Apr 29, 2014

Interview Transcript

Interviewer: Sixty-six percent of Americans say they occasionally drink, and that number is increasing. Are we drinking too much, too little, just the right amount? How does this all affect your mental health? That's coming up next on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: We're here with Dr. Jason Hunziker, psychiatrist at the University of Utah Hospital. Dr. Hunziker, the first question is mental health and alcohol addiction. Is there a connection between the two?

Dr. Jason Hunziker: Clearly. There's clearly a connection. Unfortunately, it's a complex connection, and there are several different theories on how this happens. Is it the alcohol changing neurotransmitters in you brain that causes the mental health? Were you already depressed and anxious, so you started drinking as a way to fix your anxiety and your depression? Did the alcohol and the depression start at the same time? Is it mixed that way? It's really hard to know in most people which came first and what the connection is, but we do know that mixing the two is not healthy for you.

Interviewer: What do you mean by mixing the two?

Dr. Jason Hunziker: If you're depressed, you're already putting yourself in a position, particularly if you're not getting treatment, that you have a hard time taking care of yourself. Getting out of bed is a struggle, trying to get to work, and if you have kids, taking care of your children, it's very difficult.
Then, you throw alcohol on top of that which is in and of itself a central nervous system depressant. The alcohol actually makes you more depressed. It makes it harder for you to function. You lose time at work. You have marital problems, relationship issues with your children. It can lead to more trouble taking care of yourself and lead to childhood abuse and neglect.

Interviewer: It's almost like the chicken and the egg thing. You don't really know if it's a mental thing first or if it's an addiction first, right?

Dr. Jason Hunziker: That's correct. It's really hard to know for a lot of people, and when we evaluate people who come in with alcohol and mood disorder we have to take some time to figure out were they already depressed first or did the alcohol come first and that's what caused the depression.

Interviewer: Is that important in the treatment, to know which one came first?

Dr. Jason Hunziker: It's definitely important in the way we diagnose the illness. Often, we don't diagnose depression or anxiety if we feel like the alcohol was the direct cause of that. Often, what we see is people have been depressed unknowingly for a long time and then picked up the alcohol as a way to kind of medicate that, and it didn't work.

Interviewer: I mentioned earlier that we both talked about how alcohol has become such a normal part in American society, American life. It's like a part of your day. Is that normal? Is that healthy? What's going on there?

Dr. Jason Hunziker: Again, healthy, probably not...

Interviewer: Not even the red wine?

Dr. Jason Hunziker: There is some evidence that red wine can be healthy if you drink it in the five ounce or less per night and that's all you have. The problem with most people is...

Interviewer: That's not all they have.

Dr. Jason Hunziker: ...that's not all they have. In fact, a study that came out recently from the CDC shows that 38 million Americans say they drink too much.

Interviewer: Really, they admit that?

Dr. Jason Hunziker: They admit it, and these are people who aren't considered alcohol dependent.

Interviewer: How do you treat that? Can you treat it, or is it classified as a mental illness at that point?

Dr. Jason Hunziker: It is, and in the new DSM-V it's called the substance use disorder.

Interviewer: Okay.

Dr. Jason Hunziker: Yes, there is treatment for it. First and foremost, you need to make sure if you've been drinking too much that you talk to your medical doctor. Alcohol detoxification can be tricky and at times deadly and needs to be monitored closely just to get you through that initial phase of getting the alcohol out of your body.
The detox part, believe it or not, is the easy part to this process. Staying off of alcohol is when it becomes very difficult, because if you go back and drink one drink it is never enough for you and you will start drinking again and again and again. Then, it leads to all those problems that brought you in in the first place.
We do have treatment. There are inpatient programs where you can go stay for 30 to 90 days, learn all about addiction, learn what to watch for, make sure that you stay sober. There's AA, which is free meetings all over the town. Every hour somewhere there's a meeting with great support system to help you stay sober. There's intensive outpatient programs that are available for people to go to which are four days a week at night time when most people are drinking, so it keeps people from using alcohol.
The reason alcohol is so important is that it doesn't just affect your life.

Interviewer: Right.

Dr. Jason Hunziker: It can affect everyone around you. When you're addicted to alcohol often you do drink by yourself, because you don't want people to see how much you're drinking. You'll start drinking at work. You'll drink in your car. You'll drink while you go grocery shopping. You'll drink Listerine and mouthwash and Nyquil just to get the alcohol out of it?

Interviewer: Really? Oh, so it's...

Dr. Jason Hunziker: It leads to all kinds of medical complications.

Interviewer: What are some of those medical complications that you just mentioned?

Dr. Jason Hunziker: Some of the medical complications can be liver failure.

Interviewer: Of course.

Dr. Jason Hunziker: Alcohol can also lead to hypertension. It can lead to problems with respiratory drive and respiration. Then, of course, the family issues that come from alcohol can be devastating. You're causing yourself issues, the depression, the anxiety. That can bleed over as anger and frustration to your significant other and your children, which then gets perpetrated later again in life by your kids.

Interviewer: Any final thoughts?

Dr. Jason Hunziker: I think that if you or someone you know or love or care about you think has an alcohol problem, please approach them about that. Tell them why you're concerned and what the concern is. Get them to their doctor where they can get some more resources. There are plenty of things online that you can pull up and say hey, this is where I can go get treatment.
If nothing else, go to an AA meeting. They're everywhere all the time. Everybody has an hour that they can go sit. Even if you're intoxicated, go sit in the meeting and hear what these people say about sobriety and how they can help you get sober so you can improve your life and the life of everyone around you.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.


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