Binge Drinking: What you should know before your next tailgate party

By Heidi Huang, Medical Student
Reviewed by Claudia L. Reardon, M.D.

Have you ever been in a situation where one alcoholic drink led to another and before you knew it, you had one too many drinks?

Whether it’s at college parties, summer cookouts, or tailgating at sports events, millions of Americans have experienced what it is like to binge drink and some do so regularly. Recent studies show that 1 in 6 Americans binge drink at least 4 times a month with an average of 8 drinks each time they binge drink.

Have you ever wondered if this is harmful and what to do to prevent drinking too much? Here are some commonly asked questions about binge drinking.

What is the definition of binge drinking?

Binge drinking is drinking 5 or more alcoholic drinks for men and 4 or more drinks for women in one sitting.

What are the consequences?

• There are over fifty different injuries and diseases associated with heavy alcohol use and binge drinking. Some of these include car accidents, violence, arrests, unintended pregnancies, sexually transmitted diseases, depression, and suicide.
• Heavy alcohol use causes 80,000 deaths in the U.S. each year, and binge drinking accounts for more than half of these deaths.
• Binge drinking increases your chances of developing a full-blown alcohol addiction.

Why do people binge drink?

• Some people may not be aware of the safe limits for drinking.
• People often feel social pressure from friends and peers to drink. For example, while tailgating at a football game or attending college social events, you may feel pressure to binge drink because everyone else is drinking a lot, and people are offering you too much to drink.
• Most binge drinkers are not alcoholics and are able to go many days without having a drink. Because of this, they may feel their alcohol use is not a problem and may not be aware of the serious consequences of binge drinking.
• BUT binge drinking may be part of an alcohol addiction problem.

 What are some strategies to avoid binge drinking?

1. Stay within safe limits: For men, this means no more than 4 drinks in one day and no more than 14 in a week. For women, this means no more than 3 drinks in one day and no more than 7 in a week.
2. Keep track of the number of drinks you have: Take mental note or write it down. One drink is the same as 12 ounces of beer or 5 ounces of table wine or 1.5 ounces of liquor.
3. Pace yourself: Try to have less than 1 drink per hour.
4. Alternate with non-alcoholic beverages such as water or soda.
5. Avoid drinking contests and drinking games.
6. Find someone who you can trust and who can offer some support to help limit the amount you drink.
7. Know that it is perfectly acceptable to politely refuse a drink when you have had enough.

When to get help from a health professional?

It can be difficult to tell when binge drinking will become or is already part of a more serious alcohol addiction such as alcohol abuse or alcohol dependence. If you are unsure about your alcohol use pattern or want to reduce your drinking, you should talk to your doctor or other health professional for more information and guidance to cut down. In the meantime, try some of these tips at your next get-together or sports event.

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Demystifying Schizophrenia

By Walker B. Shapiro, Medical Student
Reviewed by Claudia L. Reardon, M.D.

You have probably heard of schizophrenia - in newspapers, books, movies, and TV shows; you or somebody you know may be affected with this mental illness. Nonetheless, confusion about schizophrenia is common. This post provides some basic facts about schizophrenia, including common symptoms and available treatments. Schizophrenia is a chronic, treatable brain disease that affects an individual’s thought patterns, behavior, and perceptions of reality.

Some general facts about schizophrenia:
Affects more than 1% of the population with similar rates around the world
Affects men and women with similar frequency
Symptoms usually start between ages 16-30
Most people with schizophrenia are not dangerous or violent

The symptoms of schizophrenia vary greatly between individuals. They can also change and get better or worse over time. Some of the most common symptoms are listed below:

• Hallucinations – hearing voices is common
• Delusions – fixed belief in something untrue or impossible
• Paranoia – unhealthy or unfounded suspicion
• Disorganized thoughts – may go on tangents or not make sense when speaking
• Loss of interest or motivation – may not enjoy daily activities or social interaction

Schizophrenia is a serious chronic disease, but treatment is available to help people get back to thinking clearly and leading full lives. The most important treatment elements include:

• Medications (‘antipsychotics’) – help restore and maintain normal, healthy thought patterns
• Therapy and rehabilitation – help cope with stress and return to work, school, independent living, and social interaction

If you are concerned that somebody you know might be suffering from schizophrenia, encourage them to see a doctor for evaluation.

Find more facts on schizophrenia at www.psychiatry.org/schizophrenia.

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Tips for Talking to Children about Aurora Shooting

By David Fassler, M.D.

Parents and caretakers are faced with the challenge of discussing the recent tragic shooting in Aurora, Colorado with children. Although these may be difficult conversations, they are also important. There are no “right” or “wrong” ways to talk with children about such traumatic events. However, here are some suggestions that may be helpful:

• Create an open and supportive environment where children know they can ask questions. At the same time, it's best not to force children to talk about things unless and until they're ready. 

• Give children honest answers and information. Children will usually know, or eventually find out, if you're “making things up.” It may affect their ability to trust you or your reassurances in the future.

• Use words and concepts children can understand. Gear your explanations to the child's age, language, and developmental level.

• Be prepared to repeat information and explanations several times. Some information may be hard for them to accept or understand. Asking the same question over and over may also be a way for a child to ask for reassurance.

