This article from the Guardian highlights a personal account of alcoholism and recovery, this time featuring the talented Brit actor/director Simon Pegg. I use these stories to illustrate some characteristics of the disease process and its effect on the course of an individual’s life.

Pegg, now 48, describes himself as having been depressed since age 18. From the beginning, alcohol was his remedy of choice. A simple equation: Feel sad, have a drink, feel better. For him, it was an antidepressant. Effective, temporarily.

I noticed years ago that our patients often characterized alcohol as a “quick pick-me-up” during the early days of drinking. That struck me as odd because alcohol is a central nervous system depressant. I wondered even then whether it could be an early symptom of alcoholism– somehow, in certain people, the effects of alcohol were strangely reversed. They felt stimulated rather than sedated.

Pegg reports that things began to unravel in his mid-30s. It’s more likely that signs of impairment appeared much earlier but went unnoticed for years. By then, heavily reliant on alcohol to function, he must have felt both puzzled and hurt. His trusted “crutch” had deserted him.  When this happens, the drinker’s first impulse is to look around for someone or something to blame. It’s understandable, but doesn’t exactly foster good will in relationships.

An observation from Pegg: “One thing [addiction] does is make you clever at not giving anything away. People think junkies and alcoholics are slovenly, unmotivated people. They’re not – they are incredibly organised. They can nip out for a quick shot of whisky and you wouldn’t know they have gone. It’s as if … you are micro-managed by it….But eventually the signs are too obvious. You have taken the dog for one too many walks.”

True enough. As control erodes, the drinker may redouble efforts to regain it. Some resort to periods of “white-knuckle” abstinence, renouncing alcohol just to prove to themselves or someone else that they can. They argue that such periods of iron-fisted self-control are proof that they don’t suffer from alcoholism. In fact, it’s evidence that they do.

Rarely does it occur to the drinker that abstinence might actually be the easier course. Once drinking is compulsive– meaning having one seems to increase the desire for another –  sobriety is the logical outcome. Without continual reinforcement, the craving can recede. Which it cannot do if we insist on reactivating it at regular intervals.

Anyway, here’s good luck to the very talented Mr. Pegg. And all the others out there who are just like him.