I hate this idea that addiction is someone just getting high so they don't have to feel bad feelings, which seems to be the underlying assumption of most discussions.
My dad drank heavily for a lot of years. I grew up hearing tales of his legendary drinking. Mom would buy him a case of beer on Sunday and if he ran out mid-week, he would drunkenly accuse her of drinking his beer -- which makes no sense because mom is a tea totaller. He would go on a bar crawl on nickel night and hit dozens of bars with his buddies. Etc.
He was in the army and he fought in the front lines of two wars, WWII and Vietnam. He retired when I was three and apparently began tapering off.
I don't recall him having the DTs. I don't recall him drinking heavy in my lifetime. I recall him having a beer as part of dinner when I was four or five.
When I was seven, he was diagnosed with a heart condition. He blamed it on the alcohol and never touched the stuff again (except for a few sips when my brother hit drinking age while talking to him about what made for a good beer, I think).
By then, he had been out of the army for four years or so. He had time to taper off for a few years before making his dramatic announcement that he wasn't drinking again.
I think he drank to suppress his nightmares from serving in two wars. I think he didn't need to actively suppress his nightmares anymore after he dropped his retirement papers and no longer had to live in fear of being sent back.
I think people drink and drug for a reason. We just mostly don't bother to try to figure out what the reason is for this specific person and we just act like "You are a badly behaved child who needs a spanking and you need to just try harder." And then blame them when that stupid idea consistently fails to be an effective solution to their problem.
> I hate this idea that addiction is someone just getting high so they don't have to feel bad feelings, which seems to be the underlying assumption of most discussions.
But then the rest of your comment is a story about your father seemingly doing exactly that. What have I misunderstood here? Not trying to be flippant, I'm genuinely confused.
I struggled with addiction to alcohol and cocaine for a long time. I would not say, at least do feel it’s the case, I was trying to escape. It was fun, and as time when on it was just a thing I did. Eventually my body started feeling it and it took me two years to get clean (I still drink about once a month.) But nowhere along that decade long road did I ever feel like I was escaping my life. I was amplifying it, I can write twice the code on cocaine (I’m already pretty fast) and alcohol is a social thing, I got hooked because it was cool to drink so I drank more than everyone else. I would be the last guy up at a party.
I think the other poster, whether what he said was correct or not, is right that it is a disservice to chalk an addict up to someone escaping life. This removes the majority of drug addicts who got hooked from pain after surgery and now can’t stop, or the ones who could stop but enjoy the feeling it creates. Not all drug addicts are homeless people sleeping on the streets. I have an ex who’s sister runs a chain of stores and she’s a legit meth head, you could never tell though because she does it in moderation and doesn’t look like she takes anything at all.
Yeah, I also found it slightly conflicting. I think the author is probably saying that those bad feels are probably not an answer in themselves but have an underlying cause that often gets overlooked.
I will also add that suppressing nightmares is about being able to sleep through the night so you can do your job the next day, not necessarily about avoiding negative feelings per se. Plenty of people take sleeping pills and are not characterized as addicts for trying to address their sleep issues so they can function.
suppressing nightmares = avoiding bad memories or past experiences
being able to sleep through the night = experiencing peace artificially
not necessarily about avoiding negative feelings per se =
its about avoiding past experiences and not being able to face the 'issues' because you think they will break you or annoy you
I have a serious medical condition that can seriously interfere with my sleep at times. I see absolutely no contradiction in saying "Addiction is not just about avoiding bad feelings" and saying "I think he drank to suppress his nightmares."
Multiple people have told me that's a contradiction and I'm wrong to take that position. It's probably not worth arguing any further and needs to be filed under "We can just agree to disagree on this detail."
I really appreciate your comments on this site, this comment and all the other ones that I've seen over the years, because you give a much needed reality check and are articulate and honest.
I do think though, that it is a contradiction to say that. Avoiding nightmares is exactly about avoiding bad feelings. Other people might end up doing it earlier in the day if they don't have anything around them.
> I hate this idea that addiction is someone just getting high so they don't have to feel bad feelings
That's exactly what addiction is. Getting high is just fun.
> I think he didn't need to actively suppress his nightmares anymore after he dropped his retirement papers and no longer had to live in fear
> Avoiding nightmares is exactly about avoiding bad feelings
Why? Perhaps you don't mind the fact that you have nightmares, but they keep waking you up and keep you from being well-rested in the morning? I've had plenty of nightmares that ended with me waking rested in the morning and plenty of ones that made it so sleep was basically impossible after. The latter is worth avoiding, the former might not be. But their nightmare-ness is equally unpleasant.
My grandfather was similar - he started drinking after he returned home from WW2. He kept the outward appearance of an old-school hard guy, but he was plagued by nightmares and was obviously very disturbed by some of the things he'd seen and done. As kids, we used to love listening to his war stories, but every now and then he had to stop and wouldn't finish a story. As kids, we didn't understand how this seemingly invincible man, who we basically idolised, could have such demons.
He drank heavily for decades - vodka and super-strength lager. As a kid, I don't think I ever once saw him without a can of beer at his side.
One day when I was 16 or so, he ended up in hospital because of his drinking. He decided he would stop drinking - and he just did, having only a single hiccup in the 10 years or so before he died. It was really quite incredible - that must have taken incredible strength and will power after decades of abuse.
I've had my own brushes with drink a long time back, and I fully agree with your reasoning - I think most people that use drink and drugs are able to do so safely and responsibly, and most of those that don't sink into habitual drink or drugs for a reason; trying to ease pain (physical or psychological), make life more bearable, or to escape it altogether.
Someone once told me that just up and quitting alcohol or other things without treatment, drama, etc. was kind of the norm for the generation that fought in WWII. I have also read that Vietnam vets did a lot of drugs while in Vietnam but most of them quit when they returned to the US and did so without any kind of treatment.
Vietnam was really ugly. Women and children were acting as suicide bombers and it was an unpopular war, so we did one-year tours and most people going were about 19 years old (compared to mid twenties for average soldier age in WWII) and you are most likely to die in your first battle. If you survive your first battle, your odds of surviving the war go up.
So there were a lot of people seeing their first battle at a young age and it was a meat grinder. It was ugly even for a war.
>>"I have also read that Vietnam vets did a lot of drugs while in Vietnam but most of them quit when they returned to the US and did so without any kind of treatment."
I have read elsewhere that something that makes a big difference when quitting drugs is change your environment totally. That means, the group of people you spend time with, but maybe, also, work and even home. Moving away to another city or country probably helps.
Frequently, we don't realize to what point we are our environment.
"Change your people, your places and your things" is something I have heard as a recommended best practice for overcoming addiction. I suspect there is some element of psychology involved but probably also physical effects.
It's more or a less a recipe I followed as part of my efforts to address a completely different health issue having nothing to do with addiction. I think we are in the infancy of our understanding of how germs, chemicals, etc. proliferate in our lives and shape them.
And, yes, hopping a flight back to the US and making a clean break with Vietnam -- both the place and the war -- likely helped them make a clean break from their addiction in this case.
Yes but they are really talking about habits/triggers there. They have another saying: "Wherever you go, there you are." The core assumption of twelve-step programs is that the problem is defects of character in the individual.
Addiction can be a way to deal with problems that you are having, which is incredibly uncharitable to call a "defect of character". There's nothing wrong with using, there's perhaps something wrong with being destructive. Those two things are not at all the same.
Yup, and imagine seeing all the new people show up and get killed immediately. How that must have effected the way they interacted with people, and how it must have felt to be treated that way when you first show up.
The new people would get you killed if they didn't learn how to avoid dying.
It was apparently an issue in Vietnam, where individuals were rotated in and out of existing units. Units that had bonded over training, death, and suffering - and then a new guy (sometimes a new leader!) shows up. From what I read, people were not always welcoming and this was also a way to avoid becoming attached until after that first battle
> Women and children were acting as suicide bombers and it was an unpopular war.
From my experience with the URSS Afgan war veterans, the problem is not when children and women are trying to hurt you. The post-war nightmares come from you deliberately hurting them in most unimaginable ways. Unimaginable even to the perpetrators after the war finishes.
It was only intended to say in a nutshell "When you have a situation where people think it's appropriate to strap bombs to children, things are extremely ugly."
I didn't really want to go into a whole lot of details. The ugliness of war is not really directly on topic and I try harder than I used to to make my point in a way that shouldn't require trigger warnings.
Reminds me of this TED talk: https://www.youtube.com/watch?v=PY9DcIMGxMs"Everything you think you know about addiction is wrong", where he asserts that addiction isn't caused by the things we typically correlate with it. I was going to try to summarize, but I don't think I can do it justice. Its not long.
> I think people drink and drug for a reason. We just mostly don't bother to try to figure out what the reason is for this specific person
Absolutely. This is totally in line with what that guy says in the video too.
One thing he says: "The opposite of addiction is connection."
I know that personally, when I have problems that I struggle with and don't feel like anyone in my life can help me with or talk to about them (sadly has happened once or twice in my life), I have a tendency to binge, with anything that provides a brief escape, be it alcohol, drugs, video games, TV series', chocolate. Of course, its never been too bad, severe or long lasting for me, so it hasn't been too much of a problem and I wouldn't claim it comes close to what an alcoholic or heroin addict goes through, but I can at least see how someone might slip into such things, as a distraction from reality. And its usually coupled with a feeling of isolation and loneliness, feeling like you're alone with problems you don't know how to solve. So you hide from them instead. That's the impression I got after thinking about my past situations at least.
I used to like that video but it hasn’t aged well. The whole opioid epidemic showed how you can make addicts out of lots of people through getting them physically addicted.
Do we know that people affected by the opioid epidemic are not otherwise affected too? For example, given the past experiences that I mentioned previously, I could see how if I had been on opioids at the time, that I could have perhaps become addicted. In general, we're living in a more technologically connected but physically and mentally disconnected lonelier world, I remember reading something here on HN not that long ago about this, it doesn't at all surprise me that many otherwise normal seeming people would be prone to addiction. Most of us don't show our struggles publicly, but we still fight with them. More of us are damaged in some way than we like to admit, we see it often where some person who seemed like they had it together suddenly does something seemingly out of character (like suicide).
Having said that, I don't think its completely contradictory to the video that some level of purely physical addiction can exist too, (I know he doesn't say it, though), just that in the majority of cases there's perhaps a deeper reason. More people on opioids obviously makes a smaller percentage more visible.
But at the end of the day, I'm only speculating either way, I don't know, I'm not a doctor, pharmacist, chemist, psychologist or anyone else who might know, so... grain of salt and all that.
> One thing he says: "The opposite of addiction is connection."
Makes a lot of sense - I once read that a defining parameter to determine addiction is how it affects relationships. Addicted people often fight and eschew relationship in favour of their addiction. I am reminded of this often when I see kids fight with their parents about how much time the spend on their phones / tablets / computers instead of doing other activities.
"I am reminded of this often when I see kids fight with their parents about how much time the spend on their phones / tablets / computers instead of doing other activities."
To be fair, some parents arent worth connecting with. I'm really happy for you if this isn't your personal experience.
Most families are dysfunctional, to a greater or lesser extent. So many people come from dysfunctional families.
Sure; if the custom in your family when faced with problems is to drink or drug, then it won't be surprising if you take the same approach.
My limited experience of people from flawlessly functional families is that they tend to be - um - boring. I find people's flaws and weaknesses make them more attractive and interesting. YMMV.
Alcoholism in one person isn't contained to just one person. It affects everybody around them as they need to live with the fallout. An alcoholic will do anything to get their next drink and restricting cash access leads to horrendous consequences sometimes.
When you live with that in childhood then you make sure you don't get exposed to it in adulthood. I drink socially but made sure to marry somebody who hates alcohol. Living with an alcoholic as an adult isn't good for your mental health.
A colleague early in my career was badly wounded in Vietnam and was a heavy drinker into the late 90s. It was an escape from physical and mental scars afaik. The experience out a heavy toll on his kids, his 4 wives, and coworkers who had to deal with some of the side effects.
When I met him in the early 2000s, he had turned that aspect of his life around and moonlighted as an addiction counselor. His thought was that he could tell you within 2-3 days who would make it out of a group program — they had to have a reason.
For my friend, his granddaughter’s birth was a wake up call that lit up his motivation. It sounds like for your dad, leaving the army was the trigger.
Several members of my extended family struggled with alcohol - at the time growing up I saw it as a weakness or failure, which I regret. Growing older and gaining more understanding led me to a conclusion similar to yours in the subject.
>> I hate this idea that addiction is someone just getting high so they don't have to feel bad feelings...
>> I think he drank to suppress his nightmares from serving in two wars.
I mean... I thought the dad story was going to contradict that first thing.
I agree with you (I think) that many people use addictions to sooth or avoid unpleasant feelings. I know some people who even admit that's why they do it.
