Tag: alcohol

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Childhood Trauma and Personality: How Our Complex Lives Influence the Development of Eating Disorders and Alcohol Abuse

by Jasmine Atwal

Trigger Warning: Mentions of Suicide and Childhood Trauma/Abuse

Demi Lovato wearing a blue shirt: Demi Lovato.

Singer and Actress, Demi Lovato at Award Function, Gazette, 2020. Retrieved from Justin Bieber and Jennifer Lopez among E! People’s Choice Awards winners | Basingstoke Gazette

“I’m tired of running myself into the ground with workouts and extreme dieting. I thought the past few years was recovery from an eating disorder when it actually was just completely falling into it,” -Demi Lovato

Demi Lovato. Russel Brand. Elton John. Amanda Bynes.

Aside from being talented artists, these individuals share one more common link- they have all experienced eating disorders and substance abuse.

In 2018, Lovato was hospitalized due to an overdose and has since shared her heart-wrenching experience with alcohol abuse and eating disorders in the 2021 docuseries, Demi Lovato: Dancing with the Devil.In 2018, after mixing multiple substances, Lovato experienced multiple strokes, a heart attack, brain damage, and legal blindness. Regarding her previous experience with eating disorders, Lovato recounted:

  • “I was compulsively overeating when I was 8 years old.”
  • “For the past 10 years I’ve had a really unhealthy relationship with food.”
  • “I was performing concerts on an empty stomach.”

Lovato’s story is one among many that highlights the life-threatening impact that eating disorders and alcohol abuse can have on an individual.  

Eating disorders refer to illnesses in which individuals experience significant disturbances to their eating behaviours and accompanying emotions and thoughts. Often, these individuals are preoccupied with thoughts about food and body weight. There are many types of eating disorders including:  

  • Anorexia nervosa– The individual may have an unusually low body weight and a fear of gaining weight. These individuals will try to control their weight by limiting calories, exercising excessively, or using laxatives.   
  • Bulimia nervosa– These individuals will eat a lot of food and then try to get rid of the calories through unhealthy ways such as vomiting, using laxatives, or exercising too much.   
  • Binge eating– These individuals will likely eat too much and feel that they cannot control their eating. They will continue to eat even if they are full and often feel guilty afterwards. 

See the source image

The Signs of an Eating Disorder, Rehab Medical, 2020. Retrieved from Eating Disorders: Symptoms, Signs, Types and Causes- Rehab Medical (rehab-medical.com)

In Canada, eating disorders impact approximately 1 million individuals and these behaviours are often accompanied by other harmful behaviours, such as abusing alcohol. Abusing a substance refers to using too much, too often, or being unable to control use even though it might be harming other parts of your life. Approximately, 50% of individuals with an eating disorder also abuse alcohol.

Clearly, there is a large percentage of people who are experiencing symptoms related to two separate illnesses at the same time. Thus, these individuals require treatments that are able to target both mental illnesses. Treatments are only effective if the roots of the illness are identified and targeted, thus, it becomes extremely important to understand the specific risk factors (i.e., things that increase the likelihood of engaging in a behaviour) that contribute to the development of both disorders. It must be emphasised that the presence of these factors does not necessarily mean that you will definitely develop both/either disorder, it simply means that there may be an increased risk. Also, the factors that will be discussed can also lead to the development of other illnesses, but due to a limited number of studies that focus only on eating disorders and alcohol abuse, it is difficult to determine risk factors that are only related to these two disorders.

Also, alcohol abuse and eating disorders can be risk factors for the development of each other. For example, some individuals with anorexia may use alcohol to suppress their appetite- they drink to avoid eating. Some individuals may use alcohol to relieve themselves of feelings of guilt and shame when they do not eat or eat too much. Thus, while we will discuss what factors contribute to the development of both disorders, each one can contribute to the other as well.      

Childhood Trauma

It has been well-established that our childhood influences our adult lives by shaping our personalities, opinions, and memories. Childhood trauma refers to an emotionally painful, scary, violent, or threatening experience that occurs in one’s childhood and has a lasting impact on their mental or physical health. This can include neglect, sexual and physical abuse.

