There is something concerning happening to Miranda Hobbes, one of the “Sex and the City” characters whose story continues in the HBO sequel series, “And Just Like That…”
The no-nonsense lawyer, mom and now master’s degree student in her 50s — played by actress Cynthia Nixon — seems to be drinking alcohol a lot, and often during inappropriate moments.
There’s the time when she’s eager for a drink at a bar before a morning class — and before the bar has even opened. She brings wine in her purse to drink during a child’s piano recital. A friend discovers empty bottles of vodka in her backpack and booze seems to be a constant presence in her life, from sips at a funeral to glasses of wine before an outing.
Such symptoms could point to a drinking problem, and it’s common for a person to continue to appear put together and highly functioning even while suffering from alcohol use disorder, experts warned.
Women in midlife, like Miranda, have been accelerating drinking, binge drinking and alcohol use disorder problems more than any other demographic group in the last decade, said Katherine Keyes, an associate professor of epidemiology at the Columbia University Mailman School of Public Health in New York.
These problematic drinking patterns are also increasingly happening among women with the highest levels of education, occupational prestige and income, she added.
“Portraying a storyline in which a woman is drinking too much — and we don’t know what will happen with Miranda's story — but hopefully showing that this is something that you can recover from would be a really realistic portrayal of what it is like to have an alcohol problem as a woman in the United States,” Keyes, whose research focuses on substance use, told TODAY.
When does alcohol become a problem?
Regularly drinking in the morning or early in the day is one of the red flags — it could be a sign a person is in withdrawal and needs alcohol to calm down, said Dr. James Garbutt, an adjunct professor of psychiatry at the Bowles Center for Alcohol Studies at the University of North Carolina.
Keeping alcohol around and being protective about it are also warning signs, he noted.
“The person feels the need to drink, they have to drink, they are drinking in situations that may cause them problems, that may be inappropriate, and their attitude towards alcohol is, ‘I have to hide this. I need to protect it,’” Garbutt said.
“All that is a sign that alcohol has become a very important part of one’s life and that is possibly detrimental.”
Having a drinking problem is still highly stigmatized in the U.S., especially among women, so many people try to conceal it or to try not to show that it’s affecting their life, Keyes added. That might mean hiding bottles and using breath mints to cover up the smell of alcohol.
And because the U.S. is a drinking culture, having lots to drink might not seem like a big deal to friends and family — or even the person doing the imbibing — so it’s easy to hide a problem or not even realize there is one in the first place, Garbutt said. People can still manage many parts of their lives even as they struggle with symptoms of alcohol use disorder.
When it comes to older Americans, their drinking may not be as visible and “out there” as that of younger people, he added. Instead of going to bars or clubs, older adults may stay at home and drink two bottles of wine every night.
“Drinking alone at home is quite a problematic drinking pattern. You have less control over the pours,” Keyes noted.
“That’s certainly a problematic drinking pattern that has been especially reported by women during the pandemic.”
Questions to ask yourself
The main signs of a drinking problem include compulsive use, which is the need to drink alcohol regularly; loss of control, or not being able to stop at one or two drinks; and suffering the consequences, whether losing a job, becoming ill or getting into fights with family, Garbutt said.
It’s very common for people not to realize they have a problem.
If you are wondering whether your own drinking habits are becoming alcohol use disorder, the experts suggested asking yourself these questions:
Am I trying to hide my drinking? Do I feel very possessive of alcohol and don’t want it taken away? “Those are all signs that alcohol has become a force in one’s life and that a lot of energy is directed to making sure one gets alcohol,” Garbutt said. “That’s of concern.”
Am I giving up activities in order to continue drinking or to recover from the effects of drinking?
Do I carry my own reserve of alcohol or have a backup plan if none is being served?
Can I take a break from alcohol, perhaps during Dry January? If not, why not? Why is this so important that I can’t stop it?
How to approach a loved one
If you suspect a loved one has a drinking problem, raising the subject can be difficult, the experts said.
Since there’s more stigma associated with women drinking, framing the issue as a health and wellness matter may be more acceptable to a female friend or family member who seems to be drinking too much, Keyes advised. Mention the sober-curious movement or suggest drinking less to feel better.
“Really approach it as a health consideration,” she said. “So it’s not about judgment, it’s not about stigma — it’s, ‘Hey, I want to get healthier, do you want to get healthier, too?’ or ‘Hey, I notice that you’re starting to drink a little bit more. Is that something you want to improve in 2022? Maybe we can go on this Dry January together.’”
Any approach needs to be done in a positive, supportive way, Garbutt added. You can say, “I’m concerned about you, I want your life to be better, I want things to be better for you,” he noted.
Remind a loved one that they don’t have to go away for 30 days to an inpatient rehab to recover — there are outpatient and pharmacological and non-pharmacological treatments to help people reduce their drinking, Keyes added.
“Maybe you don’t want to be completely abstinent from drinking, but even reducing your consumption by 25%, 50% or 75% is going to have a big impact on your health,” she noted.
“So for women who are concerned that they’re drinking too much, it’s an important time to talk to a health provider about that.”