour or so beforehand, and go to an event together, rather than meet an entire group on my own and get the "OMG! I have to socialize" pressure all in one go. Before a date, I would do the whole bath/preparation routine and make it as therapeutic (in the day spa sense) as possible. Maybe invite that close friend over, too, for moral support. And while out, I would have a sparkling water with lime every other round. Just tell your friends it's a G&T.
posted by methylsalicylate at 6:35 AM on August 13, 2007

How can I cut back/quit and just learn to deal with my social phobias?

I think a professional is the ideal person to help you learn to deal with your social phobias. I'm not going to speculate whether you do or don't have an alcohol problem, but you clearly have social phobia. I used to be a lot like you, but therapy has been immensely helpful in reducing the effects of my panic disorder.

Besides traditional talk therapy, I was put on klonopin. The effect feels a lot like drinking in that it immediately relaxes me, but without the hangover and liver damage. (If you do have an alcohol problem, this isn't the drug for you, because you cannot drink while taking it.)
posted by desjardins at 6:38 AM on August 13, 2007

Yeh Paulsc's suggestions are great...also, when I'm in situations that make me nervous I try to drink things diluted with water. Can you get a thing in America that's half-beer and half-Sprite? That's what I drink when I know I'll be reflexively sipping from anxiety.

Drinking from anxiety is much better than smoking from anxiety. Also "binging" sounds to me like frat-style passing out in your vomit. That's bad. But if you just mean that you're drunk about three times a month, then you're a paragon of sobriety in my eyes.
posted by creasy boy at 6:57 AM on August 13, 2007

The thing that really helped me not use too much alcohol when I was nervous socially was basically to remember that if I was using it to quell anxiety -- I had some seasonal insomnia and having a few drinks before bed was just the thing -- I wasn't learning to deal with the underlying issue. So, tamping down anxiety with drinking didn't help me with the anxiety and made it worse when I couldn't drink.

This was not a huge problem for me generally but I decided I would rather learn not to be anxious than learn how to drink myself out of being anxious. So, in short, I'll still have a beer or two with friends, sometimes more if I'm at a party or whatever, sort of a "take the edge off" amount, but then I stop. Otherwise the absence of alcohol itself could sometimes become an anxiety-producing issue and I figured that was just plain stupid.

Also seconding what other people are saying. You haven't given much information but it doesn't sound like you're binge drinking, just drinking a lot in social situations. While moderating your alcohol intake is a good idea for other reasons, this doesn't sound like a damaging amount to be drinking and definitely not an amount that brings the risks that people talk about coming with bingeing.
posted by jessamyn at 7:10 AM on August 13, 2007 [3 favorites]

If cannabis is legal in your country, or you can obtain a medical prescription for it, smoke weed. No physical health consequences (if consumed via a vaporizer), and it'll make you talkative to boot, which always helps in dating scenarios.
posted by Gordion Knott at 7:12 AM on August 13, 2007 [1 favorite]

Not so sure if Gordion Knott has the best advice. Smoking pot will increase your risk of psychosis.

QUOTES
"There is a strongly-held view that cannabis is risk-free, reflected in the rates of its use among young people.

"Cannabis is not risk free. We have known for years that using cannabis makes the symptoms of schizophrenia far worse in people who already have the illness.

"There is a rapidly growing body of evidence showing that cannabis can trigger schizophrenia in people already at risk - and probably even in people who should only be low risk."
posted by mateuslee at 7:18 AM on August 13, 2007

I wouldn't be terribly concerned about the risk of cannabis induced psychosis. If I'm not mistaken, the above data applies to people who already have a latent disorder of some sort, and marijuana use simply increases the likelihood of its manifestation.

However, if you're already feeling anxious, it seems extremely unlikely that smoking pot is going to act as an anxiolitic. On the contrary, it's got just as good a chance of making you paranoid and withdrawn.

Pot can make you talkative and/or social, but mostly with other potheads. Getting wicked stoned and then hanging out with a bunch of folks who aren't is probably more likely to increase rather than decrease anxiety.

[NOT POTIST]
posted by solipsophistocracy at 7:38 AM on August 13, 2007

i understood "binge drinking" to mean drinking a lot at one particular time. ie drinking hard, throwing up, etc. i think that is what the original poster meant too.

i get the impression people here who say the original poster is not binge drinking seem to think it means "drinking regularly". the original question doesn't give any info, that i can see, to assess whether anonymous binge drinks or not (appart from the self-diagnosis).

maybe i'm mistaken, but this seems to be a confusion throughout the thread. for example, there may be health risks involved both with drinking regularly and with drinking excessive amounts intermittently. when people are saying there is no health risk because this is only 3 times a month they are confusing binge and regular drinking.
posted by andrew cooke at 7:56 AM on August 13, 2007

Well, the poster mentioned drinking for dates, and she didn't mention it as a problem that her drinking ruined her date...indeed it seems to help in her opinion. So that's why we're not imagining her falling down into a pool of her own vommit. If it seems to her to be helping her dates and her social life generally, then it seems likely that she's just getting drunk a couple times a month. While jessamyn's concerns about treating the underlying psychological issues might be relevant, it doesn't sound like she's damaging her liver. But we would have to hear specific amounts to make a real judgment.

Anyway in my opinion dates are a nightmare and I would never ever attempt one without drinking something. It's when you're too drunk for the date that it becomes a real problem.
posted by creasy boy at 8:16 AM on August 13, 2007

don't be afraid of the 12 step program. For many, the problem is not drinking, but how to be OK without it.
posted by Gregamell at 8:20 AM on August 13, 2007

i wouldn't worry about your liver, but one way to cut down on drinking is to alternate water or some other nonalcoholic beverage with your liquor.

more salient is the social phobia. that's where a therapist might help.
posted by thinkingwoman at 8:26 AM on August 13, 2007

How to manage dating nerves without alcohol?

