All or Nothing
Published in Blog.
“I can resist everything except temptation.” —Oscar Wilde
There are a lot of firsts in life that I can’t really remember. I don’t recall exactly when I had my first kiss or my first goal playing youth hockey for example, and to be honest I don’t really recall who my first grade teacher was either. I can tell you when and where it was that I took my first drink though. An aimless student all through high school, I eventually took to a work-program which allowed me to learn to cook under a provincially licensed chef in lieu of actually attending class. I could go to school for part of the time and work in the kitchen for the other if I agreed to the most important stipulation of the contract: by law, the first 1000 hours of my internship, and first step toward becoming a proud Red Seal Journeyman Chef in the Province of Alberta, would be unpaid. I didn’t blink an eye.
To learn the ropes in the kitchen I began as a prep cook working with a happy-hardcore-loving raver named Adam (who was perpetually riding a residual high from the night before, many times in combination with a complete lack of sleep) and a tireless small-statured man who spoke only broken English named Ricky Lo (who some of the cooks playfully called “Gwai Lo,” a common Cantonese slang term for white foreigners which literally means “ghost man.”) I dreaded the idea of getting up and going to school, but starting prep work at the crack of dawn seemed somewhat less painful than returning to a friendless hell-hole which offered me little satisfaction and a bleak future. High school: “The best years of our lives…”
To help introduce me to the grind were a pair of line-cooks who were also in at that early hour to start things up in the kitchen for breakfast: a girthy white opera singer and an equally towering black counterpart who wore Coke-bottle glasses and moonlit as an MC. Also, since we were in hours before any customers, we were allowed to listen to (read: max-out the volume on) the grungy, food-encrusted CD player in the kitchen, a luxury which we were frequently reprimanded for during feeding-hours. It was through these two behemoths that I was introduced to Soul via the Dead Presidents soundtrack (which includes the likes of Isaac Hayes, Al Green and James Brown’s “The Payback,” a song which remains my all-time favorite to this day), opera by way of the white cook’s less than welcomed impromptu rehearsal sessions, and the equally endorsed vulgar ramblings of Wesley Willis, a prolific keyboard-looping schizophrenic who performed surprisingly lovable jingles topically ranging from bestiality to whoopin’ Batman’s ass. Despite entering the latter half of the eleventh grade by enrolling in the work-program, it was then that I felt that my education was just beginning.
Though my cooking career failed to last even two years, the introduction into that environment came with an equally eye-opening welcome to the alluring off-hours fantasy world crafted by industry brethren to help balance the insanity of the workplace, where drugs and drink helped keep the ship afloat until its next scheduled dock back at the restaurant. But it wasn’t at a party that I first drank, it was at the restaurant itself. One night as we closed early to give the joint a much needed cleaning, free beers were passed around and a friend, knowing I hadn’t had a drink before, offered me a Budweiser. “It’s like fruit juice” he said, talking it down compared to the higher alcohol-content of Canadian domestics. Though I don’t recall it being terrible, fruit juice it was not. I slowly learned that drinking at work, as those who’ve worked kitchens before can likely also attest to, isn’t nearly as frowned upon as it is in some other business-casual settings. Not hard drinking mind you, but the occasional nip seemed alright. For example, following a particularly tough “rush” one night, I recall one of the front-of-house staff members came sauntering to the back with a tray of sambuca shots for everyone as reward. I distinctly remember a feeling of great pride while the licorice-flavored liqueur hit my throat as I stood in the dish-pit. It felt good to be included. Thousands of drinks have come and gone (one way or another) since, but as time progresses and age continues to mound it’s the reason for and the reaction to the drinks that has changed significantly.
“The American pendulum only swings to extremes… The chubiest of us have the strictest diets, because we can’t learn to modulate and moderate. It’s all or nothing. One bite of a cookie, and suddenly you’re on a plane to Vegas with a hooker.” —Larry Miller
For reasons that might not be considered particularly funny, my dad’s side of the family is rather “funny.” Growing up he and his brothers and sisters had less than nothing, weren’t loved by their parents, and were given about as little support along the way as seems humanly possible. One of my dad’s biggest regrets, he’s since revealed, is not going with protective services when they came to pick him up when he was young. Instead, he ran away from home as a teenager, and tried to do the best he could with what he had. It’s a tragic story, his family’s, but one that lends some perspective to how they live their lives now. Staunch advocates for sobriety, both my dad and his sister (he has other siblings, including a twin brother, but I don’t really know them) avoid and condemn the use of alcohol as it was so fiercely abused throughout their childhood. But aside from that, “moderation” isn’t necessarily a word that I’d use to describe their lifestyles: both are obese, and both have exhibited hoarding tendencies at some point in lives. My aunt, for example, has semi-trailers on her property which are used to house the decades of collected items which don’t fit inside her house and garage. My dad doesn’t have trailers, but to a far lesser degree he’s had his moments. Emotionally I’ve come to believe that growing up with nothing as children left them with an emptiness that continues to show through, manifesting in certain obsessive traits like over-eating and over-consuming. But how much different are they than the rest of us when it comes to this tendency of all or nothing?
