Overcoming alcohol addiction

Doc, I normally take alcohol to relax my brain during stressful moments. I want to avoid it, but I find it difficult. Please help.

V.K.

Dear V.K.,

It is great that you are considering quitting alcohol as a way to be healthier. It is possible to stop using alcohol completely or reduce consumption to amounts that are healthier and more manageable. There are several steps that you can take:

• Speak to a healthcare provider about your decisions. The purpose of this is to have a check-up on your current health and to create a personal plan on how to stop taking alcohol. The healthcare provider will also provide you with referrals to any required support. From the health assessment, the provider can determine the risk of developing alcohol withdrawal symptoms and advise on how to deal with them
• Understand your why – your reason for stopping alcohol. It may be helpful to write down the benefits of stopping versus the risks/costs of continuing to take alcohol, and keep reviewing it to keep you motivated. Take time to reflect on your personal reasons for stopping, for instance, it’s not a healthy coping mechanism; the financial cost; impact on relationships. Also consider the short- and long-term health effects of excessive alcohol consumption.

Some benefits of quitting alcohol include improved mood, improved sleep, increased energy and productivity, improved relationships, reduced cost and lowered risk of some health conditions.

• Set clear goals such as ‘I want to completely stop taking alcohol, and I want to do this because I want to be healthier’.
• Identify your triggers, that is, the situations, the people and the places in which you are more likely to drink. For example, feeling stressed or experiencing negative emotions is a trigger for you. Hanging out with some people, or going to some places may also be a trigger. Having alcohol in the house may also be a trigger.
• Work on strategies to deal with your triggers such as removing all alcohol from the house. Avoiding the people who you usually drink with and the places you usually go to drink. This may require getting new friends, new hobbies, new places to hang out, or controlling the situation such as inviting friends to your house and making sure there is no alcohol available. You also need to practise before hand how to refuse alcohol when it is offered to you.
• Get support by letting the concerned persons around you know that you have decided to stop drinking, and requesting for their assistance, when necessary, for instance, it is easier to say no to alcohol at a social event if you are accompanied by someone who will support you to avoid the alcohol. You can also get support from a mental health professional, or from a sobriety sponsor, or from a support group
• Self-care – eat healthy, stay hydrated, exercise regularly, get adequate sleep, and learn healthy ways to cope with stress

The journey to staying alcohol-free may take time, and it is likely to be challenging. Reward yourself when you are able to stick to your goals, forgive yourself when you fail, keep reminding yourself why you have chosen to do this, and get all the support you can get.

Dear Dr Flo, 

I am a 22-year-old lady. My breasts are still underdeveloped. They didn't develop at all during puberty and have been the same since then. All other developments took place and on time apart from changes in the size of my breasts. I have tried workouts and natural remedies but none have worked. Should I be alarmed? 

Wambui

Dear Wambui,

What you are experiencing is called breast hypoplasia. This is where there is no breast development, or there is no adequate breast tissue to support breast feeding, or the amount of breast tissue is so small that it causes psychological and/or social concerns.

The hormonal changes during puberty usually cause increase in fat tissue in the breasts, which makes them grow larger. The milk ducts also grow and develop secretory glands. This usually happens between age 13 and 18, though for some people this process may continue up to the early twenties.

It is possible for some developments during puberty to be delayed while the others happen at the expected time. This is the most common reason for delayed breast developments, and it is mostly affected by genetics. Other factors that can contribute to this are having very little body fat, or from problems with hormone levels, or from problems with how the breast tissue responds to the hormones.

Lack of breast development may also be due to as a result of having very little or no breast tissue (amazia), and this may occur on its own or is associated with other genetic syndromes. It may also be due to injuries or treatments that damage breast tissue in childhood such as suffering burns; or undergoing radiation, medical or surgical treatments that affect the breasts. In many instances, however, there is no identifiable cause of breast hypoplasia.

It is advisable for you to be reviewed by a specialist (gynaecologist and/or endocrinologist) for diagnosis, and to evaluate for and manage any underlying hormonal disorders. Based on the findings, you may not require any treatment. However, if there is no benefit of medical treatment, and based on personal preference, breast augmentation surgery may be an option.

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