Overview: The term alcoholism refers to an addictive alcohol disorder and is often used interchangeably with the DSM-IV diagnosis of Alcohol Dependence. The DSM-IV has two diagnoses for problem drinking behaviors, Alcohol Abuse and Alcohol Dependence. Alcohol Abuse refers to the repeated use of alcohol despite recurrent adverse consequences. Alcohol Dependence is a more serious progression of the disease with the same symptoms of Alcohol Abuse with the addition of tolerance, withdrawal, and an uncontrollable drive to drink.
It is estimated that about 15% of the American population suffers from Alcohol Abuse or Alcohol Dependence. Some of the risk factors include: having an alcoholic parent, being subjected to peer pressure (especially teens and college-aged students), having a comorbid psychiatric diagnosis (particularly depression, bipolar disorder, anxiety disorders, ADD/ADHD, or schizophrenia), having easy access to alcohol, having reduced self-esteem or problems with relationships, living a lifestyle that is stressful, or living in a culture where there is high social acceptance of alcohol use. Research also suggests that certain genes may increase the risk of alcoholism, but which genes and how they work are not yet fully known.
Alcoholism and Living in Tokyo and Japan: The environment and culture of Japan can be a factor in the development of alcohol abuse or dependency. Many social and business activities in Japan involve a component of alcohol use. Bars, clubs, restaurants, and karaoke establishments frequently have "all you can drink" courses on offer. In addition, the work culture in Japan often creates peer pressure for after work drinking parties and or attendance at business functions where alcohol is involved. Adjusting to a new life in Tokyo or other locations in Japan can also create a wide variety of stresses that people may try to relieve through alcohol use, potentially leading to alcohol abuse or dependence.
Treatment: The Meguro Counseling Center has considerable experience in the treatment of persons with Alcohol issues in Tokyo and Japan. Family or marital fighting, inability to function properly at work, blackouts, and medical complications of drinking are common reasons to present to therapy. Phone or Skype counseling is an effective method for persons who live far from the Tokyo area.
The treatment approach starts with taking a thorough history to determine if there is an underlying problem that also needs to be addressed. The therapist will also work with the client to have them see and understand how their drinking behaviors are having a negative impact on their lives and that it has become a behavior that is really out of their conscious control. Identifying cues or triggers and formulating strategies to avoid those situations can also be part of the treatment process that would require some consistency in attending counseling sessions.
In cases where there is a serious effect on one's health, or social or occupational functioning, outpatient treatment with medications that make drinking persons feel sick or decrease craving in addition to counseling, or inpatient rehabilitation may be useful. AA (Alcoholics Anonymous) is a helpful support network that can help some people overcome alcoholism that may be used in addition to the interventions mentioned above. The Meguro Counseling Center is also affiliated with a local medical clinic that can evaluate the medical aspects (liver function, nutritional status, gastritis, pancreatitis, etc.) that are often disturbed in persons who drink heavily.
Substance Abuse Treatment in Tokyo and Japan: Other kinds of substance abuse, cocaine, amphetamine, "crystal-meth", other forms of speed, etc. are also commonly seen in Japan. The treatment of these conditions is similar to that of alcohol in many ways, however, these substances can also commonly cause mental disorders like psychosis and depression themselves. Careful evaluation and consultation with a psychiatrist, counseling, in-patient rehabilitation, and perhaps medication intervention may be necessary to treat these conditions and their complications. The Meguro Counseling Center also has experience in treating these substance use disorders.
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The Meguro Counseling Center consists of Western-trained therapists able to provide face-to-face mental-health care for the international community in Tokyo. With extensive experience in Japan, these therapists have a deep understanding of the stresses of living in Japan.