Joey Wahler (Host): It affects many toward years end. So, we're discussing holiday drinking pressure. Our guest is Ashley Bardi. She's Senior Director of Addiction Treatment for Bergen New Bridge Medical Center. This is Wellness Waves from Bergen New Bridge Medical Center. Thanks so much for joining us. I'm Joey Wahler. Hi there, Ashley. Welcome.

Ashley Bardi, LCSW, LCADC: Thank you very much.

Host: Thank you. We appreciate the time. So first, from your experience, what are the most common social and even psychological triggers for increased alcohol consumption during the holiday season?

Ashley Bardi, LCSW, LCADC: So, we'll see a couple of different things with alcohol consumption increase during the holidays. One of the things that our clients are expecting the most of is the anxiety and anticipation of what that looks like to seeing family members. What we recognize is that whether it's led by shame, whether it's led by guilt or even grief, anxiety increases of not knowing what to expect or how to even tell their families that they're working on their recovery for fear of not being believed or it being diminished. So, we see a lot of anxiety around drinking for the holidays.

Host: Certainly makes sense. And so, that being said, how would you say that stress, loneliness, seasonal affective factors interact to influence drinking behavior during the winter holidays. What's the impact there?

Ashley Bardi, LCSW, LCADC: So, there's a couple of different impacts there. Some people become isolated drinkers where they're drinking more at home so that they can muster up the courage to go into a social situation. Some people are doing it in a social level, but overly consuming. So, those anticipatory feelings that are arising within them, not knowing how to respond, not knowing what to expect, and not having a safe outlet to be able to plan or kind of role play the situations that they're going to be in.

Host: Because, really, holiday time can be very emotional for people in a variety of ways, even if they don't have a drinking problem. So, it certainly adds up that those that may have those feelings exacerbated, right?

Ashley Bardi, LCSW, LCADC: Absolutely. That is the number one thing, is that those feelings being exacerbated, even if somebody is identifying in recovery, those feelings of overwhelmness, whether it's joy or grief, some people don't know how to process and deal with. And a lot of times families don't know how to talk about it.

Host: You mentioned families, but also I know over the years I've read about how, at holiday time, that's a popular time of year for people to start thinking about exes, past relationships, possibly getting back together, missing someone. And so, that also can be a trigger, right?

Ashley Bardi, LCSW, LCADC: Oh, all of the time, we see that shame, guilt, inability to move on or accept where life is, especially at a time where the holidays are supposed to be so joyful and hopeful. We're holding onto that hope that something is going to change or get better. But when we don't see it in the present or we don't see it for our futures, we tend to latch onto things that we used to have, even if they don't serve our best purposes.

Host: I guess holiday time is a time for reflection for many of us. Sometimes it can be positive, sometimes not so much. And if you start conjuring up those negative thoughts for whatever reason, that's obviously going to be a problem if you're prone to drinking too much, right?

Ashley Bardi, LCSW, LCADC: Absolutely. You hit it right there on the head. It's those beliefs, right? Of those negative core beliefs that I haven't changed, those negative core beliefs that I won't be accepted, those fears. It connects entirely with our self-esteem and how we see ourselves during that moment, which is also one of the things that we encourage the role play in the processing, even plans to leave or how to talk to your family prior to the holidays so that you create that safety before you go.

Host: And when we talk about that particular time of year, holiday time, what about the fact, Ashley, that even just before that, the mere turning of the seasons to fall, for many people, that can be depressing. It can be an anxious time, it gets darker earlier, gets colder in much of the country. Those things often depress people, worry people. So, the fall and then the holiday time at the start of winter, that can be a hard one-two punch for people that are prone to addiction, yes?

Ashley Bardi, LCSW, LCADC: It is. It definitely is, because the seasonal affective disorder is definitely something that we discuss here in treatment ongoing. One of the things that we do is we increase our social community during that time, having more activities. The weather alone can put somebody into a downward spiral. That isolating feeling of wanting to stay home, not wanting to go out. Those are absolutely true and a lot of individuals, they minimalize that because they feel like they should be able to adjust, but the adjustments of all of the changes can be very overwhelming for people.

Host: Oftentimes, from what I understand from experts like yourself when weather turns cold, it makes people, in some cases, feel isolated, like they have to stay indoors, they're trapped, they can't go out the way they normally do. And of course, one thing you can do when you're stuck inside is drink, right?

Ashley Bardi, LCSW, LCADC: Absolutely. And that's the other thing too, is that a lot of people have comorbid medical conditions that aren't being treated when they are drinking, right? So, the weather, when it starts to get colder too, they may be getting aches and pains to their bodies, and they don't want to hear family members identify that as an excuse, so they tend to keep it to themselves and/or they reward themselves for getting through a day and being okay, and then go into those isolated behaviors where they're trying to relieve their pain.

Host: In what ways can people recognize early signs that holiday drinking is becoming problematic rather than just social?

