Obesity, ADD, Alcoholism, are they really diseases

[Yahweh]

I dont believe Obesity is disease. One in three Americans is 20 or more pounds overweight (obese)... it just sounds like a few people just have poor diet and little or no exercise. I dont believe that 1 in 3 Americans who eat just as much food as the rest of Americans have some kind of metabolism defect that causes them to keep gaining weight. Yes, its true that there may be a few people who legitimately have a metabolism or thyroid disease but they represent a tiny percentage of the population... 33% is quite a bit. And never again do I want to here the lame cliche excuse "I eat because I'm depressed, and I'm depressed because I eat, and that creates an oh so vicious cycle of fattening."

ADD and ADHT. I remember a few years back when half the kids in the country were hooked on Ritalin. Unless there was some kind of mass misdiagnosis, there is no way every diagnosed one of them had this mysterious disease. What ever happened to being giddy (as I'm sure is common for most children). I've met kids from the SPED department who do have actual "anti-authority" and diseases that turn them into "freaking spazzoids" (thats a politically correct term I learned from a female assistant for the SPED teacher) and the ritalin doesnt help. It seems to me that ADD is some kind of "diagnoses all ailments" disease. I'm sure when ADD and ADHT stop becoming so rampant, we'll find a new disease to take their place.

Alcoholism. Yes, it is a disease and it is hereditary. A good 4 out of 5 teenagers in America (yet another of my guesstimations) dont know how its a disease and thereby believe it is a made up disease to explain someone's bad behavior. Its a disease because people who are alcoholics (about 1 in 10 people who regularly use alcohol... thats not a guesstimation) lack a chemical in the brain involved in impulse control (or the ability to know when to say "stop"). I know this because I researched it on my own, and it was also in a recent issue of Discover Magazine (or Scientific American... cant remember) where there were tests performed that involved putting a water bottle filled with alcohol on the side of a cage and getting monkeys drunk. Aside from the satirical value of those expirments, it showed monkeys that lacked impulse control chemical were staggaringly more likely to develope alcoholism.

Depression. Yes, I believe its a disease but its very rare that I'll be convinced of the validity of a non-lifethreatening or extremely common disease described as "its symptoms are known but its causes are unknown".

SIDS. I believe that is another one of those diseases that you should question. Healthy babies just dont up and keel over for no reason. To me, I believe that SIDS is explained by 1 of 3 causes: 1. The parents killed the child and they got away with murder because theyre lucky rotten bastards. 2. The child had an asthma attack or allergic reacation. 3. The child fell asleep face down on a thick blanket or pillow (hey, my wife says her coworker's 10 year old child and 1 year old infant have both been hospitalized for that same thing... good thing this coworker invests in those baby monitoring devices).

A final note: I hate when people say "My brother has ADD" or "My daughter was diagnosed with ADHD"... those dont tend to be the strongest arguements. Arguements and defenses like that have no value.

[AmateurScientist]

People used to dismiss depression as mere laziness. Many still do. To chronic sufferers, however, it is very real. Also, it kills. Depression is far more fatal than a typical cold, yet few have a problem recognizing a cold as a real illness.

A century ago it was called "melancholia" somewhat mockingly.

I wouldn't be so quick to dismiss them.

AS

[Larspeart]

No

No

and No

They are not 'diseases' in ANY sense of the word that I can think of. Find me a fat virus, or an alcohol bacteria, and I'll believe it.

[SteveGrenard]

This would depend on the definition of the word disease which implies any situation or condition making one ill at ease or dis ease as well as any condition or tendency regarded as abnormal or harmful and consisting of an identrifiable group of signs and symptoms. Here's a dictionary entry:

A pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms.

A condition or tendency, as regarded as abnormal and
harmful.

Obsolete Lack of ease; trouble.


--------------------------------------------------------------------------------
[Middle English disese, from Old French : des-, dis- + aise, ease ; see ease.]

[MartinGibbs]

My personal stance is that they are not diseases.

People CHOOSE to drink, they aren't forced into it by some unseen hand. Sure, they're mind can be quite convincing and get them to use, but they PICK UP THE BOTTLE and DRINK!!!!!!!

Sorry, we have to be responsible for our actions at some point.

I got fat because I ate more calories than I burned.

So...I ate less and exercised more, and guess what--I lost weight.

My cynical view on depression is that it's just a feeble attempt at bringing attention on oneself, but I know that's an irrational idea, but at least I know that it's an irrational idea.

Will I change it? Probably

[†= Crap!]

Originally posted by Larspeart
No

No

and No

They are not 'diseases' in ANY sense of the word that I can think of. Find me a fat virus, or an alcohol bacteria, and I'll believe it.

dis·ease [ di zz ] (plural dis·eases)
noun

1. medicine medical condition in humans: a condition that results in medically significant symptoms in a human


2. botany veterinary medicine medical condition in plants or animals: a condition in plants or animals that causes medically significant symptoms


3. specific disorder: a disorder with recognizable signs and often having a known cause


4. problem in society: a serious problem in society or with a particular group of people

They sound like they can fit under the difinition of disease to me

[specious_reasons]

Is the debate "are they real" or "should they be called diseases"?

I can't speak for all the things you mentioned, but ADD can be a real disorder. An interesting thing about this disorder: Ritalin is speed. Well, not exactly, but it is a stimulant.

One of the indicators that your child does have ADD is that the stimulant has a profound calming effect.

SIDS: I thought that there was a dominant theory for SIDS, and it had to do with your body's ability to recognize a lack of oxygen.

From the telling I heard, when you sleep, if you are not getting enough oxygen, you wake up or readjust your position. For SIDS, it is thought that either the infant can't move (because it's too young or too asleep), or because the infant's ability to detect a lack of oxygen and respond.

[aggle_rithm]

Originally posted by Yahweh

A final note: I hate when people say "My brother has ADD" or "My daughter was diagnosed with ADHD"... those dont tend to be the strongest arguements. Arguements and defenses like that have no value.

I was diagnosed with ADD at the age of 35. One of the persistent myths about this disorder is that it only affects children. The reason this was believed for a long time is that people with ADD seemed to function OK once they got out of school. However, the problem is that these adults only functioned well because they were able to get jobs that did not require them to focus on one thing for hours at a time, like school children did. These jobs, unfortunately, tend to be low-paying, low-status gigs.

By the time I was diagnosed, I had dropped out of college three times, and had worked in restaurants for ten years. I was working on a loading dock at the time of my diagnosis in 1998. My doctor gave me medication for it and recommended some books on how to deal with the disorder.

In 2001 I completed my Associate's degree in computer information systems, and this year I completed my Bachelor's in computer science, graduating Magna Cum Laude. I have been working as a programmer since 2000.

You can say ADD is not a disease if you want, but it's difficult to argue with success.

[aggle_rithm]

Originally posted by specious_reasons


I can't speak for all the things you mentioned, but ADD can be a real disorder. An interesting thing about this disorder: Ritalin is speed. Well, not exactly, but it is a stimulant.

One of the indicators that your child does have ADD is that the stimulant has a profound calming effect.




For years I wondered why Sudafed, which has a mild stimulant, made me feel sort of drowsy. It was the ADD.

[Dymanic]

We all have to struggle for self-control at times. We tend to be hard on ourselves when we fail to do that successfully, and we tend to be hard on others when they appear to have failed at this. We want to feel that we can, by our own efforts, overcome our weaknesses. There is a disturbing finality in declaring a lack of control to be the result of a 'disease'.

I think the term 'disease' is subject to abuse when applied to conditions that affect behavior, and I think it is abused. Because it is abused, we may tend to make it the default assumption that anyone claiming to be suffering from a 'disease' is just a person who needs to develop more self-control.

This does not mean that there are not conditions which so affect the ability to make choices that they deserve to be called diseases; just that such a diagnosis is prone to error -- in both directions.

Somebody gets Parkinsons or MS, it's not their fault -- that's pretty clear cut. But when a person feels tired, we don't like to hear them whine about it; we all feel tired sometimes; 'Chronic Fatigue Syndrome' sounds like an excuse. Slogging through boring details always requires effort, and can be uncomfortable. 'Attention Deficit Disorder' sounds like an excuse. For a person whose problem is that they simply need to develop more discipline, catching one of these labels could be quite damaging if it prevented them from making the necessary effort.

But some of us may have built-in limitations to our ability to exercise control in certain areas, and failing to recognize that can lead to much misery.