Childhood trauma has been found to be a risk factor for eating disorders and alcohol abuse. For example, a study by Corstorphone et al. (2007) found that individuals who had experienced any form of abuse in their childhood were more likely to develop any type of eating disorder in their adult lives. Further, childhood sexual abuse was the most significantly linked to the development of bulimia and binge-eating, alcohol abuse, and self-harming behaviours. Similarly, a study by Guillaume et al. (2016) found that any form of mistreatment in one’s childhood could predict future development of an eating disorder and accompanying alcohol abuse.    

In fact, childhood trauma is fairly common in individuals who are experiencing eating disorders and alcohol abuse. Multiple studies have found that 37% to 100% of individuals with eating disorders have experienced some form of abuse or neglect within their childhoods. While the reasons are likely complex, it is suggested that individuals with traumatic experiences in their childhood may lack proper coping skills and resort to harmful behaviours (such as eating and drinking a lot) as a way to deal with their trauma and emotions. Alongside childhood trauma, one’s personality also influences the development of these illnesses.  

See the source image

Childhood Trauma and Development of Eating Disorder, ESI, 2019. Retrieved from Childhood Feeding Neglect and Trauma in Developing Eating Disorders

Personality

Our personality influences many aspects of our lives. Impulsivity (i.e., acting quickly without thinking), how we respond to our emotions, among other factors can increase or decrease the likelihood of committing certain behaviours and in turn what disorders are developed.

            A study by Lozano-Madrid et al. (2020) focused on personality traits in female participants with diagnosed eating disorders who displayed symptoms of alcohol or drug abuse. The researchers found that impulsive individuals with executive control problems and emotional dysregulation were at a higher risk of abusing alcohol. Executive control problems refer to one’s ability to make decisions and create/work through goals while emotional dysregulation is one’s inability to control their emotional responses. Essentially, the study found that the symptoms of alcohol abuse in individuals with eating disorders were more likely to transform into a disorder in the presence of the previously mentioned risk factors.

            Similarly, a study conducted by Micheeva and Tragesser (2016) focused on multiple personality factors including negative urgency and emotionality. Negative urgency refers to a type of impulsivity in which one reacts rashly when they are in distress, such as using alcohol to cope with a problem in their lives. The researchers found that negative urgency heavily contributed to the development of eating disorders and alcohol abuse. These individuals may turn to food or alcohol as a means to cope with the problems they are currently or have in the past,- experienced and, overtime, these behaviours increase in riskiness and translate to disorders.

Concluding Remarks

            While the studies mentioned above provide important information, there are some things that we must remember. Firstly, the above list is not exhaustive as there were many factors that were not discussed in this post including genetics. Also, we must remember that the simple presence of these factors in your life do not automatically guarantee the development of eating disorders and alcohol abuse- it simply increases the risk.

            Fortunately, there are many treatments that are available for individuals with eating disorders and alcohol abuse, that target specific risk factors (such as those mentioned above). For example, cognitive-behaviour therapy (CBT) targets negative thoughts and behaviours and has been found to be effective in reducing anorexia and binge-eating. Interpersonal psychotherapy which targets interpersonal problems (i.e., family or relationship issues) in the individual’s life that may be contributing to their poor eating/drinking habits. These treatments may seem vague, but each one can be specialized to target the factors that are causing the individual’s problems. In Canada, organizations such as National Eating Disorder Information Centre (NEDIC) and Ontario Community Outreach Program for Eating Disorders can help you gain access to such treatments.

If you or a loved one require support, please refer to the following website which provides information about Canadian organizations that provide resources and support to individuals with eating disorders and other accompanying problems. https://www.eatingdisorderhope.com/treatment-for-eating-disorders/international/canada/canadas-eating-disorder-organizations-charities

References

Cookson, P. (2020, October 5). 23 Celebrities with Eating Disorders: The Recovery Village. The Recovery Village Drug and Alcohol Rehab. https://www.therecoveryvillage.com/mental-health/news/celebrities-with-eating-disorders/.