I think my father needed his sleep. I think that was his main goal: Getting enough sleep so he could function.
There likely were other benefits. As another comment here notes, alcohol is also a blood thinner. My father was on blood thinners for many years after being diagnosed with a heart condition and did have a large clot at one point that he could have lost his leg over.
But I think the fact that he apparently began winding down his drinking when he left the military means his primary reason for drinking was likely to manage his fear of being sent back to the front lines. That's not the same thing as avoiding bad feelings per se. It's more like moving stage fright out of your way because your paycheck depends on your performance and you need to perform in the here and now regardless of how you feel.
There is truth to that. We abuse substances without understanding why. Getting to the root cause of that existential angst is not easy. And I say "abuse" to distinguish between that and physiological dependency. I think the word "addiction" is overused, as most addictive behavior is overindulging and a chronic, negative habit loop.
We have nothing to go on except for the words you posted, and those words seem to contradict themselves. So, discussing them or asking for further clarification seems reasonable.
Stick to discussing the idea I'm suggesting and don't tell me and the world what I should think of my own father.
While I am making this follow up comment, I will add that no one ever once characterized him as an alcoholic, he never attended AA or any kind of treatment, and my mother did not care that he drank heavily because "he was never a mean drunk and there was always enough money."
All the stories I heard growing up about his legendary drinking were told as humorous stories that my parents laughed about from the good old days. I'm the youngest of three children. My father never hid his drinking from anyone. I just didn't happen to personally witness it because he largely stopped after he left the military even before he officially announced that he was quitting.
> no one ever once characterized him as an alcoholic, he never attended AA or any kind of treatment, and my mother did not care that he drank heavily because "he was never a mean drunk and there was always enough money."
I feel like whenever I read a description of alcoholism, an essential component of it is that you can't stop drinking despite it negatively affecting your health, work, relationships, etc. If he was able to drink at that level without causing those negative consequences, then I think it makes sense that no one would have thought of him as an alcoholic.
It was also a different world back then. Drinking and smoking weren't stigmatized like they are now and there were fewer OTC drugs to medicate aches and pains. People with physically demanding jobs routinely had a beer at the pub on the way home to ease their aches and help them sleep and it wasn't anything you needed to explain or justify.
Again, I’m not here to fight you. I still struggle with addiction, so I’m seeing if I have any insight to offer. The reasons are often so damn simple, but the solutions are the slipperiest of slopes. That’s how we slide into it, for literally the simplest reasons.
Yeah, it could be the nightmares, or it could be something even simpler.
Alcohol is known to suppress dreams. It's a physical mechanism impacting brain function in that regard.
I'm not suggesting "suppressing nightmares about the war" is the reason other people drink. Just that was the reason I believe my own father drank. It's a conclusion that took me a long time to make and it's based on an analysis of the facts of his life.
If you are still struggling with addiction, maybe you don't yet have the answers you need. Maybe the pat answers you are parroting are part of the problem.
They are answers that actively promote a sense of helplessness and actively discourage pinpointing a specific cause. I'm suggesting that's exactly the problem with our current mental models.
Edit: I will also add that suppressing nightmares is about being able to sleep through the night so you can do your job the next day, not necessarily about avoiding negative feelings per se. Plenty of people take sleeping pills and are not characterized as addicts for trying to address their sleep issues so they can function.
With kids to feed, one does what he or she has to do to go through backbreaking or stressful work.
Drinking suppresses nightmares but gives a less refreshing sleep. Must have been tough to make that choice... I wonder if he smiled less or had trouble enjoying things when he stopped... More stress or less patience. But you already shared so much about your father, you don't need to answer!
As for the sleeping pills, after I've seen how they made my grandpa dependent, and now that I'm trying to taper off antidepressants, I'd like to moderate. They probably are addicts, just not with the negative connotations of addict, if you see what I mean. I wished we'd help more people tapering off stuff.
Kudos, though, to people doing what they can to give their children and spouse a life without money worries.
At least twice, I had doctors describe me as having an "addictive personality", and saying things like "that's just how you're wired". I never went back to those doctors, as I refused to accept that's what I was stuck with being.
I'd been an excessive drinker from my late teens through to my early 30s. "Alcoholic", I'm not sure about; I've seen others who were formally diagnosed alcoholic, including one friend who ultimately died of it, and I wasn't that bad, but I was at least very socially dependent. I also smoked tobacco heavily and dabbled in some substances - not the most addictive ones, but it could have gone down that path if I hadn't seen the warning signs.
At 33 I stopped drinking and smoking completely (I'd quit smoking a few years earlier but had started again that year). For two whole years I didn't have a drop or puff, and focused on eating a very healthy diet, cleaning up my body and getting my career and relationships in better shape.
Along the way I found some deep emotional healing techniques. I started doing them regularly, and have continued doing them consistently for nearly 10 years since.
These days I can drink regularly for pleasure, and I never have a problem with it. I barely ever get drunk unless it's a major celebration, but if I do, I bounce back fine and have no temptation to do it again any time soon. And I'm never remotely tempted to smoke or use other substances when drinking, even when around others who are.
One of those doctors expressed shock that I'd gone to all the trouble of quitting my old ways, only to start drinking again. He couldn't believe that it would be possible to go from the way I was to having a healthy relationship with alcohol.
The most significant factor that's made the difference has been the emotional healing work I've been doing. It's a practice that methodically finds and enables releasing all traumas, complexes and sabotaging beliefs/patterns from the earliest times in life.
So maybe it's valid to say one can have an "addictive personality" and that I was one of those people. But we assume that "addictive personality" equals "hard wired", without realising that personality is very alterable if you work at it consistently over a long enough period of time, with a focus on the deep subconscious/unconscious aspects of personality.
I think organisations like AA do great harm when they tell their patients that you're an "addict for life". It's such a disempowering belief to have about one's self, and it's little surprise that people relapse when they're given no hope of ever being completely free of their addiction and able to live like other healthy people.
These days, I have a young child, a great relationship with my partner, family members and friends, my career is going fine, and my physiological health continues to improve. The doctor I see these days, on the infrequent occasions I need to see him, says "whatever you're doing, keep doing it".
Had the same addictive personality. Latter diagnosed with ADHD which is a brain imbalance that has difficulty regulating dopamine.
Unmedicated, I have a constant drive to find something that gives a little reward. Cigarette, beer, doom scrolling Twitter, unhealthy foods, other forms of unhealthy and impulsive behavior.
Medicated, I don't have that feeling where I just need SOMETHING. And my 'addictive personality' is just none existent.
I've also done some work on myself as far as identifying triggers and feeling and being able to identify where that drive is coming from.
I think the addictive personality trope is really harmful and it's more likely untreated trama or feelings or untreated mental health.
Mental health is so overlook at least in the US health System. It's a real bummer but I don't think any of us are beyond hope and I hope that we can start to recognize and address that.
Vyvanse changed my life, truly. Most of the amphetamine class of drugs "work" for me but their side effects are/were nearly intolerable, especially in hindsight (high school was miserable; daily stomach cramps & tons of social anxiety, despite being very focused/incredibly effective).
When Vyvanse came along it completely changed my life -- all of the benefits of the 'basic' existing drugs, zero side effects. I can barely tell if I've taken my medicine in a given day or not, aside from the ability to focus; but I eat, sleep, and am socially the same as "normal" with Vyvanse, I don't feel it 'coming on' or 'wearing off', etc...
The only downside is that it's still not generic -- so it runs me around $10/day. My ideal dose really seems to be two lower-doses per day and no insurance will cover that, meaning it'd cost me $20/day+ (this is with $1500/mo+ insurance), which means I just make do with what's reasonable.
That said, it truly has changed my life -- I went from being a low-GPA high-school student who could code, but couldn't focus (or stay motivated) about much anything, for any period of time. To founding a company, having a mildly successful exit at 18, and then going on to be CTO, and subsequently founded multiple companies.
Don't get me wrong, I still have my personal struggles (like anyone else) but, if it wasn't for Vyvanse, I think I'd be lucky to own a house -- much less live in a paid-off house & be happily married with amazing children.
for me, ritalin helped most with my focus, adderall xr helped most with my motivation, adderall ir helps me currently with my energy + motivation. i’d say adderall xr is the best of the three, though i prefer vvyanse — but vvyanse is prohibitively expensive, and adderall xr is 4x the price of the instant release. also, i had to take adderall xr twice a day; the “extended release” formulation only seems to add a few hours of duration over the instant release. i’ve yet to try dexedrine, but i’ve read good things about it.
overall though, i’d not rely on anecdotes about add meds. people’s experiences are vastly different in-practice, and the only things you’ll really find in common with other’s treatments are the more pronounced side effects. not to say that there’s anything wrong with asking for advice, just be sure to temper your expectations a bit based on what you read and try not to get too discouraged.
my advice is: if your doctor is willing, have them write you seven-day prescriptions for the different medications you’d like to try and see which one works best. keeping a short journal about sleep, eating/drinking, mood, energy, motivation, and productivity during this time also helps gather some perspective. when you find one that works, try it for a month, and then make a decision from there.
From what I’ve heard from doctors, xr is equivalent two doses released into your body, its not a steady state release as you might expect. Its basically one ir and another ir wrapped in a package that takes a few hours for your body to digest. So if you don’t really have issues with timing and xr costs you more money then ir is totally equivalent and ok to use.
If it feels different, then it might be manufacturing differences. To really determine the difference you would need to get it from the same manufacturer for both the xr and ir versions. Which doesn’t surprise me after listening to a podcast about a book called bottle of lies.
this is how i’ve understood it to work, yeah. the “feeling” of the ir is much different than the xr (for me, that is). i’ve tried comparing the teva generics of each formulation, and the xr just didn’t last as long as two perfectly-spaced ir doses — about five hours for one xr dose, eight hours for two equivalent ir doses. i have a feeling that it’s a combination of manufacturing (as you mentioned) and body chemistry to a lesser extent. vvyanse seemed to work the best, but the 70mg capsules felt slightly too weak, and a month’s prescription for them is literally 9x the cost of the adderall.
I don't really want to comment on that. I think that's a thing that people should work with a doctor on and I don't think that what works for me would work for everyone.
I will say that It took a bit to get it right, and the best thing you can do there is try to keep notes every day so that you can look back and say 20/30 days this worked and keep track of it on a larger scale.
> best thing you can do there is try to keep notes every day so that you can look back
This is key. My doc had me start keeping a log my mood twice daily. I was surprised at how low my accuracy was for self-assessment beyond the last couple of weeks. It really help codify the effects of changes to treatment.
I’m curious about what works for you as well. I have to date been able to regulate this through other behaviors - overwork for one - that I can no longer do due to other constraints on my time. It’s becoming unsustainable.
I mean, what honestly worked was going and getting medicated.
I built a pretty good life for myself by working extra hard. With ADD I didn't ever really know when I would be able to be productive, so I'd just always be ready, always plugged in waiting for lightening to strike. And then once I get going, I'm afraid to stop, so I'd get rolling and stay up all night and into the morning and basically do 20-30 hours of work all at once, but then the next day is a write off, and really the whole rest of the week.
This is great for ops work, the stress/intrigue of production systems that needed to be diagnosed and fixed always got my brain going but at some point, I need to be working on building stuff and delivering on a schedule and not just being on 24/7 oncall. As I started to move into those types of roles, I really hit a wall and that's when I realized I needed to go back and get medicated. (I was diagnosed as a teen and was on meds until my insurance dropped in my 20s)
It started to take a toll on me and my family. There are a lot of feelings of depression on days when I wasn't able to focus entirely and anxiety that I won't be able to focus enough to get things done. Oscillating between those feelings constantly makes it difficult to be functioning part of a family, not to mention keeping your schedule clear or breaking promises because things are finally clicking and I felt like I needed to skip on some activity to get enough done to keep my job. Always working, never getting anything done.
I finally decided that I needed to be able to focus my mind on demand so I can do family stuff during family time and work stuff during work time. I can sleep in and know that I can just get up and start working when I'm ready. I can watch a dumb movie with my kids for the 100th time without it feeling like a wasted opportunity. I can work and just do the things I need to do and at the end of the day, I know I've made that 8+ hours of progress toward my deliverables (generally, we all have trouble with this from time to time because of unexpected complexities and unknowns but I don't feel bad that I wasted a bunch of time). And then I can relax, and just do other things, like hobbies and family time.
There's lots of ways to help mitigate your ADD symptoms, there's counselors out there that can help with behavioral techniques to help increase your ability to focus. If that's what you want find one of them and they can help quite a bit. The danger there was that I still had problems focusing on demand and then I felt even worse about myself because I knew I had this problem and I knew things to do to fix it and I still couldn't get it done. Add a dash of meds in there and everything is clicking. And I can take all that extra hard work that I used to use to try to focus and turn it into real output.