A person who is not an alcoholic can go to a party, go to a bar, and have a couple of drinks -- secure in the knowledge that when the time comes to go home, he can choose to do that. He is protected by his self-control. For the alcoholic, self-control ceases with the first drink; if he counts on being able to exercise self-control where he actually has none, he will place himself at risk -- he may wake up a week later in a motel room in a strange city. On the next occasion, he will redouble his efforts to maintain control -- drinking beer only, never drinking in the morning, etc, -- this process often goes on for years. Many alcoholics reach a point where they are fully aware (after many such attempts) that they have no control whatsoever over their drinking, and hopelessly resign themselves to lives driven by alcohol. Their misery is compounded by the feeling of utter failure at self-control.

It is possible, however, to compensate for such conditions, but this happens only once one has abandoned as hopeless all efforts to overcome the problem through greater efforts at self-control.

A man's got to know his limitations.

[AmateurScientist]

Originally posted by MartinGibbs
My personal stance is that they are not diseases.

People CHOOSE to drink, they aren't forced into it by some unseen hand. Sure, they're mind can be quite convincing and get them to use, but they PICK UP THE BOTTLE and DRINK!!!!!!!

Sorry, we have to be responsible for our actions at some point.

I got fat because I ate more calories than I burned.

So...I ate less and exercised more, and guess what--I lost weight.

My cynical view on depression is that it's just a feeble attempt at bringing attention on oneself, but I know that's an irrational idea, but at least I know that it's an irrational idea.

Will I change it? Probably

Your views are common, but recent efforts at getting at the roots of some of these problems challenge your views.

For instance, there is plenty of evidence that depression is not mere self-pity or attention mongering. Many of those who are chronic sufferers shun attention altogether and go to great lengths to hide their depression from others. That certainly doesn't fit your model of attention seeking. For example, Abe Lincoln and Winston Churchill were both depressives for their entire adult lives. They had more attention given them due to their respective positions than just about anyone else in the world. What possible motivation could they have for faking depression? That's just not very critical or thoughtful to dismiss them.

Is cystic fibrosis a disease? It isn't caused by any pathogen. It's a genetic disorder. It is 100% fatal and causes its sufferers and their families tremendous suffering and pain.

AS

[Ladyhawk]

Originally posted by AmateurScientist


For instance, there is plenty of evidence that depression is not mere self-pity or attention mongering. Many of those who are chronic sufferers shun attention altogether and go to great lengths to hide their depression from others.
AS

How true, AS, how true! I know co-workers, relatives and friends who have suffered from either depression, manic depression ( I know, the PC term now is "bi-polar disorder....) and anxiety attacks. Now, I was the first to think anxiety attacks were the lamest excuse I ever heard for attention. But, I learned through a relative, up-close and personal, how terrible it can be! I have personally suffered through a severe depressive episode (years ago) and have learned that getting back to center wasn't as easy a process as some (myself included) thought it was...

I've also know bi-polar individuals who struggle still , even with medication. But, you're absolutely right when you say that most people suffering from depression try very hard to hide it. They typically don't get involved in social functions, making every excuse to avoid them...they don't go out a great deal and tend to just hide from the world. That's why it's such a difficult condition to detect. You just can't spot the people who suffer from depression. Worse, the ones who are suffering with it usually don't know it, either....or are terrified to consider it...

[MartinGibbs]

I'm misguided in my opinions, it seems. Thanks for the information and advice--old biases die hard sometimes.

My pre-conceived notion of a depressed person is most certaintly skewed; those who seriously try to hide it didn't fit into my window probably because they were doing well at masking it.

Much like a "closet alcoholic"


Unfortunately, my views were based on the people I know, thus anectdotal by nature and not a fair sample.

Therefore I apologize for my sweeping generalizations and will try to examine folks on a one-to-one basis.

[jj]

Originally posted by aggle_rithm

You can say ADD is not a disease if you want, but it's difficult to argue with success.

Or coffee. (Note lack of smiley.)

[jj]

Originally posted by Dymanic
A person who is not an alcoholic can go to a party, go to a bar, and have a couple of drinks -- secure in the knowledge that when the time comes to go home, he can choose to do that. He is protected by his self-control. For the alcoholic, self-control ceases with the first drink; if he counts on being able to exercise self-control where he actually has none, he will place himself at risk -- he may wake up a week later in a motel room in a strange city.

Well, I agree that some people have a pathological reaction to alcohol.

However, I've also seen alcoholism segmented into "social" vs. "chemical" alcoholics, and I've known people who fit both profiles exactly, and none who seemed to be in the middle.

You're describing the chemical alcoholic. The effect of alcohol is incapacitating in some subtle way, and judgement is gone.

The social alcoholic doesn't have that problem, but will usually continue to drink due to social pressure, learning, etc.

I've long ago lost the article, but there have been some enzyme and genetic markers demonstrated for some subset of chemical alcoholics.

BUT

I agree, if somebody has trouble with alcohol JUST DO NOT DRINK IT. It doesn't matter WHY you have trouble, if you do, don't. If it's bad for you, don't do it.

(Same applies to Big Macs, but I quite honestly can't figure out how anyone can choke them down anyhow. At least "two buck Chuck" has some aesthetic appeal. ;) ) (for those of you near a trader Joe's who like red wine, ask them about "two buck chuck"...)

[EvilYeti]

Phew, lot of topics for one post! I'll take 'em one at a time.

Obesity:

Could be considered a lifestyle "disease", but other that that, no. Its a side-effect of eating too much without exercising. If it really was a disease, then there should be millions of obese folks in America that eat moderate diets and exercise regularly. I'm still looking for one example!

ADD and ADHD:

I dunno. Probably a real disease in some cases but misdiagnosed in most. My brother is diagnosed with it and I would probably be as well if I bothered to get tested. I think much of it is a lifestyle problem, too much sugar and not enough exercise makes kids hyper. I know I can focus MUCH better after a couple miles of mountain biking. I think ADD/ADHD kids should be put on a diet and given several opportunities a day to exercise, before restorting to drugs.

Alcoholism

Again, a lifestyle choice in most cases, not a disease. Its important to note that people who have become chemically dependent on alcohol are not born that way, in reality they've damaged their metabolism through chronic excess drinking. So in this case we have a disease caused by a long string of poor decision making.
I'm skeptical of the assertion that some people lose all self control after one or two drinks. What if I offered these folks a million dollars to drink three beers, then stop? None of them would be able to do it?

Depression

Depends. If someone is depressed about about something specific in their life (a job, relationships, etc) then I would say it's psychological problem and needs to be addressed as such.
People that are just depressed in general, however, are suffering from a real condition. That type of depression can often be a side-effect of other lifestyle choices, such as poor diet and lack of exercise as well, so I would always encourage folks to try living healthier before downing some prozac. Expecting meds to fixing depression by themselves is like putting a band-aid over a bullet hole.

SIDS

Such a broad term its hard to say. In some cases I'm sure its a health problem with baby, in others it could be due to physical trauma or suffocation. The phenomenon is definately real.

[Dymanic]

Originally posted by EvilYeti

people who have become chemically dependent on alcohol are not born that way,
I think there is emerging evidence that we are not all created equal with regard to the way we handle alcohol.
in reality they've damaged their metabolism through chronic excess drinking.
I have a little trouble following the logic that says that alcoholism (defined as excessive drinking) is caused by drinking to excess.

The terms 'chronic' and 'excess' are relative anyway; one person's 'occasional' may be another's 'chronic', and one person's 'moderate' another's 'excessive'.
So in this case we have a disease caused by a long string of poor decision making.
I think poor decision making is both cause and effect.
I'm skeptical of the assertion that some people lose all self control after one or two drinks. What if I offered these folks a million dollars to drink three beers, then stop? None of them would be able to do it?
Many alcoholics have performed precisely this experiment with the prize being something they valued even more than money: proof that they were not alcoholics. Such proof brings great relief to an alcoholic, because the thought of life without alcohol is unbearable. The tough question is how long to wait before declaring the experiment a success.

I would be less surprised to see an alcoholic fail this test than I imagine you would. Many have tried and failed when the stakes were arguably higher than the million dollars you have proposed.

[RichardR]

Originally posted by Dymanic
For the alcoholic, self-control ceases with the first drink; if he counts on being able to exercise self-control where he actually has none, he will place himself at risk -- he may wake up a week later in a motel room in a strange city. He may not be able to exercise self-control, but it is still his conscious act of drinking that causes his problem. He does have a choice, even if he has trouble exercising that choice.

