There is such a wealth of knowledge and experience with alcoholism and TSM on these boards that I thought it might be good to have all that information, tools and tips in one thread, like the "What to expect on TSM" thread. I'm thinking about things that we can do and learn parallel to TSM.

I'll start, please copy and paste the list and add your own suggestions.

Best,

Curi

1) Never forget the Golden Rule- Always take 50mg of Naltrexone 1 hour before you drink. If you don't drink, don't take Naltrexone. For those of you starting out on TSM, try taking 25mg of Naltrexone for the first few days to help with side effects.

2) Count and record your units. Preferably in your signature (User Control Panel-Profile-Edit Signature) so that you and everyone can see it at a glance, this helps us to objectively evaluate our progress.

3) Be patient.Give TSM time to work, Rome wasn't built in a day and neither was that endorphin reinforced super-highway in our brains, grass needs time to grow.

4) Remember to eat and drink. I know this might sound like I'm stating the obvious but I can't stress enough how important that is! Hunger and Thirst (dehydration) are THE two biggest physical triggers and craving causers we face.

a. Eat something that contains protein, protein helps stabilise blood sugar levels and helps avoid sugar crashes which create cravings. Protein doesn't have to be a big steak meal, it can be a fist full of nuts at your desk, a meat sandwich, a hard boiled egg, a drumstick, a spoonful of peanut butter or hummus, a bean salad, cheese, yoghurt etc...

b. Drink plenty of liquids, have a bottle of water with you at all times and sip from it, or herbal tea, as well as your usual sodas and coffee.

c. Before you start drinking, for example, when you take your 50mg of Naltrexone, eat something, it doesn't have to be a meal, and drink a large glass of water, this will help you drink less and may also help with nausea.

5) Learn your triggers. Do you drink when: you are stressed?, bored?, angry?, you hear the theme tune to your favourite TV program, lonely?, happy?, sad? tired? celebrating?, sp(m)ouse is away, pleased?, other?

6) Rest. Give your body some well earned rest. If a good 8 hours sleep at night isn't possible because of your drinking or because of other obligations, try taking a small nap (20 minutes) or just sit quietly for a while doing nothing.

7) Exercise on the day(s) that you are not drinking and/or taking nal; it really helps with the endorphins, thanks to up-regulation.

8) Don't be afraid to incorporate moderation techniques if you want.

9) Participate on this forum to receive and give support, to ask question, share information and to record your progress and feelings.

10) Consider therapy.

7) Try and get some exercise on the day(s) that you are not drinking and/or taking nal; it really helps with the endorphins.

8) Don't be afraid to incorporate some moderation techniques if you want.

Maybe at the beginning we should suggest starting off on 25mg for the first few nights? I went straight on 50mg like my doctor told me to and it was BRUTAL.

Patience! Patience! Patience!

Thanks EL and Katie! Good point about the 25mg EL, I'm going to add that to point no. 1.

Anyone else?

Curi

Great idea to make a list!

Maybe add something about keeping in touch via this group? Accept support and support others. No need to fight the battle alone. Make the group part of your recovery.

And maybe: consider getting some counseling (not with an addiction specialist) to work on life issues that contribute to drinking and result from drinking.

Hi Tiller and thanks for that. Good points!

I'm very interested in your second point, could you elaborate a little please? Are you saying that we became addicted to alcohol because of psychological and/or life problems? I'd be inclined to agree that we have some of those problems because of our addiction- consequences of chronic alcohol abuse, but I'm not sure that they are the direct cause of our addiction, I suspect that there might be another level, an origin, something that caused these problems. I am questioning this myself at the moment, I'm not saying you are wrong or right, I don't know, but I think it could be a really interesting discussion.

I'm going to throw an idea out and I'd love to hear your opinions:

Suppose we were born with a biochemical or hormonal deficiency. Let's say we have less endorphin or dopamine (or other hormone) levels than the general population, this deficiency leads to psychological consequences: feelings of inadequacy, inability or reduced ability to feel satisfaction or pleasure, which lead to depression or other mental health problems. These hormone deficiencies lead us to seek behaviours that make us feel better, drinking, sport, thrill seeking activities etc...

What if we could regulate the hormone levels ? What if we could feel pleasure and satisfaction like most people?

I'd love to hear your thoughts on this.

Curi

Alcoholism is a complex disease and I'm not a scientist. But here are a few things I've learned about it.

Most of us addicts have a genetic predisposition to the disease. Doesn't mean we're doomed to become alcoholics but are at higher risk. Life events -- our life environment -- can cause that genetic marker to kick in.

Alcoholism and other mental illnesses often coexist. I have major depression and it is common for folks like me to also have problems with alcohol. Which is a drag because alcohol is a depressant in and of itself, making the underlying condition worse!

So counseling can help people work on the life events/environment that may have contributed to drinking, and with conditions like depression or anxiety that can also be implicated.

And, of course, the drinking itself produces life problems, relationship issues and etc that can also benefit from counseling.

Does this help?

Hi, Tiller, and thank you, yes, I thought that was what you meant but I just wanted to be sure.

You used the term "underlying" problem which implies that we drink because we have mental health problems, like depression or anxiety or ADHD or whatever. These problems have generally been looked upon and treated as psychiatric/psychological problems, along with addiction, and the usual treatment is psychological therapy of various sorts.

What I am wondering about though is, what if the underlying cause of our problems is not psychological but biochemical. What if we simply don't have enough endorphins and dopamine etc... ? We can spend our whole lives in therapy and still feel bad because the underlying problem has not been properly addressed- our lack of certain biochemicals.

I'm sure we've all been in the same situation several times but have reacted differently depending on how we feel, the situation remains the same e.g. our children are bickering, our boss is angry, but depending on how we feel at that moment- tired, depressed, sad etc... we will react differently to the same stimulus. If our kids are arguing and we feel good we might dismiss it as normal behaviour, however, if you we feeling depressed we might start to feel guilty, thinking we are responsible in some way for their "bad relationship". If our boss is angry and we feel good, we might put it down to him having a bad day and not feel that it is because we are incompetent, which we might feel if we are depressed.

I'm not sure if I'm making myself clear... ?

I'm wondering if the proper course of treatment for addiction and depression and any other mental health problem, should be purely through medication. I'm wondering of therapy might just make us feel worse and not better, like AA or other 12 step approaches to addiction that imply that addiction is a psychological problem or moral failing.

What if all that is wrong?

Thoughts?

I am a firm believer that many mental illnesses -- including my depression -- are biochemical. It runs in my family and I take an antidepressant to help control it. But a zillion studies have shown that, for most brain diseases, a combination of medication and psychotherapy is far more effective than either one alone.

Also, I have zero shame about having depressions. I don't talk about it with the boss, but it's no more my fault than if I had asthma.

One of the reasons I'm doing TSM is to cut down on alcohol, which makes my depression much worse. When I don't drink too much I don't feel depressed.

My suggestion is that people with a drinking problems consider some form of therapy to explore the issues that run hand-in-hand with drinking. Either problems caused by the drinking of the things that trigger it. Counseling is not for everyone but it's worth considering.

I've benefited especially from cognitive behavioral therapy (CBT). It's a positive way to change or interrupt negative thinking patterns that can make us miserable. CBT is very solutions oriented and not meant to go on for ever.

That said, I repeat that counseling is not for everyone. Nor is it magical. It's just another option for achieving a healthier life, like TSM.

Finally, any kind of therapy that makes us feel worse is like bad medicine. To be discarded.

Thanks for asking such thoughtful questions. Any others out there want to chime in from their own perspectives?

Thanks, Tiller, that all makes sense to me.

Curi