I think everyone is different for sure so if this is something you're struggling with, then get help, get a coach or mental health counselor to help you build strategies to focus at the right times. Talk to a dr or see if your counselor will recommend someone who works specifically with ADD meds.
The best thing you can do here if you realize this is becoming unsustainable is to start getting help from people who work with this stuff.
I can relate to this. Drank heavily through my twenties. But I went sober for two years during which time I identified privately as an alcoholic and addict. I did the emotional healing. I started to meditate daily and exercise and talk about my problems. I had to slowly learn who I was as I had drunkenly buried away and neglected so many aspects of myself. After those two years of cultivating a healthier life and mind I started to drink again. I can do so in moderation and with an awareness of why I’m doing it. The takeaway for me was that I wasn’t an addict or alcoholic, although they served as helpful labels while I grew and healed. I just hadn't taken the time with myself to figure out why I was unhappy and I was subsequently stuck in a feedback pattern of bad, unhealthy behaviour.
Edit: Just wanted to add that I understand this isn’t everyone’s experience and sometimes moderation isn’t a possibility. Just sharing my experience.
There are no “patients” in AA; just self-identifying alcoholics. And I understand where you’re coming from, but for every story of someone who was “disempowered” by a belief that they are an addict for life I can give you a story of someone who started drinking again after decades of sobriety and completely destroyed the good life they had found.
Alcoholism is what you might call a hard problem, in that every case is unique and there is no good way to know which “kind” of alcoholic you are dealing with, or which approach is going to have the most success, just by ticking off symptoms. AA clearly works, and works astonishingly well, for a non-negligible portion of the people who try it.
> I'd been an excessive drinker from my late teens through to my early 30s. "Alcoholic", I'm not sure about; I've seen others who were formally diagnosed alcoholic, including one friend who ultimately died of it, and I wasn't that bad, but I was at least very socially dependent.
Modern addiction specialists have mostly moved on from this kind of definition of an addict in favor of a view that says, more or less, that addiction is characterized primarily by repeated use in the face of adverse consequences.
I've noticed that I tend to get pushback on this whenever I mention it, so here are some sources.
Here's the American Psychiatric Association:
> Substance use disorder (SUD) is complex a condition in which there is uncontrolled use of a substance despite harmful consequence.
Here's the National Institute on Drug Use:
> Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain.
Here's the American Society of Addiction Medicine:
> Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.
It's hard to answer without triggering backlash in places like this, as the whole world of this kind of healing is a minefield of quackery and woo. It's taken me a long time to work through it all and be able to winnow out the practitioners and practices that are solid. And it's tricky to recommend stuff online, as some of it is linked to chiropractic (which I'm still not generally a fan of), and there are big-selling authors who have written multiple books about these topics, some of which is great, but some of which would be a dealbreaker for many.
Having said all that, if you're keen to research this stuff yourself, look up "Neuro Emotional Technique" and Psych-K, and look for books by Dr Bruce Lipton and Bradley Nelson.
But I'm happy to share more about my own experiences and practices if you contact directly. Email address is in my profile.
I think I could have ended up at that kind of rock bottom had I not found the path I ended up on. And more importantly, there's no reason why the techniques I've found wouldn't work for people in AA; they're just not widely known about. I guess mainstream psychiatry and Christianity are the sources for AA's methods, and they're just not aware of what else is out there that could be more effective.
My experience was that the AA “methods” are just a vehicle for the true healing, which comes from the people. The magic is not in the 12 steps, it is in the genuine companionship and selfless service of the other alcoholics who walk with you all along the way.
> there's no reason why the techniques I've found wouldn't work for people in AA
Respectfully, I don’t think you have any idea what you’re talking about. Spend some time in a few AA meetings, maybe a meeting in a prison, and reconsider your hypothesis.
> My experience was that the AA “methods” are just a vehicle for the true healing, which comes from the people
I can believe that, and I'll happily grant that's an extremely valuable spect of it, given how much social isolation is an exacerbating factor in addiction and relapse.
> Respectfully, I don’t think you have any idea what you’re talking about. Spend some time in a few AA meetings, maybe a meeting in a prison, and reconsider your hypothesis.
That's not respectful at all, regardless of the reality of my knowledge of the topic. I've been very close with people who went to AA, including one who lost his life after several years in it. I've been close with others with other substance addictions, including at least one who ended up in prison. Though I wasn't understanding of it at the time, in retrospect I can recognise what was powering their addictions. These techniques would have helped those people the way they helped me. It's been demonstrated by at least one prominent researcher, Dr Gabor Mate - https://drgabormate.com/topic/addiction/
I have opinions and...more importantly...skin in the game, here. It's been my experience that most of this stuff is written by folks, to whom addiction is an intellectual exercise. Maybe they know someone that may or may not be an addict, and the chances are good, that what happens to that person won't really be life-changing to the person writing about their pet theory.
Things are quite different, when it's your ass, or someone that you really care about, experiencing it.
There's also a great deal of money to be made. Desperate people are easy marks.
"to whom addiction is an intellectual exercise. Maybe they know someone that may or may not be an addict, and the chances are good, that what happens to that person won't really be life-changing to the person writing about their pet theory."
Spot on. I also got a massive armchair amateurish feel reading it. They feel very comfortable emphasizing that certain lucky addicts can seem to recover and moderate, but don't really seem to put nearly as much emphasis on addicts that might die or ruin their lives if they read that advice and think they can moderate before relapsing again. No mention in the article about %s of addicts these facts apply to, no mention of the author's name or credentials. Just a crappy article that doesn't help the situation at all really.
Agreed. This article, while interesting enough, is clearly written by someone who is not an addict and does not have close/intimate relationships with any addicts.
"In theory there is no difference between theory and practice, while in practice there is." - Benjamin Brewster
> clearly written by someone who is not an addict and does not have close/intimate relationships with any addicts
I have a disproportionately large number of addicts in my family as a percentage. I grew up around this. This article is written by someone working completely in theory.
There is nuance in everything, and many people may actually beat addiction - but from what I’ve seen, to some degree it’s always there somewhere, forever dormant or just napping, just takes the right conditions to come back.
This article is at best naive and at worst dangerous and deadly. Addiction is visceral and affects the ancient parts of the brain, the best you can do with consciousness and reason is outsmart it at every turn. Can you rationalize being hungry or in love? It's more like a natural reflex that is described: That's what it addiction feels like. Unfortunately you never get to "eat" or "fall in love". It's at best annoying and at worst crippling, and such is the rest of your life to some degree. I wish you luck brother.
Nailed it. It’s easy to pick apart the “official” writings of AA since they were mostly written in the 1930s, but the books don’t do justice to the actual experience of someone recovering from alcoholism.
I respect that but I'd wish you'd say more. I have no way to verify who's more knowledgeable about this, you or the person writing the article but as someone who knows a friend of a friend who might be dealing with this kind of problem I'm having trouble finding any real conversation about it. it seems like it's all advertising or armchair psychology when it comes to online resources about this.
I have always believed there must exist a reason I had addictions. Somehow after about 2 decades, a midlife crisis and starting all over again, and then some years : I seem to have come to terms with these reasons. I seem to understand them, and accept them and therefore accept myself.
And then the urges just disappeared. I tapered off the substances and am clean for over a year now. Fingers crossed. YMMV.
Clarity of purpose makes all the difference for me. The periods where I know what I want and what to do, I have no need for any addiction. When that feeling of purpose and control goes away, I become a slave to them. In some perverse way, they make life endurable when my brain says it shouldn't be.
This x1000. I wouldn't qualify as an "addict" by clinical definitions, but I have a set of bad habits. Over the last year or so I have been making journal entries . The journal entries made me realize exactly what you said - the odds of falling into bad habits multiply several fold during periods where I don't know what I should do.
I realize now that maintaining a journal is a very important and fruitful habit. It is a valuable exercise to record your feelings and state of mind at regular intervals. It will help you figure out your failure modes and patterns (if any) to your successes and failures.
I don't know about drugs as such but 15 years after quitting smoking I still dream I'm smoking and wake up in the morning with the urge to light one. If I get a whiff of one when walking down the street... It hurts.
For me: I think I'm still addicted to it or at least I have the neural pathways of one.
Actually this was one of the first 'signs' for me. When I started to really relax, say a 1-2 hour walk in one of our parks, embracing the void as I like to call it : I noticed I didn't smoke. After a while I stopped carrying the cigarettes.
There really seem to be different ways of quitting. You can quit while remaining addicted, but you can also quit by getting over the addiction. Clearly, you have taken the first path, i.e. are playing on hard mode. I know this path well, but for my final attempt somehow managed to take the second path after 10 years of smoking. It was easy. It continues to be easy. I don't know, but I suspect if I had one cigarette today, I'd be back to a pack a day tomorrow, so in that sense I'm still different to someone who has never smoked in the first place. But I don't have the slightest urge to smoke that first cigarette.
If we could get a clear understanding on how to facilitate this second path, that would truly be helpful to a lot of people.
That tracks. A few months after I quit, I asked my Dad (who quit in the late eighties) when the cravings go away for good. He laughed and said "they don't."
My dad says the same. But it's been five years since I quit tobacco, and I do not get the cravings anymore. I might get faintly reminded of it, still, connected to certain situations, but nowhere near what I'd call a craving.
Fo me it was not exactly easy. I self imposed a limit, in the beginning, of 1/h (used to smoke around 2x20 packs/day-chaining 2-3 at a time). When I was confortable with 1/h I went cold turkey with shivers and the full monty. I wouldn't do that a second time tbh.
On the other hand: My wife had 0 issues and quit overnight. She said she only wanted a smoke a few times/year (maybe 3-5 times or so)
I have a friend who has a similar experience to you. He quit years ago, around when I quit. I had been talking about the book, "The Easy Way to Stop Smoking", so I assumed when he quit he had read it. He had not. He continues to suffer when he thinks about cigarettes and when he smells it across the street or in a park.
I recommended that he read it anyway, and that it is a really useful book for getting over that part of the addiction. He still has not read it. He reads 100 books a year and has not read this inexpensive little 240-page book. Well, some people choose to suffer.
Really, just buy the book. But don't worry about the ceremonies of having that final cigarette. What's important is the base idea. Your mind has been tricked and tricked you in return, and all you need to do is decide to stop playing its games.
I reluctantly second the "easy way". I had heard about it, was skeptical, but found it for a buck at a second hand store so I gave it a try.
I hated it. Badly written, pop psychology trash. Lame circular logic. The same few points repeated ad nauseum. Almost painful to read. There's no way this would work.
And by 3/4 of the way through the book I smoked my last cigarette.
That was 18 years ago. I had been smoking since I was a teen, for fifteen years at least. Had tried to quit so many times, never succeeding for more than a couple of months.
I haven't even craved one since reading that damn book.
This is just an ancedata, but my 90 year old grandmother smoked like a chimney her whole life. Randomly woke up one morning and had zero desire for a cigarette. She’s been tobacco free for nearly a decade.
If you are overweight (obese) at age 18, there is only a 15%(!) chance that you will manage to have a more healthy weight during your adult life. I found that number utterly depressing and shockingly low.
Someone on HN once made the comparison between obesity and the old attitude people had towards depression. When you were depressed, you "just" had to go out and do things. You "just" had to drive out the negative thoughts with positive ones. etc.
When you're overweight, you "just" have to get into a caloric deficit. "Just" undereat 7700kcal and you've lost 1kg of bodyweight. It's that simple.
That doesn't mean it's not true, though. Obese people do lose a lot of weight when they undereat and depressive people do profit from outside activity, sports, etc.
It's just that life often looks like you cannot do it for various reasons. The complicated thing is of course to find a tiny crack in that bubble of constraints where you can force a change.
Just an example: For many people it would be beneficial to ride a bike to get to work. This alone won't change your body completely, but it is a great start, losing you a couple of hundreds of kcal per day and encouraging more bike tours. But that's obviously not possible for everyone and it is difficult to tell from the outside whether someone just rejects this approach because they are lazy or for valid reasons.
The issue e.g. with obese people isn't that they didn't have the bright idea that they could "just" eat less or "just" move more — the issue is that there are very often underlying paychological reasons for the way people take decisions. This is not laziness, this is having a personality structure that makes it harder for you to stay healthy.
We all want to be happy, if for some reason happiness for you is tied a lot more to eating than to being healthy and fit, you can try all you want it just wont make you happy if you do. That means tackling obesity means also asking yourself hard questions about what food does for you, how it got that way (e.g. having grandparents which nearly starved can have an severe effect on the food habits for a few generations down the line, sometimes parents can only express their affection through food which means now you equate food with existential parental love). Changing habits is hard, understanding your own psychological drivers and doing something about it against the resistance of your brain is way harder. Never underestimate the struggles other people have to take in order to do the thing that is easy for you.