When I got pneumonia and strep together four years ago, I did not choose to consume the bacteria. I had no choice. IMO that is different.

That’s why, in spite whatever dictionary definition we can come up with, I find it hard to really accept alcoholism as a disease. I could be wrong.

[jj]

Originally posted by RichardR
He may not be able to exercise self-control, but it is still his conscious act of drinking that causes his problem. He does have a choice, even if he has trouble exercising that choice.

Some people react to mouthwash, cough syrup (I mean in normal doses, too), alcohol-born flavorings (not cooked or when the alcohol is evaporated), and the like.

It's not as much a choice as one might like.

When I got pneumonia and strep together four years ago, I did not choose to consume the bacteria. I had no choice. IMO that is different.

That’s why, in spite whatever dictionary definition we can come up with, I find it hard to really accept alcoholism as a disease. I could be wrong.

I think it's clear it's a disease, the argument appears to be about how self-inflicted it is.

[subgenius]

Its all molecular. Viruses are not the only things that cause disease.
To recognize that these are diseases is different than recognizing that the (only currently known) cure may be within onesself.

[subgenius]

Originally posted by Larspeart
No

No

and No

They are not 'diseases' in ANY sense of the word that I can think of. Find me a fat virus, or an alcohol bacteria, and I'll believe it.
I have a serious disease that is not caused by virus or bacteria.

[Dymanic]

Originally posted by RichardR

He may not be able to exercise self-control, but it is still his conscious act of drinking that causes his problem.
I disagree. I think the problem already existed. Alcohol, for an alcoholic, is a solution long before it becomes a problem.

He does have a choice, even if he has trouble exercising that choice.
I don't think we all do have the same degree of choice about everything. A person with ADD may not be able to choose to pay attention to the same degree as a person who is not afflicted. A person in the grip of severe depression may not be able to choose to simply "snap out of it".

When I got pneumonia and strep together four years ago, I did not choose to consume the bacteria. I had no choice. IMO that is different.
That’s why, in spite whatever dictionary definition we can come up with, I find it hard to really accept alcoholism as a disease.
I'm going to agree with that -- in part.

I don't think it is at all clear that behavioral disorders like alcoholism or manic depression are diseases with purely physical causes. The problem may be in trying to stretch the concept of 'disease' too far.

We can make distinctions between conditions that have different causes: pathogens, congenital defects, physical trauma, exposure to toxins. Any of these can produce effects that include behavioral or psycological problems, and tracing those problems to the source can be a fairly simple matter in such cases. But I don't think we know enough yet about the brain (in particular) to reach firm conclusions about the causes of some things, and one of the conclusions that I would consider hasty is that they are the result of a weakness of will.

[RichardR]

Originally posted by jj


I think it's clear it's a disease, the argument appears to be about how self-inflicted it is. Aren't they allergies? Surely alcoholics aren’t allergic to alcohol? They can take it, but they just don't know when to stop.

I don't see how it can be a disease if you can choose whether or not you are going to get sick.

[RichardR]

Originally posted by Dymanic
I disagree. I think the problem already existed. Alcohol, for an alcoholic, is a solution long before it becomes a problem. By “problem”, I meant getting drunk (beyond socially).

Originally posted by Dymanic
I don't think we all do have the same degree of choice about everything. A person with ADD may not be able to choose to pay attention to the same degree as a person who is not afflicted. A person in the grip of severe depression may not be able to choose to simply "snap out of it".I agree with those two. If depression is a result of a chemical imbalance in the brain, it is probably impossible for the sufferer to not be sick (to snap out of it, as you say). But an alcoholic has to make a decision to do something (drink and keep drinking), to be sick. They do have a choice. They say it is difficult. But it is a choice they can make.

That's the way it seems to me, anyway.

[subgenius]

Originally posted by RichardR
By “problem”, I meant getting drunk (beyond socially).

I agree with those two. If depression is a result of a chemical imbalance in the brain, it is probably impossible for the sufferer to not be sick (to snap out of it, as you say). But an alcoholic has to make a decision to do something (drink and keep drinking), to be sick. They do have a choice. They say it is difficult. But it is a choice they can make.

That's the way it seems to me, anyway.
Its more like whether someone with OCD "chooses" to wash their hands 50 times an hour.
It is possible to re-train the brain in both cases, but the rate of success for addictions anyway is not good.
The choice theory is a throwback to when these people were just considered immoral.
There is objective evidence of an addiction gene.

[Hellcat]

Obesity itself might not be a disease but there are medical conditions that cause it. Thyroid failure for one.

Depression is a disease a nasty one at that and one that people can't handle knowing you have so the sufferer hides it until they end up in a breakdown or psychosis. Or is it in our heads all down to our imaginations is it?

Alcoholism is real the addiction is the disease, one drink leads to another to cope with life, might seem pathetic to those who can hold there own but not everyone has that resolve.

It's fine standing on the outside throwing criticisms at those who are suffering. Try standing in a sufferers shoes for a while and see it from there point of view, then see if you can stand there on the outside again criticising?

Dyslexia is that too added to the it's it your head it doesn't exist do pull your socks up list too?

Hyperactivity ahd is real, it may not fit that nice niche of disease but it exists and it is neither pleasant to have it or experience it.


ME is a horrid illness, it's not laziness it deabiliting and is a medical condition that shows up on tests for it.

OCD can't be cured you have to be re-educated to cope with it.

[Dymanic]

Originally posted by RichardR

But an alcoholic has to make a decision to do something (drink and keep drinking), to be sick. They do have a choice.
For an alcoholic, drinking is about getting well. Unless the underlying issues that led him to self-medicating with alcohol are addressed, the choice he has is between being sick, or being sick and numb. As subgenius touched on, it's about retraining the brain.

Alcohol fits into the life of an alcoholic in a much different way than for a person who is not. Humans are not born equipped with coping skills like courage, confidence, and peace of mind; these are developed -- often with the benefit of painful experience. Such properties may remain forever invisible to neuroanatomical scrutiny, but it is a safe bet that they are reflective of brain states; one thing we do know is that responses to stimuli are formulated and refined through changes not only in brain chemistry, but, over time, through changes in actual brain structure.

For the alcoholic, the alcohol serves as a substitute for those coping skills; a shortcut past the painstaking process of gradual development. Take away the alcohol, and what you have is a brain that is wired to function in the presence of alcohol...without the alcohol. Even after years of sobriety, this is still the case to some degree, and not surprisingly; there is a marked decrease in neural plasticity with aging. The coping skills that must be developed in order for recovery to be successful will not be the same as those that might have developed had the person not come to depend so heavily on alcohol.

[subgenius]

Originally posted by Dymanic


Very nice analysis.

[asthmatic camel]

Depression and alcoholism are often linked. Many depressives use alcohol as self-medication which leads to alcoholism, most alcoholics end up with depression whether or not they suffered from it before they began drinking.

Are they diseases? I would say so. Neither the depressive nor the alcoholic is functioning normally and both have a hugely increased risk of suicide. Surely premature death is an indication of disease ?

[jj]

Originally posted by RichardR
Aren't they allergies? Surely alcoholics aren’t allergic to alcohol? They can take it, but they just don't know when to stop.

I don't see how it can be a disease if you can choose whether or not you are going to get sick.

There are two issues here.

First, if we accept that it's not a disease, we are perilously close to accepting some supra-physical definition of conciousness.

Second, you still can't seem to get around the fact that "choose" is not always applicable. Certainly, sometimes it is. ADD people do not (at least always, I won't argue that it's been a fad diagnosis some places) CHOOSE to be distractable. Dyslexics do not CHOOSE to get things backwards. Dysgraphics do not CHOOSE to write things backwards. Bipolars do not CHOOSE to have unstable brain chemistry. Autists do not CHOOSE not to relate to the world. People hypersensitive to cocaine do not CHOOSE to be hypersensitive (it's a chemical thing, like alcohol is with some people) but some DO choose to take it the first time, which for them causes quasi-permanant changes in brain chemistry that are pretty much catastrophic, so they choose to take the drug in the first place, but they don't choose to have the biochemestry that is hypersensitive. (This is in fact why I think taking drugs is dumb, dumb, dumb, too. You have no idea, until you try, if you're a hypersensitive person. If you are, you're @%#$@# afterwards.)