Early on in my teens my parents came to me and told me they’d give me $1000 if I didn’t drink alcohol until I was 21 (though the legal drinking age where we lived was 18). I don’t know what I’d have done if I was in their same position, working with the same set of parental tools that they had, both having different types of abusive alcoholics in their family histories, but to this day I don’t understand the all or nothing approach. I’m not saying that this might have had any more or less to do with my accelerated transition toward binge-drinking than my friend’s casual Budweiser offering did, but I’m not saying that it didn’t, either. Life’s not that simple, and it’s hard to underestimate a child’s rebellious impulses. That said, and interestingly enough, it hardly seems that my life bears unique results despite the unique introduction and circumstances surrounding my introduction to drinking.
Binge drinking among American youth has rapidly increased in recent decades, with over a third of the nation’s high school seniors now claiming to have drank to physical extremes. Additionally, a notable survey of 17,000 college students sampled found that 40% weren’t strangers to consuming five or more drinks in a single sitting. But even without tough economic conditions, which happen to contribute to excessive alcohol consumption, binging isn’t limited to youth: 12% of adults claim an alcohol dependency at some point in their lives, while 13% of American men who drink can be labeled “heavy episodic drinkers.” “It is a sad testimony that obliteration of reality is the highlight of the week,” writes The Daily Mail’s Laura Powell in her profile on female binge-drinking in the UK. Hell, even in the world’s most rapidly advancing nation, the tendency to binge-drink is on the rise. It would seem that such habits are limited to age, gender, race, or whether or not there’s a grand riding on sobriety.
Frederick Goodwin, onetime director of the Alcohol, Drug, and Mental Health Administration, has co-authored a report suggesting that at least one-third of alcoholics have been given a dual-diagnosis including some form of psychiatric problem; psychologist Michael Hogan puts that number closer to 60%. The connection between drinking and depression is one I can make from my personal life experience; the rise in one typically impacts the other. With that, there’s a challenging connection between the two, and one that is at the heart of my personal exploration: the often overlooked connection between depression, dependency, and happiness. As vague and flimsy as a study on happiness might sound to some, so too do the conclusions made by many in the field of treatment and recovery sound to others.
“An alcoholic is someone you don’t like who drinks as much as you do.” —Dylan Thomas
I absolutely loathe the term “alcoholic.” I don’t like being called an alcoholic, I’ve nearly gagged the few times I’ve admitted myself as one, and I even cringe when people get cute in throwing the term around as though it’s both some sign of accomplishment and superficial shame, “Brittany, you’re such an alcoholic.” I hate the term. (And for what it’s worth, I can’t say that I particularly care for Brittany, either.) Mostly I hate the label because all at once it means so much (pain, broken families, suffering, death) and so very little (Brittany). The National Council on Alcohol and Drug Dependence defines alcoholism as “a primary, chronic disease with genetic, psycho-social and environmental factors influencing its development and manifestations,” which lends the term even more convolution. But it’s what really goes on in the brain of an alcoholic that lends the word its complexity.
