You can beat it!

You can beat it!  The movie Manchester by the Sea ends with the main protagonist, Lee Chandler's hopeless statement, "I can't beat it ...", that reflects his depressed mood. What is it that he can't beat? Is it depression or alcoholism that's stopping him from living an enjoyable and meaningful life?

Before the fire tragedy, Lee's lack of ambition and motivation in different sectors of his life might be an expression of a depressive state. He tries to numb these feelings with alcohol. I often hear from my patients with a history of substance use disorder, "I do not want to feel ...". We see Lee over drinking with his buddies, getting drunk, presumably doing it often. Underlying, undiagnosed and untreated psychiatric illness like depression or bipolar disorder led him to develop alcohol dependence.

Lee undergoes a tragic event, loosing his kids in a fire due to a careless action and poor judgement while intoxicated. He continues to drink to numb his feelings of hopelessness, helplessness and guilt and the inadequacy he carries with him. He feels empty, frustrated and worthless. As he states in the movie, "I'm no good for anything". He withdraws socially and lacks interest and motivation for moving on with his life. Lee spends long hours in bars numbing his painful feelings and getting into fights.

 Can Lee "beat it ..."?


Alcohol use disorder and underlying depression or bipolar disorder or any psychiatric illness are treatable. Alcohol is not a "good medication" to treat feelings of loss, despair and hopelessness. Alcohol is a central nervous system depressant. It will accentuate the symptoms of depression, increasing the feelings of depressed mood, anxiety, irritability and hopelessness. It is neurotoxic to the brain and can seriously affect other organs in the body. There are scientifically researched and acknowledged treatment options available for what we call the dual diagnosis treatment approach, where the underlying psychiatric disorder and substance use disorder are treated.

The first step is to acknowledge the need for help and change. The second step is to see an experienced psychiatrist for a thorough psychiatric medical evaluation. Together, a treatment plan is elaborated that includes medications and therapy, combined with a 12 steps program such as AA. Psychiatric illness and substance use disorders are medical conditions that are treatable like any other medical condition, such as high blood pressure, high cholesterol or diabetes to name a few. The brain is an important organ that deserves the right treatment. Let's beat it together!

Anna Wachtel, M.D.

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Anna Wachtel, M.D, Psychiatrist in Manhattan NYC // Copyright © 2017

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