This is aside from the fact that concentration and mental effort may at least sometimes be the best solution to some, although not all, of the afflictions.

[jj]

Originally posted by RichardR
But an alcoholic has to make a decision to do something (drink and keep drinking), to be sick.

You are ignoring what people are telling you. Some alcoholics, at least, do NOT have the choice to "keep drinking" once they've encountered even minescule quantities of alcohol, even in unexpected places.

And some do. Life is like that.

In my limited experience, the people who don't have a choice often make the best recovery, ONCE THEY UNDERSTAND THAT FACT and learn all the places that alcohol shows up that those of us who don't have the particular problem don't even notice.

I suppose you could argue that for those that it is a choice, part of the problem is that they will make that choice... But that gets back into the origin of conciousness.

The reason, of course, only marginally addresses treatment, since the treatment is to just DO NOT DO THAT in nearly all cases.

[AmateurScientist]

Originally posted by MartinGibbs
I'm misguided in my opinions, it seems. Thanks for the information and advice--old biases die hard sometimes.


It's OK to be misguided sometimes, Martin. Thanks for having the courage and honesty to admit you may be wrong about it. That's a mature and big admission.


My pre-conceived notion of a depressed person is most certaintly skewed; those who seriously try to hide it didn't fit into my window probably because they were doing well at masking it.

Much like a "closet alcoholic"


That's a very insightful and apt analogy. I think chronic depressives and alcoholics, even to the extent those groups do not overlap, have a lot of behaviors and effects caused by the stigmas attached in common. One of them is the hiding their condition from others due to shame and stigma.



Unfortunately, my views were based on the people I know, thus anectdotal by nature and not a fair sample.

Therefore I apologize for my sweeping generalizations and will try to examine folks on a one-to-one basis.

That's cool. Thanks for being understanding.

AS

[AmateurScientist]

Originally posted by asthmatic camel
Depression and alcoholism are often linked. Many depressives use alcohol as self-medication which leads to alcoholism, most alcoholics end up with depression whether or not they suffered from it before they began drinking.

Are they diseases? I would say so. Neither the depressive nor the alcoholic is functioning normally and both have a hugely increased risk of suicide. Surely premature death is an indication of disease ?

Yes, depression and alcoholism are clearly not mutually exclusive, but it is also true that one does not necessarily lead to the other.

Not all depressives who use alcohol or drugs as self-medication become alcoholics or drug addicts. Similarly, not alcoholics who become depressed are chronic depressives.

It is becoming clearer, however, that both chronic alcoholism and chronic depression can cause physical changes within the brain over time which reinforce the diseases themselves. That is to say that the brains of chronic sufferers of either illness usually look different from the brains of otherwise "normal" people.

It's a double whammy.

AS

[RichardR]

Originally posted by jj
Some alcoholics, at least, do NOT have the choice to "keep drinking" once they've encountered even minescule quantities of alcohol, even in unexpected places.Are you saying they can not physically prevent themselves from taking a drink in the same way I couldn’t physically prevent myself from breathing in the pneumonia bacterium?

[AmateurScientist]

Originally posted by RichardR
Are you saying they can not physically prevent themselves from taking a drink in the same way I couldn’t physically prevent myself from breathing in the pneumonia bacterium?

Well, it can become a compulsion as strong as any. Once someone becomes addicted to a substance, the compulsion to get it and ingest it can be much stronger than the hunger for food, the need for sleep, or even the instinct to care for one's kids.

In such a case, physical prevention is irrelevant. The brain's capacity to obssess over something is far greater than any physical considerations.
as

[asthmatic camel]

Originally posted by AmateurScientist


Yes, depression and alcoholism are clearly not mutually exclusive, but it is also true that one does not necessarily lead to the other.

Not all depressives who use alcohol or drugs as self-medication become alcoholics or drug addicts. Similarly, not alcoholics who become depressed are chronic depressives.

It is becoming clearer, however, that both chronic alcoholism and chronic depression can cause physical changes within the brain over time which reinforce the diseases themselves. That is to say that the brains of chronic sufferers of either illness usually look different from the brains of otherwise "normal" people.

It's a double whammy.

AS


AS I didn't say that the two conditions are inextricably linked, merely that they often are. The question we should ask is why people become depressed and why people become alcoholics/drug addicts.

I doubt that anyone starts out in life with the intention of becoming a drunk, junkie or depressive.

Anyone out there have any ideas about why they do ?

[jj]

Originally posted by RichardR
Are you saying they can not physically prevent themselves from taking a drink in the same way I couldn’t physically prevent myself from breathing in the pneumonia bacterium?

Why is your question germane? The proper question is: Could they stop their genetic makup from being the way it is the same way ....

I think you're being obtuse on purpose.

I am amazed that we still see the results of the old puritan fertilizer hanging around like we see here, with the "it's all their fault" logic.

Sometimes it IS, of course, and sometimes it's not.

Your implication about chemically dependent alcoholics could just as well be extended to bipolar people. Do you want to do that?

[RSLancastr]

Yah:

I know nothing about ADD, but you seem to be inconsistent with your positions on alcoholism and obesity.

I can see someone viewing BOTH as a disease. I can also see someone viewing NEITHER as a disease.

You're splitting your vote, and I'm not clear as to why.

Originally posted by Yahweh
And never again do I want to here the lame cliche excuse "I eat because I'm depressed, and I'm depressed because I eat, and that creates an oh so vicious cycle of fattening."Something can be a cliche, and still be very true.

It is a cycle which holds true for lots and lots of people, Yah. This doesn't mean it is an excuse, nor does it mean that the cycle can't be broken.

Alcoholism. ...snip... Its a disease because people who are alcoholics ...snip... lack a chemical in the brain involved in impulse control (or the ability to know when to say "stop").And you think that overeating has nothing to do with impulse control (or the ability to know when to say "stop")?

There are some dogs (and cats) who will simply eat what they need, and no more. You could fill a huge food dish for them, and they will make it last for days.

There are other dogs and cats who, if you filled a huge food dish, would gorge themselves until they can hardly waddle away. Some will even eat until they vomit, then go back and eat some more.

Why is this?

Are the pets in the first group somehow morally superior to those in the second group? More "strong-willed?"

Or are some animals (icluding some humans) with some genetic predisposition to overeating? Whether it is because of laack of "impulse control", or because their body doesn't produce (or react to) the "I'm Full" signal?

[Dymanic]

Originally posted by RichardR

Are you saying they can not physically prevent themselves from taking a drink in the same way I couldn’t physically prevent myself from breathing in the pneumonia bacterium?
I would say that they can not physically prevent themselves from taking a drink in the same way you couldn’t physically prevent yourself from breathing period.

Of course, I would be exaggerating. But it may help to illustrate how powerful the obsession can be. As AP pointed out, an alcoholic will make booze his first priority -- over food, sex, sleep, safety, family, truth, ...whatever.

I concede that being able to have a few drinks under appropriate circumstances and then quit at the appropriate time is not an absolutely impossible thing for an alcoholic to do. The trick is consistency. There are not many alcoholics who lose a job, wreck a car, or go to jail every time they drink. But in dodging cars on the freeway, a 99% success rate produces essentially the same result as a 1% success rate.

You are right, of course -- there is a choice. But the choice exists for the alcoholic only once he realizes that it exists (many reach a point, after many attempts to quit, where they abandon further attempts as hopeless) and it exists only once he realizes what the choice is -- to not drink at all (rather than through some method of proper management, to drink successfully as others do) and to do the work necessary to develop an entirely new approach to life. It includes facing life (often, the wreckage of a ruined life) without coping skills, (and without chemical substitutes for coping skills) having little recourse but to stand like a jackass in a hailstorm and take it -- something alcoholics are usually not particulary good at.

[jj]

Originally posted by Dymanic
I concede that being able to have a few drinks under appropriate circumstances and then quit at the appropriate time is not an absolutely impossible thing for an alcoholic to do.

May I please point out that the above statement depends entirely on the particular alcoholic and the nature of his/her addiction?

[Dancing David]

Depression. Yes, I believe its a disease but its very rare that I'll be convinced of the validity of a non-lifethreatening or extremely common disease described as "its symptoms are known but its causes are unknown".

--------------------------------------

This is the common mth of mental illness, you need to do your research a little better, there are two major nuero-chemical systems in depression serotonin and dopamine, there are probably other neurotransmiters as well.

