Tuesday, May 13, 2008

Drunkorexia. It's not a real word, but describes an emerging, confounding, and self-destructive behavior engaged in primarily by young women of college-age to twenty-somethings. They avoid food as much as possible, saving the calories for alcohol. Without food, of course, these young women may unwittingly get drunk quite quickly.

The Pop Culture influence on thin and sexy

In our celebrity-crazed society, maybe we can blame this practice in part on omnipresent images of super skinny celebs. These images are difficult to avoid, from the tabloid at the supermarket checkout, to television and movies. A number of stars and other high profile luminaries also seem to be going to rehab almost as if it was summer camp - a retreat from partying, a little therapy and back to hanging out with the same pals.

A frightening aspect of the recent rise of "drunkorexia" is that the young women who suffer from it don't view this as a disorder, for the most part. They thought they'd live a fun lifestyle, but for many it has spun out of control. When it does, the dual occurrence of eating disorders and drinking is threatening their health and their lives.

How does this happen? Some influence are rooted in pop culture: look at a video of Sex and the City and you'll see how sexy and smart it seems for young women friends to meet each other in hip settings for cocktails after work. And these are cool cocktails that taste sweet, like appletinis or every kind of Margarita imaginable. Drinking regularly and to excess while remaining thin has become fashionable.

Elevating the risk for "Drunkorexia"

Actually, the fact is, no one really knows all the causes for this phenomena in America today. Academic studies pose different theories but these dual disorders may have some common causes in a range of contributing factors. Does an eating disorder lead to alcohol abuse and vice versa? Bulimia is much more commonly associated with alcohol and substance abuse than anorexia, because while bulimia is associated with binging followed by purging, anorexia centers on continual and severely controlled restriction of food.

It could be that the attitude towards compulsive substance and alcohol abuse can lead to compulsivity and lack of control over drinking. Both behaviors can be self-soothing, although drinking on an empty stomach often leads to vomiting. And dehydration may require hospitalization. Some women suffered from eating disorders first, and even after purging, would drink because it self- medicated the guilt and tension they felt. Those suffering from anorexia who try to cope with the challenge of eating with other people may use alcohol to ease the stress.

Of course, a young woman may come into the wretched state of "drunkorexia" without an eating disorder, but only with the idea of having fun, being attractive and living the good life. But drinking repeatedly without food can be both humiliating and dangerous, and ongoing habits can eventually become addictive both biologically and psychologically. The brain pathways are actually altered.

Hope for recovery fro m"Drunkorexia"

Left untreated and unabated, the "drunkorexic" suffers serious consequences to her health, job or school status, and relationships. Medical stabilization is part of a treatment process that should address both the chemical dependency and the eating disorder. The Hanley Center's Center of Women's Recovery, http://www.hanleycenter.org, has increasingly treated young women with the dual diagnoses of eating disorders and alcohol and/or substance abuse. Earlier treatment methods for co-occurring eating disorders and alcohol abuse sought to treat the alcohol problems first, with the idea that this was the more serious problem. Eating disorders are deadly as well.

Treating both disorders concurrently, in a medically based, holistic program that is rooted in the Twelve Step philosophy has been shown to be effective, and therapists who treat eating disorders must also have received related training. Depression is usually associated with dual diagnoses like this, and there may underlying conditions such as bi-polar disorders. Recovery is a process that may entail longer treatment, a combination of pharmacology and interactive therapies such as Motivational Interviewing, Cognitive Behavior Therapy, and Dialectical Behavioral Therapy, based on mindfulness and mood regulation, and expressive therapies that help to address and safely express deep-seated emotions. Hormonal Shift Assessment and care plans also help women understand and address mood swings, anxiety and cravings. Continuing care and support group participation are associated with more successful recovery.

The role of culture, environment, genetics and biochemistry

Studies now have shown that young girls who start to diet at about sixth grade are more likely to abuse alcohol and other chemicals as teenagers or young adults. Besides the pop culture images we're bombarded with, family history of substance abuse, and genetic factors can be factors along with other environmental markers, such as history of abuse or abandonment or family instability.

Neurochemical changes that affect opiod peptides in the body, regulators of food intake, may also modulate intake of alcohol or cocaine, say some studies. Personality characteristics may hold clues too, such as extreme impulsiveness and difficulty in controlling behavior. Borderline Personality Disorder causes rapidly cycling mood swings and impulsively as well. Another behavioral profile is what has been called the Novelty Seeker, who continually pursues new stimuli and "more" of it. The young woman suffering from bulimia often fits a profile of the "Novelty Seeker" and one with mood wings and impulsivity.

"Drunkorexics" don't share all the same behavioral or personality types, genetic background, hormonal makeup or family histories. By understanding some underlying causes, though, treatment can be more effective, and the individual more readily engages in the recovery process. Sustained support of Twelve Step groups, for example, can provide the stability to continue, and tools learned in such therapies as Dialectical Behavior Therapy can offer help in self-regulating moods without addictive and destructive behaviors.

How to find gender-specific treatment for recovery from addiction and dual diagnosis for women: for the Center for Women's Recovery at Hanley Center, has developed a medically-based, holistic program for women that is rooted in the Twelve Step philosophyHttp://www.hanleycenter.org Jeannie Provost, program director, is a distinguished professional with broad experience in the treatment of women who suffer from addictions.

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