Do You Need Psychological Counseling for These Symptoms?

Q: Do You Need Psychological Counseling for These Symptoms?

Hello Hanhan： Given your current situation, it is advisable to avoid drinking alcohol. <br>The phenomenon of becoming intoxicated and losing control of behavior is a type of predisposition that can frequently recur. <br>Although it hasn't happened in the past, it has occurred twi

Do these symptoms require additional psychological counseling?

Hello Dr.
Liang,
I would like to ask about a person who previously had a smooth career, high emotional intelligence, was well-liked, and had good tolerance and behavior when drinking.
After experiencing a series of setbacks, this individual fell into a state of despair and began to drown their sorrows in alcohol.
Although they managed to recover a few years later, they were not as good as before, and their emotional intelligence continued to decline.
Whenever they took a break, they would drink to the point of intoxication, although their behavior remained acceptable; they became more talkative but not disruptive when drunk.
Later, their liver enzyme levels exceeded normal limits, and they stopped drinking.
After two years, they drank alcohol again for the first time, but their tolerance had worsened, and they exhibited uncontrollable behavior (alcohol-induced aggression), with no memory of the events after sobering up.
Six months later, during a second episode, their tolerance was even lower, and they lost control after just a few drinks, displaying even more violent behavior.
Could this situation be related to childhood trauma and severe adult setbacks, leading to a dual personality when intoxicated? In this case, in addition to seeking medication treatment from a psychosomatic specialist, would it be necessary to pursue psychological counseling? Regarding the issue of becoming intoxicated after only a few drinks, should they also see an internist for liver examination?
Thank you, Doctor.

Hanhan, 40~49 year old female. Ask Date: 2017/03/22

Dr. Liang Sunyuan reply Psychiatry

Hello Hanhan: Given your current situation, it is advisable to avoid drinking alcohol.
The phenomenon of becoming intoxicated and losing control of behavior is a type of predisposition that can frequently recur.
Although it hasn't happened in the past, it has occurred twice already, and there is still a risk of it happening again in the future.
Life's pressures, setbacks, and past negative experiences can indeed affect your current emotions.
It is important to calm down, recognize your negative emotions, and understand their possible sources.
By doing so, you are usually better able to manage your emotions.
Alcohol suppresses our brain's ability to exert control, which is why our self-control diminishes when intoxicated.
Seeking medical attention and psychological counseling can provide additional support, helping you gain clarity about your situation and find ways to make changes.
Wishing you all the best.

Reply Date: 2017/03/22

More Info

It sounds like you are experiencing a complex interplay of emotional distress, substance use, and possibly underlying psychological issues. Given your history of being well-adjusted and socially adept, the significant changes in your behavior and emotional state following a series of life challenges are concerning.
Firstly, the symptoms you describe—such as increased alcohol consumption, loss of control while drinking, and the emergence of aggressive behavior—suggest that you may be dealing with alcohol use disorder (AUD). This condition can develop as a coping mechanism in response to stress, trauma, or emotional pain. The fact that you have experienced blackouts and memory loss while drinking indicates that your body is reacting negatively to alcohol, which can be a sign of developing dependence.
Additionally, your mention of a low emotional quotient (EQ) and the tendency to become aggressive when intoxicated could point to deeper emotional and psychological issues. It’s not uncommon for individuals who have faced trauma or significant life stressors to develop maladaptive coping strategies, such as substance use. The duality you describe—being a generally pleasant person but exhibiting aggressive behavior when drinking—could be indicative of unresolved emotional conflicts or trauma from your past.

Regarding your question about whether psychological counseling is necessary, I would strongly recommend it. Therapy can provide a safe space to explore the underlying issues contributing to your current state. A mental health professional can help you process past traumas, develop healthier coping mechanisms, and work on emotional regulation skills. Cognitive-behavioral therapy (CBT), for example, is effective in addressing issues related to substance use and emotional dysregulation.

Moreover, it is essential to consider the impact of your alcohol consumption on your physical health, particularly your liver. Given your history of elevated liver enzymes and the recent changes in your alcohol tolerance, it would be prudent to consult with an internist or a gastroenterologist for a thorough evaluation of your liver health. They may recommend blood tests or imaging studies to assess any potential damage and provide guidance on how to manage your alcohol consumption safely.

In summary, seeking psychological counseling is highly advisable given your symptoms and history. It can help you address the emotional and psychological factors contributing to your current struggles. Additionally, consulting with a medical professional regarding your liver health is crucial, especially considering your recent experiences with alcohol. Taking these steps can lead to a more comprehensive approach to your well-being, addressing both the psychological and physical aspects of your health. Remember, reaching out for help is a sign of strength, and there are professionals who can support you through this challenging time.

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