I make an invitation to you , please live my life when I don't have my medicine, I'd be very glad for you to take the irratibilty, the flooding, the insomnia and the obsessive compulsions off my hands.


The ADD is over diagnosed but still a real thing, especialy if you have adult friends with ADD.

They are all biopsychosocial illnesses.

On obesity, in the ancestors in my past it was beneficial that nay extra calories I carry turn to body fat, makes it easy to gain weight.

[Dancing David]

Originally posted by Larspeart

They are not 'diseases' in ANY sense of the word that I can think of. Find me a fat virus, or an alcohol bacteria, and I'll believe it.
There are two types of people with alcohol problems and type two is your classic alcoholic, it is not a disease so much as a biological vulnerabilty or predisposition to alcohol. Do some research, it ain't an illness but it has a biological basis in some people.

[Dancing David]

BIO-PSYCHO-SOCIAL
All mental illnesses partake of the BPS model of disease.
There are two categories of addiction
abuse and dependance.

We have bodies, we have psyches and we are social ceatures, all human illnesses fall within this realm.

You are right an alcoholic can choose not to drink, in fact they won't ever know if they have the biological predisposition if they never drink.
"Social' addiction is a behavioral problem, and usually easily changed.
"true" addictions is part bio, part psycho and part social, teatment strategies have to understand all three to be effective.

Humans who are lucky don't have these issues in thier lives, but the weird thing is what are called 'pro-bands'. Guess what alcoholics tend to marry alocoholics or people from alcoholic families and guess what happens the biology of alcoholism gets stronger. this is called pro-banding.
It applies to depression as well.

Peace y'all.

[RichardR]

Originally posted by AmateurScientist
Well, it can become a compulsion as strong as any. Once someone becomes addicted to a substance, the compulsion to get it and ingest it can be much stronger than the hunger for food, the need for sleep, or even the instinct to care for one's kids.

In such a case, physical prevention is irrelevant. The brain's capacity to obssess over something is far greater than any physical considerations.I know something about addiction (although not to alcohol).

I understand a compulsion. I am questioning whether a compulsion is a disease. And I’m still having a hard time comparing the alcoholic, who gets sick when he makes a decision to drink, with (say) the person who suddenly finds out he has cancer. The former can stop drinking; the latter can’t decide not to have cancer anymore.

Edited to add:

Looking at your prior post – I can see that continues drinking (say) could alter the brain physically, which could eventually mean the alcoholic has no choice.

[RichardR]

Originally posted by jj
Why is your question germane? The proper question is: Could they stop their genetic makup from being the way it is the same way ....

I think you're being obtuse on purpose. No, I’m trying to explore the issue.

Originally posted by jj
I am amazed that we still see the results of the old puritan fertilizer hanging around like we see here, with the "it's all their fault" logic. Something of a straw man there.

Originally posted by jj
Your implication about chemically dependent alcoholics could just as well be extended to bipolar people. Do you want to do that? I don’t know. Please tell me what decisions bipolar people take, that makes them bipolar, in the same way an alcoholic makes a decision to drink.

[RichardR]

Originally posted by Dymanic
there is a choice. But the choice exists for the alcoholic only once he realizes that it exists (many reach a point, after many attempts to quit, where they abandon further attempts as hopeless) and it exists only once he realizes what the choice is -- to not drink at all (rather than through some method of proper management, to drink successfully as others do) and to do the work necessary to develop an entirely new approach to life. It includes facing life (often, the wreckage of a ruined life) without coping skills, (and without chemical substitutes for coping skills)…It seems to me we have had two explanations on this thread for alcoholism. You way you describe it, alcohol is a coping mechanism for an other problem(s) in their lives. Surely then, the illness is the other thing in their life (whatever that is), that is giving them the problem, not alcohol per se.

The alternate explanation is the one where the alcoholic has an imbalance in the brain, and once they take their first sip of alcohol they can’t control it any more. If this type exists it would certainly look to me like a disease in this case.

Does anyone have any idea of the ratio of the two types?

[RichardR]

Originally posted by Dancing David
there are two major nuero-chemical systems in depression serotonin and dopamine, there are probably other neurotransmiters as well.

I make an invitation to you , please live my life when I don't have my medicine, I'd be very glad for you to take the irratibilty, the flooding, the insomnia and the obsessive compulsions off my hands.I have no doubt about it. From what I know of this, you have absolutely no control of the bad feelings that you get in this situation. (Other than to take the meds, of course.)

[Dymanic]

Originally posted by RichardR

Please tell me what decisions bipolar people take, that makes them bipolar, in the same way an alcoholic makes a decision to drink.
You seem to still be assuming that it is drinking that makes one an alcoholic. The assumption that logically follows is that if he quits drinking, he is no longer an alcoholic, yet the experience of many alcoholics does not seem to bear this out. Would you consider it possible that a person could have a predisposition to alcoholism that was independent of his actually using alcohol?

[jj]

Originally posted by RichardR
I don’t know. Please tell me what decisions bipolar people take, that makes them bipolar, in the same way an alcoholic makes a decision to drink.

You're still dancing around the issue...

Please tell ME what decisions people with chemical alcohol sensitivity (is there a name for this affliction??, heavens knows there is a well-demonstrated syndrome that describes SOME alcoholics and several enzyme differences that seem to correlate) decided to have that sensitivity.

THAT much is the same as bipolars.

There are quite a few fairly bipolar people who muddle or splendidly get through life without medication or much trouble by force of will, who know when to go curl up and when to get work done.

Now, if you will (for arguments sake) accept that alcohol is a serious poison that causes a nasty kind of intoxication (I don't mean drunkenness, please, here) that CAUSES them to drink uncontrollably if they are exposed at all to alcohol (orally, or very very strongly nasally, i.e. I mean alcohol intake, although very little alcohol intake) at all, explain to me how that's voluntary.

People who are like that and who figure it out, by the way, in my limited experience, after learning how to keep it all away from them, are often very successful in living normally, but obviously without any alcohol, they have to buy special cough syrup, avoid some medicines and dishes, fresh perfumes, etc...

So, yes, a lot of them can decide, once they figure it out, that it's that first little bit of alcohol that starts the problem, and they avoid it very, very scruipulously. Is that weakness voluntary? I do NOT think so.

Now, some other people who are alcoholics are NOT like that. Alcoholism is clearly not "just one thing".

[Luke T.]

Hi. My name is Luke T., and I'm an alcoholic.

You are all supposed to say, "Hi, Luke!" at this point. :D

I am seeing some very interesting ideas about alcoholics here. For those of you who think it is a matter of willpower, you couldn't be more wrong. Step One in A.A. is "Admitted we were powerless over alcohol and our lives had become unmanageable."

Also, the misunderstandings that so many people have about alcoholism is why other alcoholics have a better success rate of getting a drunk sober. They UNDERSTAND. Some of you don't, and never will, I fear.

I am not so sure about alcoholism being hereditary. I suppose we all have at least one alkie in our families, though.

It took me a long time to accept that alcoholics have an allergy to alcohol. After all, don't you avoid the things you are allergic to?

But there is a definition of an allergy I like. It starts out something like "an abnormal reaction...." And that about sums it up.

When I drink, I get an abnormal reaction. I break out in handcuffs. (Old A.A. joke)

Can an alkie drink only three drinks for a million bucks? Sure. But he will drink all one million dollars after you are gone. :D

I was able to stop drinking for months at a time. I even know of other people who drank as much as I did that weren't alcoholics.

Alcoholism is an allergy coupled with a mental obsession.

And it is a devasting weakness.

Feel free to ask me anything about alcoholism. I have been sober for about 8 and a half years. I have worked with hundreds, maybe even a thousand by now, of other alcoholics. I've seen it all.

I don't have a degree. I am not an expert, except on the street level of things.

Fire away.

edited to add: I have also conquered life-threatening depression. I know all about that, too, from the street level.

[Luke T.]

Originally posted by Dymanic

I would say that they can not physically prevent themselves from taking a drink in the same way you couldn’t physically prevent yourself from breathing period.

Of course, I would be exaggerating. But it may help to illustrate how powerful the obsession can be. As AP pointed out, an alcoholic will make booze his first priority -- over food, sex, sleep, safety, family, truth, ...whatever.