Corstorphine, E., Waller, G., Lawson, R., & Ganis, C. (2007). Trauma and multi-impulsivity in the eating disorders. Eating Behaviors: An International Journal, 8(1), 23-30. https://doi.org/10.1016/j.eatbeh.2004.08.009

Guillaume, S., Jaussent, I., Maimoun, L., Ryst, A., Seneque, M., Villain, L., Hamroun, D., Lefebvre, P., Renard, E., & Courtet, P. (2016). Associations between adverse childhood experiences and clinical characteristics of eating disorders. Scientific Reports, 6(1), 35761-35761. https://doi.org/10.1038/srep35761

Hibberd, J. (2021, April 14). Demi Lovato’s Eating Disorder Comedy Pilot Gets NBC Order. Billboard. https://www.msn.com/en-us/tv/news/demi-lovato-s-eating-disorder-comedy-pilot-gets-nbc-order/ar-BB1fCPTX?ocid=uxbndlbing.

Hilliard, J. (2021, April 2). Alcohol and Eating Disorders. Alcohol Rehab Guide. https://www.alcoholrehabguide.org/resources/dual-diagnosis/alcohol-eating-disorders/.

Kass, A., Kolkata, R., Wilfley, D. (2014). Psychological Treatments for Eating Disorders. Curr Opin Psychiatry, 26(6), 549–555. https://doi.org/https://dx.doi.org/10.1097%2FYCO.0b013e328365a30e 

Lewaniak, L. (2016, April 1). The Link Between Eating Disorders and Alcohol Abuse. Eating Recovery Center. https://www.eatingrecoverycenter.com/blog/signs-symptoms/The-Link-Between-Eating-Disorders-Alcohol-Abuse. 

Lozano-Madrid, M., Clark Bryan, D., Granero, R., Sánchez, I., Riesco, N., Mallorquí-Bagué, N., Jiménez-Murcia, S., Treasure, J., & Fernández-Aranda, F. (2020). Impulsivity, emotional dysregulation, and executive function deficits could be associated with alcohol and drug abuse in eating disorders. Journal of Clinical Medicine, 9(6), 1936. https://doi.org/10.3390/jcm9061936

Malone More Articles April 6, C. (2021, April 6). ‘Dancing With the Devil’: Demi Lovato Was 5 Minutes From Death After Her 2018 Overdose. Showbiz Cheat Sheet. https://www.cheatsheet.com/entertainment/dancing-devil-demi-lovato-overdose.html/.

Mayo Foundation for Medical Education and Research. (2018, February 20). Anorexia nervosa. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/symptoms-causes/syc-20353591.

Mayo Foundation for Medical Education and Research. (2018, May 10). Bulimia nervosa. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bulimia/symptoms-causes/syc-20353615.

Mayo Foundation for Medical Education and Research. (2018, May 5). Binge-eating disorder. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/symptoms-causes/syc-20353627.

Mikheeva, O. V., & Tragesser, S. L. (2016). Personality features, disordered eating, and alcohol use among college students: A latent profile analysis. Personality and Individual Differences, 94, 360–365. https://doi.org/10.1016/j.paid.2016.02.004 

National Initiative for Eating Disorders. (2020, November 24). Eating Disorders in Canada. NIED. https://nied.ca/about-eating-disorders-in-canada/.

National Institute of Mental Health . (n.d.). Eating Disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml?ftag=YHF4eb9d17.

Tagay, S., Schlottbohm, E., Reyes-Rodriguez, M. L., Repic, N., & Senf, W. (2013). Eating disorders, Trauma, PTSD, and Psychosocial Resources. Eating Disorders, 22(1), 33–49. https://doi.org/10.1080/10640266.2014.857517 

Tavolacci, M. P., Ladner, J., Grigioni, S., Richard, L., Villet, H., & Dechelotte, P. (2013). Prevalence and association of perceived stress, substance use and behavioral addictions: a cross-sectional study among university students in France, 2009–2011. BMC Public Health, 13(1). https://doi.org/10.1186/1471-2458-13-724

U.S. Department of Health and Human Services. (n.d.). Helping Children and Adolescents Cope with Disasters and Other Traumatic Events: What Parents, Rescue Workers, and the Community Can Do. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/helping-children-and-adolescents-cope-with-disasters-and-other-traumatic-events/index.shtml.

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From Quarantine to Quarantini: Understanding how COVID-19 Restrictions may be Impacting your Drinking

by Dr. Sarah Dermody

It is hard to believe that it has been one year since the first COVID-19 lockdowns occurred in the US and Canada. Over the past year, many people’s daily routines have completely changed as they physically and socially-distance from others. While this distancing has been crucial to reduce COVID-19-related deaths, a question that scientists and practitioners have been facing is “Have there been harmful effects on alcohol use and related deaths?” Let’s look at the data together and see what’s the matter.