Some people preferring being obese because they are happy about eating lots of food isn’t really a counterargument to the fact that losing weight is as simple as eating less.
Honestly I am doing quite well by following those simple practices. But creating wealth out of nothing is surely more difficult than eating less of what you already have access to.
Anyway, the point was that being ok with being obese because you are happiest eating a lot doesn’t make eating less any more complicated. It’s just choosing to do something different, which everyone is free to do.
Sliding infinitly far on your socks is totally easy in a world where you ignore friction and the human need to eat/sleep/etc.
Similarily it is totally easy to imagine getting fit/slim by ignoring the forces acting on someone who is obese. Of course one can do that if it fits with ones world image, but I tend to like my models closer to reality.
Don't underestimate what it does to a kid if e.g. one parent has troubles expressing love through any other means than cooking. Suddenly love comes in the form of food. Similar with situation where ancestors nearly starved — this can fuck up multiple generations. Both examples will take conscious effort to tackle one's psychological drivers, maybe therapy, but quite certainly a lot of time and effort.
Think about a bad habbit you tried to loose and multiply it by a magnitude then you get a glimpse of what this would feel like for an actual obese person (note: I am not obese, neither have I ever been obese). This is why "just eat less and move more" as a statement is ridiculous: a bit like "have you just tried not to be poor" or "have you tried not being depressed all the time". While factually correct it displays ignorance of the forces at play.
If you are happy as you are and don’t want to lose weight, why would you be eating less in the first place much less running into psychological problems preventing you from doing so?
If the part I don’t understand is that there is no such thing as being overweight and happy, and people who feel that way have psychological defects, then it’s not that I don’t understand your point but I do disagree.
Maybe you should have a serious dialogue with any obese person to figure out why it is hard for them if you care about forming a model of the world that represents actual reality.
Most obese people are not happy with their body or the ways their eating habits impact their live in many ways. Most obese people are also happy when they eat or worse: they are unhappy when they don't eat.
If eating gives you a short term improvement even if it makes you unhappy in the long term then you might just do it, like in any other addiction (btw. a well researched topic).
The way out of this is not to "just eat less", the way out of this is to tackle the reason why you only can be happy when eating and then eat less.
the psychology was just described to you above. Not sure what foundation you have to "disagree" with. Human actions and thought patterns are not some libertarian utopia of perfect rational behavior based on an economics equation
> We all want to be happy, if for some reason happiness for you is tied a lot more to eating than to being healthy and fit, you can try all you want it just wont make you happy if you do.
The point is that overeating won’t make us happy either. Maybe it will give some 15 seconds of gratification but then most of us will feel guilt, and the long term effect has terrible consequences. Maybe the problem lies also in the fact that our simple brains can’t really understand the future. I’ve read somewhere that many asiatic languages don’t have a future tense, hence people there when facing the choice of eating something think along the lines “if I eat this I AM fatter/less healthy” and this could be a factor in the way lower obesity prevalence.
> The point is that overeating won’t make us happy either. Maybe it will give some 15 seconds of gratification but then most of us will feel guilt, and the long term effect has terrible consequences.
I don't deny that. Some get unhappy enough to derive enough energy from this unhappiness to tackle this as a real problem. Of course the first box you need to tick to get better is to accept your behaviour is problematic and realize that it makes you unhappy in the long term.
Some might never reach that step to begin with. Many however realize the problems and want to get better but they can't because they constantly fight the symptoms and not the cause, or because their lives give them enough excuses not to do it (whether they are valid excuses or not doesn't matter too much).
I chose to believe that people are a product of both their environments and their own choices. So we are neither completely determined by the circumstances we grew up in nor are we completely free to decide to "just" do things 180° different than we were lead to believe our whole lives. We can shape our environments and ourselves within certain boundaries and over given timescales, but for this we need to know the forces which act upon us. And everybody has forces acting upon them, the believes, rationalizations and stories we tell ourselves about our place in the world are partly a product of this: we try to be happy with ourselves in the place that we have within the universe. We try to establish meaning in the chaos.
This is why explainations like "some people are just lazy" is less of a true statement about the world, but more of a true statement about the stories a certain type of person has to tell themselves in order to feel good. Because if the weren't "just lazy" suddenly one had to reflect upon the environment, the incentive structures that shaped them into the way they are. Suddenly one would feel the ethical need to change said environment and feel powerless confronted with the scale of the problem. Nah. Moar better to say they are "just lazy", then one can stop thinking.
That still validates the statement that people who overeat also need to really consider the reasons they overeat and why. It’s a real deep psychological study as to why this short term joy is apparently worth the guilt later and figuring out strategies to counteract it.
I don't like how people, still, treat lazyness as a root cause, not as an effect.
Lazyness is a bug, it's a failure state, it's a medical condition. Much like depression, psychology cannot treat it in all cases, but taking the approach that people are just born lazy and iredeemable seems like the most unscientific, least promising, and most likely to annoy your devoted commenter.
In my experience, people who focus on laziness are NOT saying the lazy person is irredeemable - they're usually saying precisely "You're choosing to be lazy and you don't have to. Choose to be different!"
Granted, they often don't think through how to do that, or why the person might be struggling to perform, but it's not usually a belief that the person is incapable of doing better.
In my experience, people who focus on the laziness of others are trying to bring the focus at how they themselves are not lazy. There is something similar going on with overweight. What's so difficult? just eat less! look at me! It's a status game, instead of trying to help.
Anyway, to say to somebody "don't procrastinate" is like given a guitar to somebody and tell them "just play!". Sure man, how?
That's hard to want to believe. The problem is if you assume they're not trying to help, then either they need help (too), or there's not much we can do about it.
I feel like a whole lot of people are trying to help, they're just really bad at it and they need help themselves.
"You're choosing to be lazy and you don't have to. Choose to be different!"
This gets to the very important question of how much choice do we really have.
People are the way they are because of how they were raised, their genetics, where and among whom they were raised and their life experiences. There's arguably some choice mixed in there too, somewhere, but how much real choice people have is debatable.
If people don't have much choice in the way they are, it explains why they have a really hard time changing, and there's no sense in blaming them for something they can't change.
Of course some people do change, but maybe that's because they were the kind of person who could, and other people are the kinds of people who can't.
Thank you for trying to explain their thought process — I appreciate that, that's very kind!
I appreciate that you're very empathetic, and I feel like not everyone else is. There's a whole lot of people who probably can't imagine what it's like to be somebody else. That's hard, isn't it?
But when you tell lazy people not to be lazy, and they don't do it, then it almost sounds like you must either be calling them dumb, or defective.
So that's why I feel like thinking of it as treatable is a nice and friendly middle ground. Which a lot of people don't seem to.
That doesn't seem to be their impulse. Oh, they're lazy. Let's not fix that.
in my personal experience, laziness is absolutely a thing. As an example, many friends in college would go party or hang out far more often than I did. Its not that I didn't like hanging out, its that I valued the long term payout of good grades more than my current suffering.
I've also ran through the mountains until I literally couldn't stand from a pile of stress fractures. Even though very stupid, its an example of mind over matter.
To me laziness is an inability to mentally force action over the brains signals to not incur distress or effort.
I feel pretty confident that there is a large overlap of "lazy people" with people that would have a hard time taking cold showers in the morning for a month, if hot water was available.
> in my personal experience, laziness is absolutely a thing. As an example, many friends in college would go party or hang out far more often than I did. Its not that I didn't like hanging out, its that I valued the long term payout of good grades more than my current suffering.
This sounds more like you’re trying to explain the behavior of your friends and are choosing the word “laziness”, but that’s a pretty reductive explanation for why some people like to party and others don’t.
Perhaps if you were willing to do the hard work of questioning your own assumptions and seeing life through your friends eyes a little more you could have more sympathy.
But perhaps you aren’t because that’s hard work and causes distress you’d rather not incur, and it’s much easier to describe human behavior as “laziness” than to understand it’s causes.
I do that plenty, I used that example because it seemed most appropriate for this forum. It was probably because they had a support system, so they felt there lives would be ok even if they did average in school, where I felt I would literally be homeless if I lost my scholarships.
you know who wasn't lazy in school? All the immigrant friends I had.
I could have instead, easily described the 100s of people I grew up around, that would skip work and get drunk instead, spend all their paycheck the day they get it. The obesity, the abuse, the drug addiction.
I have zero sympathy for able bodied people that can't cope enough to feed their children. I don't care the causes, nor are they relevant.
I have worked for $10 an hour doing construction in 100 degree weather, and I have also work as a SWE at a FAANG. I have seen the complete lack of self awareness most professionals and/or those from upper class backgrounds have.
The problem is the word “just”, not the rest of the advice. “‘Just’ eat less” has been straightforward for me when my scales tell me I needed to do that, but it clearly isn’t for most people else obesity wouldn’t be one of the single biggest issues in western healthcare.
It is about the usage of 'just'. So while in the first case people think the just is justified, the before mentioned data indicates that only a few people manage to 'just' do it. The order of percentage of ppl beeing able to do it is the same as something which seems very hard to do (the everest thing). So while objectively they are comparable it shines light on that the usage of 'just' is bad in both cases while the subjective perception is very different.
Not sure if I can make it clearer.
Edit:maybe I was thinking to complicated in this reply. The analogy is: you have two different things which can be achieved through doing a specific thing, but doing this thing is hard in both cases so using the word 'just' is not appropriate which is easier to see in the example.
Yes. The odds of someone climbing without supplemental oxygen vs achieving and maintaining weight loss are comparably low, presumably because they are very difficult, and cannot “just” be chosen so simply.
Changing habits is hard, making choices is hard, doing things that feel uncomfortable is really hard. I have a lot of sympathy, for the idea and we all struggle with stuff like that.
But unfortunately this isn't a complicated subject. Weight is controlled by diet and standard healthy diets are very well known. Nearly everyone can keep their weight down. Even if people don't, it is objectively not that hard to do. A lot of people don't accept the rewards are worth the discomfort.
I would encourage you to track your steps for a week and then get two 50lb bags of sand from Home Depot and carry them around with you everywhere you go for a week. Compare the steps you took in week #1 to the steps you took in week #2 to see how “lazy” you’ve become from carrying around all the extra weight. It’s hard work being fat. Literally.
“Just ride your bike” is an easy solution for someone who is already normal weight but it’s not nearly as easy for someone who’s overweight.
This is a very valid point. A few days back I had to rearrange my kettlebells to a different place at home. So I just carried them. Given how difficult it was walking while carrying them(Heck it was even hard getting up lifting them), I went like There is no way Im carrying this kind of weight on my body.
The example of a person with a musculoskeletal system conditioned to carrying around a 60 kg body, but weighs 120 kgs is basically competing in a Olympic powerlifting competition like situation to just do basic tasks(Using toilets, walking for everyday life tasks).
I can only imagine how hard and near impossible task it is for some one to be exercising everyday.
It is bad advice, because if you just randomly restrict calories, you will run into other issues.
One problem is that calorie restriction itself is modifying how your body works. So, the weight lost in diet is typically gained back super quickly. And if you repeat the cycle, your body also adjusts by spending less calories.
The other problem is that it just lowering calories easily leads to nutritional deficiency of some sort. Which leads to feeling bad all the time, being tired and passive, unable to perform as previously. So the diet will eventually fail for that reason - because you will be more dysfunctional and breaking it will paradoxically make you more functional.
Unless you follow the diet to the maximum - eat only compatible food and skip incompatible (according to the chosen diet), calculate calories every single day. In my case keto diet worked the miracle. Maybe other people could be successful with other, different diets. But it does work if done properly. Same with exercise. Random exercise can be just as bad as restricting calories. Exercise should be systematic and balanced, as well as a diet.
Keeping track of macronutrients and carb counting sounds significantly harder than “just eat less” and I think bolsters the argument that it may in fact be hard to lose weight.
Have you ever been obese and lost a lot of weight and kept it off for a long period? I'm wondering if you are speaking from personal experience, or just repeating things you have heard from other people.
Yeah, I purposefully used the word "simple" when I meant straightforward and "hard" when I meant difficult, but I should've explained why I used those words. Either that, or I myself have gotten the meanings of the words mixed up.
Hm. There is a distinction between simple/complex and easy/hard, but it’s a basic semantic one. Simple/complex refers to a system or problem, while easy/hard refers to the difficulty of controlling the system or solving the problem.
The problem in this thread with making a distinction between simple/complex and easy/hard is that people are referring to different things. People are even talking past themselves so it’s no wonder others don’t understand what they mean.
E.g., the energy model of weight gain/loss — CICO, or calories in, calories out — is simple. But CI depends on interactions between evolution, hormonal systems (a complex balancing feedback system all its own), psychology, age, money, society, culture, family, food supply, etc., which is complex. For a particular person at a particular point in their life, that bundle of factors may happen to be balanced “downward” so that CI is easy to control and weight loss is simple — and easy). In other cases, a person may need to dig in to those factors and find a way to rebalance them, which is complex — and hard.