I concede that being able to have a few drinks under appropriate circumstances and then quit at the appropriate time is not an absolutely impossible thing for an alcoholic to do. The trick is consistency. There are not many alcoholics who lose a job, wreck a car, or go to jail every time they drink. But in dodging cars on the freeway, a 99% success rate produces essentially the same result as a 1% success rate.

You are right, of course -- there is a choice. But the choice exists for the alcoholic only once he realizes that it exists (many reach a point, after many attempts to quit, where they abandon further attempts as hopeless) and it exists only once he realizes what the choice is -- to not drink at all (rather than through some method of proper management, to drink successfully as others do) and to do the work necessary to develop an entirely new approach to life. It includes facing life (often, the wreckage of a ruined life) without coping skills, (and without chemical substitutes for coping skills) having little recourse but to stand like a jackass in a hailstorm and take it -- something alcoholics are usually not particulary good at.

I just want to say that Dynamic is right on the money here.

[Tez]

Hey Luke,

How do you know when youre on track to become an alkie?

I binge drank once or twice a week as a student. I rarely do that now - but I drink 2-3 standard drinks a night (large glass of wine with dinner, and sometimes a brandy or scotch to help me clear my head of equations and get to sleep - not a common problem I'll admit :D )

My paternal grandfather died an alcoholic. My father, who drinks once or twice a year, wrote a book which has been used by AA and similar support groups in australia and south africa (and made into a movie in SA). So I've been exposed to much of the thinking about how to help alcoholics. But I never really understood what were the warning signs - the things to catch yourself *before* you fall off the cliff. Did you know you were going over? Or did you only know when you hit the bottom?

[Luke T.]

Alkies have willpower to spare. Too much willpower. We are a stubborn lot. We are able to accomplish much at half capacity. We just have no willpower when it comes to alcohol. Alcohol is unbeatable for an alcoholic all by himself/herself.

[asthmatic camel]

Originally posted by RichardR
No, I’m trying to explore the issue.

Something of a straw man there.

I don’t know. Please tell me what decisions bipolar people take, that makes them bipolar, in the same way an alcoholic makes a decision to drink.

With respect RichardR I think you are missing the point. Few people in the Western World never take a drink. That first drink doesn't make anyone an alcoholic overnight, it's a long, slow process. The alcoholic does have a choice to drink or not in the early stages but as the syndrome progresses he/she becomes increasingly dependent until the choice is no longer there.

Speak to a few alcoholics who are recovering and ask them when and why they became an alcoholic. They won't be able to give you a time and date because there isn't one to give; the illness is progressive. They may be able to give you some idea of why, and would probably be glad to do so.

Although I have no scientific proof available, I do strongly suspect that most substance abusers have an underlying psychological problem which may be aggravated by a genetic predisposition.

No doubt you will enlighten me in due course.

[Dancing David]

Hi Luke! My name is david, I am chemicaly dependant.

You are so right, it's not the will power it's the application of the willpower.

I found that I had to live my life to not use, which at that point meant recreating my life. Especialy learning to cope with boredom and other triggers.

For me the hardest part is when something good happens to me, those old habits are still there and they say lets go party.

Then there is overcoming the social isolation as well.

Thanks for your story.
_______________________________________

There are as many kinds of addictions as there are addicts, in mental health we believed that a lot of people wre self medicating or that they were hiding.

Keep on keeping on!

[jj]

Originally posted by asthmatic camel
Speak to a few alcoholics who are recovering and ask them when and why they became an alcoholic. They won't be able to give you a time and date because there isn't one to give; the illness is progressive. They may be able to give you some idea of why, and would probably be glad to do so.

It's anectodal (sample size of 1) but I know very well one person (well, dead now, he's 2 generations older than me) who could identify when he knew he was an alcoholic. He said it was the first time he ever took a drink, he felt the "effect" (he couldn't explain it) and that was it. He had drinking problems for a short while, had one bad episode, experimented in a safe (although not very humane) setting after that to find out what his "tolerance" was, concluded it was 0.0, and ceased alcohol. He got caught once by a perfume and once by a medicine in alcohol, over many years. He got in trouble once for decking someone who tried to spike his ginger ale, unsuccessfully. The charges were dropped.

For some people it's that bad. Obviously with a sample size of 1, I don't have much statistics to offer.

Although I have no scientific proof available, I do strongly suspect that most substance abusers have an underlying psychological problem which may be aggravated by a genetic predisposition.

No doubt you will enlighten me in due course.

Some may have one, some may have the other, some both. At what point does a psychological problem itself become suspect genetically? Messy question, that. It may not affect treatment, of course.

It's pretty clear the treatment is "don't. not at all. period. just don't"

[asthmatic camel]

jj I suspect that we are at cross purposes here. By "alcoholic" I intended to mean those who are physically dependent rather than those who have an extreme reaction. The term alcoholic is poorly defined and often abused. It would seem, however, that your friend would not be viewed as an alcoholic.

[Luke T.]

Originally posted by Dancing David
Hi Luke! My name is david, I am chemicaly dependant.

You are so right, it's not the will power it's the application of the willpower.

I found that I had to live my life to not use, which at that point meant recreating my life. Especialy learning to cope with boredom and other triggers.

For me the hardest part is when something good happens to me, those old habits are still there and they say lets go party.

Then there is overcoming the social isolation as well.

Thanks for your story.
_______________________________________

There are as many kinds of addictions as there are addicts, in mental health we believed that a lot of people wre self medicating or that they were hiding.

Keep on keeping on!

Hi, David!

My chief complaint when I was trying to quit drinking on my own was, "What else is there to do?!?"

The thought of bowling or movies or cookouts with Ozzie and Harriet seemed a fate worse than death. :D

[Luke T.]

Originally posted by asthmatic camel
jj I suspect that we are at cross purposes here. By "alcoholic" I intended to mean those who are physically dependent rather than those who have an extreme reaction. The term alcoholic is poorly defined and often abused. It would seem, however, that your friend would not be viewed as an alcoholic.

Actually, he would.

I, too, drank alcoholically from my very first drink. I hated the taste of it, but I couldn't put it down. Now that's insanity!

Some alkies don't become alkies right away. They do "acquire" it. But then there are the ones like me who drink like fish right out of the gate. From the very first taste.

By the end of my drinking, I was drinking what I considered to be Jack and Cokes, but were really almost all Jack. You learn how to manipulate bartenders when you are an alkie. One night, someone sipped my drink and grimaced. He said, "That tastes like bug spray." And don't you know that idea got stuck in my head? I couldn't shake it. Right up to the day I quit drinking, I thought my drinks tasted like bug spray. Seriously. I hated the stuff. But still I couldn't stop.

[jj]

Originally posted by asthmatic camel
jj I suspect that we are at cross purposes here. By "alcoholic" I intended to mean those who are physically dependent rather than those who have an extreme reaction. The term alcoholic is poorly defined and often abused. It would seem, however, that your friend would not be viewed as an alcoholic.

The extreme reaction is much more common, I suspect, than you seem to believe.

I think it would be possible to gather statistics. To my knowledge, nobody has done so.

[Ladyhawk]

First off, to Dancing David and Luke and others who have shared their stories of addiction and depression: THANK YOU for your courage!

My parents both battled alcohol. My mother died in her early 40's from cirrhosis of the liver when I was only 11. This, after she had 'dried out'. My father died of cancer but had fought alcoholism for years prior. I divorced my ex-husband due to his alcoholism and refusal to get help. As you can probably guess, Ladyhawk doesn't drink. Ever. Alcoholism may or may not constitute a genetic predisposure to the condition but I'm not going to dance with the devil, given my experience.

My boyfriend openly admits his former drug addiction (he's been clean for 14 years now). He told me something that echoes the sentiments of many here. He said that the most difficult thing with recovery was learning how to enjoy life w/out benefit of booze, drugs, etc. He has traded his former addictions for a new one: the outdoors. (I've adopted his new addiction with him
:) )

With respect to obesity, I believe the clinical definition says that a person is considered obese if 100+ lbs over their ideal weight. (I may be wrong...) I think the occurences of a legitimate thyroid problem are rare and that overreating is more often the cause of self-esteem or other psycho-social issues. I'm not an expert, it's just my opinion.

With these conditions, as with depression, I think the greatest challenge is for those who suffer from them to admit that there is a problem and to gather their courage to get help. To those of you who have, my hat is off to you!

[Luke T.]