Ashley Bardi, LCSW, LCADC: So, one of the things that we highly recommend is identifying what the normal drinking pattern is and talking to somebody about whether or not it is normal for society or just normal for you. Having the conversations. "Am I using too much? Am I spending too much money on it? Did I drink more than I expected to?" are some of the big questions that a lot of individuals need to ask themselves. But also asking our close community, people who we feel safe about and being able to express that to somebody else so that they can-- I don't want to say compare, because compare is not the right words-- so that they can get a different perspective on how they're feeling and what they're utilizing during those times.

Host: And when you talk about, as you did a moment ago, "normal drinking", normal amounts, one person's normal is not the same as another's, right?

Ashley Bardi, LCSW, LCADC: Correct. So, we use here AUDIT-Cs, where we identify drinking patterns and behaviors. Typically, anything more than four drinks a week is considered an excessive amount of alcohol. And we want that to really regulate with people, because with women it's three drinks or less. So, we want to really be able to get those standards out there so that people do have a way to measure what is acceptable and what is not. Also, if you're putting yourself into any harmful behavior, increased impulsive activities, driving while under the influence should never be encouraged. So, we also want to have those conversations too.

Host: Having discussed all of the above, what evidence-based behavioral strategies can help patients navigate the social gatherings at the time of year we're discussing without feeling pressured to drink?

Ashley Bardi, LCSW, LCADC: Yes. So, the first intervention that we would definitely identify is cognitive behavioral therapy. Set the boundaries. You don't have to have a reason why, but you need to process these things with somebody who is a neutral party and can support that, whether it's through a text message with a peer recovery specialist, whether it's a relapse prevention plan, you want to set the boundaries with your family or whoever you're visiting for the holidays to say, "These are the things that I need. If I ask to leave, I need you to respect that decision. If I ask you not to have alcohol at the party, I need you to respect that decision." Learning how to have fun in ways that don't include alcohol consumption. Maybe bring a game. Maybe bring your own drinks so that you have something to indulge in without having to feel like you're missing out on something. But the conversation has to happen before. And the other thing is you need to have a plan to leave if it's unsafe and you need to have a safe person in the room with you who will help support that decision.

Host: So, have kind of an escape route ready before you even walk in, right?

Ashley Bardi, LCSW, LCADC: Yes, absolutely. Map it all out.

Host: And if nothing else, it can be a great excuse to bow out early if you see somebody that you don't want to deal with, right?

Ashley Bardi, LCSW, LCADC: Absolutely.

Host: Couple of other things. How about practical strategies for patients who still wish to participate socially, but remain sober or moderate their drinking at least?

Ashley Bardi, LCSW, LCADC: Again, having a community to support you around that and being able to have somebody have that conversation with you, understand that when somebody comes to you and expresses they think that you've had one too many, or you think that you should cut, remind them. "You asked me to bring this to your attention." We encourage that support to be via text or in person because we do have applications now where we can have things at our fingertips, but that's instant gratification. Being able to have somebody there with you who you can connect with and call you out without feeling like they're disrespecting you, has been super important to even people who are moderating their use.

Host: We've touched a little bit on family here. How can family members support loved ones trying to reduce or abstain from alcohol over the holidays? How can they help?

Ashley Bardi, LCSW, LCADC: They can help by simply asking the question about meeting the person where they're at. What can we do to support you? Is this okay? And not feeling like they need to change their whole structure or routine, but hear what the individual is saying about what they need to feel successful in this moment. A lot of families will put their personal beliefs in it or their opinions in it, not recognizing that then they're creating the anxiety that the individual is not good enough.

So, just ask the question, be respectful. Don't take it personally. Reduce the alcohol that's in the home. And reinforce the changed behaviors. "I'm really proud of you" goes a long way or "I see the change" goes a long way.

Host: And then, in summary, if someone joining us may have a drinking problem and they want to reach out for help from you and yours, what's the first step?

Ashley Bardi, LCSW, LCADC: So, the first step is getting on the phone and calling us. We have an access center that's open 24 hours, seven days a week that we can be connected with a peer recovery specialist. You can be connected to a professional and really just come in to have the conversation. We have minimal barriers to accessible treatment. We have inpatient options. We have outpatient options. We have peer recovery specialists, which have been a huge change to our recovery environment, because some people don't even know what they're expecting until they talk to somebody who's actually doing it.

Host: Finally, ASshley when you say that, so much of this-- reaching out for help, getting it, adjusting to it and benefiting from it-- it's really much of it, isn't it, about realizing that you're not alone, that many other people are in a similar boat, and that there are people who can help like yourself, right?

Ashley Bardi, LCSW, LCADC: Absolutely. So, the opposite of addiction is community and being able to have a community that is non-judgmental, that you can connect with and help lead you in a direction that your hopes are going into, create a community around you to really safeguard you.

Host: Absolutely. Well, folks, we trust you are now more familiar with holiday drinking pressure and how to cope. Ashley, keep up all your great work and thanks so much again.

Ashley Bardi, LCSW, LCADC: Thank you very much. Have a great day.

Host: You too. And for more information, please visit newbridgehealth.org. Now, if you found this podcast helpful, please do share it on your social media. And thanks again for being part of Wellness Waves from Bergen New Bridge Medical Center.