When you’re actually referring to the same thing, simple and easy or complex and hard go together. It is easy to control simple system. It is hard to control complex ones.
> Simple/complex refers to a system or problem, while easy/hard refers to the difficulty of controlling the system or solving the problem.
I do think the distinction is important. I did realise as soon as I'd typed the last comment that it was just people talking past each other -- apologies to others in the thread, I should have edited. But what I mean: with specific exceptions (genetic, psychological, physical) normally both the process and the solution is simple, because of the energy model. Eat less, eat sensibly, exercise very regularly, and the majority of people will see positive results. That's simple, not quite trivially so, but almost. Actually doing that is not, however, easy for the majority of people.
A better example I think is: I smoke. This is clearly not good for a number of reasons. The solution, and the process to get to that solution is comically simple: I just stop. But yet it is hard.
Meaning seems correct afaics? In particular any commenters who build software or engineer products should recognise this, making simple things is often very hard.
I don't buy calories in. Life forms are full of parts that encourage stability. Your body maintains blood pressure, temperature, oxygen etc. Why not weight as well?
That the relationship of calories in to calories absorbed is linear needs some heavy proof before I'll believe it.
You are currently downvoted but I think there is something to homeostasis.
My favorite counter point to calories in/out crowd is that the body is a dynamic system. The calories out portion doesn't stay constant. I have lost weight while eating more because my base metabolism increased. In "That Sugar Film," the guy eats the same amount of calories and same activity level but starts to include "daily recommended sugar" and increased his weight. The body is a dynamic system and will change how it stores and processes energy. Yes, you can't violate thermodynamics and eating a calorie deficit will cause weight loss (and possibly other issues), but the system tries to adapt.
(a) CICO (calories-in/calories out) is not the same as the energy conservation principle, you can claim that CICO model does not work while firmly believing in the energy conservation principle
(b) CICO isn't untrue, its just too simple to model the bodies approach to managing the fat stores. Fat storage is very much controlled by insulin and cortisol. If one or both are high, your body is primed to increase your fat storage
CICO crowd equates 7000kcal with 1kg of fat body mass and then you can do calculations that losing 10k of body mass in a year can be achieved by reducing caloric intake by 200kcal/day, or increasing expenditure by the same amount, or a mix of both.
Experienced dieters know that this doesn't work as easily.
I was trying to loose weight with CICO and hang out in the CICO-crowd forums for 2-3 years until I realised I couldn't lose more than 10kg that way until I plateaued. And in these forums, it seemed to be similar for many.
Then, with fasting and/or keto forums I hang out in there are so many more credible reports of extreme weight loss. And that is because water fasting and/or keto reduce the amount of insulin your body emits, and thus allows your body to really tap into the fat reserves it has in store.
When you weigh a certain weight, you have a certain resting energy expenditure.
Let's say the average 200lb(Sorry for the American units) man burns 2000 calories a day. If he then goes a week only eating 1500 calories, he will have burned a pound, and now only weighs 199lb, and his new resting energy expenditure will be slightly less. The next week when he is still eating 1500 calories, he will lose only 0.99 pounds.
So of course you will run into a time eventually when you plateau. At some point 1500 calories a day will be your new equilibrium weight and you will no longer lose weight without additional changes.
This is typically an argument the other way, as when you do the math this way it's very clear that the energy when stored as fat is incredibly energy efficient. An extra 100 calories might mean that you gain a pound in slightly more than a month, but you won't settle on your new equilibrium until you gain more than 10 pounds. According to wolfram alpha, the basal metabolic rate of a 200lb male is 1997 calories. The basal metabolic rate of a 300lb male is 2465 calories. The daily energy expenditure of a 200 pound male, who runs daily for 3 miles over 30 minutes, is equivalent to a 300 pound male. 100 pounds of fat is actually a shockingly small amount of daily calories difference.
Anecdotal evidence: I've lost 70 pounds, then regained the 60 pounds, then lost the 60 pounds, and am currently up 30 pounds. Simple does not mean easy.
The inability to burn calories because of nutrient deficiencies is the biggest flaw of CICO. You just won't burn more than your metabolism is capable of burning no matter how hard you try. You can't will yourself to use energy that isn't available.
Keto has nothing to do with insulin, it's just a backup mechanism that fails last.
Calories in is just a rough measure, as absorption is non-linier as you suggest.
The more you eat the less your body will absorb, as your digestive system will digest and absorb more of a 100Kcal meal that a 300Kcal meal. Also the more you consume higher your metabolic rate will be, while the converse it also true. Because of that you you have to restrict your calorie intake by a fair amount to lose weight, and overeat by so much to start gaining weight. Don't forget that all calories are not created equally, as some foods are digested better that others, and different combinations of fat, protein and carbohydrates will affect digestion. The addition of simple carbohydrates raise insulin which can also increase absorption, which is great for gaining weight and stimulating your appetite.
That's not called stability its called 'causality'. The body is a bio-chemical-mechanical machine. Changes over short periods of time are small enough to give a perception of noticeable normal. But small changes are happening nevertheless.
You get fat one more morsel of food, and one less body movement at a time. You lose weight the same way. One less morsel of food, and one more body movement at a time.
What is the new attitude towards depression? I think that going out and doing things along with driving out the negative thoughts with positive ones tends to work. Yes it is hard, but that is besides the point. It's not insurmountable.
I was obese[0] 3 months ago, and had been that way for about two years. Now I'm a healthy weight. It was easy to do with minimal lifestyle changes - calorie tracking, minor dietary changes, and couch to 5k running a couple of times a week.
The way most studies of weight loss work is by recruiting a pool of obese applicants. This is intrinsically biased: someone who has had a lifelong struggle with obesity can be recruited across 100% of their lifespan, whereas someone who spent two years obese and then lost the weight and kept it off can only be recruited for that 2 year window, or 2.5%. There are probably other factors that come into play that bias the sample even further.
The question these studies answer is "given a random obese person, how likely is this person to lose weight?" This is a relevant clinical question, and the answer is usually a pretty low percentage. For an individual who hasn't struggled with obesity their entire life, a more pertinent question is "given that I have just become obese, how likely am I to lose the weight again and keep it off?" The chances of that are much higher.
[0] By BMI, which has a pretty big margin for error, but I was visibly overweight.
Did you grow up obese though? I think the statistic suggests there is something to having the body grow under those conditions.
I was athletic growing up and I’ll always have that experience and know how it feels. Someone obese at 18 has no reference point and neither do any of their body systems.
While I wasn't obese, I was overweight until the end of high school. For some reason I thought weight = 10*age and it took me a while to realize that this would be unsustainable past 20. Now I'd say I'm more fit than average (try to work out ≥4 times/week, have ran several half marathons and a marathon, decently adept at skateboarding) and people can't believe that photos of me as a child are the same person.
I'd say this is more of a boiling frog situation where I don't perceive a demarcation between life before and after getting fit.
No, but I'm trying to explain the sampling bias, not talking about growing up obese. If you randomly sample obese people at any age, 18 or 81, your sample will still be biased by years-spent-obese.
There probably is some effect from growing up obese, but the sampling bias is hugely relevant to interpreting the statistics, and it's not talked about much.
Relevant to the topic of personality and choice in the article. Robert Plomin in his book Blueprint cites the pretty astonishing finding that the weight of adopted children is pretty much not at all correlated to the weight of the adopted parents, whereas the weight of the birth parents is a strong indicator for weight in adulthood, even if separated at birth.
Is that surprising? Weight is strongly correlated with height, which is absolutely genetic. I'm sure that BMI would be less correlated than pure weight, although I don't know by how much.
I think all that suggests is that we do poor a job of helping specific individuals pinpoint the root cause of obesity for them.
I have lost multiple dress sizes without trying to do so. I finally got the right diagnosis in my thirties, "a better name for my problem than crazy", and changed my diet in accordance with medical recommendations.
I was 245 pounds for at least three years. I haven't weighed myself in upwards of a decade but I've likely finally dropped back below 180 pounds this year. I say that based on no longer feeling like "a beached whale" who has trouble getting up out of a chair and past experience with where that point occurs for me in terms of weight.
I imagine the minority who do solve it likely don't really talk much about what actually worked for them and why they think it worked. I have gotten insane amounts of ugly pushback for trying to talk about what works for me and my opinions about my own life and body and medical condition.
If you have any sense, you find what works for you and keep your trap shut so the "crabs" don't rip your arms off. Unfortunately that means the other 85 percent don't get to hear "calorie counting might just be a broken mental model and seems largely unrelated to what worked for me" and that leaves a whole lot of people stranded behind our current broken mental models because it's not socially acceptable to say "Well, that doesn't fit my experience. Here's what I think about my own life and maybe we can work out better mental models."
Through, while long term weight loss have unintuitively low success chances, it is possible to improve health results themselves.
Things like moving regularly improve people's health even if they don't result in long term weight loss. The same with diet change - you can eat better and have better health even if you remain fat. You can lower your sugar consumption, stop to drink sweetened drinks and your chance of getting diabetes 2 will go down regardless if whether it moves your weight.
That lines up with intuition; if you are obede at 18, chances are your parents have not prioritized a healthy relationship with food, meaning it has never been a priority for you or your family, and you are unlikely to change those entrenched habits.
That might depend a lot on the country you are in/from.
The huge majority of (similar aged) people I had meet between 16-20 which had been obese where so because of "health issues" not directly related to them eating unhealthy being lazy.
As such it's not surprising if you have problems changing it because "just" eating healthy and doing sports is far from enough to fix it. And trying to fix it with that is often a task needing far more discipline and self control then the large majority of humans (independent of weight) have.
I mean let's be honest the difficulty many of this people face is way higher then the difficulty for a young(1) health male to get a black belt in Judo, Karate or similar.
(1): Start training with ~14 or earlier, through not necessary with high commitment, then at some point later (e.g. 16,18,20) added commitment trying to get a black belt.
Are health issues unrelated to obesity the primary cause of obesity in under 18s?
Also, I specifically never called anyone out as lazy. The majority of obesity is overeating (a single Starbucks muffin is a 10k run). Yes there are people with imbalances/medication that are outliers but most people aren't outliers.
I specifically called out a relationship with food being something that's carried into adulthood as the cause of the relationship between those figures.
An obese 14 year old may have some underlying health condition but is more likely to be a victim of socioeconomic problems; lack of access to healthier and more balanced foods, or to have obese parents (which appears to be a good indicator for childhood obesity). Neither of these are easy solves, and the blame doesn't lie with an individual, but it does explain that someone who is obese as a child is more likely to be obese as an adult.
> Are health issues unrelated to obesity the primary cause of obesity in under 18s?
Idk, I can only speak about people in my environment.
Where I can only remember one case which might have been because of overeating and I say might because I simple don't know.
Multiple of the obese people I did know had a more controlled and some times far more healthy diet then most people I know.
Many cases I know did slowly but continuously got bigger, i.e. something which can totally happen without overeating.
I also had meet people the other way around, like needing to consume ~6000+ kcal a day when they don't
do sports or they are at risk of becoming severely underweight...
> called anyone out as lazy.
The main reason I mentioned sport is because I know of a case where the person had a controlled diet and did more sport then most other people in class and still looked quite square, from what I learned this person slowly over multiple years got more and more weight without being able to lose any of it.
> . The majority of obesity is overeating (a single Starbucks muffin is a 10k run).
I'm not sure if it's the majority. It's definitely a thing, and very often a thing for extreme cases. It also might very well play a big role in countries with unusual many and many unusual extreme cases of obesity. But many of the cases I know did slowly accumulate weight over years without being able to lose weight starting from a very very young age on.
There was a recent article discussed here that made the case that our obesity epidemic was primarily caused by something environmental, not by individual eating choices. It seemed pretty convincing.
It's worth remembering that only a portion of those people actually make losing weight a goal. It might be a high portion, but still a portion. Simply making the goal increases your chances.
It's similarly bad with alcohol. The lower the age of the first super drunken state the higher the chance of alcoholism later in life. It really messes with the young brain.
Maybe the underlying reason why you're overweight later in life is the same reason you're overweight by age 18?
I think a lot of people upon seeing that statistic will assume that being overweight by 18 will lead to being overweight later in life, but that's not necessarily the case. Perhaps the body's self-regulation on food is 'inherently broken' and that's why they end up overweight in both cases?
