Well done there

Leaving aside the fact I’m off to Birmingham Pride this weekend, my alcohol intake (i.e regular slovenly insobriety) has slumped back to normal levels – well done there.

And aside from several large slabs of chocolate, last night’s Deliverance burger, chips and chicken wings extravaganza, an upsetting number of impulse detours to McDonald’s, and whole 6 pack of breakfast muffins the other morning, I’ve not had any self control problems at all.

#FML

(Note: Again, this is one of those occasions where the ‘physical’ side effects of my medication – in this case, reduction in hunger pangs – is easily overridden by the ‘mental’ side effect of impulse disinhibition. This doesn’t happen with my sex drive, where I’d actually ENJOY it; because biology and psychology both have a wicked sense of humour)

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Loose boundaries

The psychiatrist eyes me over his glasses, notepad in hand. The day is too bright, the room too noisy, even in silence. Me, a social worker, a trainee clinical psychologist, and the psychiatrist. He seems affable; in my memory he has a short beard, a stereotypical shrink. But memories are unreliable, and my memory of this time more unreliable than most.

“You’re right”, he comments, “SSRIs have, in general, only slight efficacy. It depends on the person and their situation, obviously. We don’t really understand it.

But it seems, from what you’ve said, that they affect you a great deal more than most”

Generally, I take this to be a good thing.

*

My alcohol consumption has rocketed.

Normally I drink only at weekends, a few glasses (OK, bottles) of wine with a meal, with friends. If we’re going out, obviously I drink more, but again this is a weekends thing.

And I have a curious relationship with alcohol, in that it reliably makes me feel good. Yes, I can get maudlin, but warmly so. Even in my depression, it can lift me. Fact is, I enjoy being drunk. And I thank whatever guardian angels I have that, for some reason, this has never quite twigged with my subconscious. When I’m depressed, I don’t drink – I drink socially, I drink randomly, but I never drink to get happy. I never self medicate.

Which is why it’s curious that my consumption has rocketed. And I’ve got to put it down to the meds. SSRIs actually make most people more sensitive to alcohol, so you’d expect they’d drink less; but while I do get more sensitive, I end up drinking more. Lunchtime pints, nipping in to the pub after lab, staying for one more, one more, another more, more.

And it’s impulse control. I somehow lose impulse control on these drugs. I get some of it back after a few weeks, but initially there’s this loosening of my behavioural boundaries. Curiously, this is one of the mechanisms by which SSRI medication is presumed to trigger suicide behaviour (don’t worry, that’s not going to happen). It’s also something which alcohol itself disrupts – which is why drunk people can be so, well, impulsive. I don’t pretend to know the ins and outs of it (and I doubt anyone does), but it’s strange to watch yourself from the outside, behaviour staggering more than you’d anticipated, willpower veering, only half in control. Sober, acting drunk.