Something else just occurred to me about willpower and alcoholics while I was replying to AS's topic on AIDS. I first joined A.A. in July of 1993 in Mississippi, six months after my brother died. I went to meetings for three months and then I was transferred by the Navy to Virginia. I didn't look up A.A. there. I decided to go it alone. And then my marriage started to go really sour. But I thought I had enough self-knowledge to stay sober on my own. Sheer willpower. I made it for 19 months. But I eventually couldn't take it any more and set out to get good and drunk. And boy did I! Setting foot in a bar for the first time in 19 months, I stayed there for 12 hours. I drank that place dry. I was literally blind drunk. Driving home, I spent more time off the road than on it. It was pure luck I didn't kill myself or anyone else or was spotted by a cop. Pure luck.

So there's your willpower.

You want to see some willpower in an active alcoholic? Just get between him and the drink. :D

[RSLancastr]

Originally posted by Ladyhawk
With respect to obesity, I believe the clinical definition says that a person is considered obese if 100+ lbs over their ideal weight. (I may be wrong...)Yes - you are wrong! :)

The clinical definition of obesity is not based solely on "pounds over ideal weight". It is based on the Body Mass Index (http://www.healthcentral.com/cooltools/ct_fitness/BMI_short.cfm), which takes height and weight into account. For example, a six-foot tall person carrying a certain number of extra pounds might be considered "overweight", while a five-foot tall person carrying the same amount of extra weight might fall into the "obese" category.

A "rule of thumb" is: if you are at least 30% over your ideal weight, you are obese.

I think the occurences of a legitimate thyroid problem are rare and that overreating is more often the cause of self-esteem or other psycho-social issues. I'm not an expert, it's just my opinion.I assume you meant "the result of" rather than "the cause of"?

[aggle_rithm]

Originally posted by RichardR


I understand a compulsion. I am questioning whether a compulsion is a disease. And I’m still having a hard time comparing the alcoholic, who gets sick when he makes a decision to drink, with (say) the person who suddenly finds out he has cancer. The former can stop drinking; the latter can’t decide not to have cancer anymore.



An alcoholic can choose not to drink, but cannot choose not to be an alcoholic. That's why alcoholism is called a disease. The pathological compulsion to drink can be suppressed, but never goes away. That's why we say "recovering alcoholic" rather than "former alcoholic".

My brother, who has been clean and sober for almost twenty years, has a very succinct and appropriate definition for an alcoholic: "Someone who has no damn business drinking."

[Luke T.]

Originally posted by RSLancastr

A "rule of thumb" is: if you are at least 30% over your ideal weight, you are obese.


IIRC, in the Navy the official "obese" milestone is 36% body fat.

edited to add: That was for women. For men the figure was much lower, but I don't recall the exact number. Somewhere around 25%.

The Navy used to distinguish between overweight and obsese. A woman was considered overweight at 33% and obese at 36%. A male was overweight at 22%, and like I said, I don't remember the obsese percentage.

I think nowadays, though, they just go by height and weight and don't actually measure body fat percentages any more.

[Mouse]

This is my first post on this board, so apologies if I make a mess of it.

Comment on SIDS - The term is limited to babies for whom all other causes of death can be ruled out (clever infanticides may slip by). Post mortem histological examination of the brainstem suggest there is an abnormalilty in neurons in the breathing center in the brainstem. There are published reports, but the story is still in the developing stage.

Comment on what is a disease, what is the result of "lack of self-control": Lots of things that most everyone considers "disease" have a "self-control" or behavioral factor - smoking contributes to emphysema and lung cancer; diet and exercise to diabetes, heart disease, stroke, osteoporosis, just to name some of the more obvious ones.

Comment on biological predisposition: Everyone gets a genetic deck of cards they have to live with. Mine allows me to eat a diet containing a pleasing amount of fat and sugar while having an amazingly healthy blood cholesterol profile (but I really ought to lose a few pounds). My husband has high cholesterol, despite a concerted effort over the last 2 years of careful dieting and exercise that has left him skinny as a rail. Which of us is healthier? Which is the better person?

[Ladyhawk]

Originally posted by RSLancastr
Yes - you are wrong! :)

The clinical definition of obesity is not based solely on "pounds over ideal weight". It is based on the Body Mass Index (http://www.healthcentral.com/cooltools/ct_fitness/BMI_short.cfm), which takes height and weight into account. For example, a six-foot tall person carrying a certain number of extra pounds might be considered "overweight", while a five-foot tall person carrying the same amount of extra weight might fall into the "obese" category.

A "rule of thumb" is: if you are at least 30% over your ideal weight, you are obese.

I assume you meant "the result of" rather than "the cause of"?

Thanks, RS! I had heard the 100 lb definition on some television show and couldn't site the date and name of the broadcast which is why I recognized it may not be accurate...

And, yes, to your last point. That's what I get for typing faster than I think.....

[Darwin]

Obesity-No.I´d even go as far as to call it an evolutionary "rudimentary" condition,or a symptom of something else.
Depression-Yes.
ADD-There is supposed to be a biological basis,but probably overdiagnosed.
Alcoholism-Kind of.

[RSLancastr]

Originally posted by Darwin
Obesity-No.I´d even go as far as to call it an evolutionary "rudimentary" condition,or a symptom of something else.Could you please explain what the term evolutionary "rudimentary" condition means? I am not familiar with it.

[Darwin]

Sure.
At first,I used it rather loosely since it cannot be made a very strong argument for but it follows logic.
The theory goes that the fact of considerable problem of overweight,is due to these evolutionary factors (as far as it can be stretched) Simply put,in our action packed past,stuffing plenty of fat would have been an advantage,which it obviously is not considering the modern lifestyle of many.
The term is really my own invention.

[Yahweh]

Welcome back Darwin. Its been a while since I've last saw you post on the boards.

[RichardR]

Originally posted by Luke T.
I, too, drank alcoholically from my very first drink. I hated the taste of it, but I couldn't put it down. Now that's insanity!Sure sounds like it!

Thanks Luke and others for sharing your experiences. You’ve all certainly given me much to think about wrt this subject, and I have to admit I’m still unsure about all cases, but I also have to admit I don’t really have any experience to compare to yours. I can certainly see that the “alcoholic from your first drink” must be something genetic you can’t control, and is therefore a disease. So I agree, it’s a disease. Thanks for educating me everyone – I’m happy to agree I was wrong.

And The Wabbit isn’t wrong very often. :D

[Darwin]

Thank you Yahweh.

[asthmatic camel]

Originally posted by jj


The extreme reaction is much more common, I suspect, than you seem to believe.

I think it would be possible to gather statistics. To my knowledge, nobody has done so.

JJ the extreme reaction to alcohol may be common but I suspect that it is insignificant as a percentage of the population.

As for the definition of alcoholism try this link

www.dundee.ac.uk/forensicmedicine/llb/alcohol.htm

Kindly note this comment " Dependent or addicted drinker ("alcoholic") - has subjective awareness of compulsion to drink; exhibits prominent drink-seeking behaviour; becomes tolerant to alcohol; obvious physical, psychological and social problems.
Liable to withdrawal symptoms following cessation or reduction in alcohol intake; uses alcohol to avoid or relieve symptoms of withdrawal. "

A Google search for definitions of alcoholism provided a bewildering variety of results, I understand that the above is close to whatever the medics accept. As with all mental illnesses the definition and diagnosis is difficult.

All this aside, I am glad that your friend realised a problem existed and took appropriate action.

Regards

[Earthborn]

Is sleepwalking a real disease? Or is it just something people do to attract attention? Surely if people don't want to sleepwalk, they can choose to stop doing it, right? Or...

Could it be that there is something wrong with the brains of these people that makes them behave in a way they don't want to? After all, the brain is the organ that controls our behavior. It should not be surprising that if something is wrong with it people start behaving in strange, even self-destructive ways.

But, I hear some people countering, a sleepwalker isn't conscious. Without consciousness they can't control their behavior.

Now do these people assume that consciousness is some sort of all powerful force that can force the brain to do whatever it chooses. If so, what is their evidence for it? Could they name a single neurologist who believes such a thing?

[Luke T.]

Originally posted by asthmatic camel

" Dependent or addicted drinker ("alcoholic") - has subjective awareness of compulsion to drink; exhibits prominent drink-seeking behaviour; becomes tolerant to alcohol; obvious physical, psychological and social problems.
Liable to withdrawal symptoms following cessation or reduction in alcohol intake; uses alcohol to avoid or relieve symptoms of withdrawal. "



I don't know why, but I find this clinical description which could serve as a biographical synopsis of 25 years of my life, extremely funny.