“We drink to one another’s healths, and spoil our own.” —Jerome K. Jerome
To deny alcoholism as a “disease” is a dispute of semantics, but to deny physical addiction is entirely misguided. Odd as it might be, plenty of people grow up under the exact same circumstances, yet we all evolve differently based in part on our own unique physical chemistry. Dopamine, for example, controls the brain’s pleasure and reward centers while mediating addictive and impulsive behavior, but how the brain reacts to external stimuli on an individual basis is largely unpredictable. A lifelong sub-par student of the sciences, my understanding of the specifics is dim at best, but when we drink, alcohol is broken down into ethanol, water, carbon dioxide, and acetic acid or acetaldehyde (a toxic product which damages our DNA, no less). From there, the liver and the stomach (as well as other tissues such as the brain) begin to metabolize the alcohol. While alcohol, as all addictive substances are to do, initially increases the release of dopamine into the mesolimbic system, a main pathway which carries dopamine from one part of the brain to another, chronic alcohol exposure to the brain hijacks this reward reinforcement pathway by decreasing the release of dopamine. In a recent commentary on suicide and addiction, famed filmmaker and photographer Bruce La Bruce explained this process as it played out in his own life, “A therapist described it this way: imagine your brain is a pan that holds all the chemicals that make you feel good. A snort of coke or some ecstasy tips the pan, releasing more of it into your system and making you feel great. Meth turns the pan right over, flooding your system with a feeling of euphoria. But when it’s gone, and the pan is temporarily empty, what do you have to give you a sense of well-being? Nothing. And what happens when the pan is empty all the time?” Alcohol might not turn the pan right over, but the fallout and feeling of emptiness which follows a hearty bender is no less real. And that doesn’t even begin to take into account other physical factors including the insomnia, cellular damage, full-body withdraw, depression, and central nervous system damage associated with severe drinking. In short: alcohol’s effects are complicated.
Back to the mental illness portion of the equation where the World Health Organization explains depression to be “characterized by sustained sadness and loss of interest along with psychological, behavioral and physical symptoms. It is ranked as the leading cause of disability worldwide.” But again, and not to be redundant, what is at the core of depression is about as ambiguous as what is at the core of happiness. The National Institute of Mental Health suggests that “depression is caused by a combination of genetic, biological, environmental, and psychological factors,” which is to say there’s really no absolute answer for what it is or how we’re affected by it, either.
“Mental health should be more than the absence of mental illness.” —Martin Seligman
Not unlike happiness, the reality of depression and addiction holds few certainties. What our society has become successful at through this process isn’t the attainment of wellness for its people, but the devising and assigning of countless independent “solutions,” each a physical, social, or emotional anesthetic, each resulting in varying degrees of failure. All of this isn’t to say that our culture is only going about “treatment” by using ineffective methods, but that, as the University of Houston’s Dr. Brené Brown has suggested, you can’t always numb the hard feelings that accompany life without also numbing other emotions such as joy, gratitude, and happiness. When we latch onto the methods instant gratification proposed by medicating ourselves, what we’re left with is an overly-numb, increasingly unhappy society perpetually looking for the next temporary solution to mask its happiness deficit.
That considered, there’s a tricky catch 22 that has developed, and one which continually safeguards against personal accountability, political incorrectness, and insensitivity, while guarding the concept of genetic victimization. As Jennifer Baker of Psychology Today has explained, “Seeing addiction as a lack of willpower can keep us from acknowledging a difference in addicts’ brains. Regarding it as a disease can mask the very real possibility of recovery through a choice to stop. Thinking of the ‘chemicals’ themselves as the cause of addiction obscures the real cause.” It’s hard to examine issues when they’re generally considered “off limits,” but we can’t fix the problem at hand until we examine the issues. The connection begins to mount.
For about three years following my suicide attempt I was on anti-depressants (most recently Wellbutrin), but it was long before my 2008 collapse that I began to have issues with self-medicating. Whether it be loneliness or sheer boredom, if the circumstances were (are?) right I’ve historically sabotaged myself by binge eating and drinking. It’s not that the binging makes no sense, but that it’s a reward process that makes no sense. Drinking heavily, in particular, comes with a wave of euphoria (remember that whole dopamine release thing?) and leaves me feeling impenetrable to any unhappiness that might be on the horizon. Yes, tying on a serious drunk is mistaking a seemingly pleasurable state for happiness, yet how much different is it (blunt destructiveness aside) from playing Russian Roulette with prescription anti-depressants when their side-effects are actually considered?
