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Alcohol was also medication. I drank to quiet angst or because I was lonesome. I drank, it took years to realize, because I had clinical depression. Eventually I treated the depression but kept drinking. Alcohol was my stress-reducer, my reality fighter, the conferrer of artificial joys. Life changed in my 40s. I married, and with my husband, adopted our beloved daughter, now 17. Working from home, I made dinner, drinking wine with a neighbor mom. My morning-after headaches were worsening, though. Nights, rather than reading or chatting with my husband, I’d crash. I feared my drinking was destroying brain cells. I’d written about how alcohol is harder on women than men and that worried me, too. Some years ago, to prove I had control, I cut down to five nights a week. It was tough. How could I not drink after a rough day? I couldn’t manage two consecutive sober nights. Achieving my two sober nights was always an exercise in military-level strategizing. But every Sunday, I felt virtuous. An actual alcoholic couldn’t skip any nights, I thought. But I could. What does it mean to have a serious drinking problem? The answer is surprisingly vague. “Alcoholism” isn’t an actual diagnosis. In 1980, the American Psychiatric Association’s authoritative Diagnostic and Statistical Manual of Mental Disorders established two different classifications: alcohol abuse and alcohol dependence. In 2013, the D.S.M. combined the categories to create “alcohol use disorder,” a spectrum ranging from mild to severe, based not on how much someone drinks but on how many of 11 behavioral or psychological symptoms a person has. Meanwhile, the Centers for Disease Control and Prevention has its own standards, focused more on quantity of alcoholic consumption. Seven drinks per week or fewer is considered safe for women, 14 or fewer for men. But guidelines fluctuate internationally, according to a Stanford University study from 2016. In Canada or France, you can drink more weekly and be considered “low risk.” Moreover, a recent study in The Lancet concluded alcohol is so tough on health that there’s no safe level.
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