Maybe going on a date somewhere alcohol is not available would be good for this. Try something where there will be an activity to focus on, go on a hike or to a driving range. Don't be afraid to admit you are nervous to your date, they might be nervous too. Doing some sort of relaxation exercise before you go on a date might be helpful.

You might also think about what you are looking for in a date. If you are looking for a long term relationship, dating this way will tend to find people who drink the way you describe on a regular basis, whether you are going out for the evening or not.

As far as alcohol goes, if you are concerned about your drinking and feel like you are using it as a crutch, that's a good signal to take a look at your behavior. There's no fixed amount that's a de facto problem. You have become aware that you are using alcohol to self medicate for social anxiety, and that this might be a problem for you. Don't let the chorus of voices singing "you are not drinking very much at all" keep you from examining your own behavior and looking for alternative ways to deal with situations in your life besides drinking.
posted by yohko at 8:44 AM on August 13, 2007

Cannabis's main side-effect on some people is inducing anxiety. I woudlnt recommend this course unless you have precious experience with the drug.

I would not recommend self-medicating at all. In the long run it just hurts you. Your drinking doesnt sound too bad, but you really need to be mindful of abusing this crutch. You do not want to find yourself in a position of having a couple shots in the morning to calm the nerves.

You may want to check out some self-help resources if you dont feel like you need professional help.
posted by damn dirty ape at 8:55 AM on August 13, 2007

How can I cut back/quit and just learn to deal with my social phobias?

A taste of arrogance :)
The nervousness probably stems from worries that you're doing something wrong, or not enough of this, or that, etc. Regardless of how grounded these worries are, the effect on your socialising of worrying turns them into self-fulfilling prophecies.
Remind yourself that you're just so gosh-darn-it^* awesome you don't need to make a good impression - you have no need to even care what impression you leave. Do it constantly until your gut starts to believe it. And decide in advance that "this month, I'm not planning to find a boyfriend" so that it really is no skin off your nose whatever impression you leave. Get used to concentrating on the things at hand, rather than the worries, even when stone cold sober.

And once you're convinced that you're so great you have no need to overthink your every action, that's far enough - the world doesn't need more self-important assholes who have taken the self-confidence thing beyond the realm of grounded reality :-)

*But not in these words
posted by -harlequin- at 8:58 AM on August 13, 2007

I am a nervous sipper and can drink myself sick on whatever's available, from water to wine, so I sympathize. Keeping my hands busy helps (and keeps me from chain-smoking), but looks dorky or is inappropriate for dates or professional situations, though I use big fat pens at work so I can death-grip without breaking them.

The best thing I can do is drink something I don't really like (club soda, for example, which tastes like salted metal to me) to slow me down. I often have to all-or-nothing it, though, because if I'm switching back and forth my discipline slips after the second round of wine and club soda. Chewing gum isn't exactly classy, but I loathe the texture of gum that's been touched by any beverage, so that'll work for a bit too.

Just beware caffeine. I've jittered myself up too much to drive before.
posted by Lyn Never at 10:18 AM on August 13, 2007

You know what might help you to interact freely and stop overanalyzing? Taking an improv class. I just took one on a lark, and that's exactly what a lot of it's about.

If you happen to be in the Seattle area, you can check out my teacher, Roberta Maguire. She is beyond fabulous.
posted by palmcorder_yajna at 11:21 AM on August 13, 2007

Smoking pot will increase your risk of psychosis.

Not really. Well, it might do, but probably no more so than alcohol (which, I read somewhere, increases your risk of psychosis by about 800%.. can't find the cite now though).

Similar correlations are found with other drugs, including tobacco; funnily enough, people with mental illnesses tend to self-medicate. I know I did, and my vaguely correlated mental status change involved a lifting of depression and social anxiety.

(We, of course, understand what correlation doesn't imply :)
posted by Freaky at 12:10 PM on August 13, 2007

when i was concerned about how much i was drinking, i used this site: Down Your Drink. it provides a series of exercises that you can work through to help understand what is happening. and it's pretty neutral - not judgemental.

i found it helped me understand better the issues involved and, as a consequence, i actually drink slightly less (although my conclusion was that my drinking wasn't a problem i took on board the idea of having more "alcohol free" days).

ps. the one drawback was that they kept sending me emails asking me to do follow-up surveys, but they now have an opt-out system (i complained...) so that shouldn't be an issue any more.
posted by andrew cooke at 12:55 PM on August 13, 2007

It's difficult to know whether you are just getting a little tipsy 3 times a month, or are truly binge drinking. Binge drinking has no agreed on definition, but a useful guideline is that 25+ units for men or 18+ units for women in a single session constitutes binge drinking.

Just FYI, this is factually untrue. There is no consensus definition of binge drinking, but the numbers from your wiki article are well over anything I've ever heard of, as well as well over anything reported at the BMA website.

Of note, in the US, the most common definition of binge drinking would only requre 4 alcoholic beverages for a woman in one session.
posted by drpynchon at 6:11 PM on August 13, 2007

drpynchon: "4 alcoholic beverages" as typically poured is still 8+ units. If Wikipedia is wrong on the matter of threshold, you're free to change it.

"4 alcoholic beverages", in the UK where binge drinking is raised to an art form, still only constitutes a quiet night in.
posted by methylsalicylate at 1:41 AM on August 14, 2007