Being overweight for any length of time can ruin you appetite and metabolism. Being overweight usually causes insulin resistance at some point, and develop into metabolic syndrome. Also continuous overeating down regulates the production of leptin which is produced when the stomach is full. Competitive eater have this issue, as when they eat they don't feel full so they are able to eat much more,
I would probably class myself as someone with an addictive personality. not with drugs (except alcohol), but with anything - if I like something, I find it very hard to not have more, wether it's good or bad. eg going to the gym 6x week or getting takeaways every day
I've analsysed this for sometime and the best (for me) way of dealing with it is to keep track of every thing I do or I like.
"The power of habit" book helped a lot with my ability to control my addictions
Note that you could probably „weaponize“ this addictive personality to achieve what normal people cannot (eg dedicate an extreme amount of time to a difficult task and achieve it)
I'm not who you're responding to, but I very much identify with what they wrote. I once accidentally trained for a marathon.
Weaponizing this is unhealthy. It doesn't end well. The reason normal people can't do X and an addict can is because an addict is making egregious trade-offs.
"I know I'm going to mess up my shoulder for the rest of my life, but I'm going to bench heavy anyway"
"I know I haven't seen my kids in a month, but I'm going to shut myself away and work on my side business anyway"
It's collapsing your entire life into a single, simplistic max/min function. It's a quick path to misery.
I'm reminded of a quote from J. M. Barrie, the author of Peter Pan: "You can have anything in life if you will sacrifice everything else for it." I once thought it was, and have often seen it used as, an inspirational quote until I later read another opinion that it was a warning of the dangers of being too single focused.
I simply take it as a description of reality. As a child, you are nothing yet, but you have the potential to become almost anything. As you get older, you trade in that potential for something specific. It's up to you to choose. You can trade all your potential for one thing only or you can divide it up to become multiple things. The right balance is debatable. The real danger lies in taking it to the limit. If you try to become everything, you divide your potential up into infinitesimal pieces and end up remaining nothing at all, a child.
In any case, there is some real wisdom in Peter Pan, but it was completely lost on me as a child.
Note that dedicating an extreme amount of time to a task can be unhealthy in it's own right, if it's to the detriment of other aspects of life. Depending on exactly what you're picturing, it may also be worth noting that hyper-fixation can lead to working past the point of productivity (sometime you just need to sleep on it, take a walk, etc.). It's not a clear-cut advantage.
Same. I literally got addicted to exercise. Not trying to brag, I’ve also dealt with addictions to food, sleep, video games.
I also have mild OCD. And I’m not depressed, but i get bored very easily and very fast.
The key for me is also habits, diversion, and moderation. I have an easy time forming habits because of OCD so I just have to prune bad ones, easier said than done. I also keep track of how i feel, and just naturally feel bad if i eat too much or sleep late, which seems to subconsciously make me not want to do those things, so i don’t have to use as much willpower.
I have touches of OCD. It's not all bad (it got me through school and has made me decent at work), though when I was younger I used alcohol a bit to disconnect. Met a great girl, mostly quit alcohol, but that disconnect mechanism transferred to MMOs. Faster forward a year or so and I'm playing MMOs 8+ hours/day and girl leaves. I'm devastated and lost. Walk into work a few days later and give all my MMO accounts (yes, I had multiple accounts for the same game to bot, buff, etc...) to a co-worker, and never played again. Started back down the alcohol path, but this time caught myself and decided to try the gym one day.
20+ years later I still workout almost every single day. I think about how easy it could have been to take a far worse path, but exercise has been my savior. To paraphrase Henry Rollins, 225# is always 225# no matter what else is happening in your life. It is the great constant.
>just naturally feel bad if i eat too much or sleep late, which seems to subconsciously make me not want to do those things, so i don’t have to use as much willpower.
feeling bad works a little in reducing various cravings,
but my brain seems to have a way of fading my bad memories somewhat
It reads as if you don't consider alcohol a drug. Due to its social acceptance people tend to look at alcohol this way but when u give it a better look alcohol should be at least classed as a class 1 drug substance, especially if we're going to keep placing marijuana in the same class as heroine.
I'm somewhat surprised this hasn't been attempted as a product actually. Guess it would probably be dreadful for your stomach lining but would be a novel alternative to shots
The “haircut” where you pour a mixer into your mouth, someone pours liquor into your mouth, and then you swallow in a way such that the liquor doesn’t touch your mouth or throat is the closest thing to an “alcohol pill” I can think of. Come to think of it, shots plus chasers are somewhat “pill like” too
The premise of this article (that "Once an addict always an addict" is false when evaluated from a rational, scientific standpoint) is flawed from the start because the phrase isn't _meant_ to be a rational, scientific claim.
The phrase is a contextual, emotional expression. Sometimes it's used to express frustration that even after years of work and/or progress, an addict might still _feel_ urges and have to deploy coping mechanisms against them. Other times it's a way of empathizing with someone who is a victim of a relapsed addict's maladaptive behavior. Still other times it's a mantra for recovered addicts to stay vigilant.
The repeated references to "victimization" are a red flag to me that anything this author has to say about addiction isn't inclusive of everyone's (e.g. my own) lived experience of addiction. Admitting the difficulty and struggle of being an addict does not weaken me and prevent me from working towards recovery.
> Your brain can start functioning normally again in a span of a few months. It doesn’t have to be the same, but it should work just fine.
The two articles linked to at the bottom talk about multiple years, the third link points to a news article that refers to some research that uses one year as a minimum.
This feels more believable than "a few months". My flat mate has ADD and has phases during which he's clearly addicted to alcohol. At one point he stopped drinking completely for over 6 months, but drank a small amount once and things spiralled out of control again.
He does view addiction as a personality trait (in part because he knows that people with ADD develop addictions more often), and that attitue actually seems to help him. These days he abstains from addictive things because he "knows" that he'll get addicted to them once he starts.
I believe in the thesis of this blogpost (that addiction is in fact an emotion regulation problem, and that it can therefore be cured), but the approach my flat mate takes these days works pretty well, at least for the first year.
Alcohol is a depressant - it gradually wanes your higher cognitive skills over the course of hours. Very convenient when one's thoughts are racing. I believe there's no causation in "drinking once" -> "drinking more". I believe there's causation in "trying to self medicate" -> "drinking".
I suggest you mention the Sinclair Method to him. It has worked wonders for thousands who were addicted to alcohol. It is a cheap prescription that you take before drinking and over time people actually drink normally again since the brain is rearranged (the medicine takes away pleasure from the drinking). It might save his life or reduce his cravings.
Notice that they said can, not will start functioning normally in a few months. Basically it's a lower bound, and elsewhere they do say it can take years.
"If enough time passes, you can start engaging in the behavior in a healthy way once again."
Spoken like the author has never had someone close with addiction, imo. You'll notice that actual medical professionals never are like "oh just quit your massively health-ruining addiction for several years then you're good to go potentially! Happens all the time, look at these studies." It's because such advice or facts--while technically true in a % of cases--downplay how devastating the next relapse might be for the addict (often it means death, or at the very least, their life ruined). Framing these things to addicts and individuals properly given their situations is very important, but has been totally bypassed by this author "helpfully." They present the article without mentioning their intentions or target audience too, which hardly helps.
"So I dove deep into the topic and looked at what science says about it."
So what credentials if any do they have at evaluating scientific consensus on addiction? Oddly enough the article includes some sources but makes no mention of who the author is from what I can see. Is this some high schooler's opinion after Googling around for an evening? We can't be sure.
"This has some merit, for example, when it comes to alcohol - you can go from being addicted to alcohol, to having a social drink once a week."
"However, that doesn’t mean you need to avoid the behavior forever."
This author needs to like stop repeatedly emphasizing this stuff and muddying the waters--it HIGHLY depends. Again, this is spoken like someone who has never seen someone kill themselves young after that "one last relapse" because they thought they could control it finally. So this article comes off very poorly and I'm disappointed it got upvoted to be honest. Like, the lucky few addicts who recover and can moderate (& their loved ones) probably won't need this article. To the rest of the addicts and people who may be giving them advice, it seems to be a pretty irresponsible article to me.
'Consider the source' is not the same as an ad hominem: 'The source is unreliable therefore we should distrust the information' vs 'The information is false because the source has bad credentials'.
Agreed, if you're in recovery, do not attempt moderation. That normalizes the behavior and is a slippery slope. Seriously thinking this may work for you is a probable sign you should talk to your sponsor or attend an AA meeting.
The AA perspective on this can come across binary and tautological: if one is an alcoholic, moderation is impossible. But the reality is alcohol dependencies occur across a varied spectrum. Implying there is only one solution is theism.
Whatever works for you to keep you sober. If you're feeling tempted and want someone to talk to though, go to an AA meeting. You don't have to agree with any of the religious stuff they say to be around people that know what you're going through and can help.
Depends on where we place the goalposts. Abstinence or agency? For some cases, full abstinence is the most effective means to a fruitful life of agency. For others, an appeal to our inherent agency (rather than submitting to the impossibility of control / higher power) is the path, possibly one that returns to moderate use.
First, can is the important word here. The point is that if the rest of your life is okay, there's no need to run away by drinking yourself under the table. You seem to be implying that there are no people on Earth who went from addiction to moderation. There's nuance to it.
To be fair, however, we're not encouraging people who've struggled with alcoholism (esp. severe) to have a drink.
> if the rest of your life is okay, there's no need to run away by drinking yourself under the table.
That's... not how it works. One might have become an alcoholic because the rest of their life was shit; but remaining an alcoholic is another matter. Highly-functioning addicts are still addicts. A lot of neurochemical processes don't care for the social or psychological situation.
It's a bit like saying that "people can sail the Atlantic in a kayak"; a few might make it, but the overwhelming majority will die under the waves, and telling them they can do it is just Bad.
Fair enough, given that the rest of the series is more about behavioral addictions that substance addictions, it might make sense to change that passage. Thank you for the feedback.
I have some strong, perhaps knee jerk feelings about the idea that addicts can come around to become healthy social drinkers, smokers, etc. I feel like some probably can, but most probably can't. As someone who had major addiction issues for about a decade and has been clean for 12 years, I have no desire to test those waters, and feel a bit offended at the notion that my life would be better if I figured out how to be a functional user. I have everything to lose and very little to gain.
I have the same but reverse knee jerk feelings towards AA.
The entire idea that i should treat something other people can manage as if it were some forbidden fruit just doesn't sit with me. That doesn't mean I've solved any issue, It just means i've figured out a way to avoid it.
> and feel a bit offended at the notion that my life would be better if I figured out how to be a functional user.
Lets try to reframe that then: given that conventional AA is basically the only game in town, do you think that there are people who have either failed to take to its abstinence only system that might be successful at a different approach or is somebody who flat out refuse to seek help from an AA style system for the reason i laid out, such as myself, who could use access to a different approach?
I actually agree that it's a shame that AA is the only game in town and I think its effectiveness is vastly overestimated. It's also seriously dogmatic about way more than just complete abstinence (I mean it's 12 steps, meetings every week or every day, etc). I prefer to keep my past far in the rear view mirror instead of continually drudging it up.
I am just very dubious that people who have shown they have the capacity to fuck up their lives with drinking/drugs, especially for an extended period of time, are going to reprogram themselves successfully to become casual users. I don't know how black and white it is. But I count my lucky stars for the last 12 years of life compared the 10 before that.
I know, right? My wife basically never drinks, and she’s doing just fine. I’m really not missing anything by abstaining from alcohol for the rest of my life.
For anyone who wants a more evidence-based approach to addiction than 12-step programs, SMART recovery might do the trick for you. It helped me greatly with my alcohol addiction, and it doesn't treat addiction as a forever thing. I've been sober for 6 years or so now, and I haven't needed to attend a meeting since I beat the addiction.
Meetings are free, there are online sessions all the time, and it's just a great community overall.
What is your experience about the following paragraph?
> you can go from being addicted to alcohol, to having a social drink once a week.
That goes against pretty much everything I've ever been told by addicts to alcohol and drugs. Once you've been "in the tunnel", there just isn't "a social drink" - even a drop will get you off the wagon for good.
It's not my experience. I do believe it's riskier than simply abstaining long-term. You are, in fact, reminding yourself of something you found so compelling once that it derailed your life. But personally, I have been addicted to amphetamine and alcohol/benzodiazepines badly enough in the past, that I could not discontinue them suddenly due to the severity of the withdrawal. Yet in recent years I have felt able to get drunk at a party for example, without serious cravings in the weeks that follow. And I'm back on amphetamines for ADHD which I take to schedule. I won't lie though; the thought of taking two pills instead of one does occur to me not infrequently. The temptation is probably always there once you know what it's like. But my experience is that no, it doesn't automatically derail necessarily.
That’s not 100% true. Exhaustion is real. Can you watch the same Marvel super hero movie for the n-th time, even though you loved the first few? You can’t, you just get tired. Burn out is real even amongst addicts.
You literally get tired of this shit. Before I became an addict, another legitimate addict told me why he stopped - he just got tired. I’m talking years of daily drinking, and all the consequences that come with it (every bridge burnt, every path destroyed, credentialed as a true fuck-up). Exhausted.