About 13% of Americans use some form of mental health service, while one in ten Americans are taking prescription medications to combat depression (antidepressants are the most prescribed medications in the States, for what it’s worth). Yet clinically tested “meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment.” In fact, upward of 80% of the effectiveness of medications such as Prozac come from placebo effect (in all of its curious power). (Which isn’t even to mention how Botox might actually work better than any antidepressant available today.) The Big Business behind pharmaceutical companies marketing their products to doctors and patients alike (can you even count how many commercials, magazine ads, or billboards for medications you see every day?) has created a tremendous disparity between the perceived necessity for medication and the actual need. Scientific breakthroughs are still in testing phases and experimental procedures are out of reach for the average person suffering. Psychiatrists, while able to prescribe medication and treatment, might not always be medically qualified to deal with addiction or dependencies (and it’s not unheard of that trained professionals create problems that they believe they’ve merely uncovered). Not unlike questionable treatment for depression, methods to combat dependency and addiction are largely hit or miss. “Most of what we previously knew about alcoholism has been based on studies of 40-year-old white male alcoholics in treatment,” suggests Dr. Mark L. Willenbring, director of the Treatment and Recovery Research Division at the National Institute on Alcohol Abuse and Alcoholism. Federal regulation prohibits proven treatment methods to help addicts, while the historical twelve-step models used to help nurture those looking to change their lives are exactly as effective as choosing to quit drinking cold-turkey by themselves: both about 5%. (Perhaps that’s not the reason why court mandated attendance of Alcoholics Anonymous meetings has since been deemed unconstitutional, but still…) This isn’t to say that certain methods and techniques can’t be beneficial but what harm does it do to assess these issues within the realm of happiness or Positive Psychology rather than diving headlong into treatment models which have consistently proven questionable benefit.
“I don’t have a drinking problem, I have a thinking problem.” —Craig Ferguson
What follows isn’t a plea to wipe the slate clean and throw the baby out with the bathwater, but rather to reexamine the existing principles themselves, which takes us, in a roundabout way, back to “the good life.” Aristotelian belief dictates that depression, no matter how sinister its effects, might actually be quite valuable because of the personal insights that accompany it. That glass-half-full perspective not withstanding, it would seem that the practice of valuing virtue and the pursuit of living well allows individuals to reflect and experiment within the realm of personal healing. No matter how dark a reality depression might paint for us at times, without accepting responsibility that we’re ultimately the source of our own happiness it seems rather irrational to believe that flawed treatment plans and ineffective medications would bring about true relief on their own.
Though her conclusions might not draw an immediate correlation to depression, social anthropologist Kate Fox’s assessment of binge drinking in the U.K. brings with it a dramatic conclusion that speaks far beyond the realm of addiction or dependency. As she bluntly explains, “The problem is that we Brits believe that alcohol has magical powers — that it causes us to shed our inhibitions and become aggressive, promiscuous, disorderly and even violent. But we are wrong.” Uncompromising in her findings, she further explains “ambivalent” drinking-cultures: “In high doses, alcohol impairs our reaction times, muscle control, co-ordination, short-term memory, perceptual field, cognitive abilities and ability to speak clearly. But it does not cause us selectively to break specific social rules.” Alcohol, itself, she argues, does not lead to disinhibition, aggression, promiscuity, violence, or anti-social behavior, but instead that the effects of alcohol are determined more by cultural rules and norms. Comparatively, Fox continues, “There are other societies (such as Latin and Mediterranean cultures in particular, but in fact the vast majority of cultures), where drinking is not associated with these undesirable behaviors — cultures where alcohol is just a morally neutral, normal, integral part of ordinary, everyday life — about on a par with, say, coffee or tea. These are known as ‘integrated’ drinking cultures.” Yes, alcohol affects the individuals who drink it, and yes, heavy consumption on a regular basis has consequences on the mind and body which are still not entirely known. But I, an “alcoholic” myself, agree with Fox’s conclusions, and further argue that genetic susceptibility, a pre-existing chemical imbalance, or habitual over-consumption does not dismiss personal accountability or erase liability for one’s actions.
Speaking to the confounding ailment, Bruce La Bruce continues in his article, “Depression has a wide variety of causes — environmental, genetic, and stress-related — so you can’t always blame suicide on the chemicals inside you or those you put inside you.” As much as this next idea might suggest that I’m a prime candidate for sensitivity training, I see this to be true in my own dependency and depression as I do in others: The road to recovery begins with self. The closer in you’re able to look, the easier the connection is to be drawn between the scenario painted by Fox — otherwise-unacceptable behavior becoming reasonable while under the influence — and the tendency of a depressive to similarly confuse cause and effect. Depression might not have to lead to self-destructiveness any more than heavy drinking has to lead to “undesirable behaviors.” Empathy and sensitivity shouldn’t equate overlooking beliefs that may otherwise be considered true: by any other name virtue might be the key to wellness.
