Lawyers Journal

Lawyers’ concerns:Dealing with the discomfort of early sobriety

This column offers mental health and wellness-related information to the Massachusetts legal community. Lawyers Concerned for Lawyers bases the column on questions frequently asked by its clients and help-line callers. The information is general in nature and not meant for treatment.
Q:After years of concern and pressure from my husband, some friends and recently my law partner, and realizing in the back of my mind that my drinking had become central in my life, I stopped drinking about a month ago. I didn't suffer from anything physical like shakes and have been able to stay away from alcohol, but my anxiety level has skyrocketed. I guess I was always an anxious person, but now I spend much of each day feeling very jumpy, intensely uncomfortable in my own skin. On a few occasions, I've even had what I'm told are panic attacks. What do I do about this?
 
A
:Early sobriety can be a time of considerable discomfort. It is possible that alcohol has been masking a longstanding anxiety disorder. It is also likely that your nervous system, which for years has been compensating for the depressant properties of alcohol, is still in the process of readjusting. (For these and other reasons, we prefer to see people stop drinking with treatment support rather than on their own.) In addition, without drinking as a coping mechanism, you are now forced to find alternative ways to manage anxiety.
It's too early to conclude that you have a primary anxiety disorder. (Even if you do, treating it will not make it safe to resume drinking.) The idea of taking tranquilizers (benzodiazepines) will be tempting as a source of relief, but please beware (even if you doctor prescribes them): for many, these drugs are cross-addictive with alcohol and develop into a second addiction with their own extremely unpleasant withdrawal symptoms.
So, what's a safer course of action? Aside from temporarily reducing sources of stress in your life (e.g., by shifting some of your demanding cases to another attorney) while you focus on learning to live sober, this is also a good time to explore non-chemical means of anxiety reduction. These might include: exercise; relaxation/meditation techniques; hobbies; acupuncture; therapeutic massage; etc.
In terms of therapy/counseling, make sure that you turn to someone with specialized experience in addictions as well as general mental health. And there is no substitute for the kind of support and reassurance to be gained from support groups, which could include LCL's peer-led, lawyer-specific meetings.
If your anxiety symptoms remain severe after you are stabilized in sobriety, cognitive-behavioral therapy may be appropriate, and is often as effective as medication for reduction or elimination of anxiety/panic. Panic attacks, which are time-limited and not fatal even though it may feel as if you're about to die, are often brought on by fearful thoughts and anticipation. If medication is needed, there are non-addictive options that, although less immediate and potent in providing relief, are much safer for someone with an addictive history. We can provide more detailed information on all of these options if you simply call or visit LCL.

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