That’s the thing about abuse. If you took one hit of cocaine, and you die, that’s the end of your abuse. Addicts can take hit after hit after hit, and still live. That’s scarier than death, and extremely tiring.
I am tired of it, pure exhaustion is a way out. The implication of that is that you yourself are such a piece of shit that you didn’t quit until you yourself got tired.
I'm going to second the Sinclair method, which involves taking naltrexone or nalmefene. I started with the Sinclair method at the same time I started participating in SMART recovery online meetings. I only drink alcohol about once a week now and only in moderate quantities.
For alcohol that may be true, but the ultimate goal of SMART is sobriety. There is another (smaller) branch of REBT drug-based therapy called 'Rational Recovery' that uses naltrexone (an opiate blocker) before drinking to reduce the pleasurable feeling associated with drinking.
I tried it, but it didn't work for me. It certainly makes drinking less pleasurable, but I was using it as a coping mechanism for my anxiety.
I think for some people, that approach might work. Also, if a person solves their underlying psychological problem which led to the need of alcohol for a coping mechanism, I think it might work as well.
I'm probably saddled with anxiety for life, but I've learned healthy coping mechanisms. Besides the taste of a cold beer after mowing the lawn, I don't miss it in the slightest.
What evidence is it based on? When you say evidence-based, do you mean the initial development of the program, or its ongoing claim to efficacy in light of the results?
There is evidence supporting AA as a treatment for alcoholism.
It's great there are alternatives, and I'm sure different treatments will work best for different people, but it is for that reason you shouldn't imply other programs are not an evidence-based treatment (at least of similar quality).
Contrary to popular depictions addiction is not bolean, it's a unbounded scale. And roughly each consumption of an addictive substance increase addiction and for each substance some time is required to go back to baseline. And if another take occurs before this period, then the addiction will grow.
As a very simple model it's ovmbviously wrong but it's a very helpful proxy.
Another euristic that is helpful in dealing with addiction is to avoid repeated use before 6-7 times the halflife of the substance. Such that > 99% of it has been eliminated.
Finally looking for "harm reduction techniques" when dealing with a substance provides many helpful tips.
I believe those advice can probably be translated in the case of an addictive behaviour instead of a substance but will obviously yield less precise recommendations.
Really funny thing happened to me last year. I got COVID, luckily fairly mild but with some long lasting symptoms. The odd thing is that I no longer have appetite for drink or opiates/cocaine (on top of my maintenance medication) Surprising as I’ve been on that path for 15+ years. It’s not much but at least something good has come out of (having) COVID…
If you are out there struggling with addiction I would checkout: Naltrexone. Naltrexone binds to the endorphin receptors in the body, and blocks the effects and feelings of alcohol. IMHO: The addict brain needs to be reprogrammed with chemicals - not just 'understanding why' or making macaroni necklaces in rehab. Naltrexone can be used with both opioid and alcohol dependence and is extremely cheap. Once on Naltrexone you can still drink/opioid and you wont get the high. Drinking a beer would be like drinking a Coke on Naltrexone. Pounding down two liters of Coke is gross - and your brain will start to associate that drinking is terrible.
Low Dose Naltrexone is also a super interesting modality that's gaining more traction. The idea is that at low doses you are training your body to reset and produce its own endogenous opioids.
> "Opinion A can make people feel powerless. I’m an addict and I’ll be that way forever- it creates feelings of shame and being a victim. It also creates a stigma in society that addicts are somewhat broken and can’t be fixed.
Opinion A seems a little bit outdated. Abstinence isn’t necessarily the goal."
This isn't a very informed argument at all. One, abstinence isn't the goal of AA or 12-step ; recovery is the goal, and it starts with abstinence. Two, addiction is best defined as having lost the power of choice. So not only does this opinion ignore that, it propagates the very stigma it intends to diminish.
The ironic thing, as a former smoker, is that we never lose the power of choice. We simply choose not to exercise it, and perhaps forget that we can. But it's always there. And the one weakness of many of these programs is that they never force the person to confront that uncomfortable reality within themselves. IMO.
Reminder: AA and 12 step are faith-based, and aren't very effective when actually measured (roughly equal to the effectiveness of not using AA/12-step).
"The 2020 Cochrane meta-study of Alcoholics Anonymous says that, based on randomized controlled trials, AA-oriented therapies have a 42% abstinent rate one year after treatment, compared to the 35% abstinence rate with other therapies."
https://en.m.wikipedia.org/wiki/Effectiveness_of_Alcoholics_...
Sorry, there are untold (but not unknown) millions more people around the world who've recovered from addiction with 12-step than anything medical. AA was founded in part by a doctor (himself an alcoholic) who recognized that medical science had no solution to alcoholism. Fast-forward to now and the 'medical solution' to addiction is usually another addictive substance. Can those help? Sure, and they do. But I don't think there's been any significant studies confirming medical science has a better solution than 12-step. If you have evidence that relapse rates are lower outside of 12-step than within, please share because I've never heard of it.
Here's an article from The Atlantic that you might want to read.
> Its faith-based 12-step program dominates treatment in the United States. But researchers have debunked central tenets of AA doctrine and found dozens of other treatments more effective.
> But I don't think there's been any significant studies confirming medical science has a better solution than 12-step.
This is false. 12-step is a faith-based system, and is approximately equal to other unscientific systems in terms of success rate.
The AA book itself perpetuates the lie of its effectiveness:
> Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves. There are such unfortunates. They are not at fault; they seem to have been born that way.
I went to AA when I was concerned about my drinking. A fair few people there seemed to have swapped alcohol dependence for AA meeting dependence.
Definitely better to be reliant on a supportive group of peers than something that'll eventually kill you, but felt like swapping smoking for vaping - definitely better for you, but not solving the underlying cause.
And their view that you're always going to be an alcoholic, for the rest of your life feels like a belief rather than scientific fact, and sometimes, a self-fulfilling prophecy when members relapse.
But ultimately, it works for some people, so more power to them.
Your dismissal of 12-steps system purely due to it being faith-based, is unscientific. Psilocybin (a religious experience inducing substance) appears to be a very promising treatment.
"This drug induces hallucinations. Some people interpret those hallucinations to be religious in nature. Therefore, this drug is faith-based."
That's not a very strong chain of logic. The 12-step system is, at least based on my very limited understanding, founded with assumptions that the people using it will be either Christian or theistic and raised in a culturally Christian society, and thus have a similar notion of "faith in a higher power". That's what "faith-based" means.
Psilocybin has a distinct spiritual phenomenology that not all hallucinogens have.
While there is a difference between a faith and a spiritual experience, they both work within a religious framing of life, which might be helping the individual with addictive behavior here.
I have been around addicts my whole life (drugs and alcohol), I've known many people who died from their addiction, and I've struggled with addiction myself at times (drugs and alcohol). I have a few issues with this article.
1. Behavioral addictions are not comparable to a serious chemical addiction. The person who can't stop watching Netflix or can't get off Facebook is not the same as someone who can't stop sticking needles in their arm (heroin) and is flirting with death everyday. I've had behavioral addictions and chemical addictions, and I can tell you first hand that a chemical addiction is a different monster. You start to feel physically and mentally ill when you can't get your fix for a chemical addiction. Flu like symptoms, you can even die from withdrawal from some things. Comparing that to something like video game addiction is a huge stretch and somewhat offensive.
2. Saying that an addictive personality is really just deep seated emotional issues is not really changing much. Deep seated emotional issues are very hard to change. We try and some do, but a lot of us only make minor progress or don't change at all. Especially the people whose emotional issues have led them to a serious drug or alcohol addiction. Sometimes the best they can do is just abstain and use something healthier to cope.
The whole article feels like the author is engaging with the issue on an intellectual level. Sure, there are addicts who can recover and then even use their substance without relapsing. But there are many addicts who relapse and die, or ruin their lives. It makes sense then to err on the side of caution. For most addicts, there's more to lose than to gain, and it's hard enough fighting addiction that I don't think we should encourage addicts to push their boundaries.
I've just known many people first hand that truly embody the phrase "Once an addict, always an addict." Sure, maybe it's not true for some people, but it's true for a lot of people, especially the addicts that have it really bad.
The disease model of addiction is still hotly debated in the USA. It has been widely discredited and thrown out in other western nations. What's the difference in these nations? These other nations have some form of socialized medicine so you don't have to have a medical illness to have your treatment costs covered. On the contrary, the only way to get treatment costs paid for addictive behaviours in the USA, by a medical insurance company, is if you have a disease. Try asking your medical insurance to pay to stop you making bad choices or changing your habits. The work of Stanton Peele is seminal in this field for anyone interested. Also check out The Freedom Model. Completely heretical to AA types but to rational thinkers struggling with an addictive behaviour, it could be life changing.
>On the contrary, the only way to get treatment costs paid for addictive behaviours in the USA, by a medical insurance company, is if you have a disease. Try asking your medical insurance to pay to stop you making bad choices or changing your habits.
Bingo. In the late 80's there was an explosion of teenagers going into drug rehab centers which were usually setup in hospitals with unused bed spaces. It had no correlation with teen drug use increasing and everything to do with insurance paying for it.
This clearly isn’t true since plenty of people get access to psychotherapy who have public and private insurance without being diagnosed with a specific illness.
Every time I look at a therapist while seeking treatment, they always put a disclaimer on their insurance page that a diagnosis is required to be paid for claims. Maybe it's just my state.
Will insurance really cover a psychiatrist without a diagnosis? I always assumed the doctor was reporting a diagnosis to the insurance company even if they weren't telling the patient.
All the feel good theories in the world can't contradict the numerous examples of addicts who relapse after trying to moderate what they previosly used in excess.
The article is basically a hook for buying the course. They can't accept the once always theory because it would make their product not attractive.
I also thought their 2 ways only characterization was contrived. And I don't buy stock into the way they are founding their arguments on their definition of the word 'disease.'
But I guess it's a good point that harm reduction is good and abstinence is not the goal for everyone.
> All the feel good theories in the world can't contradict the numerous examples of addicts who relapse after trying to moderate what they previosly used in excess
How does it compare to the number of addicts who relapse after striving to be 100% clean?
As the saying goes: all models are false, but some are useful. Every theory has its limits, but that doesn't mean it can't be helpful. The opinion that once-always theory can be damaging is rejected by many people in the field, not just us. We're simply presenting it in a digestible format (without the need to dive into the sources for hours and hours). See the rest of the series for a better understanding of the subject matter.
And yes, our blog is a part of our marketing, but that doesn't mean that we "just" want to make money from it. The aim of the whole project is to help people, in a sustainable way, with some free and some paid resources.
Honestly I don't think putting it into sharp categories like A or B are useful.
I don't have addiction but I suffer from chronic mental illness. Strangely despite being diagnosed at a young age and having dealt with it all through college and into my mid 20s people were still treating me like it was just something I could "get over". So I guess this is more in the B camp. For me this wasn't helpful and I felt just as helpless because the problems didn't go away.
Now I embrace the fact that I have a chronic mental illness that is NOT going to go away. This is more in the A camp. But once you embrace that at least for me I felt less helpless. I knew it wasn't going away and I worked to put up supports because it wasn't just a passing thing. It never will be for me.
You can change your response to things and that's maybe the "neuroplasticity" he's talking about? But your brain actually isn't that plastic after childhood. If addiction is anything like my mental illness you'll always have the same response in a situation. You can have years of learned behaviors and coping mechanisms but that doesn't mean that it doesn't destroy you initially when you run into a rough situation. It's accepting that and how to deal with it and the aftermath that you can change.
The author states that thinking that you have an addictive personality is unhelpful. Articulated that way, it could be true, but understanding that there is a predisposition towards addiction[1] is helpful to overcome it, and does not contradict the fact that one can recover from addiction.
From Overcoming Sex Addiction by Thaddeus Birchard [2]:
“A predisposition towards addiction, be it genetic or a legacy from the historic family dynamic, is important to understand. It reduces shame to know that you are vulnerable to sexual addiction not because you are morally deficient but because you are predisposed towards addiction either through genetic inheritance or though interfamilial patterns. The more that shame is reduced, the more that the drive to act out sexually is lessened.”
“Once you understand that this dysfunctional regulation was set up in childhood, there is a reduction in shame because you are not responsible for having the problem. However, you are responsible for what you do about it.”
As usual, the term "addiction" is being used in the article (and in the comments, unfortunately) to refer to two quite different things.
Addiction to something like Oxycontin is a physical addiction; the symptoms of withdrawal can be severe enough to kill you. Addiction to something like Twitter may involve dopamine pathways, or not; but withdrawal isn't going to result in serious physical symptoms.
