Opinion: We can learn much from the accounts of people who have survived attempts to kill themselves
There has been much debate and discussion in Ireland recently about intoxicating substances and our relationship with them. In the past few days attention has centred on cannabis but in previous weeks the focus was very much on our nation’s favourite drug: alcohol. Even during the debate on cannabis, alcohol was never far from the discussion. The pro-cannabis lobby groups were keen to tell us that their drug wasn’t really any worse than our legal drug.
I am unsure about their strategy of drawing links to drink at a time when our society appears to be on the cusp of facing up to the huge damage that alcohol inflicts upon us. It would be a bit like someone coming up to your house at your party and asking to be let in by arguing that they were not quite as bad as the roaring, violent, window-smashing nutcase you let in earlier.
Like most western societies, we have sought to regulate the alcohol market. Recent history has taught us that regulation, in a general sense, is not one of our talents here in Ireland. Certainly our generation has failed rather miserably in its efforts to keep alcohol out of the hands of children. The age of first drinking has crept downwards in the past few decades, with the average child now drinking at about 14 or 15 years of age.
There is now good evidence that people who start to drink alcohol in mid-adolescence are at increased risk of alcohol dependence when they reach adulthood.
From the recent My World survey of young people aged 12-24 years we know that drinking patterns among our youth are very concerning. That survey reported that half of all Leaving Cert students were drinking in a problematic manner. By the early 20s the proportion with problem drinking was more than 60 per cent.
The survey also confirmed the link between drinking and mental health problems. The more young people drink, the more likely they are to have anxiety and depression symptoms.
Last month, an Irish government accepted for the first time in recent history that something needed to be done about our drink problem. The Government outlined a range of measures intended to reduce the carnage from its current level of about 1,100 deaths a year.
The alcohol-related deaths among our youth are particularly tragic. These deaths fall into two broad categories.
First there are the drunken incidents in which people take risks driving, swimming, climbing or crossing roads. The reluctance of journalists to report the role of alcohol in individual deaths is particularly unfortunate as it conceals from the public the extent and frequency of these avoidable catastrophes.
The second major group of alcohol- related deaths in our youth is suicides. The majority of young men who take their own lives are intoxicated at the time. While we may choose to believe that people take alcohol in order to complete the act of suicide this is rarely the case.
Many of these young men and women have no history of suicidal behaviour. While we cannot know what exactly is going on in the mind of someone who completes suicide, we can at least learn from those who survive serious attempts. As I psychiatrist I have met many such people.
The typical sequence of events goes as follows. You are in bad form for whatever reason, often to do with relationships. You decide to have a few drinks to help you forget about it, as our culture encourages you to do. It doesn’t work.
You think about it even more. You do or say something, perhaps in an effort to sort out the relationship problem; but you are drunk, so it doesn’t work out so well. You feel worse. You decide to drink some more.
As you get more drunk the future is foreshortened. You are impulsive and have greater difficulty thinking of solutions. Life seems suddenly impossible and unbearable. Suicide begins to look like a solution and in your disinhibited, disorientated state you act on it.
Too many of us use alcohol to deal with tough times. At the end of a difficult week, or following some disappointment, how often do we say to ourselves: “I’ll feel better after a few drinks”?
We sometimes advise our friends and loved ones to use alcohol to cope with tough times. Many parents will casually say “I’ve had such a stressful day, I need a drink” as they open a bottle of wine in front of their nine-year-old. What the child is then learning is that wine is the way to deal with feelings of stress. And so the cycle continues.
A strange drug
Alcohol is a strange drug. It can sometimes help us forget, albeit just for a few hours. Very few of us end up feeling suicidal but many of us end up feeling psychologically worse.
We may attempt to drown our sorrows but, as the Mexican painter Frida Kahlo observed 70 years ago, when trying to do this “the bastards learned how to swim”. Her words are poignant as she died, after decades of alcohol abuse and emotional problems, in an apparent suicide. Nevertheless, she was probably underestimating the futility of this activity. In reality, alcohol probably teaches your sorrows how to swim. There are other ways of dealing with tough times. Turning to drink only hampers our ability to find them.