“If you devote your whole life to completely avoiding something you like, then that thing still controls your life. And you’ve never learned any discipline at all… All or nothing is easy. But learning to drink a little bit, responsibly, that’s a discipline. Discipline comes from within.” —Stan Marsh, South Park
Long personal stories and fact regurgitating aside, there really aren’t any answers that universally define a proper way to approach dependency or depression, regardless of whether or not happiness is figured into the mix. Alcoholics Anonymous might be built on ridiculous foundations and have pitiful results, but Moderation Management, Rational Recovery, and any number of other of alternative forms of treatment have hardly fared any better. And treatment for depression… Well, the results speak for themselves there as well. Not unlike Jennifer Senior’s explanation of “set points” regarding mood, we all have physical set points that help determine not only our physical starting point, but what might be beneficial in helping us arrive at a state of wellness (as well as what has the complete opposite effect!).
Without a doubt, drinking and depression are two separate issues on their own, with vast worlds beneath the surface of both which continue to evolve alongside our ever-changing culture. Yet painting a picture of recovery with broad stroke across the canvas for either, or both, as treatment and medication research has done to this point, has worked so very sparingly that it seems nothing but a colossal failure. Certainly, it would seem wise to teach those coming of age the merits of safer drinking rather than proposing these attitudes of all or nothing, destructive or wholesome. And likewise, it might be great benefit to offer youth more a safety net of information and support as they recognize their own place along the wellness spectrum But who’s to say that they’re not the exception, that they don’t have the genetic make-up or predisposition which might send them spiraling “out of control”? The answers simply aren’t all there yet.
Above all, and maybe more now than ever, our society is becoming a grand incubator for the un-well: Increased reliability on technology and welcomed seclusion is creating an epidemic of loneliness, while the abundance of cheap, unhealthy indulgences is expanding our waistlines while hindering our self-esteem. Yet while other tenets of well being remain shaky there are some that continue to remain consistent: nutritional therapy is beneficial: eat right, and you’ll feel better; plenty of sleep and a reduction in stress both lead to a tangible decrease in depression levels; those who exercise regularly experience enhanced levels of enthusiasm and are are equally successful in curbing depression as those who take antidepressants alone (they’re also less likely, to experience recurrent depression). As tacky and cliché as it sounds: if you work at it, as those who’ve lived through it and survived will so happily tell you, it can get better.
“Once you break through that wet gillnet of depression… that net that’s just hanging over you, well, at a certain point when you become productive and you start breaking out of that depression and you start accomplishing things in your life, it becomes addictive. And just as addictive as eating the Häagen-Dazs, and spending the day in your bathrobe… just as addictive as that may have felt at a certain time. Well then, writing a book, and working on an independent movie, and working on a podcast, and an idea for an invention, and whatever it is, whatever your thing is, will become equally as addicting and you will start taking on life in the exact opposite direction that you’re going now. But the first part is, you gotta, you have to beat yourself up because people beat you up coming up. Meaning, you need to kick your own ass. You need to create your own boot camp. Just get your ass out of bed and just start moving.
Pick it up, don’t look at it, don’t think about it: For me it started always with a coffee mug that would be rattling around the passenger floor of my truck. I’d stare at it: pick it up… ‘I’ll get it tomorrow.’ No, get it now. ‘You know what, it can stay till tomorrow.’ Yeah, but then you’ll bring another mug in there and it’s going to clank around, then the handle’s goin’ to break. And I realize: I just spent 20 minutes sitting – don’t spend 20 minutes staring at the mug. Go get it. And eventually, you’ll just be that person that grabs the mug and brings it into the kitchen. Maybe you’re insane. Maybe you’re lazy. Maybe you’re depressed. But, you know what? The mug’s in the sink.” —Adam Carolla
The only real certainty along each of our own paths is us, the individual. We are the only ones who really know what we’re feeling at any point in time, and to move forward we have to honestly assess our lives and determine which events we can build off of and which need to be left in the past. What’s worked to this point and what hasn’t? In my own life, depression notwithstanding, moderation remains the most difficult hurdle for me. But for as easy as it is to dismiss self-discipline and moderation, instead looking for solace in abstinence, for as long back as my parents trying to motivate me to remain sober, that hasn’t worked for me either. And my depression, well that dates back long before my first sip of Bud. As I continue to dust myself off after my most recent mental collapse, the only thing that makes sense right now is to be honest with myself: if I know that exercise helps me feel better, don’t make excuses for how I’m paralyzed by my mood; if I catch myself slipping emotionally, don’t prop myself back up on a crutch of indulgence. I know the traps all too well, perhaps it’s time to start avoiding them. We might not be able to train our brains to react differently to dependency or addiction, but we can train them to be less susceptible to roadblocks and more susceptible to happiness. If you want to feel better, it starts with today’s commitment, which strangely enough, appears to have to be all or nothing to have any chance at working.