• Acknowledge and validate the child's thoughts, feelings, and reactions. Let them know that you think their questions and concerns are important and appropriate. 

• Remember that children tend to personalize situations. For example, they may worry about their own safety or the safety of friends when going to the movies or other public areas.

• Let children know that lots of people are helping the families affected by the recent shooting. 

• Children learn from watching their parents. They are very interested in how you respond to local and national events. They also learn from listening to your conversations with other adults.

• Don't let children watch too much television / news coverage with frightening images. The repetition of such scenes can be disturbing and confusing. 

• Children who have experienced trauma or losses in the past are particularly vulnerable to prolonged or intense reactions to news or images of violent incidents. These children may need extra support and attention.

• Children who are preoccupied with questions or concerns about safety should be evaluated by a trained and qualified mental health professional. Other signs that a child may need additional help include ongoing sleep disturbances; intrusive thoughts or worries; recurring fears about death, leaving parents, or going out to public areas. If these behaviors persist, ask your child's pediatrician, family physician, or school counselor to help arrange an appropriate referral.

• Although parents may follow the news with close scrutiny, most children just want to be children. They may not want to think about or discuss violent events.  They'd rather play ball, climb trees, or ride bikes.

A senseless, violent crime is not easy for anyone to comprehend or accept. Understandably, some young children may feel frightened or confused. As parents and caring adults, we can best help by listening and responding in an honest, consistent, and supportive manner.

Fortunately, most children -- even those exposed to trauma -- are quite resilient. However, by creating an open environment where they feel free to ask questions, we can help them cope with stressful events and experiences and reduce the risk of lasting emotional difficulties.

David Fassler, M.D., is a child and adolescent psychiatrist practicing in Burlington, Vermont.  He is also a clinical professor in the Department of Psychiatry at the University of Vermont College of Medicine.

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What to do about side effects of antidepressant medications?

By Felicia K. Wong, M.D.

There are various treatment options for depression including therapy and medication. Antidepressant medications can be extremely helpful to the recovery and healing process of someone suffering from depression. However, sometimes medications that are meant to help may cause unpleasant side effects. The most common symptoms my patients report include headache or upset stomach. These typically improve after a few days and go away within a few weeks. If such side effects remain, you should discuss other options with your doctor / psychiatrist. He or she can try a different medication or treatment option; just be sure to stay in touch with your physician to find the best treatment choice for you.

If the side effects seem intolerable, you may be tempted to stop taking an antidepressant or to reduce your dose on your own. Don't do it. Stopping your antidepressant suddenly may cause your symptoms to return and could cause an unpleasant withdrawal-like reaction. That’s why it’s so important to talk to your doctor.

The Mayo Clinic provides a wonderful resource with practical tips for coping with some of the most common side effects of antidepressant medications that includes explanations for the side effects. For example, sometimes people may gain weight because of fluid retention or lack of physical activity, or because appetite returns or improves when depression symptoms ease up. The resource also presents coping strategies such as cutting back on sweets and sugary drinks, avoiding fast food, and getting regular exercise most days of the week – since exercise is also known to help with depression.

Find more tips at Mayo Clinic online.

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Too Much of a Good Thing: Exercise Addiction

By Claudia L. Reardon, M.D.

We all know it’s possible to have too much of a good thing. But can that apply to exercise too? Many people struggle to exercise even a small amount, so it might be hard to imagine that "exercise addiction" could be a problem. However, research shows that it can be, with one report estimating that 3% of the population could be addicted to exercise.

Some researchers suggest the following symptoms for "exercise addiction." These are some of the same symptoms of other addictions like alcoholism.

·    Tolerance: increasing the amount of exercise in order to feel the desired effect, be it a “buzz”  or sense of accomplishment.

·    Withdrawal: in the absence of exercise, experiencing negative effects such as anxiety, irritability, restlessness, and sleep problems.

·    Lack of control: unsuccessfully attempting to reduce exercise amount or to stop exercising for a certain period of time.

·    Intention effects: unable to stick to one’s intended routine as evidenced by exceeding the amount of time devoted to exercise or consistently going beyond the intended amount.

·    Time: a great deal of time is spent preparing for, engaging in, and recovering from exercise.

·    Reduction in other activities: as a direct result of exercise, social, occupational, and/or recreational activities occur less often or are stopped.

·    Continuance: continuing to exercise despite knowing that this activity is creating or worsening physical, psychological, and/or relationship problems.

·    Behaviors and conditions that often occur together with "exercise addiction" are eating disorders, excessive use of substances such as caffeine to improve athletic performance, and "work addiction."

It's important to point out that not all people who exercise at an intense level have an addiction. For example, competitive athletes often need to spend significant time and energy to their sports. Also, many people may be highly committed to their exercise routines without experiencing the negative effects that go along with an addiction. 

Usually, exercise is a very healthy and positive behavior, and most people benefit from a regular exercise schedule. However, if you think you or someone close to you may be suffering from "exercise addiction," you should seek help from a doctor. Cognitive behavioral therapy may be used to bring a patient back to a normal exercise schedule.

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