Dr. Sarah Wakeman
speaker
484 appearances
2 recordings
2 series
first heard Jan 2025
last heard May 2025
Dr. Sarah Wakeman’s voice in public audio — every appearance, attributed to the second.
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So you may, if you're drinking heavily, you may actually be running, you know, working again at cross purposes with your efforts to try to manage your depression or anxiety. The other thing is there are some types of medications that are really dangerous when they mix with alcohol and anxiety medications in particular, especially any medication that also has sort of a slowing down effect.
So some people take medicines in a class called benzodiazepines, so things like Xanax or Klonopin or Ativan. Those when mixed with alcohol have sort of a combination effect that can actually slow down your breathing, could cause an overdose, could make you very sick, could make you more sort of impaired sooner. So really important to not mix those medications with alcohol.
How does alcohol compromise your memory? So alcohol affects all parts of the brain, including the amygdala, which is an area that lays down memory. And it has complicated actions in the brain. So it increases sort of more slowing down hormones. So we think of it as a depressant because it sort of slows you down and relaxes you. And it decreases more excitatory neurotransmitters.
In the short term, because your consciousness is being affected, you won't be making new memories. Over the long term, heavy alcohol use can actually cause dementia. It can cause severe memory problems.
There's actually a unique condition that we only see with alcohol generally, where the part of your brain that lays down new memories gets damaged and people get basically an amnesia syndrome where they can't make new memories. So they can only remember things from the past, but they're unable to make any new memories anymore.
And that's a very extreme example, but we see it in the hospital and it's really scary when it happens.
We actually see brain damage on people who've had chronic heavy alcohol use over many years. So if you take a picture of the brain, like with a CAT scan or with an MRI, what we describe it as is volume loss. So normally you want to see a big, healthy, robust brain. And as you age and with types of dementia, One thing that we see is the brain starts to shrink.
So like the actual functional parts of the brain are smaller. We see that process accelerated with heavy alcohol use. So often take someone who's in their 50s who really shouldn't have volume loss in their brain at that age. But if they've been using alcohol at a very heavy amount for a long time, we'll often see their brain looks like a much older brain because of that shrinking.
And then there are very extreme examples like this rare memory condition where we literally see that part of the brain almost die. Like you can see it light up that it's been severely impacted. That's scary. Yeah. It is really scary.
Yeah.
Yeah, I think these are such important questions. And one of the greatest tragedies to me around substance use disorder is often family members and the general public have been fed the wrong thing to do. And so I think it's a great thing to talk about. First, it's important to define sort of what is an alcohol use disorder, because that's sort of what we're getting at.
You know, there's there's heavy drinking where we're worried about the long term health effects. And then there is where alcohol has become a problem in your life. And really, the definition of an alcohol use disorder is losing control over your drinking, compulsive use of alcohol and using despite consequences.
So if you are continuing to drink despite the fact that your partner has shared that they're really worried about you or you've started to have problems at work because you're calling out sick or you're You're continuing to drink despite health problems related to it. So your doctor says, you know what, your liver tests are elevated.
You really need to cut back on drinking and you continue to drink. Those are all signs that alcohol started to play a different role in your life. About 15% of the population will have an alcohol use disorder in their life. So this is a very common health condition, more common than many other conditions we see. The great news is that it's entirely treatable. Most people will get well.
I think we often have in our minds that this is like a terrible stigmatizing recalcitrant condition that no one ever gets better from. That is not true. And that notion that this, you know, something to feel hopeless about, I think drives a lot of the stigma and shame. There is good treatment out there. People will get well, but they do need care and they need support.
I think the first thing you can do if you're a loved one is just share your worries, not in a way that blames the person, not in a way that's judgmental, but in a loving way, just like you would about anything else with someone's health, that this is what you've observed. This is why you're worried. Explore what the person thinks.
And that becomes really important because when it comes to addiction, it really doesn't matter at all why I think someone should make changes to their alcohol use. The only thing that matters is they think their life will get better in some way. And so really starting to sort of untangle what are this person's goals and how is alcohol getting in the way of them reaching it? That becomes the work.
And a partner can be a wonderful mirror for that. You know, I know you're working towards a promotion at work and you mentioned that you had to call it sick twice this week and your boss is frustrated at you. What do you think about that? So really exploring it.
And ultimately, you're sort of empowering the person to feel like they can make a change and that you're supporting them, but you're not forcing it on them, which is often what people feel caught up in having to do.
I think people have heard these notions of like tough love, enabling, hitting bottom. Those are probably the biggest fallacies. So for people who aren't familiar with those concepts, the idea that tough love is that like you really should make things hard on a person that if sort of consequences pile up, the person will ultimately get better.
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