Along with this, which follows in the same link from camel:


A practical definition of dependent drinking or alcoholism is persistent drinking that interferes with the person's health, legal position, interpersonal relationships, or means of livelihood.


Man, that was me: prominent drink-seeking behavior. :D

Also posted by camel:


JJ the extreme reaction to alcohol may be common but I suspect that it is insignificant as a percentage of the population.

Maybe. But I can tell you it isn't insignificant as a percentage of the alcoholic population.

There was a movie once, I think it Richard Gere in it, I forget who the female character was played by, in which a woman would become instantly insane upon the slightest imbibement of alcohol. Gere was a psychiatrist, and he called the phenomenon something, I forget what. But at the time I saw this movie, I thought it was the stupidest thing I ever heard of.

Then I met my second wife. And she was just like that. One drink, and whammo! I actually got scared a couple of times because when I looked into her eyes, I didn't know the person in there.

[RichardR]

Originally posted by Earthborn
Now do these people assume that consciousness is some sort of all powerful force that can force the brain to do whatever it chooses. If so, what is their evidence for it? Could they name a single neurologist who believes such a thing? So no one is responsible for their action? All criminals would just have a disease, right, since they can't force the brain to do whatever they choose? Is that what you meant?

[Earthborn]

It seems to me we have had two explanations on this thread for alcoholism. You way you describe it, alcohol is a coping mechanism for an other problem(s) in their lives. Surely then, the illness is the other thing in their life (whatever that is), that is giving them the problem, not alcohol per se.

The alternate explanation is the one where the alcoholic has an imbalance in the brain, and once they take their first sip of alcohol they can’t control it any more. If this type exists it would certainly look to me like a disease in this case.

Does anyone have any idea of the ratio of the two types?Let's define the number of alcoholics as 100%, then I would think the ratio between the two groups is about 99%:99%.

Those two ways of looking at it are hardly mutually exclusive, in fact they are two sides of the same coin: people may use alcohol as a coping mechanism to deal with their problems, and become addicted because they have a predisposition to alcohol addiction.

[Luke T.]

Asmathic camel, I don't have my A.A. text with me right now, which we refer to as the Big Book, but I will post later a quote from it in which they describe I think 5 different kinds of heavy drinkers. I haven't yet met anyone who does not fit into one of these categories. And not all of the categories are even considered to be alcoholics, even by A.A.

One of the "social problems" that I have found to be common among alcoholics is the feeling of being separate from the rest of the human race. In fact, some A.A. people refer to normal drinkers as "Earth people." :)

But staying with your line of argument regarding people like me who are addicted to alcohol from the very first exposure, I will tell you that when I first began thinking about my drinking problem, I was really far along, and I was pretty sure it had only started in the last couple of years of my drinking career.

It wasn't until I had been sober for some time that I realized I had been an alcoholic from the beginning. I think there were less than ten times in my life where I had drank alcohol and not drank until I was drunk.

To this day, I do not see the point of drinking unless it is to get drunk.

That's the "mental obsession" part of this disease. That, and the "prominent drink-seeking behavior."

That phrase describing my behavior is so apt and so tragic that is passes into the realm of comedy for me. But for those who are still trapped in it, it isn't funny at all.

I have met many fellow alcoholics in A.A. who share the same problem as me in the immediate addicition situation.

Are there not other drugs in which you can believe people become immediately addicted? Crack cocaine, maybe? So why not alcohol?

How long does a person have to drink alcoholically to qualify as an alcoholic?

I have a friend who joined A.A. when he was 11, and by all accounts of those who knew him then, he needed it. Bad.

[asthmatic camel]

Luke, believe me, I know about alcoholism. My point is that no-one becomes physically dependent on alcohol after just that first drink. To reach the stage where two bottles of whisky plus a few beers a day doesn't cause coma and/or death takes time.

Sure, drinking causes problems from day one for those who are vulnerable but severe physical dependence, to the point where people cannot function without alcohol and suffer potentially fatal withdrawal symptoms, does not happen overnight.

Looking back, are you certain you were physically addicted to alcohol after your first drinking session ? I'm sure it triggered compulsive behaviour but very much doubt that you would have suffered delirium tremens had you decided never to drink again the next day.

I'm not attempting to downplay the horrendous effects that alcoholism has on people's lives, far from it, but I'm sure you'll agree that the sooner someone with a problem stops drinking the less traumatic the experience is. I have watched several friends die because their addiction had become so bad that the thought of life without alcohol was intolerable.

Anyway, I admire your honesty and courage in telling your story; I hope it helps persuade others that alcoholism is a very real and debilitating illness. About that I have no doubt at all.

[Earthborn]

Is that what you meant?No, not really. What I meant was that whatever we call 'free will', whether it is some metaphysical property of our soul, or just exhibiting behavior that is consistent with our survival instincts and our knowledge of what is right and wrong... I think it is quite obvious that there are neurological conditions that can make people lose it: they start behaving in ways they don't want to. They start behaving in ways that they know is self-destructive, but knowing this is not enough to change it.

But yes, I would argue that many of the most dangerous criminals are in fact suffering from neurological conditions and they can't help themselves. Do you have any evidence that suggests that when someone brutally murders people, he is perfectly normal and sane? If not, why even assume it?

[Dymanic]

Originally posted by RichardR

So no one is responsible for their action? All criminals would just have a disease, right, since they can't force the brain to do whatever they choose?
Bit of a slippery slope there, eh? Next thing you know, being crazed with sugar will be used as a defense!

What we seem to be examining here is how we regard someone who commits a crime.

When someone breaks society's rules, we hold them responsible (well, actually, we hold them irresponsible), and if the offense is serious, we may isolate such a person from society (subject to the availability of space in our prisons). We do this mainly to protect society from him -- but also to punish him, hoping that it will act as a deterrent to his committing future offences and, by example, to others as well. Rehabilitation tends to be viewed as pretty much a waste of time and resources, and therefore recieves little of either.

Maybe such a person was acting on his own free will and simply chose to be evil and rotten, or maybe he was out of control due to some neurological disorder -- either way, we still have to lock him up; it's just a matter of where: a penal institution, where he will be penalized (punished), or a psychiatric institution, where he will be 'treated'?

Suppose that we did come to view criminal behavior as a priori evidence of neurological disorder? Would we be willing to commit the necessary resources to converting our penal system to a system of psychiatric treatment? I doubt it. I think you'd have better luck selling this idea: death by beheading, if practiced consistently over time, might be an effective (and quite economical) means of eliminating such undesireable traits from the human gene pool.

[jj]

Originally posted by asthmatic camel
Kindly note this comment " Dependent or addicted drinker ("alcoholic") - has subjective awareness of compulsion to drink; exhibits prominent drink-seeking behaviour; becomes tolerant to alcohol; obvious physical, psychological and social problems.
Liable to withdrawal symptoms following cessation or reduction in alcohol intake; uses alcohol to avoid or relieve symptoms of withdrawal. "


This doesn't contract, confirm, or deny anything. It's broad enough for many mechanisms and many kinds of alcoholic behavior.

I still think that you're wrong about the total number of ALCOHOLICS who have the kind of reaction I describe. Yes, they are much rarer in the entire population, but why is this surprising?

[jj]

Originally posted by asthmatic camel
Luke, believe me, I know about alcoholism. My point is that no-one becomes physically dependent on alcohol after just that first drink. To reach the stage where two bottles of whisky plus a few beers a day doesn't cause coma and/or death takes time.


That's not the issue at hand.

You're confusing a destruction of judgment and a compulsion to drink MORE MORE MORE (which is what I'm talking about) with dependency in the withdrawal sense.

They appear (if the stuff I've read is half-decent) to be two different mechanisms.

That doesn't mean they are the only two, of course, and the two don't have to be mutually exclusive, either, I dare say.

[asthmatic camel]

JJ I don't think I'm confusing anything. It seems clear that some people are vulnerable to compulsive drinking behaviour after very little exposure to alcohol, probably for a variety of reasons. The medical definitions of alcoholism I have read, however, invariably include references to increased tolerance (and intake) over time together with physical dependence.

Not all long term heavy drinkers become physically dependent although it seems probable that most have a degree of psychological dependence.

Whatever the causes I am convinced that alcoholism is a disease, not some form of moral weakness as the original post implied.

Regards,

AC