The Quarantini

martini

Over the past year, many bars and restaurants have had to limit “drink-in” services. At the same time, many rules around alcohol sales and delivery have laxed (cocktail delivery – anyone?) and alcohol vendors have been deemed essential services.

It is not possible to know for sure if the pandemic has changed drinking. This is would require a study where we control people’s exposure to pandemic-like conditions and give them alcohol to see what happens (aka an experiment). What we do know, however, is that in some regions during certain periods of the pandemic there have been increases in the sale of alcohol. Of course, based on this alone, we do not know if people are drinking that extra alcohol they have purchased or if it is now part of a new pandemic trend of building a wine cellar.

We also know that people are telling us they are drinking more. In an online survey of 320 Canadian adults who drink, some individuals reported increased alcohol use when the pandemic started [1]. Some people reported greater increases in drinking than others, such as individuals who had children under the age of 18, had greater depression, or were less socially connected to others. An important question is why are certain people drinking more during the pandemic?

Tears in Your Beer

While alcohol use is often thought of as a social activity, how has social distancing and the pandemic affected people’s alcohol use?

The COVID-19 pandemic is a stressful ongoing event affecting the lives for many people. For quite some time, researchers have argued that feeling stressed, sad, or anxious can lead individuals to use substances (like alcohol) to cope with those unwanted feelings. Consistent with this idea, research supports that individuals who were more likely to report drinking alcohol to deal with negative emotions during the pandemic were most likely to increase their alcohol use.[1] Drinking to cope with negative emotions also was associated with experiencing consequences from drinking, such as being unhappy, getting in trouble, doing impulsive things, and harming relationships.

A Short-Term Solution that can create Longer-Term Problems

Attention has been drawn to recent increases in “deaths of despair” that include deaths from alcohol and other drug overdoses (as well as liver disease and suicide).[2] For instance, in Ontario, there was an increase in opioid-related deaths after the state of emergency was declared in March 2020 (see page 5 ).  While there are many possible explanations for this increase, one possibility that has been put forward is that the sudden and then ongoing stress of the COVID-19 pandemic has led individuals to drink to cope and this can fuel an increase in drinking and potentially harms from drinking (such as overdose and alcohol-related liver disease).

As the COVID-19 pandemic continues to burden us with considerable stress and worry, alcohol serves as only short-term solution to a longer-term problem. As stated by Koob and colleagues (2020):

“Alcohol can temporarily dampen negative emotional states, providing short-term relief…Over time, [changes to the brain] reduce the relief that is provided by alcohol and increase emotional misery between episodes of [alcohol] use.”

In other words, alcohol may help relieve distress in the short-term, but in the longer term, it can make distress much worse.

Finding Other Ways to Cope

Image by mohamed Hassan from Pixabay

Given the potential physical, emotional, and financial costs of drinking, alternative ways of coping with COVID-19 related distress are needed. It is important to find options that will work for you and your current pandemic lifestyle. It may not be easy, but your mind and body may thank you later for finding alternative ways to relax and take a break.

Here are some options that you could try!

  • Enjoy a different beverage: your favorite soda, a warm tea, or an indulgent hot chocolate
  • Find another way to temporarily escape: have a bubble bath, listen to your favourite album, or watch a new show
  • Develop new ways of coping: practice mindfulness, start a new exercise routine, go for a walk
  • Reconnect with others: plan a virtual game night or simply catch-up with others by phone

Where can I find out more about reducing my drinking?

[1]Wardell, J. D., Kempe, T., Rapinda, K. K., Single, A., Bilevicius, E., Frohlich, J. R., … & Keough, M. T. (2020). Drinking to Cope During COVID‐19 Pandemic: The Role of External and Internal Factors in Coping Motive Pathways to Alcohol Use, Solitary Drinking, and Alcohol Problems. Alcoholism: Clinical and Experimental Research, 44(10), 2073-2083.

[2] Koob, G. F., Powell, P., & White, A. (2020). Addiction as a coping response: hyperkatifeia, deaths of despair, and COVID-19. American Journal of Psychiatry, 177(11), 1031-1037.