Dr Ciara Kelly: Four women who make me think about drink
General practice is a funny job. Much like flipping a coin where you can throw tails 50 times in a row - the random nature of who comes in to see us means you can spend a day seeing the same thing all day or see something once and never see it again. I saw four women one day who made me think on this.
The first was a woman in her thirties. Single with small children and a history of an abusive relationship, she was struggling to cope with holding down her job, minding her kids and dealing with a difficult relationship with her parents, whom she was quite reliant on, and who were helping her but only on their own often quite demanding and unreasonable terms.
In tears and feeling quite desperate, she didn't know what she could do to turn around her situation.
The next was a woman in her forties. Married with kids and a supportive family, she was suffering with anxiety, an inability to relax or feel calm or even safe.
She was consumed by irrational fears on a daily basis and had fallen out with some of her closest friends because she would sometimes lash out at them when she was feeling agitated by her distress.
She knew something had to give.
The next was a separated woman in her fifties. Her children were now grown and gone and she was a bit low and was planning some major life changes she hoped would work out for the better. Her main concern was despite huge efforts with diet and exercise she was struggling to lose weight. It was getting to her. No matter what she did the weight didn't budge or indeed crept on. It was damaging her confidence. And it made her fearful of what life would be like as she got older.
The last was a woman in her sixties. Living alone, quite isolated and having difficulties with her boss, whom she was now mostly avoiding - which was leading to further problems - she was scared of what would happen to her if she lost her job.
How would she cope financially? What would she do all day if she had no job to go to; would she just cease to exist? Would anyone even miss her?
These seem like unrelated stories, albeit they are all about women who were struggling in various ways in their lives.
What I haven't told you is what they all had in common. These women are all alcoholics.
They didn't present to me regarding their alcohol use. They came in with the other issues. But that is the thread that binds them. The awful thing was you could see a straight-line life trajectory from the 30-year-old to the 60-year-old if she didn't do something about her drinking.
Seeing four female alcoholics in one day, struck me as a lot. But then I wondered was it? I'd had no idea about one of them until that day, despite knowing her for 15 years. Another one I'd known even longer, and I'd had an inkling but she hadn't confirmed it until that visit. Yes, I knew about the other two but only because both had previously been admitted to hospital in crisis. Up until that point I hadn't known a thing.
So perhaps it isn't unusual to see four female alcoholics in a day. Perhaps I do every day, I just don't know it. Alcoholism in women is such a covert thing.
But seeing these four, very nice, likeable, decent women in the one day made me wonder. How many other women do I see who are drinking a bottle of wine a night to help them sleep. Or a few G&Ts because they've had a tough day, but actually every day is tough. How many women do we all see, whose choices, relationships, jobs and lives are damaged by alcohol, but actually we don't see it at all. Nobody sees it. Nobody says it.
I think it's probably the case that there are far more than we like to think about. We know these women. We are these women. In Ireland the only alcoholics we really recognise are either the ones in the gutter or the ones who don't drink at all having recognised the problem in themselves and stopped.
The ones who drink enough to damage themselves but keep going. Those are the ones we never see.
Sunday Indo Living