Consider nicotine. Withdrawal from even a serious habit takes no more than about 72 hours. The habit of having a ciggie between your fingers is another matter; habits are really hard to shift.
I think it's a mistake to subsume habitual behaviours under the handle "addiction". There are two different things going on here, and it's useful to have two words, with distinct meanings, so that we can distinguish them in discourse.
There's physiological addiction, withdrawal alleviation, and psychological addiction too, to games or habits or anything. Then, I find where you live, who you know, and how you use drugs in patterns while also living in those patterns, this makes it harder to quit. Finally, there's the coping, the escapism, the alternate forms of consciousness, which help us get through the suffering of daily life.
For me, only using legal "softcore" stuff, I have to think in terms of delay and moderation. I am fortunate, as Lincoln once said, to not have the urge and scourge of strong addiction to alcohol. I can't claim some magical fortitude or moral superiority, I was lucky enough to have a safe life and a "meh" feeling about alcohol and nicotine.
Being an addict seems more social than anything. It’s possible to go through a party phase and then years later go through an unrelated tough patch, having not touched drugs for years, and then hear whispers of addiction to explain the unrelated issue. Nobody dares broach the subject, and so a person clean for years and never really an addict can have their life ruined by others calling them one. Maybe they have real pictures from the phase or similar to circulate. It is slander even if the photos are real, and there’s no recourse. That can happen to a non-addict who experimented; can only imagine how likely a true addict would be to relapse in such a hopeless situation. Addiction is a destructive habit or system that needs to be replaced.
I really want to believe this, because "once an addict, always an addict" has always sounded like an unsupported, junk-science, catchy thing to say, and not something based in reality. And I don't really want to believe (yes, I know this is an emotional take), that some people's brains are just fundamentally "broken" in a way that means they can't enjoy some nice things without destroying their health and relationships.
I think also the idea of addiction (or an "addictive personality") as this inherent, unchangeable thing just doesn't pass the smell test for me. Our understanding of the human brain is still pretty limited, and making a blanket statement like that just doesn't make sense.
I can certainly understand this attitude for practical reasons: if you can get an alcoholic to stop drinking, and stay sober for the rest of their life, yes, you've certainly solved that problem. But I also suspect you haven't solved some of the underlying issues (e.g. around anxiety, dealing with emotion, etc.) that probably led them to drink excessively and uncontrollably in the first place.
But I know very few people who have (to my knowledge) gone through this sort of thing, so while I can intellectually spout off what I believe to be true, it's not coming from a position of experience.
The only real data point I have that perhaps aligns with this article is my father, and this is only from what I was told (by him, decades later). In his teens and early 20s, he drank heavily (to the point of doing some pretty unsafe things), nearly every night of the week; he was friends with the bartenders at many of the local bars, and would stay after closing to continue drinking. But during my childhood, I'd only known him to have a beer or two at a family get-together or neighborhood block party, so I asked him what changed. He said that he wanted to marry my mom, and that required him to put all that behind him. She was ok with the occasional social drink, but binge drinking or any kind of drunkenness was not kosher. He told me all this when I was in my late 20s, while we were having dinner at a brewery... drinking beer, of course.
FWIW, my church has an excellent 12-step program also, free, with online materials (ducuments, videos), and meetings (including phone/video), for individuals, affected spouses & families: https://addictionrecovery.churchofjesuschrist.org/
(There are also very good materials on general self-reliance (being stable and better able to go forward), including improving employment, self-employment, family finances, preparedness, general family welfare, forgiveness, and other topics, at ProvidentLiving.org.)
A lot can be said about this article, but just to pick on one thing. It can be useful to think of yourself as having an "addictive personality" if it helps you make smarter life decisions about avoiding situations where addiction is a possibility. "Discretion is the better part of valor".
It is possible to recognize certain paths in life will put you under greater stress and do some cost benefit analysis of that, to do an accurate cost benefit analysis you must have a realistic idea of how you deal with stress and how likely serious issues might arise.
Pretty much yes from my experience. Both personal and by observation of others. That being said I know many addicts/alcoholics who live happy productive lives- they avoid the chemicals that suck them in.
Here is what helped me kick two major addictions in my life:
I smoked 3 packs of cigarettes a day for 6 years straight. It started to take a huge hit on my health and I quit.
I smoked marijuana every night for 4 years then quit and have just smoked it occasionally.
I started doing vipassana several years ago, everyday a little bit of a good chemical balance accumulates in my brain and body to the point where a lot of cravings start to disappear and you feel good in your head and body even without drugs like caffeine.
I wouldn’t say I’ve beat all my cravings but they’re 90% better ..
It’s very hard to understand addiction. I know I had two distinct addictions for wildly different reasons. With certain games or porn, it’s just, I loved it too much. Later, with alcohol and prescription meds, it just made me feel less shitty. The former I just enjoyed it too much, and the latter, I never found a better substitute for anxiety and self hatred.
One was truly an insatiable desire, the other was truly self medication. If you suffered from this, it’s very hard not to think you were born this way.
I look at someone like Steve-o and say nah, people can change. If someone as addicted as him can pull out of the spiral, then no you can break the cycle. But not everyone can do that.
This article seems weird to me, because I view non-substance addictions as a way of procrastination, which in turn is a way to fix a bad emotional state.
When your environment is hostile and depressing, and it certainly is for many people now thanks to covid and the faceless megacorps we have to deal with to get through daily life, then it kind of makes sense to disassociate from reality and get lost in a good video game.
“There are people who went through AA, recovered from their alcohol addiction, and are able to drink moderately.”
There are also people who have survived skydives without a parachute. This article seems like some kind of self-justification for returning to destructive behavior. I imagine their codependent somewhere rolling their eyes again at this mental gymnastics routine. Here we go again….
Well, quit smoking cold turkey after doing so for 10 years. No addiction.
Quit eating lots of sugar, after doing so for 30 years, replaces with fruits and nuts. No addiction.
Can't stop reading books, doing so for 40+ years; addictive as hell.
I know iv drug users , they quit and do not look back, so , oaaa does not hold true in general
Marc Lewis, a neuroscientist has a nice book on the topic, which to me makes complete sense (and is grounded in sound science). His view on the topic is that addiction is nothing special, just a learned behavior. Hebbian learning states that neurons that fire together wire together (corollary: neurons that don't, the connection weakens). The neurons in the limbic system control emotions, attention, desire, and fear. The prefrontal cortex (PFC) controls planning, expectation, and long term planning. We are motivated to do things that we desire, or avoid things we fear, which is controlled by the limbic system (also involving dopamine release).
Let's take drugs for an example but this can apply to other behaviors like internet usage, eating, falling in love, becoming obsessed with a hobby, or cronic anxiety toward something (avoiding fear). When we take a drug (or do xyz behavior ) it gives us a positive feeling (pleasure, or comfort in avoiding fear) and probably a favorable outcome occurred, so we are likely to engage in the behavior again. Each time we engage in the behavior the connection between the limbic system and the stimulus that triggers it, strengthen. When the trigger happens the limbic system lights up and triggers the PFC to create a plan and imagine how good it will be (then a positive feedback will occur - this is craving). Over time more and more stimuli will become triggers. Also, if you don't use it you lose it, and the neurons responsible for long term planning will weaken their connection to the limbic system (also, shown in brain scans), making it harder for you to assert self control.
However, your brain is plastic, and you can also unlearn the behavior over time (studies also support this). Meditation can help because you can stimulate these neural pathways in a controlled environment. For example you can imagine how a trigger leads to drugs, then you can imagine how drugs leads to bad things while meditating - over time you can strengthen the connection from the trigger to the emotion and imagery of bad things happening. Ofcourse meditation is not the only thing that can help, but the main idea is that you want to make your brain associate the bad behavior with bad outcome, and strengthen the association of good outcomes with fear/desire circuit.
I smoked meth almost everyday for a few years, abruptly quit, and never relapsed. I've been trying to quit diet soda for more than a decade and I can't go longer than a week ..
This article is not a good summary on addiction and current understanding. It jumps around a lot between ideas that should not be linked and is factually wrong often.
RE title - "Once an Addict, Always an Addict"
This doesn't rule out moderation, and it is well known you don't use this wording or idea on some people.
Addiction treatments fail around 90%+ of the time. That's why there are so many around, different ideas work on different people, and probably so people don't get bored or despondent as the churn through them multiple times.
"Once an Addict, Always an Addict" might be someones win, someone else might just randomly stop.
To me, a lot of time addiction is a choice. I'm not saying all the time, but very often still. I've tried helping different people overcome an addiction, and even though at first they want to stop it, when they start to think more about it they don't really want it to stop.
If you are not entirely convinced that the addiction is doing more harm than good, it is much more difficult to overcome it.
Trying to think rationally is not going to be very helpful, most of people are not able to think that way, emotions and perceptions are much more important. I often say, life is much much easier when you are a rationalist
I think this is the dumbest take on addiction. I've seen normal upstanding people resort to stealing copper to get a fix because the drug has wired their brain to get that hit. Or food addiction causing people to binge eat because they can't function without it. This isn't "hey that feels good I need more" this is "my brain is telling me I need this at all costs". Are you the same type of person who thinks people just need to "get over it" when it comes to depression?
Of course you can't control an addiction, because your brain, or body is asking for it. But when you are aware that you are addict, there are ways to overcome it.
The fact that you don't have the energy, or motivation or anything else to fix it is that you either don't feel like it is going to be better without your addiction or you are not able to maintain the long term work needed. And both of those case are a choice. These are not easy choice, like choosing the color of your socks on the morning, they are difficult choices, but they are still choices you are making.
And when I talk about addictions I dont only talk about big trauma, most of addictions are along the lines of people not being able to prevent themselves to eat chocolate everyday.
People who think you just need to get over depression, have never been depressed.
I understand, I hope you know that my initial comment was curt, but I’m glad we’re seemingly coming to the same conclusion. I guess the “choice” is just a little different in frame of mind.
I agree that it is, or can be, a matter of "choice", but that's a subtle thing. What does it mean to "choose" or "want" something when you have conflicting motives, when you both enjoy and hate the same thing, even at the same time? I think a large part of reaching emotional maturity (for some people at least, me included) is about resolving those conflicts and achieving a sort of unity of self. This often involves letting some parts of yourself go, deciding not to be a particular person any more, which the "addiction" may only be one aspect of.
In my case I finally succeeded in quitting smoking, after 9 years of 20-30 a day and innumerable failed attempts to stop, just after I got married, 18 years ago. It was easy.
Genuine question, have you ever recovered from addiction yourself?
Because that phrasing is a bit odd, IMO.
No-one chooses to become dependent, and there's a lot of optimism bias/hubris when people start dabbling in addictive substances - I won't get addicted like _those_ people, I'm different...
But the hard bit, as you've noted, is making the choice to end your dependence. The choice to face whatever in life your vice of choice was numbing you to, to face it naked and vulnerable.
...that takes a lot of guts. And a lot of repeated attempts.
And you're right about the need for intrinsic instead of external motivation.
I think that’s much harder to study whether or not it’s a “choice” because the scales of choice are extremely biased. For example if someone is dealing with deep trauma, addiction may be a way of preventing extremely distressing or suicidal behavior by numbing or overwhelming the agony. If the choice is “I’m going to kill myself tonight” and “I’m going to drink until I don’t feel anything anymore and will probably live to see tomorrow” then the choice is really stacked towards alcohol.
That's what I meant by choice. I never said they made the choice to be unhappy. They just made the choice to be addicted. An addiction is not always something negative
My dad drank heavily for a lot of years. I grew up hearing tales of his legendary drinking. Mom would buy him a case of beer on Sunday and if he ran out mid-week, he would drunkenly accuse her of drinking his beer -- which makes no sense because mom is a tea totaller. He would go on a bar crawl on nickel night and hit dozens of bars with his buddies. Etc.
He was in the army and he fought in the front lines of two wars, WWII and Vietnam. He retired when I was three and apparently began tapering off.
I don't recall him having the DTs. I don't recall him drinking heavy in my lifetime. I recall him having a beer as part of dinner when I was four or five.
When I was seven, he was diagnosed with a heart condition. He blamed it on the alcohol and never touched the stuff again (except for a few sips when my brother hit drinking age while talking to him about what made for a good beer, I think).
By then, he had been out of the army for four years or so. He had time to taper off for a few years before making his dramatic announcement that he wasn't drinking again.
I think he drank to suppress his nightmares from serving in two wars. I think he didn't need to actively suppress his nightmares anymore after he dropped his retirement papers and no longer had to live in fear of being sent back.
I think people drink and drug for a reason. We just mostly don't bother to try to figure out what the reason is for this specific person and we just act like "You are a badly behaved child who needs a spanking and you need to just try harder." And then blame them when that stupid idea consistently fails to be an effective solution to their problem.
Edited. Cuz typos and auto-corrupt.